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	Backup User Access Contact	Director of Systems	Mr	Wilsey	David		2025212264				2025304064	DWilsey@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/05/2021	2026	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	CAP Report Contact for Public Website	Director, Operations & Program Development	Ms.	Angotti-Watts	Christine		2025212229				2027284731	CWatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/14/2024	2026	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	CEO - CMS Administrator Contact	Executive Director	Ms.	Lewis	Lorraine		2025212390				2025212394	LLewis@UMWAFUNDS.ORG	UMWA Health & Retirement Funds	2121 K Street, NW	Washington	DC	20037	03/19/2009	2026	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	CEO - Senior Official for Contracting	Executive Director	Ms.	Lewis	Lorraine		2025212390				2025212394	LLewis@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	07/31/2007	2026	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	Chief Financial Officer	Director of Finance	Ms.	Amselle	Anna		2025212295				2025212291	aamselle@umwafunds.org	2121 K Street,  NW	Suite 350	Washington	DC	20037	08/08/2023	2026	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	Chief Operating Officer	Director, Operations & Program Development	Ms.	Angotti-Watts	Christine	N	2025212222				2027284731	kali@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	08/07/2025	2026	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	Chief Information Officer	Director of Systems	Mr.	Wilsey	David		2025212264				2025304064	DWilsey@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	08/24/2016	2026	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	Chief Information Security Officer	Director of Systems	Mr.	Wilsey	David		2025212264				2025304064	DWilsey@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	08/24/2016	2026	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		2025212293				2025304035	KBlackburn@UMWAFunds.org	160 Heartland Drive		Beckley	WV	25802	10/21/2016	2026	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	Complaints Tracking Contact	Senior Program Manager, Quality/Compliance	Ms	Blackburn	Kimberly		2025212293				2025304035	KBlackburn@UMWAFunds.org	160 Heartland Drive		Beckley	WV	25802	10/21/2016	2026	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	Contact for Fraud Investigations	Director, Operations & Program Development	Ms.	Angotti-Watts	Christine		2025212229				2027284731	CWatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/14/2024	2026	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	Corporate Mailing						2025212394					LLewis@umwafunds.org	UMWA Health and Retirement Funds	2121 K Street, NW       Suite 350	Washington	DC	20037	05/05/2021	2026	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	Cost Report Contact	Director of Finance	Ms.	Amselle	Anna		2025212295				2025212291	AAmselle@umwafunds.org	2121 K Street,  NW	Suite 350	Washington	DC	20037	08/11/2023	2026	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		3042562633				3042562604	KBailey@umwafunds.org	UMWA Health & Retirement Funds	160 Heartland Drive	Beckley	WV	25802	05/05/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	Senior Mgr, Claims Admin & Beneficiary Relations	Ms.	Bailey	Kelly		3042562633				3042562604	KBailey@umwafunds.org	UMWA Health & Retirement Funds	160 Heartland Drive	Beckley	WV	25802	05/05/2021	2026	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	Enrollment Contact	Deputy Director, Eligibility Services	Ms.	Bratcher	Jennelle		2025212320				2027284701	JBratcher@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	08/22/2023	2026	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	General Contact	Director, Operations & Program Developmnet	Ms.	Angotti-Watts	Christine		2025212229				2027284731	CWatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/14/2024	2026	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	Sr Compliance Manager	Ms.	Ali	Kimberly	N	2025212229				2027284731	kali@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	08/07/2025	2026	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	Interoperability Contact	Does not apply to Funds		able to the Funds	Not applic		2025212304					cwatts@umwafunds.org	2121 K St.,  NW	Suite 350	Washington	DC	20037	01/03/2024	2026	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	MA Appeals/Grievances Contact	Senior Program Manager, Quality/Compliance	Ms	Blackburn	Kimberly		2025212293				2025304035	KBlackburn@UMWAFunds.org	160 Heartland Drive		Beckley	WV	25802	10/21/2016	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8888655290				2145743599	Funds.CustomerService@HealthSmart.com	UMWA Health & Retirement Funds Claims Processing Center	PO Box 211551	Eagan	MN	551212751	09/01/2023	2026	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	Marketing Contact	Does not apply to Funds		able to the Funds	Not Applic		2025212304					cwatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	01/03/2024	2026	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	Medical Director	Medical Director	Dr.	Dixon	Karen		2025212296				2025212260	KDixon@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	09/02/2022	2026	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	Sr. Compliance Manager	Ms.	Ali	Kimberly	N	2025212229				2027284731	kali@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	08/07/2025	2026	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 Coordinator	Director, Operations & Program Development	Ms.	Angotti-Watts	Christine		2025212229				2027284731	CWatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/14/2024	2026	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	Part C Application Contact	Director, Operations & Program Development	Ms.	Angotti-Watts	Christine		2025212229				2027284731	CWatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/14/2024	2026	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	Payment Contact	Director of Finance	Ms.	Amselle	Anna		2025212295				2025212291	AAmselle@umwafunds.org	2121 K Street,  NW	Suite 350	Washington	DC	20037	08/11/2023	2026	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	Plan Directory Contact for Public Website			Call Center	Health		8002911425				3042562626	Health1@umwafunds.org	UMWA Health and Retirement Funds	160 Heartland Drive	Beckley	WV	25802	10/21/2016	2026	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	Quality Contact	Senior Program Manager, Quality/Compliance	Ms	Blackburn	Kimberly		2025212293				2025304035	KBlackburn@UMWAFunds.org	160 Heartland Drive		Beckley	WV	25802	10/21/2016	2026	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	Surveillance Contact	Does not apply to Funds		able to the Funds	Not Applic		2025212304					cwatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	01/03/2024	2026	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	System Contact	Director of Systems	Mr.	Wilsey	David		2025212264				2025304064	DWilsey@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	08/24/2016	2026	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	User Access Contact	Mgr Eligibility Processing Appeal & Monitoring Svs	Ms.	Kruse	Krystal		3042562618				3042562604	KKruse@umwafunds.org	UMWA Health and Retirement Funds	160 Heartland Drive	Beckley	WV	25802	05/05/2021	2026	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	Utilization Management Contact	Director, Operations & Program Development	Ms.	Angotti-Watts	Christine		2025212229				2027284731	CWatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/14/2024	2026	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	Utilization Review Contact	Director, Operations & Program Development	Ms.	Angotti-Watts	Christine		2025212229				2027284731	CWatts@umwafunds.org	2121 K Street, NW	Suite 350	Washington	DC	20037	05/14/2024	2026	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	Business Analyst		Zeiset	Sheril		7173917108				8774114921	szeiset@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	07/01/2024	2026	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	Backup User Access Contact	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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		7173917158				8774114921	PSERShopeligiblityteam@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	11/22/2023	2026	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	Bid Primary Contact	Vice President & Health Actuary		Noonan	Mark		2675131788				2023305694	mnoonan@segalco.com	500 Office Center Drive	#400	Fort Washington	PA	19034	12/11/2017	2026	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	CAP Report Contact for Public Website	Senior Health Plan Services Consultant		Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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	CEO - CMS Administrator Contact	Deputy Executive Director and Director of Defined	Mrs.	Mills	Jennifer	A	7177204805					jenmills@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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	CEO - Senior Official for Contracting	Director, Health Insurance Office	Mr.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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.	Lyman	Brian		7177204720					bylman@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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 Operating Officer	Director, Health Insurance Office	Mr.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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 Information Officer		Mr.	Goldstein	Steven		7177204697					sgoldstein@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Hocker	Steve		7177204699					shocker@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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		5033143388				8473782989	carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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	Complaints Tracking Contact	Senior Health Plan Services Consultant		Winters	Carmen		5033143388				8473782989	carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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	Contact for Fraud Investigations	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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		7173917108					szeiset@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	11/22/2023	2026	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	Corporate Mailing						7177204805				7177725372	jenmills@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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	Business Analyst		Zeiset	Sheril		7173917108				8774114921	szeiset@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	07/01/2024	2026	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	DIR Contact	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	DIR Contact (Secondary)	Vice President & Health Actuary		Noonan	Mark		2675131788				2023305694	mnoonan@segalco.com	500 Office Center Drive	#400	Fort Washington	PA	19034	12/05/2018	2026	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	Discount Program Payment Contact	Staff Accountant		Kupres	Angela		7173994277	12435				akupres@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	11/22/2023	2026	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	Emergency Part D Contact	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	Emergency Part D Contact (Secondary)	Senior Health Plan Services Consultant		Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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	Employer Direct Contact	Director, Health Insurance Office	Mr.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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	Enrollment Contact	HOP Eligibility Supervisor		Dixon	Ivy		7173917158				8774114921	idixon@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	11/22/2023	2026	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	EOB Transfer Contact	Senior Health Plan Services Consultant		Winters	Carmen		5033143388				8473782989	carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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	Financial Audit Contact	Assistant Audit Executive, Benefits & Fin Rptg	Mrs.	Lanius	Stephanie		7177204640				7177831741	slanius@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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	Financial Reporting Contact	Associate Consultant		Bearden	Suzanne		6783063131				6783063190	sbearden@segalco.com	2018 Powers Ferry Road	Suite 850	Atlanta	GA	30339	08/23/2010	2026	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	Formulary Contact	Clinical Consultant		Page	Lorry		6126427887					lorry.page8@optum.com	17310 Wright Street	Suite 100	Omaha	NE	68130	01/08/2021	2026	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	Formulary Contact (Secondary)	Vice President & Senior Pharmacy Consultant		Pincay	Eileen		2122515279					epincay@segalco.com	333 West 34th St.		New York	NY	10001	02/23/2018	2026	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	General Contact	Director, Health Insurance Office	Mr.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/26/2025	2026	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	HIPAA Privacy Officer	Deputy Director, Health Insurance Office		Charlesworth	Sonya		7177204875				7177725372	scharleswo@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer	Mr.	Hocker	Steve		7177204699					shocker@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	Interoperability Contact	Senior Project Manager		Roman	Doug		7637977183					doug.roman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	06/09/2022	2026	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	Marketing Contact	Senior Health Plan Services Consultant		Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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	Medical Director	Senior Medical Director		Curtis	Bradford		9492526866					brad.curtis@optum.com	2300 Main St	MS CA 134-1000	Irvine	CA	92614	03/09/2021	2026	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		7177204640				7177831741	slanius@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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 Coordinator	Director, Health Insurance Office	Mr.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/26/2025	2026	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 Part D Opioid Overutilization Contact	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	Medication Therapy Management Contact	Clinical Consultant		Page	Lorry		6126427887					lorry.page8@optum.com	17310 Wright Street	Suite 100	Omaha	NE	68130	01/08/2021	2026	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 Appeals	Director, Part D/Pharmacy		Miller	Greg							gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	7172697202				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Part D Appeals Contact (Secondary)	Clinical Consultant		Page	Lorry							lorry.page8@optum.com	17310 Wright Street	Suite 100	Omaha	NE	68130	01/07/2021	2026	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	6126427887				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Part D Application Contact	Director, Health Insurance Office	Mr.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/26/2025	2026	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 Benefits Contact	Business Analyst		Zeiset	Sheril		7173917108				8774114921	szeiset@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	07/01/2024	2026	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 Claims Submission Contact	Strategic Account Executive, Account Management		Guzan	Sarah		7637972594					sarah.guzan@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	06/10/2020	2026	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	Director, Part D/Pharmacy		Miller	Greg							gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	7172697202				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Part D Exceptions Contact (Secondary)	Vice President & Senior Pharmacy Consultant		Pincay	Eileen							epincay@segalco.com	333 West 34th St.		New York	NY	10001	02/23/2018	2026	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	2122515279				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Part D Price File Contact (Back-up)	Director, Health Insurance Office	Mr.	Koshy	Mathew	M	7177982037				7177725372	mkoshy@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/26/2025	2026	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 Price File Contact (Primary)	Vice President & Health Actuary		Noonan	Mark		2675131788				2023305694	mnoonan@segalco.com	500 Office Center Drive	Suite 400	Fort Washington	PA	19034	12/11/2017	2026	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 Quality Assurance Contact	Senior Health Plan Services Consultant		Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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 Reporting Contact	Associate Consultant		Bearden	Suzanne		6783063131				6783063190	sbearden@segalco.com	2018 Powers Ferry Road	Suite 850	Atlanta	GA	30339	08/23/2010	2026	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	Patient Safety Contact	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	Payment Contact	Health Care Accounting		Dandapat	Manaswita		7177204827					mdandapat@pa.gov	5 N 5th Street		Harrisburg	PA	171011905	08/29/2025	2026	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 Director	Vice President & Senior Pharmacy Consultant		Pincay	Eileen		2122515279					epincay@segalco.com	333 West 34th St.		New York	NY	10001	02/23/2018	2026	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 Network Management Contact	Director, Pharmacy Networks		Luby	Dwayne		9492526813				9494744268	dwayne.luby@optum.com	PO Box 9742		Minneapolis	MN	55440	03/12/2018	2026	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 Network Management Contact (Secondary)	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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						9494744268	michael.erbe@optum.com	3515 Harbor Blvd		Costa Mesa	CA	92626	03/12/2018	2026	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	8007979791				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	PHR Beneficiary Contact																	03/31/2015	2026	PSERS HOP PROGRAM	Employer/Union Only Direct Contract PDP	Pennsylvania Public School Employees Retirement Sy	Employer/Union Only Direct Contract PDP	OptumRx	Commonwealth of PA Pub Schools Retirement System	61	Yes	Active	8882391301				Employer/Union Only Direct Contract PDP		5	Philadelphia
E3014	Plan Directory Contact for Public Website			Administration Unit	PSERS HOP		7173057388					PSERShopeligiblityteam@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	11/22/2023	2026	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	Plan to Plan Reconciliation Contact	Business Analyst		Zeiset	Sheril		7173917108				8774114921	szeiset@luminarehealth.com	1280 N. Plum Street		Lancaster	PA	17601	07/01/2024	2026	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	Processor Contact	Processor Contact		Contact	Processor		8007979791				9494744268	michael.erbe@optum.com	3515 Harbor Blvd		Costa Mesa	CA	92626	03/12/2018	2026	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	Reconciliation Contact	Vice President & Health Actuary		Noonan	Mark		2675131788				2023305694	mnoonan@segalco.com	500 Office Center Drive	#400	Fort Washington	PA	19034	03/23/2018	2026	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	Reconciliation Contact (Secondary)	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	Recovery Audit Contact	Senior Health Plan Services Consultant	Mrs.	Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	Surveillance Contact	Director, Part D/Pharmacy		Miller	Greg		7172697202					gregory_miller@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	System Contact	Senior Health Plan Services Consultant	Mrs.	Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	07/24/2025	2026	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	Third Party Administrator (TPA) Liaison	Senior Health Plan Services Consultant		Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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	User Access Contact	Senior Health Plan Services Consultant		Winters	Carmen		5033143388					carmen_winters@ajg.com	2850 Golf Road		Rolling Meadows	IL	60008	10/30/2023	2026	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
H0016	Automated TrOOP Balance Transfer Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Backup User Access Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Best Available Evidence Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Bid Primary Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	CAP Report Contact for Public Website	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	CEO - CMS Administrator Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	CEO - Senior Official for Contracting	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Chief Financial Officer	CFO	Mr	Isaacs	William		8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	02/26/2024	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Chief Operating Officer	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Chief Information Officer	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Chief Information Security Officer	CEO	Ms	Everitt	Nancy	C	8852095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	02/08/2024	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	CMS Casework Communication Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Complaints Tracking Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Contact for Fraud Investigations	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Coordination of Benefits Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Corporate Mailing						8852095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Customer Service Operations Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	DIR Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	DIR Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Discount Program Payment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Emergency Part D Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Emergency Part D Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Encounter Data & Risk Adjustment Operations Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Enrollment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	EOB Transfer Contact	CEO	Ms	Everitt	Nancy	C	8552095451				8666113827		PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Financial Audit Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Financial Reporting Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Formulary Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Formulary Contact (Secondary)	SVP Program Operations, Quality and Compliance	Mr.	Kapolas	Peter		8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	02/08/2024	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	General Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Government Relations Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	HIPAA Privacy Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	HIPAA Security Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Interoperability Contact	CEO	Mr	Everitt	Nancy	C	8852095451					scantoria@heops.com	PO Box 2403		Brentwood	TN	37024	04/15/2025	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	MA Appeals/Grievances Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	MA Claims Processing Contact for Public Website	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Marketing Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Medical Director	Medical Director	Mr	Wells	Wayne	O	8552095451					wwells@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Medicare Compliance Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Medicare Coordinator	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Medicare Part D Opioid Overutilization Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Medication Therapy Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part C Application Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part D Appeals	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active	8552095451				PACE - Nat		C	Atlanta
H0016	Part D Appeals Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr.	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	02/08/2024	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active	8552095451				PACE - Nat		C	Atlanta
H0016	Part D Application Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part D Benefits Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part D Claims Submission Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part D Exceptions Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active	8552095451				PACE - Nat		C	Atlanta
H0016	Part D Price File Contact (Back-up)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part D Price File Contact (Primary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part D Quality Assurance Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Part D Reporting Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Patient Safety Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Payment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Pharmacy Director	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Pharmacy Network Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Pharmacy Technical Help Desk Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active	8552095451				PACE - Nat		C	Atlanta
H0016	Plan Directory Contact for Public Website	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Plan to Plan Reconciliation Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Processor Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Quality Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Reconciliation Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Recovery Audit Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Surveillance Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	System Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Third Party Administrator (TPA) Liaison	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	03/29/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	User Access Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Utilization Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0016	Utilization Review Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	03/28/2023	2026	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE	LIFE COORDINATED COMMONWEALTH PACE INC	National PACE		LIFE COORDINATED COMMONWEALTH PACE, Inc	825	Yes	Active					PACE - Nat		C	Atlanta
H0020	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Backup User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Best Available Evidence Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	CAP Report Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Chicago
H0020	CEO - CMS Administrator Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Chief Operating Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Complaints Tracking Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Contact for Fraud Investigations	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Coordination of Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Customer Service Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	DIR Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Encounter Data & Risk Adjustment Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Enrollment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Financial Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	General Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Government Relations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	HIPAA Privacy Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	HIPAA Security Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	MA Appeals/Grievances Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Marketing Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Medical Director	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Medicare Compliance Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Medicare Coordinator	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Medicare Part D Opioid Overutilization Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part C Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part D Appeals	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Chicago
H0020	Part D Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part D Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part D Claims Submission Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Chicago
H0020	Part D Price File Contact (Back-up)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part D Price File Contact (Primary)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part D Quality Assurance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Part D Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Chicago
H0020	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Quality Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Reconciliation Contact (Secondary)	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	System Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0020	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF ILLINOIS, LLC	National PACE	Kinship PACE of Illinois, LLC	National PACE				Yes	Pending					PACE - Nat		C	Chicago
H0028	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	07/02/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	06/25/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	06/25/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	07/02/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	07/02/2024	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	12/29/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	03/03/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	05/26/2021	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	12/20/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	12/20/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	05/26/2021	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	05/29/2019	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	06/21/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	07/02/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	12/29/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	06/21/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	06/25/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street	Floor 22	Louisville	KY	40202	11/18/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	06/21/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	07/02/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	06/21/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	09/01/2023	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	12/20/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	04/04/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	07/17/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	04/04/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	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	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	06/21/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	07/13/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/27/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	06/21/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	07/13/2023	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H0028	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H0028	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	06/21/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	07/17/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	07/25/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	07/25/2025	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	12/29/2022	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	05/26/2021	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0028	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	12/18/2024	2026	CHA HMO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0029	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	05/08/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3143493212					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	08/16/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Backup User Access Contact	Senior Compliance Analyst		Smith	Robert		3143493085					Robert.K.Smith@CENTENE.COM	7676 Forsyth Blvd.		St. Louis	MO	63105	11/05/2021	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	08/16/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	08/16/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	05/12/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	01/14/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Chief Information Officer	Senior Vice President, Chief Information Officer	Mr.	Brooks	Mark		3147254477					Mark.Brooks@centene.com	7700 Forsyth Boulevard		St. Louis	MO	63105	03/10/2020	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/28/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	08/14/2017	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/29/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	02/22/2024	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	02/20/2024	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/05/2022	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/29/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/30/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/30/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/08/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7676 Forsyth Blvd		Clayton	MO	63105	08/16/2021	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/16/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	08/04/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	08/04/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7711 Carondelet Avenue		Clayton	MO	63105	08/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3143493212					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	08/16/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	08/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/07/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	09/21/2022	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	09/21/2022	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0029	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0029	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Benefits Contact	Director, Pharmacy	Mr.	Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	09/21/2022	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/22/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	09/03/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0029	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0029	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/04/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	12/04/2024	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/25/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0029	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/02/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0029	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Plan Directory Contact for Public Website			Net	Health		8008676564				8009778226	CorporateMedicareComplianceDept@Centene.com	PO Box 419069		Rancho Cordova	CA	95741	08/14/2017	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	08/16/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/10/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/30/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	CA	91367	12/04/2023	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/15/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0029	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	COORDINATED CARE OF WASHINGTON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0034	Agent/Broker Compensation Data Contact	VP of Human Resources	Ms.	Schlesinger	Chaya		8455030504					cschlesinger@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/18/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Automated TrOOP Balance Transfer Contact	Director, Product and Program Mgmt.	Ms.	Arinsburg	Valerie		4806249349					valerie.arinsberg@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/07/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Backup User Access Contact	Chief Technology Officer	Ms.	Manning	Emily		8456080568					emanning@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/18/2024	2026	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 of Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Bid Audit Contact	Chief Financial Officer	Ms.	Back	Chaya		8455030807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/18/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Bid Audit Site Contact	Chief Financial Officer	Ms.	Back	Chaya		8455030807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/18/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Bid Primary Contact	Chief Financial Officer	Ms.	Back	Chaya		8455030807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/18/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	CAP Report Contact for Public Website	VP of Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	8884262774				HMO - Health Maintenance Organization		C	New York
H0034	CEO - CMS Administrator Contact	Executive Director	Mr.	Bernath	Yoel		8455030228					ybernath@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	CEO - Senior Official for Contracting	Executive Director	Mr.	Bernath	Yoel		8455030228					ybernath@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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	Ms.	Back	Chaya		8455030807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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 Operating Officer	Chief Operating Officer	Mr.	Gorbacz	David		8456555180					dgorbacz@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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 Information Officer	Chief Information Officer	Mr.	Zelik	Judah		8455030921					jzelik@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Steinberg	Lipa		8455030930					lsteinberg@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Complaints Tracking Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Contact for Fraud Investigations	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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.	Braish	Gitty		8459159400					Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Corporate Mailing						8453881199					efisch@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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	Director of Member Services	Ms.	Slaney	Rayne		8456550175					rslaney@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	DIR Contact	Vice President, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	DIR Contact (Secondary)	Compliance Analyst	Ms.	Geldzahler	Malka		8455030965					mgeldzahler@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	07/31/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Discount Program Payment Contact	Comptroller	Mrs	Braish	Gitty		8459159400					Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	05/19/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Emergency Part D Contact	Chief Operating Officer	Mr.	Gorbacz	David		8456555180					dgorbacz@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Ms.	Back	Chaya		8455031807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Enrollment Contact	Director, Intake and Enrollment	Ms.	Brach	Miriam		8456555150					sfliegman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	EOB Transfer Contact	Vice President, Finance	Mr.	Ornstein	Mendy		8453881199	570			8455031570	mornstein@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Financial Audit Contact	Chief Finance Officer	Mr.	Back	Chaya		8455030807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Financial Reporting Contact	Comptroller, Medicare	Ms.	Braish	Gitty		8459159400					Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Formulary Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Formulary Contact (Secondary)	Manager, Clinical Pharmacy Operations, Medicare Pa		Miller	Steven		5088876299					steven.miller@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/07/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	General Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	HIPAA Privacy Officer	VP, Compliance & Regulatory Affairs	Mr.	Friedman	David		8455030901	507				dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	HIPAA Security Officer	Chief Information Security Officer	Mr.	Steinberg	Lipa		8455030930					lsteinberg@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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	Chief Operating Officer	Mr.	Gorbacz	David		8456555180					dgorbacz@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Interoperability Contact	Chief Information Officer	Mr.	Zelik	Judah		8455030921					jzelik@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	MA Appeals/Grievances Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	MA Claims Processing Contact for Public Website	Vice President, Finance	Mr.	Ornstein	Mendy		8453881199	570				mornstein@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Marketing Contact	Chief Business Development Officer	Ms.	Schwartz	Tziporah		8455030125					tschwartz@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Medical Director	Medical Director	Dr.	Rizvi	Hammad		8482289959					hrizvi@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 Coordinator	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr.	Rizvi	Hammad		8453881199					hrizvi@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Medication Therapy Management Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Online Enrollment Center Contact (Back-up)	Director of Medicare Enrollment	Ms.	Brach	Miriam		8456555150					mbernath@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Online Enrollment Center Contact (Optional)	Chief Technology Officer	Ms.	Manning	Emily		8456080568					emanning@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	11/03/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Online Enrollment Center Contact (Primary)	Vice President, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 C Application Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 C Reporting Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 Appeals	VP, Compliance and Regulatory Affairs	Ms.	Friedman	David							dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	8455030901				HMO - Health Maintenance Organization		C	New York
H0034	Part D Appeals Contact (Secondary)	VP, Utilization Management	Ms.	Shteierman	Devora							dshteierman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	8455030564				HMO - Health Maintenance Organization		C	New York
H0034	Part D Application Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 Benefits Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 Claims Submission Contact	Comptroller, Medicare	Ms.	Braish	Gitty		8459159400					Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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	VP, Compliance and Regulatory Affairs	Ms.	Friedman	David							dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	8455030901				HMO - Health Maintenance Organization		C	New York
H0034	Part D Exceptions Contact (Secondary)	Manager, Clinical Pharmacists		Boucher	Zachary							zachary.boucher@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/07/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	4012398035				HMO - Health Maintenance Organization		C	New York
H0034	Part D Price File Contact (Back-up)			Simmons	Brenda		8164352295					PCompare@dsthealth.com	Magellan Rx Management	2520 Industrial Row Drive	Troy	MI	48084	02/20/2019	2026	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 Price File Contact (Primary)	Director, Product and Program Mgmt.		Arensberg	Valerie		4806249349					valerie.arinsberg@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/07/2025	2026	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 Quality Assurance Contact	Director, Quality Management	Ms.	Grunsweig	Leah		8455030513					lgrunsweig@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	01/07/2025	2026	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 Reporting Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Patient Safety Contact	Medical Director	Dr.	Rizvi	Hammad		8482289959					hrizvi@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Payment Contact	Comptroller, Medicare	Ms.	Braish	Gitty		8459159400					Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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 Director	Medical Director	Dr.	Rizvi	Hammad		8482289959					hrizvi@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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 Network Management Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	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 Network Management Contact (Secondary)	Director, Product and Program Mgmt.		Arensberg	Valerie		4806249349					valerie.arinsberg@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/07/2025	2026	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		Muhammed	Atiyya							atiyya.muhammad@primetherapeutics.com	Prime Rx Management	2900 Ames Crossing Road	Eagan	MN	55121	12/16/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active	8004244437				HMO - Health Maintenance Organization		C	New York
H0034	Plan Directory Contact for Public Website	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Plan to Plan Reconciliation Contact	Comptroller, Medicare	Ms.	Braish	Gitty		8459159400	570				Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Processor Contact	Comptroller, Medicare	Ms.	Braish	Gitty		8459159400					Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Quality Contact	Director of Quality	Ms.	Grunsweig	Leah		8455031513					lgrunsweig@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Reconciliation Contact	Chief Financial Officer	Ms.	Back	Chaya		8455030807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Recovery Audit Contact	Chief Financial Officer	Ms.	Back	Chaya		8455030807					cback@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	SNP Application Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Surveillance Contact	VP, Compliance and Regulatory Affairs	Mr.	Friedman	David		8455030901					dfriedman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	03/04/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	System Contact	Chief Information Officer	Mr.	Zelik	Judah		8455030921					jzelik@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Third Party Administrator (TPA) Liaison	Comptroller	Mrs	Braish	Gitty		8459159400					Gbraish@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	05/19/2025	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	User Access Contact	Director, IT Systems	Mr.	Lowy	Alex		8455030543					alowy@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Utilization Management Contact	VP of Utilization Management	Ms.	Shteierman	Devora		8455030564					dshteierman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	HAMASPIK, INC.	Local CCP	Hamaspik, Inc.	HMO/HMOPOS		Hamaspik of Rockland County, Inc.	522	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0034	Utilization Review Contact	VP of Utilization Management	Ms.	Shteierman	Devora		8455030564					dshteierman@hamaspikchoice.org	775 North Main Street		Spring Valley	NY	10977	12/19/2024	2026	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		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739					cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie	A	7206829848				3039961600	Lteter@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	9096779517				PACE - Nat		C	San Francisco
H0035	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	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 Operating Officer	Market President	Ms.	Hopkins	Laura		7208127180				9094249948	lhopkins@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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 Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Naus	Cole		7204564635				3039961600	mnaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	12/08/2023	2026	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	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Complaints Tracking Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Corporate Mailing						7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	DIR Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/22/2023	2026	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	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/11/2023	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Interoperability Contact	SVP, Application Systems		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	MA Appeals/Grievances Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	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	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	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 Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	04/03/2024	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	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 Appeals	Director of Compliance		Martin	Jeremy						3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	7208796016				PACE - Nat		C	San Francisco
H0035	Part D Appeals Contact (Secondary)	Director of Compliance		Martin	Jeremy						3039961600	jmartin@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	7208796016				PACE - Nat		C	San Francisco
H0035	Part D Application Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	7206663817				PACE - Nat		C	San Francisco
H0035	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	7207896083				PACE - Nat		C	San Francisco
H0035	Part D Price File Contact (Back-up)	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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 Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Quality Assurance Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	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 Reporting Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending	7206663817				PACE - Nat		C	San Francisco
H0035	PHR Beneficiary Contact																	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Pending	8772776163	732			PACE - Nat		C	San Francisco
H0035	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	AKizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/28/2023	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Reconciliation Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	System Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Third Party Administrator (TPA) Liaison	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	User Access Contact	Director of Compliance		Martin	Jeremy		7207896016					jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0035	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-LOS ANGELES, LLC	National PACE	InnovAge	National PACE		Total Community Options, Inc.	230	Yes	Pending					PACE - Nat		C	San Francisco
H0062	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Medical Director	Deputy Chief Health Officer	Mr.	Harmon	David		5124163782	22182				dharmon@centene.com	5900 E. Ben White Blvd.		Austin	TX	78741	08/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0062	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0062	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0062	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0062	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/04/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/25/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/15/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504258				HMO - Health Maintenance Organization		C	Denver
H0062	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/15/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504258				HMO - Health Maintenance Organization		C	Denver
H0062	PHR Beneficiary Contact																	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H0062	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/30/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0062	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0074	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	01/24/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	03/19/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	08/16/2023	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	08/16/2023	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/17/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	04/05/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	11/05/2021	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/05/2022	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/08/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/26/2023	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/16/2023	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	08/16/2023	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	03/19/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H0074	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H0074	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H0074	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H0074	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/04/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	04/05/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/25/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H0074	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H0074	PHR Beneficiary Contact																	09/27/2022	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H0074	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/16/2023	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	08/16/2023	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	03/19/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/30/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/12/2024	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0074	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	WELLCARE OF MISSISSIPPI, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0104	Agent/Broker Compensation Data Contact	Consumer Sales Manager		Carter	Brent		2052207681					bcarter@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
H0104	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/13/2022	2026	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	New York
H0104	Backup User Access Contact	Compliance Analyst I		Blevins	Dominique		2052207984					dominique.blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/30/2025	2026	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	New York
H0104	Best Available Evidence Contact	Sr. Business Analyst		Hurst	Terri		2052202695					Terri.Hurst@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/01/2023	2026	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	New York
H0104	Bid Audit Contact	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	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	New York
H0104	Bid Audit Site Contact	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	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	New York
H0104	Bid Primary Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
H0104	CAP Report Contact for Public Website	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	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	New York
H0104	CEO - CMS Administrator Contact	President and Chief Executive Officer	Mr	Vines	Tim		2052206363					TVines@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	07/14/2020	2026	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	New York
H0104	CEO - Senior Official for Contracting	Executive Vice President	Mr.	Briggs III	Dick	D	2052206952					dbriggs@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	07/01/2020	2026	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	New York
H0104	Chief Financial Officer	SVP & Chief Financial Officer	Mr.	Carden	Noel		2052207741					ncarden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2022	2026	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	New York
H0104	Chief Operating Officer	SVP Business Operations	Mr.	Hill	James	S	2052202196					Jim.Hill@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/24/2020	2026	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	New York
H0104	Chief Information Officer	SVP and CIO	Mr.	Dunsmore	Joe		2052202441					jdunsmore@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	04/08/2025	2026	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	New York
H0104	Chief Information Security Officer	Chief Info Security Officer	Mr.	Parton	Chris		2052207421					cparton@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	02/26/2016	2026	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	New York
H0104	CMMI Model Point of Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
H0104	CMS Casework Communication Contact	Compliance Analyst		Stoudemire	Danielle		2052205678					Danielle.Stoudemire@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/14/2024	2026	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	New York
H0104	Complaints Tracking Contact	Compliance Analyst		Stoudemire	Danielle		2052205678					Danielle.Stoudemire@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/14/2024	2026	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	New York
H0104	Contact for Fraud Investigations	Special Investigations Manager		Ellison	Amy		2052202573					AELLISON@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	07/16/2025	2026	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	New York
H0104	Coordination of Benefits Contact	Manager Claims Processing		Cole	Jason		2052202490					Jason.Cole@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/02/2023	2026	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	New York
H0104	Corporate Mailing						2052206655					Laney.ODell@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/28/2025	2026	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	New York
H0104	Customer Service Operations Contact	Dept Manager Customer Service		Pearson	Latreta		2052207905					llpearson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2026	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	New York
H0104	DIR Contact	VP Controller		DeLawrence	Jennifer		2052207282				2052202795	JDeLawrence@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/12/2020	2026	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	New York
H0104	DIR Contact (Secondary)	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/04/2022	2026	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	New York
H0104	Discount Program Payment Contact	Sr. Accountant		Lambert	Christophe		2052206593					CLambert@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	04/19/2016	2026	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	New York
H0104	Electronic Health Record Contact	Compliance Analyst II		Blevins	Dominique		2052207984					Dominique.Blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/25/2025	2026	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	New York
H0104	Emergency Part D Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/23/2023	2026	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	New York
H0104	Emergency Part D Contact (Secondary)	Pharmacy Services Manager		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
H0104	Employer Waiver Contact	Manager Enrollment Service		Sexton	Missy		2052206589					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/23/2023	2026	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	New York
H0104	Encounter Data & Risk Adjustment Operations Contact	MAQM Department Manager		Baggs	Sarah		2052207286					Sbaggs@bcbsal.org	450 Riverchase Pkwy East		Hoover	AL	35244	04/10/2025	2026	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	New York
H0104	Enrollment Contact	Manager Enrollment Service		Sexton	Missy		2052206589					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2023	2026	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	New York
H0104	EOB Transfer Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2052200803	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
H0104	Financial Audit Contact	Dept Manager Internal Audit	Ms	Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/31/2025	2026	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	New York
H0104	Financial Reporting Contact	Dept Mgr Accounting/Reporting		O'Neal	Keith		2052206202					Keith.ONeal@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2026	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	New York
H0104	Formulary Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/13/2018	2026	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	New York
H0104	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	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	New York
H0104	General Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					RGregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/01/2017	2026	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	New York
H0104	Government Relations Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
H0104	HIPAA Privacy Officer	Manager Corporate Compliance		Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/28/2012	2026	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	New York
H0104	HIPAA Security Officer	Manager Corporate Compliance		Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/24/2009	2026	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	New York
H0104	Hospice Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					WStevens@BCBSAL.ORG	450 Riverchase Parkway East		Birmingham	AL	35244	04/16/2019	2026	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	New York
H0104	Interoperability Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					rgregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
H0104	MA Appeals/Grievances Contact	Health Management Unit Mgr		Mattioli	Jared		2052205315					jmattioli@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/15/2021	2026	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	New York
H0104	MA Claims Processing Contact for Public Website	Manager Claims Operations		Corley	Jeff		2052206367					jcorley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2026	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	New York
H0104	Marketing Contact	Senior Compliance Analyst		Parham	Andrea	M	2052207206					AParham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/24/2024	2026	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	New York
H0104	Medical Director	Associate Medical Director	Dr.	Darden	Barry		2052206605					James.Darden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/11/2018	2026	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	New York
H0104	Medicare Compliance Officer	Manager Corporate Compliance	Mr.	Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/24/2009	2026	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	New York
H0104	Medicare Coordinator	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
H0104	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacists		Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	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	New York
H0104	Medication Therapy Management Contact	VP Pharmacy Services		Cale	Dorinda		2052202655					dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/12/2020	2026	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	New York
H0104	OffShore Subcontractor Contact	Compliance Analyst II		Blevins	Dominique		2052207984					dominique.blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/30/2025	2026	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	New York
H0104	Online Enrollment Center Contact (Back-up)	Sr. Business Analyst		Johnson	Geraldine		2052206077					gejohnson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/08/2021	2026	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	New York
H0104	Online Enrollment Center Contact (Optional)	Manager Enrollment Service		Sexton	Missy		2052207276					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2023	2026	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	New York
H0104	Online Enrollment Center Contact (Primary)	Sr Business Analyst		Hurst	Terri		2052202695					Terri.Hurst@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	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	New York
H0104	Part C Application Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
H0104	Part C Reporting Contact	Senior Compliance Analyst		Parham	Andrea		2052207206					aparham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/10/2022	2026	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	New York
H0104	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	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	8006936651				PPO - BBA		C	New York
H0104	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936651	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	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	8006936703				PPO - BBA		C	New York
H0104	Part D Application Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
H0104	Part D Benefits Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
H0104	Part D Claims Submission Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
H0104	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Mendota Heights	MN	55120	12/18/2024	2026	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	8006936651				PPO - BBA		C	New York
H0104	Part D Exceptions Contact (Secondary)	Pharmacy Services Manager		Matthews	Ginny							Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	2052206558				PPO - BBA		C	New York
H0104	Part D Price File Contact (Back-up)	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593				2052202939	Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/13/2018	2026	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	New York
H0104	Part D Price File Contact (Optional)	Business Solution Analyst Sr.		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/17/2024	2026	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	New York
H0104	Part D Price File Contact (Primary)	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2057337486	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
H0104	Part D Quality Assurance Contact	Clinical Program Manager		Hamid	Samer		2055639884					samer.hamid@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/13/2024	2026	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	New York
H0104	Part D Reporting Contact	Senior Compliance Analyst		Parham	Andrea		2052207206					aparham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/10/2022	2026	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	New York
H0104	Patient Safety Contact	VP Pharmacy Services		Cale	Dorinda		2052202655				2052208739	dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/12/2020	2026	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	New York
H0104	Payment Contact	VP Controller		DeLawrence	Jennifer		2052207282					JDeLawrence@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/12/2020	2026	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	New York
H0104	Pharmacy Director	VP Pharmacy Services		Cale	Dorinda		2052202655					dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/12/2020	2026	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	New York
H0104	Pharmacy Network Management Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2054034052	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
H0104	Pharmacy Network Management Contact (Secondary)	AVP Network Relations		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	12/17/2024	2026	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	New York
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	2026	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	8778788668				PPO - BBA		C	New York
H0104	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/17/2024	2026	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	8778788668				PPO - BBA		C	New York
H0104	Physician Incentive Contact	VP Provider Engagement/Support		Weaver	Darrel		2052207007					darrel.weaver@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/23/2025	2026	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	New York
H0104	Plan Directory Contact for Public Website	Manager Claims Operations		Corley	Jeff		8005176425					jcorley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2026	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	New York
H0104	Plan to Plan Reconciliation Contact	In-charge Analyst Cash Mgmt		Prince	Jonathan		2052207723					jonathan.prince@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	03/18/2024	2026	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	New York
H0104	Processor Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2052208739	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
H0104	Quality Contact	Quality Improvement Manager		Kendrick	Brooke		2052207251					Brooke.Kendrick@BCBSAL.ORG	450 Riverchase Parkway East		Birmingham	AL	35244	03/13/2024	2026	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	New York
H0104	Reconciliation Contact	Manager Financial Accounting		Williamson	Amanda		2052207289					Amanda.Williamson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/20/2018	2026	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	New York
H0104	Reconciliation Contact (Secondary)	Sr. Accountant		Lambert	Christophe		2052206593				2052202795	CLambert@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/15/2021	2026	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	New York
H0104	Recovery Audit Contact	Manager Corporate Compliance	Mr.	Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/27/2012	2026	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	New York
H0104	Surveillance Contact	Consumer Sales Manager		Carter	Brent		2052207681					bcarter@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	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	New York
H0104	System Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					RGregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/01/2017	2026	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	New York
H0104	Third Party Administrator (TPA) Liaison	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/13/2018	2026	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	New York
H0104	User Access Contact	Regulatory Compliance Manager		O'Dell	Laney		2052206655					Laney.ODell@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	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	New York
H0104	Utilization Management Contact	Health Management Unit Mgr		Daniel	Charlotte		2052204673					CHDaniel@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/27/2024	2026	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	New York
H0104	Utilization Review Contact	Health Management Unit Mgr		Daniel	Charlotte		2052204673					CHDaniel@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/27/2024	2026	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	New York
H0105	Automated TrOOP Balance Transfer Contact	Executive Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	12/30/2024	2026	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	Backup User Access Contact	RN, Quality Improvement Coordinator	Ms	Russell	Crystal		8032685303				8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	Executive Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	12/30/2024	2026	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	Bid Primary Contact	Executive Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	12/30/2024	2026	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	CAP Report Contact for Public Website	CFO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Fowler	Clay		7705002705				8032685302	clay.fowlerhealthcareenterprise@gmail.com	153 Founders Ct.		Orangeburg	SC	29118	03/29/2024	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Fowler	Clay		7705002705				8032685302	clay.fowlerhealthcareenterprise@gmail.com	153 Founders Ct.		Orangeburg	SC	29118	03/29/2024	2026	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	Mr.	Fowler	Clay		7705002705				8032685302	clay.fowlerhealthcareenterprise@gmail.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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 Operating Officer	COO	Mrs.	Kornegay	Allie		8032685315	5315			8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	09/08/2023	2026	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 Information Officer	CFO	Mr.	Fowler	Clay		7705002705				8032685302	clay.fowlerhealthcareenterprise@gmail.com	153 Founders Ct.		Orangeburg	SC	29118	04/26/2024	2026	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 Information Security Officer	CFO	Mr.	Fowler	Clay		7705002705				8032685302	clay.fowlerhealthcareenterprise@gmail.com	153 Founders Ct.		Orangeburg	SC	29118	04/26/2024	2026	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	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303				8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	Complaints Tracking Contact	Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	09/10/2023	2026	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	Contact for Fraud Investigations	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303				8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	Executive Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	12/30/2024	2026	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	Corporate Mailing						8032685315				8032685302	allie.kornegay@orangeburgshcpace.org	153 Founders Ct		Orangeburg	SC	29118	09/10/2023	2026	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	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303				8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	DIR Contact	Executive Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	12/30/2024	2026	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	DIR Contact (Secondary)	CEO	Mr.	Fowler	Clay		7075002705				8032685302	clay.fowlerhealthcareenterprise@gmail.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Discount Program Payment Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Emergency Part D Contact	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303	5326			8032685302	kathy.nichols@theoakssc.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	Emergency Part D Contact (Secondary)	Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	09/10/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	09/10/2023	2026	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	Enrollment Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	09/10/2023	2026	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	EOB Transfer Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Financial Audit Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Financial Reporting Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Formulary Contact	Pharmacist/Owner  Grove Park Pharmacy	Mr	Thompson	Charles		8035360007					grovepark@earthlink.net	1324 Chestnut Street		Orangeburg	SC	29118	04/25/2016	2026	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	Formulary Contact (Secondary)	Pharm D	Mrs.	Wimberly	Jennifer		8035360007					thadjen@aol.com	1324 Chestnut Street		Orangeburg	SC	29118	04/26/2016	2026	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	General Contact	Executive Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	12/30/2024	2026	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	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	09/10/2023	2026	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	HIPAA Privacy Officer	PACE Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	09/10/2023	2026	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	HIPAA Security Officer	PACE Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	09/10/2023	2026	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	Interoperability Contact	Pace Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	09/10/2023	2026	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	MA Appeals/Grievances Contact	Program Director	Mrs	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	08/23/2023	2026	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	MA Claims Processing Contact for Public Website	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Marketing Contact	Marketing Outreach	Mrs.	Griffith	Amber		8035345301				8032685302	amber.griffith@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	04/08/2024	2026	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	Medical Director	Medical Director	Dr	Guest	Ketih		8035341212	5304			8032685302	keith.guest@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	08/15/2022	2026	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	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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 Coordinator	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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 Part D Opioid Overutilization Contact	COO	Mrs.	Kornegay	Allie		8032685315	1573			8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Medication Therapy Management Contact	Pharm D	Mrs.	Wimberly	Jennifer		8035360007					thadjen@aol.com	1324 Chestnut Street		Orangeburg	SC	29118	04/25/2016	2026	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	Online Enrollment Center Contact (Back-up)	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303				8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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 C Application Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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 Appeals	COO	Mrs.	Kornegay	Allie						8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	8032685315				PACE - Nat		C	Atlanta
H0105	Part D Application Contact	Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/26/2024	2026	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 Benefits Contact	COO		Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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 Claims Submission Contact	COO		Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Mrs.	Kornegay	Allie						8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	09/10/2023	2026	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	8032685315				PACE - Nat		C	Atlanta
H0105	Part D Price File Contact (Back-up)	Program Director	Mrs.	Kornegay	Allie		8032685315				8035351540	allie.kornegay@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	09/10/2023	2026	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 Price File Contact (Primary)	COO		Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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 Quality Assurance Contact	Pharm D	Mrs.	Wimberly	Jennifer		8035360007					thadjen@aol.com	1324 Chestnut Street		Orangeburg	SC	29118	04/25/2016	2026	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 Reporting Contact	COO		Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Patient Safety Contact	Executive Director	Mrs	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	12/30/2024	2026	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	Payment Contact	COO		Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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 Director	Pharmacist/Owner  Grove Park Pharmacy	Mr	Thompson	Charles		8035360007					grovepark@earthlink.net	1324 Chestnut Street		Orangeburg	SC	29118	04/25/2016	2026	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 Network Management Contact	Pharmacist/Owner  Grove Park Pharmacy	Mr	Thompson	Charles		8035360007					grovepark@earthlink.net	1324 Chestnut Street		Orangeburg	SC	29118	04/25/2016	2026	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						8032685302	grovepark@earthlink.net	1324 Chestnut Street		Orangeburg	SC	29118	12/18/2020	2026	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	8775053131				PACE - Nat		C	Atlanta
H0105	Pharmacy Technical Help Desk Contact (Secondary)	Pharm D	Mrs.	Wimberly	Jennifer							thadjen@aol.com	1324 Chestnut Street		Orangeburg	SC	29118	04/25/2016	2026	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	8775053131				PACE - Nat		C	Atlanta
H0105	Plan Directory Contact for Public Website	Executive Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	12/30/2024	2026	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	Plan to Plan Reconciliation Contact	COO		Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Processor Contact	Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/26/2024	2026	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	Quality Contact	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303	5326			8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	Reconciliation Contact	COO		Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/08/2024	2026	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	Recovery Audit Contact	Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct		Orangeburg	SC	29118	09/10/2023	2026	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	Surveillance Contact	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303	5326			8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	System Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	04/08/2024	2026	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	Third Party Administrator (TPA) Liaison	Program Director	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Ct.		Orangeburg	SC	29118	04/26/2024	2026	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	User Access Contact	COO	Mrs.	Kornegay	Allie		8032685315				8032685302	allie.kornegay@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	04/08/2024	2026	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	Utilization Management Contact	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303	5326			8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	Utilization Review Contact	RN, Quality Improvement Coordinator	Ms.	Russell	Crystal		8032685303				8032685302	crystal.russell@orangeburgshcpace.com	153 Founders Court		Orangeburg	SC	29118	10/02/2023	2026	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	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	CAP Report Contact for Public Website	DSVP Government Programs	Ms	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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 Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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 Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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 Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	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	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Blue Cross Blue Shield of Texas	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Formulary Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	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	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	03/25/2019	2026	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	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	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	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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 Coordinator	DSVP Government Programs	Ms.	Mott	Dana		4044024274				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	04/04/2025	2026	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 Part D Opioid Overutilization Contact	Manager, Clinical Pharmacist	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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 C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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 C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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 Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Denver
H0107	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Denver
H0107	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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 Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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 Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/16/2024	2026	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 Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Denver
H0107	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/16/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Denver
H0107	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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 Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/11/2023	2026	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 Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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 Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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 Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	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 Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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 Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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 Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	8772777898				PPO - BBA		C	Denver
H0107	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of Montana	Local PPO		Health Care Service Corporation	110	Yes	Active	0000000000				PPO - BBA		C	Denver
H0107	Plan Directory Contact for Public Website			Service	Customer		8777748592				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	10/20/2023	2026	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	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	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	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Services Corporation	1001 E. Lookout Drive	Richardson	TX	75082	08/14/2020	2026	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	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/26/2018	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H0111	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H0111	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H0111	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H0111	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/04/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/25/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H0111	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H0111	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H0111	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/30/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0111	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0112	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@morselife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Backup User Access Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack  Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Bid Primary Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	CAP Report Contact for Public Website	Director of Information Technology		Schultz	Michael		5616875765				5616834556	Michaels@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	01/08/2021	2026	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	CEO - CMS Administrator Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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	CEO - Senior Official for Contracting	President/CEO	Mr	Myers	Keith	A	5616875744				5616834556	Keithm@MorseLife.org	4847 David S. Mack  Dr.		West Palm Beach	FL	33417	11/10/2023	2026	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	Wolan	Randy	T	5615781173				5616834556	rwolan@MorseLife.org	4847David S. Mack  Dr.		West Palm Beach	FL	33417	05/02/2023	2026	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 Operating Officer	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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 Information Officer	Director Information Technology	Mr	Schultz	Michael		5616875765				5616834556	MichaelS@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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 Information Security Officer	Director Information Technology	Mr	Schultz	Michael		5616875765				5616834556	MichaelS@MorseLife.org	4847 David S. Mack  Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack  Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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	Complaints Tracking Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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	Contact for Fraud Investigations	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack  Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Corporate Mailing						5614715111					ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	01/10/2023	2026	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	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	DIR Contact	Chief Financial Officer	Mr	Wolan	Randy		5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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	DIR Contact (Secondary)	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Discount Program Payment Contact	Chief Financial Officer	Mr	Wolan	Randy		5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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	Emergency Part D Contact	Chief Financial Officer	Mr	Wolan	Randy		5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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	Emergency Part D Contact (Secondary)	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Enrollment Contact	Regional Enrollment Director	Ms	Camacho	Angie		5613036882				5616834556	acamacho@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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	EOB Transfer Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Financial Audit Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Formulary Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Formulary Contact (Secondary)	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	General Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	HIPAA Privacy Officer	Director of Information Technology		Schultz	Michael		5616875765				5616834556	Michaels@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	HIPAA Security Officer	Director of Information Technology		Schultz	Michael		5616875765				5616834556	Michaels@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Interoperability Contact	Director of Information Technology		Schultz	Michael		5612349515					michaels@morselife.org	4847 David S Mack Drive		West Palm Beach	FL	33417	06/03/2022	2026	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	MA Appeals/Grievances Contact	Senior VP Home & Community Based Services	Ms	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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	MA Claims Processing Contact for Public Website	Provider Relations Supervisor	Mrs	Moniger	Brittany		5619074855				5618932511	bmoniger@morselife.org	4847 David S. Mack Drive		West Palm Beach	FL	33417	12/16/2025	2026	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	Marketing Contact	Regional Marketing Director	Ms.	Barreto-Najarro	Nadia		5615426579					nbarreto-najarro@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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	Medical Director	Medical Director	Dr.	Merkelj	Ivan		5612825386				5616834556	imerkelj@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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 Coordinator	Regional Enrollment Director	Ms	Camacho	Angie		5613036882					acamacho@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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 Part D Opioid Overutilization Contact	Medical Director PACE	Dr.	Merkelj	Ivan		5612825382				5616898718	Ivanm@morselife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Medication Therapy Management Contact	Medical Director	Dr.	Merkelj	Ivan		5612825386				5616834556	imerkelj@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	OffShore Subcontractor Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Online Enrollment Center Contact (Back-up)	Regional Marketing Director		Najarro-Barreto	Nadia		5615426579					nbarreto-najarro@morselife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	11/10/2023	2026	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	Online Enrollment Center Contact (Optional)	Regional Marketing Director	Ms.	Barreto-Najarro	Nadia		5615426579					nbarreto-najarro@morselife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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 C Application Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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 Appeals	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola						5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	5616875745				PACE - Nat		C	Atlanta
H0112	Part D Appeals Contact (Secondary)	Chief Financial Officer	Mr	Wolan	Randy	T					5615781173	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	8886160707				PACE - Nat		C	Atlanta
H0112	Part D Application Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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 Benefits Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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 Claims Submission Contact	Chief Financial Officer	Mr.	Wolan	Randy		5612096198				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	09/25/2023	2026	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	Ms.	Pouponneau-Nisbett	Paola						5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	5616875745				PACE - Nat		C	Atlanta
H0112	Part D Exceptions Contact (Secondary)	Chief Financial Officer	Mr	Wolan	Randy	T					5615781173	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	8886160707				PACE - Nat		C	Atlanta
H0112	Part D Price File Contact (Back-up)	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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 Price File Contact (Primary)	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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 Quality Assurance Contact	Medical Director	Dr.	Merkelj	Ivan		5612825386				5616834556	imerkelj@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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 Reporting Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Patient Safety Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Payment Contact	Provider Relations Supervisor	Mrs.	Moniger	Brittany		5619074855				5612932511	bmoniger@morselife.org	4847 David S. Mack Drive		West Palm Beach	FL	33417	12/16/2025	2026	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	Personal Health Record Contact	Director of Information Technology		Schultz	Michael		5616875765				5616834556	Michaels@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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 Director	Medical Director	Dr.	Merkelj	Ivan		5612825386				5616834556	imerkelj@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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 Network Management Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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 Network Management Contact (Secondary)	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Wolan	Randy	T					5615781173	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	8886160707				PACE - Nat		C	Atlanta
H0112	Pharmacy Technical Help Desk Contact (Secondary)	Medical Director	Dr.	Merkelj	Ivan						5616834556	ivanm@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/10/2023	2026	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active	5612825386				PACE - Nat		C	Atlanta
H0112	Plan Directory Contact for Public Website	Director of Information Technology		Schultz	Michael		5616875765				5616834556	Michaels@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Processor Contact	Director of Information Technology		Schultz	Michael		5616875765				5616834556	Michaels@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Quality Contact	Medical Director	Dr.	Merkelj	Ivan		5612825386				5616834556	imerkelj@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Reconciliation Contact	Chief Financial Officer	Mr	Wolan	Randy		5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	11/10/2023	2026	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	Reconciliation Contact (Secondary)	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr.		West Palm Beach	FL	33417	08/10/2023	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr	Wolan	Randy	T	5615781173				5616898718	rwolan@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	05/02/2023	2026	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	Surveillance Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	System Contact	Senior VP Home & Community Based Services	Ms.	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Third Party Administrator (TPA) Liaison	Provider Relations Supervisor	Mrs	Moniger	Brittany		5619074855				5612932511	bmoniger@morselife.org	4847 David S. Mack Drive		West Palm Beach	FL	33417	12/16/2025	2026	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	User Access Contact	Senior VP Home & Community Based Services	Ms	Pouponneau-Nisbett	Paola		5616875745				5616834556	ppnisbett@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	08/10/2023	2026	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	Utilization Management Contact	Medical Director	Dr.	Merkelj	Ivan		5612825386				5616834556	imerkelj@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	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	Utilization Review Contact	Medical Director	Dr.	Merkelj	Ivan		5612825386				5616834556	imerkelj@MorseLife.org	4847 David S. Mack Dr		West Palm Beach	FL	33417	01/08/2021	2026	MORSE LIFE HOME CARE, INC.	National PACE	Palm Beach PACE	National PACE		Morse Life Home Care, Inc.	550	Yes	Active					PACE - Nat		C	Atlanta
H0154	Agent/Broker Compensation Data Contact	Director - Medicare Sales		Hey	Lisa		2055583341					lhey@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Tressler	Damon		4803914702				4803146023	Damon.tressler@caremark.com	9501 E Shea Blvd.		Scottsdale	AZ	85260	01/10/2013	2026	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	Backup User Access Contact	Exec Dir - Privacy and Vendor Oversight	Ms.	Evans	Teresa		2055587544				2054497626	temevans@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Supervisor Medicare Enrollment	Ms.	Stevenson	Chelsea		2055583274				2054497628	ccstevenson@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	09/15/2023	2026	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	Bid Audit Contact	CFO	Ms.	Watkins	Letitia		2055587480				2059391748	lwatkins@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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	Bid Audit Site Contact	CFO	Ms.	Watkins	Letitia		2055587480				2059391748	lwatkins@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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	Bid Primary Contact	Chief  Administrative Officer	Ms.	Yates	Libba		2055587406				2059391748	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/30/2015	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mr.	Morgan	Darius		2055323705				2054497626	dariusmorgan@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	06/17/2025	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Rollow	Brad		2055207332				2059391748	brollow@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/12/2024	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Rollow	Brad		2055207332				2059391748	brollow@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	09/24/2025	2026	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		2055587480				2059391748	lwatkins@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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 Operating Officer	Chief Operating Officer	Mr.	Feagin	Cardwell		2055587436				2055587571	cfeagin@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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 Information Officer	VP of Information Systems	Mr.	Cannon	Doug		2055587432				2059391748	dcannon@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	11/11/2016	2026	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 Information Security Officer	VP of Information Systems	Mr.	Cannon	Doug		2055587432				2059391748	dcannon@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	11/11/2016	2026	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	Manager - Appeals and Grievances	Ms.	McReynolds	Nia		2055587410				2055587414	niamcreynolds@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Complaints Tracking Contact	Director - Appeals and Grievances	Ms.	Gardner	Marquetter		2055587583				2055587414	mgardner@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Contact for Fraud Investigations	Compliance Manager	Ms.	Pfaffman	Ann	M	2055583190				2054497626	apfaffman@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	10/06/2025	2026	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		2055587690				2055587546	bjmarshall@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/31/2015	2026	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	Corporate Mailing						2059391718				2055587538	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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	Executive Director - Customer Service	Ms.	Mitchell	Dee		2055587452				2055587414	dmitchell@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	DIR Contact	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150				2059331232	kmlynch@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	DIR Contact (Secondary)	Executive Director - Corporate Controller	Mr.	Yeatman	Wes		2055587404				2055587546	jyeatman@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Discount Program Payment Contact	Senior Accountant		Johnson	Tish		2055587411				2055587546	ldjohnson@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	09/11/2018	2026	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	Emergency Part D Contact	Pharmacy Help Desk		Help Desk	Pharmacy		8006934620					no.email.address.available@caremark.com	9501 E. Shea Blvd MC 019		Scottsdale	AZ	85260	12/09/2011	2026	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	Emergency Part D Contact (Secondary)	Executive Director Pharmacy		Wingate	Tanya		2055582873					tgwingate@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35242	07/11/2025	2026	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	Employer Waiver Contact	Chief  Administrative Officer	Ms.	Yates	Libba		2055587406				2059391748	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/30/2015	2026	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	Encounter Data & Risk Adjustment Operations Contact	Assoc Director Risk Adjustment	Ms.	Powell	Denise		2055587661				2054497971	dwpowell@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	09/15/2023	2026	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	Enrollment Contact	Supervisor Medicare Enrollment	Ms.	Stevenson	Chelsea		2055583274				2054497628	ccstevenson@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	09/15/2023	2026	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	EOB Transfer Contact	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150				2054499765	kmlynch@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	Financial Audit Contact	CFO	Ms.	Watkins	Letitia		2055587480				2059391748	lwatkins@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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	Financial Reporting Contact	CFO	Ms.	Watkins	Letitia		2055587480				2059391748	lwatkins@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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	Formulary Contact	Executive Director Pharmacy		Wingate	Tanya		2055582873				2054499765	tgwingate@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	Formulary Contact (Secondary)	Compliance Manager		Pfaffman	Ann		2055583190				2054499765	apfaffman@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	10/06/2025	2026	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	General Contact	Chief  Administrative Officer	Ms.	Yates	Libba		2055587406				2059391748	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/30/2015	2026	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		2055587406				2059391748	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/30/2015	2026	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	HIPAA Privacy Officer	Privacy Officer	Ms.	Evans	Teresa		2055587544				2054497626	temevans@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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	HIPAA Security Officer	Data Security Officer	Ms.	Murphree	Lynn		2055582026				2059391748	lmurphree@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	11/11/2016	2026	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	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150				2059331232	kmlynch@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	Interoperability Contact			Velasco	Anna		2055587641				2054497626	avelasco@uabmc.edu	417 20th St N	Suite 1100	Birmingham	AL	35203	11/15/2021	2026	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	MA Appeals/Grievances Contact	Director - Appeals and Grievances	Ms.	Gardner	Marquetter		2055587583				2055587414	mgardner@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	MA Claims Processing Contact for Public Website	Manager - Claims	Ms.	McGee	Treasure		2055587697				2055587571	tmcgee@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Marketing Contact	Director of Marketing, Communications & Comm Sales	Mr.	Ceasar	Tony		2055587558				2053931748	tceasar@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	09/29/2015	2026	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	Medical Director	VP Clinical Services	Ms.	Cook	Anne-Laura		2055043398				2059331232	alrcook@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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.	Morgan	Darius		2055323705				2054497626	dariusmorgan@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35205	06/17/2025	2026	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 Coordinator	AVP - Operations	Ms.	Thomas	Donna		2055587446				2055587414	Donnathomas@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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 Part D Opioid Overutilization Contact	Supervisor Clinical Pharmacy	Ms.	Sirna	Mary		2055587796				2055587796	maryhunt@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	Medication Therapy Management Contact	Manager Clinical Pharmacy Programs	Ms.	Saab	Helen		2055583358				2055583358	helenwalker@uabmc.edu	417 20th Street N	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	OffShore Subcontractor Contact	Exec Dir - Privacy and Vendor Oversight	Ms.	Evans	Teresa		2055587544				2054497626	temevans@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Online Enrollment Center Contact (Back-up)	Supervisor Medicare Enrollment	Mr.	Stevenson	Chelsea		2055583274				2055587414	ccstevenson@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Online Enrollment Center Contact (Optional)	Exec Dir - Cust Engage & ME	Mr.	Owens	John		2055587564				2055587414	jaowens@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Online Enrollment Center Contact (Primary)	Director Medicare Enrollment	Ms.	Acton	Kelli		2055583354				2055587414	ksacton@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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 C Application Contact	Exec Dir - Privacy and Vendor Oversight	Ms.	Evans	Teresa		2055587544				2054497626	temevans@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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 C Reporting Contact	Compliance Officer	Mr.	Morgan	Darius		2055323705				2054497626	dariusmorgan@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	06/17/2025	2026	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 Appeals	Senior Clinical Pharmacist	Ms.	Hornikel	Mallory						2054492465	malloryanderson@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	2055583372				HMO - Health Maintenance Organization		C	Atlanta
H0154	Part D Appeals Contact (Secondary)	Compliance Manager	Ms.	Pfaffman	Ann						2054492465	apfaffman@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	10/06/2025	2026	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	8006331542				HMO - Health Maintenance Organization		C	Atlanta
H0154	Part D Application Contact	Exec Dir - Privacy and Vendor Oversight	Ms.	Evans	Teresa		2055587544				2054497626	temevans@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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 Benefits Contact	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150				2054499765	kmlynch@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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 Claims Submission Contact	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150				2054499765	kmlynch@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	Senior Clinical Pharmacist	Ms.	Hornikel	Mallory						2059331232	malloryanderson@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	2055583372				HMO - Health Maintenance Organization		C	Atlanta
H0154	Part D Exceptions Contact (Secondary)	Pharmacy Operations Manager	Ms.	Lynch	Kaylee						2054499765	kmlynch@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	2055583150				HMO - Health Maintenance Organization		C	Atlanta
H0154	Part D Price File Contact (Back-up)	CVS Operations	Ms.	Scott	Sarah		8018363750					Sarah.Scott@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2025	2026	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 Price File Contact (Optional)	CVS Operations	Ms.	Perry	Michele		8018363750					Michele.Perry@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	07/11/2025	2026	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 Price File Contact (Primary)	Manager, Pharmacy Operations	Ms.	Lynch	Kaylee		2055582013				2054499765	kmlynch@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	11/14/2024	2026	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 Quality Assurance Contact	Executive Director of Performance Improvement and	Mr.	Parker	Matthew		2055587178				2059331232	mparker@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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 Reporting Contact	Compliance Officer	Mr.	Morgan	Darius		2055323705				2054497626	dariusmorgan@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	06/17/2025	2026	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	Patient Safety Contact	Manager Clinical Pharmacy Programs		Saab	Helen		2055583358				2059331232	helenwalker@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	Payment Contact	CFO	Ms.	Watkins	Letitia		2055587480				2059391748	lwatkins@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	10/25/2013	2026	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 Director	Executive Director Pharmacy	Ms.	Wingate	Tanya		2055582873				2054499765	tgwingate@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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 Network Management Contact	Director, Network Systems		Tressler	Damon		4803914702				4803146324	Damon.tressler@caremark.com	9501 E. Shea Blvd., MC080		Scottsdale	AZ	85260	01/10/2013	2026	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 Network Management Contact (Secondary)	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150					kmlynch@uabmc.edu	417 20th S N	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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						4803146077	doug.halbert@caremark.com	9501 E Shea Blvd., MC 005		Scottsdale	AZ	85260	02/19/2013	2026	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H0154	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Operations Manager	Ms.	Lynch	Kaylee							kmlynch@uabmc.edu	417 20th S N	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	VIVA HEALTH, INC.	Local CCP	VIVA Medicare	HMO/HMOPOS		Triton Health Systems, L.L.C.	237	Yes	Active	2055583150				HMO - Health Maintenance Organization		C	Atlanta
H0154	Physician Incentive Contact	Chief  Administrative Officer	Ms.	Yates	Libba		2055587406				2059391748	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/30/2015	2026	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	Plan Directory Contact for Public Website			Member Services	Viva		8006331542				2055587414	VivaAgentSupport@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	10/24/2023	2026	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	Plan to Plan Reconciliation Contact	Pharmacy Analyst Sr	Ms.	Holsombeck	Susan		2055587551				2059331232	sholsombeck@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Processor Contact	Manager - Claims	Ms.	McGee	Treasure		2055587697					tmcgee@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Quality Contact	Supervisor RN and Quality Improvement	Ms	Burnett	Stephanie		2055587765				2054497853	sdburnett@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	03/21/2019	2026	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	Reconciliation Contact	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150				2059331232	kmlynch@uabmc.edu	417 20th S N	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	Reconciliation Contact (Secondary)	Executive Director - Corporate Controller	Mr.	Yeatman	Wes		2055587404				2055587546	jyeatman@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Recovery Audit Contact	Compliance Officer	Mr.	Morgan	Darius		2055323705				2054497626	dariusmorgan@uabmc.edu	417 20th Street North	1222 14th Avenue South	Birmingham	AL	35203	06/17/2025	2026	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	SNP Application Contact	Exec Dir - Privacy and Vendor Oversight	Ms.	Evans	Teresa		2055587544				2054497626	temevans@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	SNP State Contact	Chief  Administrative Officer	Ms.	Yates	Libba		2055587406				2059391748	lyates@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/30/2015	2026	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	Surveillance Contact	Compliance Officer	Mr.	Morgan	Darius		2055323705				2054497626	dariusmorgan@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	06/17/2025	2026	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	System Contact	Vice President, Information Systems	Mr.	Cannon	Doug		2055587432				2054497626	dcannon@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	07/01/2013	2026	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	Third Party Administrator (TPA) Liaison	Pharmacy Operations Manager	Ms.	Lynch	Kaylee		2055583150				2054499765	kmlynch@uabmc.edu	417 20th S N	Suite 1100	Birmingham	AL	35203	07/11/2025	2026	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	User Access Contact	Compliance Officer	Mr.	Morgan	Darius		2055323705				2054497626	dariusmorgan@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	06/17/2025	2026	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	Utilization Management Contact	AVP - Operations	Ms.	Thomas	Donna		2055587446				2059331232	donnathomas@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Utilization Review Contact	AVP - Operations	Ms.	Thomas	Donna		2055587446				2059331232	donnathomas@uabmc.edu	417 20th Street North	Suite 1100	Birmingham	AL	35203	12/27/2023	2026	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	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/09/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	05/15/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	05/15/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	01/02/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/09/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	02/20/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/04/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/09/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/09/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0169	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/05/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0169	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	04/09/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/17/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0169	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/04/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/20/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	06/04/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0169	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/29/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/16/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	05/11/2023	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	01/02/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0169	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0174	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/08/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0174	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0174	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0174	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0174	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/04/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/25/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H0174	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H0174	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H0174	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/30/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0174	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	WELLCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0216	Automated TrOOP Balance Transfer Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Backup User Access Contact	DIR Health Plan Management	Mrs.	Boyle	Amanda		4028292993				4028292998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Best Available Evidence Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Bid Primary Contact	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/22/2018	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	CAP Report Contact for Public Website	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	CEO - CMS Administrator Contact	CEO	Mr	Gurley	Eric		4028292950				4028292939	egurley@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	08/28/2017	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	CEO - Senior Official for Contracting	CEO	Mr	Gurley	Eric		4028292950				4028292939	egurley@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/14/2016	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Chief Financial Officer	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/22/2018	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Chief Operating Officer	Senior VP & COO	Mrs	Kaminski	Julie		4028292954				4028292939	Jkaminski@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	08/28/2017	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Chief Information Officer	CFO	Mr	Bear	Scott		4028292922					sbear@immanuel.com	1044 North 115th Street Suite 500		Omaha	NE	68154	02/16/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Chief Information Security Officer	CFO	Mr.	Bear	Scott		4028292922					sbear@immanuel.com	1044 North 115th Street Suite 500		Omaha	NE	68154	01/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	CMS Casework Communication Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Complaints Tracking Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Contact for Fraud Investigations	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	TDurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/25/2021	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Coordination of Benefits Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Corporate Mailing						4028292999				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Customer Service Operations Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	DIR Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	DIR Contact (Secondary)	Dir. Health Plan Management	Mrs.	Boyle	Amanda		4028292993				4028292998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/14/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Discount Program Payment Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Emergency Part D Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Emergency Part D Contact (Secondary)	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951					tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	09/21/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Encounter Data & Risk Adjustment Operations Contact	Dir. Health Plan Management	Mrs.	Boyle	Amanda		4028292993				4028292998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/14/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Enrollment Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	EOB Transfer Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Financial Audit Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951					tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Financial Reporting Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951					tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Formulary Contact	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/22/2018	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	General Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Government Relations Contact	Corporate Compliance Officer	Mr	Sigmond	John		4028292910					jsigmond@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/14/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	HIPAA Privacy Officer	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	Tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	HIPAA Security Officer	CFO	Mr	Bear	Scott		4028292922					sbear@immanuel.com	1044 North 115th Street Suite 500		Omaha	NE	68154	02/16/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Interoperability Contact	CFO	Mr	Bear	Scott		4028292922					sbear@immanuel.com	1044 N 115th Street		Omaha	NE	68135	02/16/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	MA Appeals/Grievances Contact	Director of PACE Clinical Operations	Mrs	Grasz	Liza		4028292967					LGrasz@immanuel.com	1044 N 115th Street	Suite 500	Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	MA Claims Processing Contact for Public Website	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Marketing Contact	VP of PACE Operations	Mrs.	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Medical Director	VP of Clinical Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Medicare Compliance Officer	Corp Compliance Officer	Ms	Durbin	Tracy		4028292968					tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	09/21/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Medicare Coordinator	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Medicare Part D Opioid Overutilization Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 N 115th Street		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Medication Therapy Management Contact	Vice President of Clinic Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street		Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part C Application Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part D Appeals	Corporate Compliance Officer	Mrs	Durbin	Tracy						4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/22/2021	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active	4028292968				PACE - Nat		C	San Francisco
H0216	Part D Appeals Contact (Secondary)	Dir. Health Plan Management	Mrs.	Boyle	Amanda						4028292939	aboyle@immanuel.com	1044 N 115th Street		Omaha	NE	68154	07/14/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active	4028292993				PACE - Nat		C	San Francisco
H0216	Part D Application Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part D Benefits Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part D Claims Submission Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part D Exceptions Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha						4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active	4028296951				PACE - Nat		C	San Francisco
H0216	Part D Exceptions Contact (Secondary)	DIR Health Plan Management	Mrs	Boyle	Amanda						4028292939	aboyle@immanuel.com	1044 N Street		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active	4028292993				PACE - Nat		C	San Francisco
H0216	Part D Price File Contact (Back-up)	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part D Price File Contact (Primary)	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/22/2018	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part D Quality Assurance Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 N 115th Street		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Part D Reporting Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Patient Safety Contact	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/25/2021	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Payment Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Personal Health Record Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	07/06/2022	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Pharmacy Director	VP of Clinical Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Pharmacy Network Management Contact	VP of Clincial Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Pharmacy Technical Help Desk Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha						4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active	4028296951				PACE - Nat		C	San Francisco
H0216	Plan Directory Contact for Public Website	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Plan to Plan Reconciliation Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Processor Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Quality Contact	Director of Clincial Operations	Mrs	Grasz	Liza		5155182403					LGrasz@immanuel.com	1044 N 115th Street		Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Reconciliation Contact	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	03/22/2018	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Recovery Audit Contact	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	01/05/2021	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Surveillance Contact	Corporate Compliance Officer	Ms	Durbin	Tracy		4028292968				4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	08/13/2021	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	System Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Third Party Administrator (TPA) Liaison	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	User Access Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Utilization Management Contact	Director of Clinical Operations	Mrs	Grasz	Liza		4028292967					LGrasz@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0216	Utilization Review Contact	Director of Clinical Operations	Mrs	Grasz	Liza		4028292697					LGrasz@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	02/20/2023	2026	PACE IOWA	National PACE	Immanuel Pathways Iowa	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H0235	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Backup User Access Contact	Executive Director	Mrs.	Hougham	Katie		2604694148	643				khougham@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/05/2024	2026	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	New York
H0235	Best Available Evidence Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Bid Primary Contact	Chief Financial Officer	Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	CAP Report Contact for Public Website	VP of PACE Operations		Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	2604694148				PACE - Nat		C	New York
H0235	CEO - CMS Administrator Contact		Ms.	Benton Wolfe	Connie		2607451200	222				cbwolfe@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/20/2018	2026	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	New York
H0235	CEO - Senior Official for Contracting		Ms.	Benton Wolfe	Connie		2607451200	222				cbwolfe@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/20/2018	2026	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	New York
H0235	Chief Financial Officer		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/20/2018	2026	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	New York
H0235	Chief Operating Officer	Chief Operating Officer	Ms	Widner	Maureen		2607451200	285				mwidner@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/20/2018	2026	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	New York
H0235	Chief Information Officer	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Chief Information Security Officer	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	CMS Casework Communication Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Complaints Tracking Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Contact for Fraud Investigations	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Coordination of Benefits Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Corporate Mailing						2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Customer Service Operations Contact	Chief Operating Officer		Widner	Maureen		2607451200	285				mwidner@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	12/20/2018	2026	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	New York
H0235	DIR Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	DIR Contact (Secondary)	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Discount Program Payment Contact		Mrs.	Leazier	Isabella		2604694148	640				ileazier@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	03/05/2025	2026	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	New York
H0235	Emergency Part D Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Emergency Part D Contact (Secondary)	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Encounter Data & Risk Adjustment Operations Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Enrollment Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	EOB Transfer Contact	Chief Financial Officer		Shapiro	Aaron		2607451200	261			2604224916	ashapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Financial Audit Contact	Chief Financial Officer	Mr	Shapiro	Aaron		2607451200	261				ashapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Financial Reporting Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Formulary Contact	Chief Financial Officer		Shapiro	Aaron		2607451200	261				ashapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Formulary Contact (Secondary)	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	General Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Government Relations Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	HIPAA Privacy Officer	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	HIPAA Security Officer	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Interoperability Contact			Houghman	Katie		2604694148					katie.hougham@pacenein.org	2927 Lake Ave		Fort Wayne	IN	46805	06/01/2022	2026	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	New York
H0235	MA Appeals/Grievances Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	MA Claims Processing Contact for Public Website	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Marketing Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Medical Director	Medical Director		Uncheselu	Dona		2604694148					dona.uncheselu@parkview.com	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Medicare Compliance Officer	VP of PACE Operations	Mr	Hougham	Katie		2604694148	316				katie.hougham@pacenein.org	2927 Lake Ave		Fort Wayne	IN	46805	09/28/2021	2026	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	New York
H0235	Medicare Coordinator	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Medicare Part D Opioid Overutilization Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	06/01/2022	2026	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	New York
H0235	Medication Therapy Management Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Part C Application Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Part D Appeals	VP of PACE Operations		Hougham	Katie							katie.hougham@pacenein.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	2604694148	643			PACE - Nat		C	New York
H0235	Part D Appeals Contact (Secondary)	VP of PACE Operations		Hougham	Katie							khougham@agingihs.org	2927 Lake Ave		Fort Wayne	IN	46805	01/25/2021	2026	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	2607451200	334			PACE - Nat		C	New York
H0235	Part D Application Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Part D Benefits Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Part D Claims Submission Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
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	2026	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	2604694148	643			PACE - Nat		C	New York
H0235	Part D Price File Contact (Back-up)	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Part D Price File Contact (Primary)	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Part D Quality Assurance Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Part D Reporting Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Patient Safety Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Payment Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Pharmacy Director	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Pharmacy Network Management Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
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	2026	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	2604694148	643			PACE - Nat		C	New York
H0235	Plan Directory Contact for Public Website	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Plan to Plan Reconciliation Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Processor Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Quality Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Reconciliation Contact		Mr	Shapiro	Aaron		2607451200	261				AShapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Recovery Audit Contact	Chief Financial Officer	Mr	Shapiro	Aaron		2607451200	261				ashapiro@agingihs.org	2927 Lake Avenue		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Surveillance Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	System Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Third Party Administrator (TPA) Liaison	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	User Access Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Utilization Management Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0235	Utilization Review Contact	VP of PACE Operations	Ms	Hougham	Katie		2604694148	643				katie.hougham@pacenein.org	2927 Lake Ave		Ft. Wayne	IN	46805	05/27/2021	2026	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	New York
H0244	Part C Application Contact			Austin	Mary		2156098714					maustin@boldagepace.com	134 Maryhill Road		Phoenixville	PA	19460	11/03/2025	2026	BOLDAGE PACE PINELLAS COUNTY FL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0244	Part D Application Contact			Austin	Mary		2156098714					maustin@boldagepace.com	134 Maryhill Road		Phoenixville	PA	19460	11/03/2025	2026	BOLDAGE PACE PINELLAS COUNTY FL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0251	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0251	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0251	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0251	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0251	Plan Directory Contact for Public Website			Customer Service	UHC		8006901606					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/29/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0251	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0270	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H0270	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H0270	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H0270	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H0270	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H0270	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H0270	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H0270	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0270	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H0292	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0292	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H0292	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0292	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H0292	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H0292	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H0292	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0292	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF OHIO, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0294	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H0294	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0294	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0294	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H0294	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0294	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0302	Agent/Broker Compensation Data Contact	Medicare Sales Compliance & Audit Oversight Specia	Ms.	Aguayo	Nancy		6029168515					nancy.aguayo@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/28/2020	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Automated TrOOP Balance Transfer Contact	Associate Director, Claims Business Process		Cassata	Mercedes		7143172628					mercedes.cassata@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	05/28/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Backup User Access Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Best Available Evidence Contact	Mgr- Medicare Enrollment		Olivas Renteria	Juan		6028644395					Juan.OlivasRenteria@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	03/05/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Bid Audit Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		PHOENIX	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Bid Primary Contact	Segment Product and Program Strategist-Product Dev		Haimanot	Tsedey		6029168542					tsedey.haimanot@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	04/01/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	CAP Report Contact for Public Website			Services	Member		4809370409					contact.advantage@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/23/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	CEO - CMS Administrator Contact	General Manager, Government Business Segment	Mr.	Fernandez	Frank		6232732116					frank.fernandez@azblue.com	8220 N. 23rd Ave.		Phoenix	AZ	85021	11/05/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	CEO - Senior Official for Contracting	General Manager, Government Business Segment	Mr.	Fernandez	Frank		6232732116					frank.fernandez@azblue.com	8220 N. 23rd Ave.		Phoenix	AZ	85021	11/05/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Chief Financial Officer	Chief Financial Officer	Mr.	Black	Cameron		6023367463					Cameron.Black@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	06/25/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Chief Operating Officer	Chief Operating Officer	Mr.	Greenberg	Joe		6029166930					joe.greenberg@azblue.com	8220 N. 23rd Ave		Phoenix	AZ	85021	04/18/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Chief Information Officer	VP- CIO	Mr.	Pencek	Michael		6029166728					michael.pencek@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/23/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Chief Information Security Officer	Director, Chief Information Security Officer	Mr.	Pencek	Michael		6029166728					Michael.Pencek@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	CMS Casework Communication Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Complaints Tracking Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Contact for Fraud Investigations	Staff Vice President, Corp & Medicare Compliance	Ms.	Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Coordination of Benefits Contact	Mgr- Medicare Finance		Soliman	Bishoy		6232732042					bishoy.soliman@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	07/23/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Corporate Mailing						4809370409					contact.advantage@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/23/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Customer Service Operations Contact	Staff VP, MA Ops & FEP Progs		Langum	Becca	S	6029166742					rebecca.langum@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	DIR Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	DIR Contact (Secondary)	Mgr- Medicare Finance		Soliman	Bishoy		6232732042					bishoy.soliman@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	07/23/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Discount Program Payment Contact	Financial Analyst/Accountant	Mr.	Westphal	Robert		6029168503					robert.westphal@azblue.com	8220 N 23rd Ave.		Phoenix	AZ	85021	08/07/2019	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Emergency Part D Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Emergency Part D Contact (Secondary)	General Manager, Government Business Segment		Fernandez	Frank		6232732116					frank.fernandez@azblue.com	8220 N. 23rd Ave.		Phoenix	AZ	85021	11/05/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Encounter Data & Risk Adjustment Operations Contact	Staff VP, Revenue and Retention Operations		Hubler	Jamee		6029168220					Jamee.Hubler@azblue.com	8220 N. 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Enrollment Contact	Mgr- Medicare Enrollment		Olivas Renteria	Juan		6028644395					juan.olivasrenteria@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	12/12/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	EOB Transfer Contact	Dir- Clinical Pharmacy Programs		Wahlgren	Chad		6028642271				8583572494	chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Financial Audit Contact	Chief Audit Executive	Mrs.	Lohse	Deepa		6028644452					deepa.lohse@azblue.com	8220 N 23rd Ave	MS C211	Phoenix	AZ	85021	09/20/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Financial Reporting Contact	Director, Financial Reporting	Ms.	Acquafredda	Brandy		6028644683					brandy.acquafredda@azblue.com	8220 N 23rd Ave	MS C211	Phoenix	AZ	85021	03/09/2020	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Formulary Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	General Contact	General Manager, Government Business Segment		Fernandez	Frank		6232732116					frank.fernandez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	11/05/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Government Relations Contact	General Manager, Government Business Segment		Fernandez	Frank		6232732116					frank.fernandez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	11/05/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	HIPAA Privacy Officer	VP- Chief Compliance and Privacy Officer		Schrock	Anne		6028644315					anne.schrock@azblue.com	8220 N 23rd Avenue		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	HIPAA Security Officer	Chief Information Security Officer	Mr.	Pencek	Michael		6029166728					Michael.Pencek@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Hospice Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	03/05/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Interoperability Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	MA Appeals/Grievances Contact			Services	Member		4809370409					contact.advantage@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/23/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	MA Claims Processing Contact for Public Website	General Manager, Government Business Segment		Fernandez	Frank		6232732116					frank.fernandez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	11/05/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Marketing Contact	Marketing Manager		Johnson	Nichelle		6028645215					MedSalesHPMSMaterial@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Medical Director	Medical Director	Dr	Raja	Rubina		6028642176					rubina.raja@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Medicare Compliance Officer	Staff Vice President, Corp & Medicare Compliance	Ms.	Moore	Veronica		6023367600				6028643152	veronica.moore@azblue.com	8220 N 23rd Ave.		Phoenix	AZ	85021	05/28/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Medicare Coordinator	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Medicare Part D Opioid Overutilization Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	02/12/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Medication Therapy Management Contact	Director, Clinical Pharmacy		Minich	Elizabeth		2242311722					elizabeth.minich@optum.com	OptumRx	11000 Optum Cir	Eden Prairie	MN	55344	12/15/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Online Enrollment Center Contact (Primary)	Mgr- Medicare Enrollment		Olivas Renteria	Juan		6028644395					Juan.OlivasRenteria@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	03/05/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part C Application Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		PHOENIX	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part C Reporting Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		PHOENIX	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Appeals			Services	Member							contact.advantage@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/23/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	8004468331				HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Appeals Contact (Secondary)	Manager Disputes and Appeals Department		Angel	Clarissa							GrievanceAppeals@Azblue.com	8220 N 23rd Avenue		Phoenix	AZ	85021	01/08/2021	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	6029168073				HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Application Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Benefits Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Claims Submission Contact	Director, Business Analysis		Smith	Brian		7637974702					brian_l_smith@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	05/28/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Exceptions Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad							chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	6028642271				HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Price File Contact (Back-up)	Senior Business Analyst		Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	05/28/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Price File Contact (Optional)	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Price File Contact (Primary)	Director, Business Analyst		Molberg	Brandi		6514955369					Brandi.molberg@optum.com	OptumRx	1600 McConnor Parkway	Schaumburg	IL	60173	12/15/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Quality Assurance Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Part D Reporting Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Patient Safety Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Payment Contact	Finance Manager	Mr.	Soliman	Bishoy		6232732042					bishoy.soliman@azblue.com	8220 N 23rd Ave.		Phoenix	AZ	85021	07/23/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Pharmacy Director	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Pharmacy Network Management Contact	Manager, Retail Network Operations		Perez	Felix		3053313044					Felix.perez@optum.com	OptumRx	11000 Optum Cir	Eden Prairie	MN	55344	03/08/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Pharmacy Network Management Contact (Secondary)	Director of General Management, Retail Network Ops		Smith	Carmen		0000000000					carmen.smith@optum.com	OptumRx	11000 Optum Cir	Eden Prairie	MN	55344	12/15/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Villanueva	Juan							Juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/16/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	8448838523				HMO - Health Maintenance Organization		C	Chicago
H0302	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/16/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	8448838523				HMO - Health Maintenance Organization		C	Chicago
H0302	Plan Directory Contact for Public Website			Services	Member		4809370409					contact.advantage@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/23/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Plan to Plan Reconciliation Contact	Director, Financial Reporting		Acquafredda	Brandy		6028644683				6028645308	brandy.acquafredda@azblue.com	PO Box 81049		Phoenix	AZ	85069	03/09/2020	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Processor Contact	Dir-Clinical Pharmacy Prgm, Clinical Therapeutics		Wahlgren	Chad		6028642271					chad.wahlgren@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/28/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Quality Contact	Staff VP Medicare & FEP Quality		Haddad	Jodi		6029167934					jodi.haddad@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/24/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Reconciliation Contact	Mgr- Medicare Finance		Soliman	Bishoy		6232732042					bishoy.soliman@azblue.com	8220 N 23rd Ave	MS C211	Phoenix	AZ	85021	07/23/2024	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Reconciliation Contact (Secondary)	Director, Financial Reporting		Acquafredda	Brandy		6028644683					brandy.acquafredda@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	02/26/2021	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Recovery Audit Contact	Staff Vice President, Corp & Medicare Compliance	Ms.	Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Surveillance Contact	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	System Contact	Informatn Security Svcs	Ms.	Herrington	Jennifer		6028644643					jennifer.herrington@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	04/15/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Third Party Administrator (TPA) Liaison	Finacial Analyst/Accountant	Mr.	Westphal	Robert		6029168503					robert.westphal@azblue.com	8220 N 23rd Ave.		Phoenix	AZ	85021	08/07/2019	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	User Access Contact	Informatn Security Svcs	Ms.	Herrington	Jennifer		6028644643					jennifer.herrington@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	04/15/2025	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Utilization Management Contact	Mgr- Utilization Management		Guddendorf	Kelly		6028644358					kelly.guddendorf@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/28/2020	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0302	Utilization Review Contact	Mgr- Utilization Management		Guddendorf	Kelly		6028644358					kelly.guddendorf@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/28/2020	2026	MEDISUN, INC.	Local CCP	Blue Cross Blue Shield of Arizona (AZ Blue)	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0321	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0321	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0321	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0321	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0321	Plan Directory Contact for Public Website			Customer Service	UHC		8776140623					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/29/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0321	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	ARIZONA PHYSICIANS IPA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Agent/Broker Compensation Data Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Automated TrOOP Balance Transfer Contact	Sr Director, Healthplan Services		Gandhi	Kirti		7134425519				7134425105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Backup User Access Contact	VP of Health Plan Services/COO		Jonathan	Denise	M	7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Best Available Evidence Contact	Director of Appeals & Grievances and Enrollment	Mr.	Thomas	Don	G	8182093846				7134425450	donald.thomas@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	02/20/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Bid Audit Contact	VP, Managed Care Analytics		Dixon	Sarah		7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/06/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Bid Audit Site Contact	VP, Managed Care Analytics		Dixon	Sarah		7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/06/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Bid Primary Contact	VP of Health Plan Services/COO	Ms	Jonathan	Denise	M	7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	CAP Report Contact for Public Website	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425212	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	CEO - CMS Administrator Contact	President	Mrs.	Matheny	Marnie	P	7139627242				7134420771	marnie.matheny@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	12/20/2019	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	CEO - Senior Official for Contracting	President	Mrs.	Matheny	Marnie		7134420775				7134420771	marnie.matheny@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	10/26/2017	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Chief Financial Officer	Chief Financial Officer	Mr.	Loney	Matthew	A	6126167055				7134420799	matthew.loney@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	01/29/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Chief Operating Officer	VP of Health Plan Services/COO	Ms	Jonathan	Denise	M	7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Chief Information Officer	Chief Technology Officer	Mr.	Littmann	Martin	H	7134429977					martin.littman@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	03/06/2017	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Chief Information Security Officer	Chief Technology Officer	Mr.	Littmann	Martin	H	7134429977					martin.littman@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	04/15/2016	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	CMS Casework Communication Contact	Director of Appeals & Grievances and Enrollment	Mr.	Thomas	Don	G	8182093846				7134425450	donald.thomas@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	02/20/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Complaints Tracking Contact	Director of Appeals & Grievances and Enrollment	Mr.	Thomas	Don	G	8182093846				7134425450	donald.thomas@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	02/20/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Contact for Fraud Investigations	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7124425450	MedicareFraudHotline@kelseycareadvantage.com	11511 Shadow Creek Parkway		Pearland	TX	77584	08/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Coordination of Benefits Contact	Director of Appeals & Grievances and Enrollment	Mr.	Thomas	Donald		8182093846				7134425450	donald.thomas@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	08/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Corporate Mailing						7134420775				7134420771	marnie.matheny@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	10/26/2017	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Customer Service Operations Contact	Director, Member Services	Mr.	Delacruz	Rodolfo		2103921323				7134425450	rodolfo.delacruz@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	08/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	DIR Contact	Director, Actuarial Services & Chief Actuary		Jannsen	Bradley		2812510750				7134425105	bradley.jannsen@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	01/15/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	DIR Contact (Secondary)	Sr Director, Healthplan Services		Gandhi	Kirti		7134425519					kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rdFloor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Discount Program Payment Contact	VP, Managed Care Analytics		Dixon	Sarah		7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/06/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Emergency Part D Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Emergency Part D Contact (Secondary)	Sr Director, Healthplan Services	Ms.	Gandhi	Kirti		7134425519				7134425105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rdFloor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Employer Waiver Contact	Director of Account Strategy		Hueske	Kristen		7134429081					kristen.hueske@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	08/13/2020	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Encounter Data & Risk Adjustment Operations Contact	VP, Managed Care Analytics		Dixon	Sarah		7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/06/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Enrollment Contact	Director of Appeals & Grievances and Enrollment	Mr.	Thomas	Don	G	8182093846				7134425450	donald.thomas@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	02/20/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	EOB Transfer Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Financial Audit Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	shelly.garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Financial Reporting Contact	Manager, Finance - Medicare Advantage	Mrs.	Vincent	Haley	W	7134425639				7134420799	haley.vincent@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	07/15/2021	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Formulary Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Formulary Contact (Secondary)	Sr. Business Analyst		Janzen	Kyle		9522464020					kyle.janzen@optum.com	1600 McConnor Parkway		Schaumburg	IL	60143	01/03/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	General Contact	VP of Health Plan Services/COO		Jonathan	Denise		7134425592				7134425212	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Government Relations Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	HIPAA Privacy Officer	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	HIPAA Security Officer	Chief Technology Officer	Ms.	Littmann	Martin	H	7134429977					martin.littman@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	12/20/2019	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Hospice Contact	VP of Health Plan Services/COO		Jonathan	Denise		7134425592					Denise.Jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/28/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Interoperability Contact	VP of Health Plan Services/COO	Ms	Jonathan	Denise	M	7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	MA Appeals/Grievances Contact	Director of Appeals & Grievances and Enrollment	Mr.	Thomas	Don	G	8182093846				7134425450	donald.thomas@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	02/20/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	MA Claims Processing Contact for Public Website	Director, Delegation Services		Chavez	Nellie		7134425453				7134425101	Nellie.Chavez@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	01/02/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Marketing Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Medical Director	Medical Director	Dr.	O'Leary	Paul	A	7134422136				7134425212	paul.oleary@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	11/09/2020	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Medicare Compliance Officer	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Medicare Coordinator	VP of Health Plan Services/COO		Jonathan	Denise		7134425592				7134425212	Denise.Jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/28/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Medication Therapy Management Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	OffShore Subcontractor Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Online Enrollment Center Contact (Back-up)	Reconciliation Business Analyst		Triplett	Toni		7134425283				7124425450	Toni.Triplett@Kelsey-Seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	05/07/2019	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Online Enrollment Center Contact (Optional)	Manager of Appeals & Grievances and Enrollment	Mr.	Myers	Elisha		8182056217				7134425450	Eisha.Myers@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/20/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Online Enrollment Center Contact (Primary)	Director of Appeals & Grievances and Enrollment	Mr.	Thomas	Don	G	8182093846				7134425450	donald.thomas@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77587	02/20/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part C Application Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part C Reporting Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Appeals	Manager, Prior Auth/Appeals		Le	Christina						8772394565	christina.le@optum.com	PO Box 2975		Mission	KS	66201	01/28/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Boston
H0332	Part D Appeals Contact (Secondary)	Pharmacy Tech Lead		Jackson	Shannon						8772394565	shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	01/03/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Boston
H0332	Part D Application Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Benefits Contact	Sr Director, Healthplan Services		Gandhi	Kirti		7134425519				7134425105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Claims Submission Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Exceptions Contact	Manager, Prior Auth/Appeals		Le	Christina						8772394565	christina.le@optum.com	PO Box 2975		Mission	KS	66201	01/28/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Boston
H0332	Part D Exceptions Contact (Secondary)	Pharmacy Tech Lead		Jackson	Shannon						8772394565	shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	01/28/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Boston
H0332	Part D Price File Contact (Back-up)	Sr Director, Healthplan Services	Ms	Gandhi	Kirti		7134425519				7134425105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Price File Contact (Optional)	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Price File Contact (Primary)	Director, Retail Network Operations		Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/03/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Quality Assurance Contact	Sr Director, Healthplan Services		Gandhi	Kirti		7134425519				7134425105	kirti.gandhi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Part D Reporting Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Patient Safety Contact	VP of Health Plan Services/COO	Ms	Jonathan	Denise	M	7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Payment Contact	VP, Managed Care Analytics		Dixon	Sarah		7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/06/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Pharmacy Director	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Pharmacy Network Management Contact	Manager, Retail Network Operations		Perez	Felix		3053313044					felix.perez@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	01/03/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Ashby	Jo Lynn		4696470504					Jashby@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	01/03/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	02/03/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8007078194				HMO - Health Maintenance Organization		C	Boston
H0332	Plan Directory Contact for Public Website	Member Services Representative		Services	Member		8665358343					memberservices@kelseycareadvantage.com	11511 Shadow Creek Parkway		Pearland	TX	77584	10/26/2017	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Plan to Plan Reconciliation Contact	Director of Pharmacy, Health Plan Services		Asadi	Angelica		7134425617				7134425105	angelica.asadi@kelsey-seybold.com	11511 Shadow Creek Parkway	3rd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Processor Contact	VP of Health Plan Services/COO		Jonathan	Denise		7134425592				7134425105	Denise.Jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	10/31/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Quality Contact	VP of Health Plan Services/COO	Ms	Jonathan	Denise	M	7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Reconciliation Contact	VP, Managed Care Analytics		Dixon	Sarah		7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/06/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Reconciliation Contact (Secondary)	VP of Health Plan Services/COO	Ms.	Jonathan	Denise	M	7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Recovery Audit Contact	VP, Managed Care Analytics	Ms.	Dixon	Sarah		7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Surveillance Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	System Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Third Party Administrator (TPA) Liaison	VP, Managed Care Analytics	Ms	Dixon	Sarah	L	7134420069				7134425105	sarah.dixon@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	06/06/2022	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	User Access Contact	Director, Medicare Compliance	Mrs.	Garcia	Shelly	R	7134429502				7134425450	Shelly.Garcia@kelsey-seybold.com	11511 Shadow Creek Parkway		Pearland	TX	77584	02/21/2024	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Utilization Management Contact	VP of Health Plan Services/COO		Jonathan	Denise		7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0332	Utilization Review Contact	VP of Health Plan Services/COO		Jonathan	Denise		7134425592				7134425105	denise.jonathan@kelsey-seybold.com	11511 Shadow Creek Parkway	2nd Floor	Pearland	TX	77584	06/13/2025	2026	KS PLAN ADMINISTRATORS, LLC	Local CCP	KelseyCare Advantage	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0335	Automated TrOOP Balance Transfer Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Backup User Access Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Best Available Evidence Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Bid Primary Contact	Health Plan Specialist	Ms	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	CAP Report Contact for Public Website	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	CEO - CMS Administrator Contact	CEO and President	Mr.	Surowitz	Dale		8189422295				8187743020	dale.surowitz@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	CEO - Senior Official for Contracting	CEO and President	Mr.	Surowitz	Dale		8189422295				8187743020	dale.surowitz@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Chief Financial Officer	Chief Financial Officer	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Chief Operating Officer	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Chief Information Officer	Director of Information Services	Mr.	Lucich	Tony		8187743350				8187743389	tony.lucich@jha.org	7150 Tampa Ave.		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Chief Information Security Officer	DIrector of Information Services	Mr.	Lucich	Tony		8187743350				8187743389	tony.lucich@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	CMS Casework Communication Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Complaints Tracking Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Contact for Fraud Investigations	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Coordination of Benefits Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Corporate Mailing						8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Customer Service Operations Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	DIR Contact	Health Plan Specialist		Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	DIR Contact (Secondary)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Discount Program Payment Contact	Health Plan Specialist		Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Emergency Part D Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Emergency Part D Contact (Secondary)	COO		Stepanians	Larissa		8184300709					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Encounter Data & Risk Adjustment Operations Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Enrollment Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	EOB Transfer Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Financial Audit Contact	CFO	Mrs.	Ruditsky	Crystal		8187743336				8187745907	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Financial Reporting Contact	CFO	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Formulary Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Formulary Contact (Secondary)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	General Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Government Relations Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	HIPAA Privacy Officer	Chief Nursing & Compliance Officer	Mr.	Carlson	Timothy		8187743397				8187742424	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	HIPAA Security Officer	Director of Information Technology	Mr.	Lucich	Tony		8187743350				8187743020	tony.lucich@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Interoperability Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	MA Appeals/Grievances Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	MA Claims Processing Contact for Public Website	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Marketing Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Medical Director	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Medicare Compliance Officer	Compliance Officer	Mr.	Carlson	Timothy		8187743397				8187742424	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Medicare Coordinator	Health Plan Specialist	Ms	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Medicare Part D Opioid Overutilization Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/28/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Medication Therapy Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	OffShore Subcontractor Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Online Enrollment Center Contact (Optional)	COO	Ms.	Stepanians	Larissa		8184300709					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Online Enrollment Center Contact (Primary)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part C Application Contact			Fishenfeld	Susie		8187743274					susie.fishenfeld@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part D Appeals	Vice President	Mrs.	Stratman	Kim						8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending	8186548643				PACE - Nat		C	San Francisco
H0335	Part D Appeals Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie						8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending	8187574458				PACE - Nat		C	San Francisco
H0335	Part D Application Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part D Benefits Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574588				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part D Claims Submission Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part D Exceptions Contact	Health Plan Specialist	Ms.	Ilcken	Leslie						8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending	8187574458				PACE - Nat		C	San Francisco
H0335	Part D Exceptions Contact (Secondary)	Vice President	Mrs.	Stratman	Kim							kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending	8186548643				PACE - Nat		C	San Francisco
H0335	Part D Price File Contact (Back-up)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part D Price File Contact (Primary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part D Quality Assurance Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187748444				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Part D Reporting Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Patient Safety Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Payment Contact	CFO	Mrs.	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Personal Health Record Contact	Director of Operations	Ms.	Graham	Amy		8187743328				8187745900	amy.graham@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Pharmacy Director	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Pharmacy Network Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Pharmacy Network Management Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Pharmacy Technical Help Desk Contact	Pharmacist	Ms.	Aramyan	Ani						8187745900	ani.aramyan@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending	8556543023				PACE - Nat		C	San Francisco
H0335	PHR Beneficiary Contact																	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE	Los Angeles Jewish Health	Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending	8187743274				PACE - Nat		C	San Francisco
H0335	Plan Directory Contact for Public Website	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Plan to Plan Reconciliation Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Processor Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Quality Contact	Chief Nursing & Compliance	Ms.	Carlson	Timothy		8187743397				8187745907	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Reconciliation Contact	CFO	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Reconciliation Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Recovery Audit Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Surveillance Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	System Contact	Director of Information Technology	Mr.	Lucich	Tony		8187743350				8187743020	tony.lucich@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Third Party Administrator (TPA) Liaison	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	User Access Contact	Vice President	Mrs.	Stratman	Kim		8186548643					kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Utilization Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0335	Utilization Review Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - SOUTH BAY, LP	National PACE	Brandman Centers for Senior Care - South Bay	National PACE		Brandman Centers for Senior Care   South Bay, LP	880	Yes	Pending					PACE - Nat		C	San Francisco
H0339	Automated TrOOP Balance Transfer Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Backup User Access Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Best Available Evidence Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Bid Primary Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	CAP Report Contact for Public Website	CEO	Mr	Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending	8145356000				PACE - Nat		C	Philadelphia
H0339	CEO - CMS Administrator Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	CEO - Senior Official for Contracting	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Chief Financial Officer	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Chief Operating Officer	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Chief Information Officer	IT Director	Mr	Keck	Cliff		4129630700					Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Chief Information Security Officer	IT Director	Mr	Keck	Cliff		4129630700					Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	CMS Casework Communication Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Complaints Tracking Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Contact for Fraud Investigations	Executive Director	Mr	Voeghtly	Robert		8145356000					Rvoeghtly@seniorlifejohnstown.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Coordination of Benefits Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Corporate Mailing						8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Customer Service Operations Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	DIR Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Discount Program Payment Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Emergency Part D Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Encounter Data & Risk Adjustment Operations Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Enrollment Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	EOB Transfer Contact	CFO	Mr	Dodson	David		8145356000				8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Financial Reporting Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Formulary Contact		Mr	Rowland	Bob		7242751203					Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	General Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Government Relations Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	HIPAA Privacy Officer	IT Director	Mr	Keck	Cliff		4129630700					Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	HIPAA Security Officer	IT Director	Mr	Keck	Cliff		4129630700	144				Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Interoperability Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	MA Appeals/Grievances Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	MA Claims Processing Contact for Public Website	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Marketing Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Medical Director	Medical Director	Mr	Ratchford	Donald		8145356000					DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Medicare Compliance Officer	Executive Director	Mr	Voeghtly	Robert		8145356000					Rvoeghtly@seniorlifejohnstown.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Medicare Coordinator	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Medicare Part D Opioid Overutilization Contact	Medical Director	Mr	Ratchford	Donald		8145356000					DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Medication Therapy Management Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Boulevard, Suite 140		Columbia	SC	29209	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part D Appeals	CFO	Mr	Dodson	David							ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending	8145356000				PACE - Nat		C	Philadelphia
H0339	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Boulevard, Suite 140		Columbia	SC	29209	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part D Benefits Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part D Claims Submission Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part D Exceptions Contact	CFO	Mr	Dodson	David							ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending	8145356000				PACE - Nat		C	Philadelphia
H0339	Part D Price File Contact (Back-up)	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part D Price File Contact (Primary)	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part D Quality Assurance Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Part D Reporting Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Patient Safety Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Payment Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Pharmacy Director		Mr	Rowland	Bob		7242751203					Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Pharmacy Network Management Contact		Mr	Rowland	Bob		7242751203					Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Pharmacy Technical Help Desk Contact		Mr	Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending	7242751203				PACE - Nat		C	Philadelphia
H0339	Plan Directory Contact for Public Website	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Plan to Plan Reconciliation Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Processor Contact	Claims Manager	Mrs	Best	Karen		8145356000					KBest@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Quality Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Reconciliation Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Recovery Audit Contact	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Surveillance Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	System Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Third Party Administrator (TPA) Liaison	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	User Access Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Utilization Management Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0339	Utilization Review Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	06/19/2024	2026	SENIOR LIFE BERGEN, INC.	National PACE	Senior LIFE Passaic	National PACE				Yes	Pending					PACE - Nat		C	Philadelphia
H0342	Agent/Broker Compensation Data Contact	Manager, Sales Operations		Chowdhury	Nahar		6179729400	60926				Nahar.Chowdury@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Automated TrOOP Balance Transfer Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Backup User Access Contact	Lead Govt Prgms Compliance Manager		Foster	Amber		7816128333					Amber.Foster@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	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	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	3152780				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Bid Audit Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Bid Audit Site Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Bid Primary Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	CAP Report Contact for Public Website	Director, Government Programs Compliance Officer		Geroski	Tami		7816121000	86892				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Chief Financial Officer	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Chief Operating Officer	Chief Operating Officer	Ms.	Catlender	Kathryn		7816126840	84588				Katie.Catlender@point32health.org	1 Wellness Way		Canton	MA	02021	07/14/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Chief Information Officer	SVP and Chief Information Officer	Ms.	Ferhatbegovic	Selma		7816121000	84633				Selma.Ferhatbegovic@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	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	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Complaints Tracking Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				Sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Contact for Fraud Investigations	VP,  Privacy, Fraud Prevention & Recovery		Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	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			COB Inquiries	Medicare		7816121000					Medicare_COB_Inquiries@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Corporate Mailing						7816121000					R.Scott.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	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		Villatoro	Yesly		7816121000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	DIR Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	DIR Contact (Secondary)	Pharmacy Analyst Senior		Santino	Cristina		7816121000	82560				cristina.santino@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Discount Program Payment Contact	Sr. Manager, Accounting		Parikh	Roshni		7816121000	84512				roshni.parikh@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Electronic Health Record Contact	Director, Core Administration System Application		Pavao	Joseph		7816121000	83289				Joseph.Pavao@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Emergency Part D Contact	Director, Pharmacy Operations		Bonica	Joseph		7816123342					joseph.bonica@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Emergency Part D Contact (Secondary)	Senior Manager, Pharmacy Operations		MacAuley	Jacqueline		6176123059					jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/04/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Employer Waiver Contact	Manager, Client Services		Bartkiewicz	Mary		7816121000	83937				Mary.Bartkiewicz@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment Data & Reporting		Quinlan	Judith		7816121000	83377				judith.quinlan@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Enrollment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	EOB Transfer Contact	Manager, Business Implementation		Nesmith	Tanisha		7816124861				6176730286	tanisha.nesmith@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Financial Audit Contact	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Financial Reporting Contact	Assistant Corporate Controller		Jaiswal	Ruchi		6179729400	84518				Ruchi.Jaiswal@point32health.org	1 Wellness Way		Canton	MA	02021	08/01/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Formulary Contact	Clinical Pharmacist Senior		Kowalski	Alec		7816121000	82045				alec.kowalski@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	General Contact	Medicare Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	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		Lewis	Kristin		7816121000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	HIPAA Privacy Officer	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	10/06/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	HIPAA Security Officer	VP Chief  Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	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		MacAuley	Jacqueline		7816121000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Interoperability Contact	VP, Information Security Officer		Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Gonzalez	Michelle		6179729400	83114				michelle.gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	MA Claims Processing Contact for Public Website	Director, Claims		Patel	Monal		7816121000	88187				Monal.Patel@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Marketing Contact	Director, Marketing		Walsh	Tim		7816121000	87541				Tim.Walsh@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Medical Director	Medical Director	Dr.	Courtemanche	Abbie		7816121000	67024				Abbie.Courtemanche@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	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	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Medicare Coordinator	Vice President, Medicare		Walker	Eddie		7816121000	84471				Edward.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Dohan	David		7816121000	82615				David.Dohan@point32health.org	1 Wellness Way		Canton	MA	02021	10/28/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Medication Therapy Management Contact	Sr Pharmacy Program Manager		Burns	Ashlyn		7816122239					ashlyn.burns@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Ben-Ezra	Daniel		7816121000	54054				Daniel.Ben-Ezra@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Online Enrollment Center Contact (Optional)	Supervisor, Enrollment		Maloney	Kimberly		7816121000	83576				Kimberly.Maloney@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Online Enrollment Center Contact (Primary)	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part C Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part C Reporting Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Appeals	Director, Appeals & Grievances		Gonzalez	Michelle							Michelle.Gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	83114			PPO - BBA		C	Boston
H0342	Part D Appeals Contact (Secondary)	Sr. Program Manager, Appeals & Grievances		Mello	Sheri							sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	84862			PPO - BBA		C	Boston
H0342	Part D Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Benefits Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Claims Submission Contact	Senior Manager, Pharmacy Operations		Alves	Heather		7816121000	82988				heather.alves@point32health.org	1 Wellness Way		Canton	MA	02021	10/09/2025	2026	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		Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	82370			PPO - BBA		C	Boston
H0342	Part D Exceptions Contact (Secondary)	Supervisor, Pharmacy Utilization Management		Bannan	Philip							Philip.Bannan@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	60178			PPO - BBA		C	Boston
H0342	Part D Price File Contact (Back-up)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					Tim.Sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Price File Contact (Optional)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					tim.sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	08/22/2023	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Price File Contact (Primary)	Sr Business Analyst		Moore-Elliott	Shalandria		7637974305					shalandria.moore-elliott@optum.com	1600 McConnor Pwy.		Schaumburg	IL	60173	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Quality Assurance Contact	Vice President, Pharmacy		Fenton	Karen		7186121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	01/06/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Part D Reporting Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Patient Safety Contact	Sr Pharmacy Implementation Specialist		von Fritzinger	Lisa		7816123778					lisa.vonfritzinger@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Payment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Pharmacy Director	Vice President, Pharmacy		Fenton	Karen		7816121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	01/06/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Pharmacy Network Management Contact	Manager, Retail Network Operations		Hagan	Kyle		3039895828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Ashby	JoLynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	10/07/2024	2026	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	Sr. Manager		Villaneuva	Juan							Juan.Villanueva@optum.com	3515 S Harbor Blvd.		Costa Mesa	CA	92626	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	8556792639				PPO - BBA		C	Boston
H0342	Pharmacy Technical Help Desk Contact (Secondary)	Associate Director, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active	8556792639				PPO - BBA		C	Boston
H0342	Plan Directory Contact for Public Website	Marketing Materials Production Manager		Kayser	Kenneth		7816121000	83518				kenneth.kayser@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Plan to Plan Reconciliation Contact	Manager, Finance Operations Compliance		Schumaker	Tyler		6179729400	87394				Tyler.Schumaker@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Processor Contact	Director, Claims		Patel	Monal		7816121000	88187				monal.patel@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Quality Contact	Director, HEDIS Quality Informatics		McCoy	Kelly		7816121000	83515				kelly.mccoy@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Reconciliation Contact	Senior Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Reconciliation Contact (Secondary)	Pharmacy Analyst Sr.		Santino	Cristina		7816121000	82560				Cristino.Santino@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Recovery Audit Contact	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Surveillance Contact	Director, Sales Operations		Tollefsen	John		7816122266					John.Tollefsen@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	System Contact	Senior Manager, Business Account Management		Allen	Jeffrey		7816121000	83167			6179729008	Jeffrey.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Third Party Administrator (TPA) Liaison	Manager, Accounting		Gatzen	Kelly	A	8609896689					kelly.gatzen@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	User Access Contact	Director Medicare Compliance Officer		Geroski	Tami	A	5708142999	0				Tami.Geroski@Point32health.org	1 Wellness Way		Canton	MA	02021	10/21/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Utilization Management Contact	Director, Utilization Management		Walker	Karen		7816121000					Karen.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0342	Utilization Review Contact	Lead Medical Director, Clinical Reviews	Dr.	Slota	Janet		6179729400	87527				Janet.Slota@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H0351	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Medical Director	Chief Medical Officer	Dr.	Chen	Alex		8186766564					alex.y.chen@healthnet.com	21281 Burbank Blvd		Woodland Hills	CA	91367	03/30/2021	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0351	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0351	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0351	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0351	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0351	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/02/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0351	PHR Beneficiary Contact																	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H0351	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0351	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	HEALTH NET OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0354	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/18/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Best Available Evidence Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/03/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/19/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/19/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/18/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	11/04/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	12/02/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/26/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	07/17/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Customer Service Operations Contact	Customer Service Director	Mr.	Soltis	Mike	F	6238063361					mike.soltis@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/03/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	11/04/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Discount Program Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/14/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	11/04/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/07/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/19/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Enrollment Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	EOB Transfer Contact	Program Management Senior Manager	Ms.	Bodyk	Sheila		5715396358				4802965600	sheila.bodyk@cignahealthcare.com	900 Cottage Grove Road		Bloomfield	CT	06002	11/04/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	11/04/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/26/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	11/07/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/19/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Hospice Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/26/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	07/17/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	11/22/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Online Enrollment Center Contact (Back-up)	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/03/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H0354	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	1601 Chestnut Street		Philadelphia	PA	19192	01/07/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H0354	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H0354	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	1601 Chestnut Street		Philadelphia	PA	19192	01/07/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H0354	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	11/08/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	02/17/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/03/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/14/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/02/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/03/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H0354	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H0354	Plan Directory Contact for Public Website	Customer Service Director	Mr.	Soltis	Mike	F	6238063361					mike.soltis@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	12/03/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/26/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/03/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/02/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Third Party Administrator (TPA) Liaison	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	01/14/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/02/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0354	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/02/2024	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0363	Agent/Broker Compensation Data Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	04/07/2025	2026	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	Seattle
H0363	Automated TrOOP Balance Transfer Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Backup User Access Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/13/2024	2026	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	Seattle
H0363	Best Available Evidence Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Bid Audit Contact			Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Bid Audit Site Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/14/2024	2026	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	Seattle
H0363	Bid Primary Contact		Mr.	Granow	Les		5614440709					Les.Granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	CAP Report Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	CEO - CMS Administrator Contact		Mr.	Lerer	Ben		5614440780					Ben.lerer@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H0363	CEO - Senior Official for Contracting		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/14/2024	2026	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	Seattle
H0363	Chief Financial Officer		Mr.	Granow	Les		5614440709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Chief Operating Officer		Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Chief Information Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Chief Information Security Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	CMS Casework Communication Contact			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Complaints Tracking Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Contact for Fraud Investigations			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Coordination of Benefits Contact		Ms.	Crowl	Lacey		7657921412					Lacey.crowl@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Corporate Mailing						5616901134					compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Customer Service Operations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	DIR Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	DIR Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Discount Program Payment Contact		Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	Longevity Health Plan	485 Madison Avenue Suite 202	New York	NY	10022	03/11/2021	2026	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	Seattle
H0363	Electronic Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Emergency Part D Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Emergency Part D Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Encounter Data & Risk Adjustment Operations Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Enrollment Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	EOB Transfer Contact		Ms.	Socoski	Beth		5616901134				5616901134	Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Financial Audit Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Financial Reporting Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Formulary Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Formulary Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	General Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Government Relations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	HIPAA Privacy Officer	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	HIPAA Security Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/13/2024	2026	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	Seattle
H0363	Hospice Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Interoperability Contact	CIO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	MA Appeals/Grievances Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	MA Claims Processing Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Marketing Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Medical Director		Mr.	Orgain	Javette		3127206656					javette.orgain@longevityhealthplan.com	Longevity Health Plan	1611 Church Street	Evanston	IL	60201	02/15/2021	2026	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	Seattle
H0363	Medicare Compliance Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/10/2024	2026	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	Seattle
H0363	Medicare Coordinator	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Medicare Part D Opioid Overutilization Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Medication Therapy Management Contact		Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	OffShore Subcontractor Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Part C Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/14/2024	2026	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	Seattle
H0363	Part C Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H0363	Part D Appeals Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H0363	Part D Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/14/2024	2026	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	Seattle
H0363	Part D Benefits Contact		Mr.	Latko	Jeff		6363352997					JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H0363	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		8002040016					Rosario_dovico@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H0363	Part D Exceptions Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H0363	Part D Price File Contact (Back-up)	Product Manager Advisor	Ms.	Williams	Stephanie		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	07/11/2022	2026	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	Seattle
H0363	Part D Price File Contact (Optional)	Medicare Compliance Director	Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Part D Price File Contact (Primary)	sr mgr, Government Programs		Dolfi	Amanda		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	07/11/2022	2026	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	Seattle
H0363	Part D Quality Assurance Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Part D Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Patient Safety Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Payment Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Personal Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Pharmacy Director	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		8002040016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Pharmacy Network Management Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						8882358551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H0363	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Account Manager	Mr.	Latko	Jeff							JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	LONGEVITY HEALTH PLAN OF COLORADO, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	6363352997				HMO - Health Maintenance Organization		C	Seattle
H0363	Physician Incentive Contact		Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Plan Directory Contact for Public Website	Medicare Compliance Director	Ms.	Socoski	Beth		8883133609					Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Plan to Plan Reconciliation Contact		Ms.	Ajayi	Bisi		5616328915					bisi.ajayi@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	02/02/2024	2026	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	Seattle
H0363	Processor Contact		Mr.	Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Quality Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Reconciliation Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	Reconciliation Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Recovery Audit Contact	VP Compliance	Ms.	Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	SNP Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/14/2024	2026	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	Seattle
H0363	SNP State Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	03/13/2024	2026	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	Seattle
H0363	Surveillance Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	System Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Third Party Administrator (TPA) Liaison	COO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/03/2022	2026	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	Seattle
H0363	User Access Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H0363	Utilization Management Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0363	Utilization Review Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	10/30/2023	2026	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	Seattle
H0390	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084378					chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Backup User Access Contact	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Best Available Evidence Contact	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Bid Primary Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360					chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	10/30/2023	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	CAP Report Contact for Public Website	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	CEO - CMS Administrator Contact	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	CEO - Senior Official for Contracting	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Chief Financial Officer	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	10/30/2023	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Chief Operating Officer	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Chief Information Officer	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Chief Information Security Officer	CEO	Mr.	Zdrodowski	Mike		2694084375	4330			2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	CMS Casework Communication Contact	CEO	Mr.	Zdrodowski	Mike		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Complaints Tracking Contact	Director of Program Integrity	Mrs	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Contact for Fraud Investigations	CEO	Mr.	Zdrodowski	Mike		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Coordination of Benefits Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Corporate Mailing						2694084375					mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Customer Service Operations Contact	CEO		Zdrodowski	Mike		2694084375					sandilewis@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	DIR Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	10/30/2023	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	DIR Contact (Secondary)	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Discount Program Payment Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	10/30/2023	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Emergency Part D Contact	CEO	Mr.	Zdrodowski	Mike		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Emergency Part D Contact (Secondary)	Medical Director	Ms.	White	Jennifer		2694084322				2694084340	jenniferwhite@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	01/07/2022	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Enrollment Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	EOB Transfer Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Financial Audit Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	10/30/2023	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Financial Reporting Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Formulary Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084330				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Formulary Contact (Secondary)	CEO		Zdrodowski	Mike		2694084375					mikezdrodowski@paceswmi.org	2920 Lakeview Ave		St. Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	General Contact	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Government Relations Contact	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	HIPAA Privacy Officer	Director of Program Integrity		Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	HIPAA Security Officer	Director of Program Integrity	Mrs	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Interoperability Contact	Chief Financial Officer		Rendell	Chris		2694084360					chrisrendell@paceswmi.org	2920 LAKEVIEW AVE		ST JOSEPH	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	MA Appeals/Grievances Contact	Director of Program Integrity	Ms.	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	MA Claims Processing Contact for Public Website	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Marketing Contact	Marketing and Enrollment Manager	Ms.	Amicarelli	Natalie		2694084319	4302			2694084340	natalieamicarelli@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Medical Director	Medical Director	Ms.	White	Jennifer		2694084322				2694084340	jenniferwhite@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	09/02/2021	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Medicare Compliance Officer	Director of Program Integrity	Mrs	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Medicare Coordinator	Chief Financial Officer	Ms.	Rendell	Chris		2694084378					chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Medicare Part D Opioid Overutilization Contact	Medical Director	Ms.	White	Jennifer		2694084322				2694084340	jenniferwhite@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	08/11/2022	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Medication Therapy Management Contact	CEO		Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	OffShore Subcontractor Contact			N/A	N/A		0000000000					N/A@na.org	N/A		N/A	MI	49085	04/09/2013	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Online Enrollment Center Contact (Back-up)			N/A	N/A		0000000000					N/A@na.org	N/A		N/A	MI	49085	01/29/2018	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Online Enrollment Center Contact (Optional)			N/A	N/A		0000000000					N/A@na.org	N/A		N/A	MI	49085	01/29/2018	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Online Enrollment Center Contact (Primary)	Chief Financial Officer		Rendell	Chris		2694084360					chrisrendell@paceswmi.org	2900 Lakeview		Saint Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part C Application Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Appeals	Director of Program Integrity	Ms.	Lewis	Sandi						2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	2694084370				PACE - Nat		C	Atlanta
H0390	Part D Appeals Contact (Secondary)	CEO	Mr.	Zdrodowski	Mike						2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	2694084375				PACE - Nat		C	Atlanta
H0390	Part D Application Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Benefits Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Claims Submission Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Exceptions Contact	CEO	Mr.	Zdrodowski	Mike						2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	2694084375				PACE - Nat		C	Atlanta
H0390	Part D Exceptions Contact (Secondary)	Chief Financial Officer	Ms.	Rendell	Chris						2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	2694084360				PACE - Nat		C	Atlanta
H0390	Part D Price File Contact (Back-up)	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Price File Contact (Optional)	CEO		Zdrodowski	Mike		2694084375					mikezdrodowski@paceswmi.org	2900 lakeview Ave		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Price File Contact (Primary)	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Quality Assurance Contact	Director of Program Integrity	Ms.	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Part D Reporting Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Patient Safety Contact	Director of Program Integrity	Ms.	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Payment Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Personal Health Record Contact	Director of Program Integrity	Ms.	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Pharmacy Director	Medical Director	Ms.	White	Jennifer		2694084322				2694084340	jenniferwhite@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	01/07/2022	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Pharmacy Network Management Contact	CEO	Mr.	Zdrodowski	Mike		2694084370				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Pharmacy Network Management Contact (Secondary)	Medical Director		White	Jennifer		2694084322					jenniferwhite@paceswmi.org	2900 lakeview Ave		Saint Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Pharmacy Technical Help Desk Contact	CEO	Mr.	Zdrodowski	Mike						2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	2694084375				PACE - Nat		C	Atlanta
H0390	Pharmacy Technical Help Desk Contact (Secondary)	Medical Director	Ms.	White	Jennifer						2694084340	jenniferwhite@paceswmi.org	2900 Lakeview Ave.		St. Joseph	MI	49085	03/16/2022	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active	2694084353				PACE - Nat		C	Atlanta
H0390	Plan Directory Contact for Public Website	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview		Saint Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Processor Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview		Saint Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Quality Contact	Director of Program Integrity	Ms.	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Reconciliation Contact	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview		Saint Joseph	MI	49085	03/04/2024	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Reconciliation Contact (Secondary)			Zdrodowski	Mike		2694084375					mikezdrodowski@paceswmi.org	2900 lakeview Ave		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Recovery Audit Contact	Director of Program Integrity	Mrs	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Surveillance Contact	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	System Contact	CEO	Mr.	Zdrodowski	Mike		2694084375				2694084340	mikezdrodowski@paceswmi.org	2900 Lakeview Avenue		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Ms.	Rendell	Chris		2694084360				2694084340	chrisrendell@paceswmi.org	2900 Lakeview		Saint Joseph	MI	49085	02/06/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	User Access Contact	Director of Program Integrity		Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Utilization Management Contact	Director of Program Integrity	Ms.	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0390	Utilization Review Contact	Director of Program Integrity	Ms.	Lewis	Sandi		2694084370				2694084340	sandilewis@paceswmi.org	2900 Lakeview Avenue		St Joseph	MI	49085	05/27/2025	2026	PACE OF SOUTHWEST MICHIGAN, INC.	National PACE	PACE of Southwest Michigan	National PACE		PACE of Southwest Michigan, Inc.	507	Yes	Active					PACE - Nat		C	Atlanta
H0413	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H0413	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Atlanta
H0413	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H0413	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H0413	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Atlanta
H0413	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H0413	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Atlanta
H0413	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0413	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H0421	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H0421	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0421	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0421	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H0421	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0421	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0423	Agent/Broker Compensation Data Contact	VP, Compliance	Ms.	Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	Automated TrOOP Balance Transfer Contact	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		2129083131				2129088603	ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Backup User Access Contact	Sr. Manager Medicare Regulatory Compliance	Ms.	Rasch	Jennifer		2129085221					Raschj@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Best Available Evidence Contact	Sr. Manager, Medicare Operations		Palmowski	Natalia		2129088534				2129088603	palmown@metroplus.org	50 Water Street	12th floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Bid Audit Contact	Chief Financial Officer	Ms.	Leverich	Lauren		2129088592				2129088520	LEVERL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Bid Audit Site Contact	Chief Financial Officer	Ms.	Leverich	Lauren		2129088592				2129088520	LEVERL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	08/13/2021	2026	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	Atlanta
H0423	Bid Primary Contact	Chief Financial Officer	Ms.	Leverich	Lauren		2129088592				2129088520	LEVERL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	CAP Report Contact for Public Website	VP, Compliance	Ms.	Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/15/2024	2026	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	2129083329				HMO - Health Maintenance Organization		C	Atlanta
H0423	CEO - CMS Administrator Contact	President & Chief Executive Officer	Dr.	Schwartz	Talya		2129088569				2129088667	schwata@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	CEO - Senior Official for Contracting	President & Chief Executive Officer	Dr.	Schwartz	Talya		2129088569				2129088667	schwata@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Chief Financial Officer	Chief Financial Officer	Ms.	Leverich	Lauren		2129088592					LEVERL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Chief Operating Officer	Chief Operating Officer	Ms.	Benayoun	Lila		2129088627				2129084402	BENAYL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	09/19/2022	2026	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	Atlanta
H0423	Chief Information Officer	Chief Information Officer	Mr.	Ramratan	Ganesh		2129088803					ramratg@metroplus.org	50 Water St	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Chief Information Security Officer	Chief Information Security Officer	Mr.	Micillo	Robert		2129088425					micillor@metroplus.org	50 Water St	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	CMS Casework Communication Contact	VP, Service Operations	Ms.	Bartley	Kenesha		2129083643				2129088701	bartleyk@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Complaints Tracking Contact	Senior Director of Customer Services	Ms.	Woodard	Terri		2129085212				2129088701	WOODATE@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/03/2025	2026	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	Atlanta
H0423	Contact for Fraud Investigations	Director of SIU	Mr.	Spaventa	Anthony		2129088682				2129084402	spavean@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Coordination of Benefits Contact	Sr. Manager Medicare Operations	Mrs.	Palmowski	Natalia		2129088534					palmown@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Corporate Mailing						2129088600				2129088667	schwata@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Customer Service Operations Contact	Senior Director of Customer Services	Ms.	Woodard	Terri		2129085212				2129088705	WOODATE@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/03/2025	2026	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	Atlanta
H0423	DIR Contact	Director of Value Based Payment & Quality Strategy	Mr.	Badillo	Frank		2129083715					badilf@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/15/2025	2026	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	Atlanta
H0423	DIR Contact (Secondary)	Chief Financial Officer	Ms.	Leverich	Lauren		2129088592	9088592			2129088520	LEVERL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Discount Program Payment Contact	Finance Analyst	Ms.	Goyal	Anandita		2129088807				2129088520	goyalan@metroplus.org	50 Water St	7th Floor	New York	NY	10004	08/31/2021	2026	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	Atlanta
H0423	Emergency Part D Contact	VP, Compliance	Ms.	Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	Emergency Part D Contact (Secondary)	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati		2129083765					suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	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	Atlanta
H0423	Encounter Data & Risk Adjustment Operations Contact	Director of Value-Based Payment & Quality Strategy	Mr.	Badillo	Frank		2129083715					badilf@metroplus.org	50 Water St	7th Floor	New York	NY	10004	12/15/2025	2026	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	Atlanta
H0423	Enrollment Contact	Sr. Manager, Medicare Operations	Ms.	Palmowski	Natalia		2129088534				2129088603	palmown@metroplus.org	50 Water Street	12th floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	EOB Transfer Contact	Director of Claims		Hardy	Monique		2129088852				2129088666	hardymo@metroplus.org	50 Water Street	7th floor	New York	NY	10004	08/29/2022	2026	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	Atlanta
H0423	Financial Audit Contact	Chief Financial Officer	Ms.	Leverich	Lauren		2129088592					leverl@metroplus.org	50 Water Street	12th floor	New York	NY	10004	08/13/2021	2026	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	Atlanta
H0423	Financial Reporting Contact	Director of Value-Based Payment & Quality Strategy	Mr.	Badillo	Frank		2129083715					badilf@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/15/2025	2026	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	Atlanta
H0423	Formulary Contact	Clinical Advisor		Zoppa	Leonardo		9735343920					leonardo.zoppa@cvshealth.com	One CVS Drive		Woonsocket	RI	02895	08/06/2024	2026	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	Atlanta
H0423	Formulary Contact (Secondary)	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati		2129083765					suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	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	Atlanta
H0423	General Contact	Sr. Manager, Medicare Operations	Ms.	Palmowski	Natalia		2129088534				2129088603	palmown@metroplus.org	50 Water Street	12th floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Government Relations Contact	President & Chief Executive Officer	Dr.	Schwartz	Talya		2129088569				2129088667	schwata@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	HIPAA Privacy Officer	Chief Legal & Compliance Officer	Ms.	Solon	Raven	R	2129085205				2129088602	solonr@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	HIPAA Security Officer	Chief Information Security Officer	Mr.	Micillo	Robert		2129088425					micillor@metroplus.org	50 Water St	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Hospice Contact	Deputy Director Pharmacy Department		Suchdeve	Swati		2129083765					suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/17/2021	2026	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	Atlanta
H0423	Interoperability Contact	MIS Core Systems Analyst		Fox	Howard		2129088739					foxh@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	05/02/2022	2026	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	Atlanta
H0423	MA Appeals/Grievances Contact	VP, Compliance	Ms.	Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	MA Claims Processing Contact for Public Website			Services	Customer		8669860356				2129088620	pricek@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Marketing Contact	Federal and Integrated Products Material Reviewer		Ruiz	Beatriz		2129088741					RUIZBEA@metroplus.org	50 Water Street	12th floor	New York	NY	10004	12/03/2025	2026	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	Atlanta
H0423	Medical Director	Chief Medical Officer	Dr.	Shah	Sanjiv		2129083640					shahs@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Medicare Compliance Officer	VP, Compliance	Ms.	Binns	Pamela		2129085149				2129083013	binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	Medicare Coordinator	Sr. Manager, Medicare Operations	Ms.	Palmowski	Natalia		2129088534					palmown@metroplus.org	50 Water Street	12th floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Medicare Part D Opioid Overutilization Contact	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		2129083131					ohben@metroplus.org	50 Water Street	7th Floor	NY	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Medication Therapy Management Contact	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		2129083131					ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Online Enrollment Center Contact (Back-up)	DST Health Solutions	Ms.	Wimer	Lori		8164353266					lawimer@dsthealthsolutions.com	2400 Thea Dr		Harrisburg	PA	17110	02/08/2017	2026	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	Atlanta
H0423	Online Enrollment Center Contact (Primary)	Sr. Manager, Medicare Operations	Ms.	Palmowski	Natalia		2129088534				2129088603	palmown@metroplus.org	50 Water Street	12th floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Part C Application Contact	VP, Compliance	Ms.	Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	Part C Reporting Contact	Sr. Manager, Medicare Operations	Ms.	Natalia	Palmowski		2129088534				2129088603	palmown@metroplus.org	50 Water Street	12th floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Part D Appeals	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati							suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	2129083765				HMO - Health Maintenance Organization		C	Atlanta
H0423	Part D Appeals Contact (Secondary)	Medicare Part D Operations Manager	Mr.	Oh	Benjamin							ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	2129083131				HMO - Health Maintenance Organization		C	Atlanta
H0423	Part D Application Contact	VP, Compliance		Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	Part D Benefits Contact	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		2129083131				2129088603	ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	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	Atlanta
H0423	Part D Claims Submission Contact	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		2129083131				2129088603	ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
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	2026	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	2129083765				HMO - Health Maintenance Organization		C	Atlanta
H0423	Part D Exceptions Contact (Secondary)	Medicare Part D Operations Manager	Mr.	Oh	Benjamin						2129088603	ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	2129083131				HMO - Health Maintenance Organization		C	Atlanta
H0423	Part D Price File Contact (Back-up)	Manager		Okrie	Courtney		4803181864					courtney.okrie@cvshealth.com	9501 E Shea Blvd	MC121	Scottsdale	AZ	85260	07/14/2021	2026	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	Atlanta
H0423	Part D Price File Contact (Primary)	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		2129083131					ohben@metroplus.org	50 Water St	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Part D Quality Assurance Contact	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati		2129083765					suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	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	Atlanta
H0423	Part D Reporting Contact	Sr. Manager, Medicare Operations	Ms.	Palmowski	Natalia		2129088534				2129088603	palmown@metroplus.org	50 Water Street	12th floor	New York	NY	10004	01/22/2024	2026	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	Atlanta
H0423	Patient Safety Contact	Medicare Part D Operations Manager	Mr.	Oh	Benjamin		2129083131					ohben@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Payment Contact	VP, Finance Controls and Operations		Pham	Lilly		2129088795					phamli@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Personal Health Record Contact	VP, Compliance	Ms.	Binns	Pamela		2129085205				2129088602	binnspa@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Pharmacy Director	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati		2129083765					suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	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	Atlanta
H0423	Pharmacy Network Management Contact	Director of Pharmacy		Patel	Suzana		2129083014				2129083014	patelsu@metroplus.org	50 Water St	7th Floor	New York	NY	10004	07/12/2021	2026	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	Atlanta
H0423	Pharmacy Network Management Contact (Secondary)	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati		2129083765					suchds@metroplus.org	50 Water St	7th Floor	New York	NY	10004	07/12/2021	2026	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	Atlanta
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	2026	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H0423	Pharmacy Technical Help Desk Contact (Secondary)	Deputy Director of Pharmacy	Ms.	Suchdeve	Swati							suchds@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	07/12/2021	2026	METROPLUS HEALTH PLAN, INC.	Local CCP	MetroPlus Health Plan	HMO/HMOPOS		New York City Health and Hospitals Corporation	430	Yes	Active	2129083765				HMO - Health Maintenance Organization		C	Atlanta
H0423	Plan Directory Contact for Public Website	Director of Communications	Ms.	Soman	Kathryn		2129088588				2129088603	somank@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Plan to Plan Reconciliation Contact	Finance Analyst	Ms.	Goyal	Anandita		2129088807					goyalan@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	08/31/2021	2026	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	Atlanta
H0423	Processor Contact	Director of MIS Core Systems	Mr.	Baig	Aleem		2129088869				2129088655	baiga@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Quality Contact	Sr. Director, Quality Performance Improvement		McMaster	Keith		2129088613					mcmastek@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	03/11/2025	2026	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	Atlanta
H0423	Reconciliation Contact	Director of Value-Based Payment & Quality Strategy	Mr.	Badillo	Frank		2129083715					badilf@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/15/2025	2026	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	Atlanta
H0423	Reconciliation Contact (Secondary)	Chief Financial Officer	Ms.	Leverich	Lauren		2129088592					LEVERL@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Recovery Audit Contact	Director of Value-Based Payment & Quality Strategy	Mr.	Badillo	Frank		2129083715					badilf@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/15/2025	2026	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	Atlanta
H0423	SNP Application Contact	VP, Compliance		Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	SNP State Contact	VP, Compliance		Binns	Pamela		2129085149					binnspa@metroplus.org	50 Water Street	12th floor	New York	NY	10004	04/15/2024	2026	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	Atlanta
H0423	Surveillance Contact	Chief Compliance and Regulatory Officer	Ms.	Solon	Raven	R	2129085205				2129084402	solonr@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	System Contact	Director of MIS Core Systems	Mr.	Baig	Aleem		2129088600	8869			2129088655	baiga@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/28/2021	2026	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	Atlanta
H0423	Third Party Administrator (TPA) Liaison	Finance Analyst	Ms.	Goyal	Anandita		2129088807				2129088520	goyalan@metroplus.org	50 Water St	7th Floor	New York	NY	10004	08/31/2021	2026	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	Atlanta
H0423	User Access Contact	Chief Compliance and Regulatory Officer	Ms.	Solon	Raven	R	2129085205				2129085205	solonr@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	12/16/2024	2026	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	Atlanta
H0423	Utilization Management Contact	Sr.Director of Clinical Services	Ms.	St. Hilaire	Lynn		2129085296					sthilail@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/09/2025	2026	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	Atlanta
H0423	Utilization Review Contact	Sr.Director of Clinical Services	Ms.	St. Hilaire	Lynn		2129085296					sthilail@metroplus.org	50 Water Street	7th Floor	New York	NY	10004	04/09/2025	2026	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	Atlanta
H0424	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie		7203929719				3039961600	lteter@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Chief Operating Officer	Market President	Mr.	Jones	Steve		8049442904				3039961600	sjones2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Chief Information Security Officer	SVP of Information Technology	Mr.	Naus	Cole		7209210443				3039961600	MNaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	CMS Casework Communication Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Complaints Tracking Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Coordination of Benefits Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Corporate Mailing						3038694664				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Customer Service Operations Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	DIR Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Encounter Data & Risk Adjustment Operations Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E Lowry Blvd		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	General Contact	Director of Compliance		Licht	Hannah		7203844161					hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Government Relations Contact	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Interoperability Contact	SVP of Applications		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	MA Appeals/Grievances Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Appeals	Director of Compliance		Licht	Hannah						3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Atlanta
H0424	Part D Appeals Contact (Secondary)	Director of Compliance		Licht	Hannah						3039961600	hlicht@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Atlanta
H0424	Part D Application Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Atlanta
H0424	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Atlanta
H0424	Part D Price File Contact (Back-up)	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Quality Assurance Contact	SVP, Clinical Strategic Partnerships Clinical Oper		Cinque	Michael		7207444048				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Part D Reporting Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Atlanta
H0424	PHR Beneficiary Contact																	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE	Total Longterm Care Inc	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Atlanta
H0424	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Plan to Plan Reconciliation Contact	Finance and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	akizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Reconciliation Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	System Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	User Access Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0424	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE FLORIDA PACE II, LLC	National PACE	InnovAge Florida PACE - Orlando	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H0432	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0432	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0432	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0432	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0432	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0432	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0439	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	11/21/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/19/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/19/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/26/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/26/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/03/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Enrollment Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/26/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/26/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/19/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	11/21/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/19/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/26/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	02/11/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	11/06/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H0439	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H0439	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H0439	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H0439	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	02/17/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H0439	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H0439	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/26/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	SNP State Contact	Mgr Medicare Duals Product		Valdez	Tamara		7736125588				0000000000	tamara_valdez@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	09/26/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0439	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/19/2024	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0440	Automated TrOOP Balance Transfer Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Backup User Access Contact	VP of IT	Mr	Clark	Arthur		7275234050				7275234006	arthurclark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Best Available Evidence Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Bid Primary Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	CAP Report Contact for Public Website	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	CEO - CMS Administrator Contact	CEO	Mr	Fleece	Jonathan		9415527525					JFleece@EmpathHealth.org	5955 Rand Blvd		Sarasota	FL	34238	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	CEO - Senior Official for Contracting	CEO	Mr	Fleece	Jonathan		9415527525					JFleece@EmpathHealth.org	5955 Rand Blvd		Sarasota	FL	34238	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Chief Financial Officer	Chief Financial Officer	Ms.	Bouhamid	Saida		7275233339				7275232122	sbouhamid@tidewell.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Chief Operating Officer	COO	Ms	Lowry	Tarrah		5612275277					tlowry@trustbridge.com	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Chief Information Officer	VP IT	Mr.	Clark	Arthur		9413743213					ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Chief Information Security Officer	VP IT	Mr.	Clark	Arthur		9413743213					ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	CMS Casework Communication Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Complaints Tracking Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Contact for Fraud Investigations	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Coordination of Benefits Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Corporate Mailing						8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd.	Suite 625	Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Customer Service Operations Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	DIR Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	DIR Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Discount Program Payment Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Emergency Part D Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Emergency Part D Contact (Secondary)	Health Plan Medicare Specialist		Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Encounter Data & Risk Adjustment Operations Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Enrollment Contact	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	EOB Transfer Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716				7272458892	jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Financial Audit Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Financial Reporting Contact	CFO	Ms	Bouhamid	Saida		7275233339					SaidaBouhamid@EmpathHealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Formulary Contact	Interim Program Director	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Formulary Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	General Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Government Relations Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	HIPAA Privacy Officer	Vice Presidnet, Compliance	Mrs	Mosby	Laura		7275232106					LauraMosby@EmpathHealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	HIPAA Security Officer	Director of Organizational Integrity	Ms	Mosby	Laura		7275232106					lauramosby@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Interoperability Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	MA Appeals/Grievances Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	MA Claims Processing Contact for Public Website	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Marketing Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Medical Director	Medical Director	Mr	Alokeh	Wael		7272890062					waelalokeh@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Medicare Compliance Officer	Director of Organizational Integrity	Ms	Mosby	Laura		7275232106				7275232122	lauramosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Medicare Coordinator	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Medicare Part D Opioid Overutilization Contact	Director of Health Plan Operations		Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Medication Therapy Management Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Online Enrollment Center Contact (Back-up)	Interim Program Director	Ms.	Schulte	Komal		7272890062					komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Online Enrollment Center Contact (Primary)	Director of Health Plan Operatons	Ms.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part C Application Contact	Director of Health Plan Operations	Mr//	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part D Appeals	Director of Health Plan Operations	Mr.	Pettry	Jason							jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7277355716				PACE - Nat		C	Atlanta
H0440	Part D Appeals Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H0440	Part D Application Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part D Benefits Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part D Claims Submission Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part D Exceptions Contact	Director of Health Plan Operations	Mr.	Pettry	Jason							jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7277355716				PACE - Nat		C	Atlanta
H0440	Part D Exceptions Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H0440	Part D Price File Contact (Back-up)	Director of Health Plan Operations		Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part D Price File Contact (Primary)	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part D Quality Assurance Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Part D Reporting Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Patient Safety Contact	Director of Heath Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Payment Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Personal Health Record Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Pharmacy Director	Director of Pharmacy	Ms	Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Pharmacy Network Management Contact	Pharmacy Director		Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33765	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Pharmacy Network Management Contact (Secondary)	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Pharmacy Technical Help Desk Contact	Pharmacy Director		Harvey	Tracey							tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33765	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7275232530				PACE - Nat		C	Atlanta
H0440	Pharmacy Technical Help Desk Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H0440	PHR Beneficiary Contact																	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE	Empath Health	Empath Health, Inc.	635	Yes	Active	8136512851				PACE - Nat		C	Atlanta
H0440	Plan Directory Contact for Public Website	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Plan to Plan Reconciliation Contact	Director of Health Plan Operations	Ms.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Processor Contact	Pharmacy Director		Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Quality Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Reconciliation Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Reconciliation Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Recovery Audit Contact	Director of Organizational Integrity	Ms	Mosby	Laura		7275232106					lauramosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Surveillance Contact	Director of Organizational Integrity	Ms	Mosby	Laura		7275232106					lauramosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	System Contact	VP of IT	Mr	Clark	Arthur		7275234050				7275234006	ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Third Party Administrator (TPA) Liaison	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	User Access Contact	VP of IT	Mr	Clark	Arthur		7275234050				7275234006	arthurclark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Utilization Management Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0440	Utilization Review Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	EMPATH LIFE, INC.	National PACE	Empath LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H0473	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H0473	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024989871				PPO - BBA		C	Kansas City
H0473	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H0473	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024682494				PPO - BBA		C	Kansas City
H0473	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8008658715				PPO - BBA		C	Kansas City
H0473	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5025800475				PPO - BBA		C	Kansas City
H0473	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF KENTUCKY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H0473	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	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			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/28/2025	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Backup User Access Contact			Norton Moroz	Margarita	N	4136279772					rita.norton@ihserv.org	P.O.Box 2006		Andover,	MA	01810	06/10/2025	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Best Available Evidence Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Bid Primary Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	CAP Report Contact for Public Website			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	CEO - CMS Administrator Contact		Mrs.	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	CEO - Senior Official for Contracting	Administrator	Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Chief Financial Officer	Administrator	Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Chief Operating Officer		Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	604 Cottage st		Springfield	MA	01104	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Chief Information Officer		Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	604 Cottage st		Springfield	MA	01104	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Chief Information Security Officer		Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	604 Cottage st		Springfield	MA	01104	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	CMS Casework Communication Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Complaints Tracking Contact		Ms	Bessarabova	Daniella		4133742416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Contact for Fraud Investigations		Ms	Bassarabova	Daniella		4133742416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Coordination of Benefits Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Corporate Mailing						6176050727					rita.blanter@ihserv.org	P.O.Box2006		Andover	MA	01810	04/23/2013	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Customer Service Operations Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	DIR Contact			Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	04/23/2013	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Discount Program Payment Contact	Administrator	Mrs	Frost	Susan	N	6178167558					sfrost@ihserv.org	P.O.Box 2006		Andover,	MA	01810	10/02/2025	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Emergency Part D Contact		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Encounter Data & Risk Adjustment Operations Contact			Blanter	Margarita		4132416231					rita.blanter@ihserv.org	604 Cottage Street		Springfield	MA	01104	05/28/2020	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Enrollment Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	EOB Transfer Contact		Mrs.	Blanter	Margarita		6176050727				6174875261	rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Financial Audit Contact	Administrator	Mrs.	Blanter	Margarita		6176050727				6174875261	rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Financial Reporting Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Formulary Contact		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	General Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Government Relations Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	HIPAA Privacy Officer		Ms	Bessarabova	Daniella		4133742416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	HIPAA Security Officer		Mrs	Bessarabova	Daniella		4133742416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	04/24/2021	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Interoperability Contact			Norton Moroz	Margarita		4136279772					rita.norton@ihserv.org	17 Wyncrest Circle		Andover	MA	01810	06/10/2025	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	MA Appeals/Grievances Contact		Ms	Bessarabova	Daniella		4133742416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	MA Claims Processing Contact for Public Website			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Marketing Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Medical Director		Dr.	Alexeyenko	Alexandre		6176050727					rita.blanter@ihserv.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Medicare Compliance Officer		Ms	Bessarabova	Daniella		4133742416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	04/24/2021	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Medicare Coordinator			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Medicare Part D Opioid Overutilization Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Medication Therapy Management Contact		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part C Application Contact	Executive Director	Mrs	Blanter	Margarita		6176050727				9788870032	rita.blanter@ihserv.org	P.O. Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part D Appeals		Ms	Bessarabova	Daniella							daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active	4137342416				PACE - Nat		C	New York
H0477	Part D Appeals Contact (Secondary)	Part D Compliance Officer	Ms	Bessarabova	Daniella						4138316639	daniella.bessarabova@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active	6176050727				PACE - Nat		C	New York
H0477	Part D Application Contact	Executive Director	Mrs	Blanter	Margarita		6176050727				9788870032	rita.blanter@ihserv.org	P.O. Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part D Benefits Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part D Claims Submission Contact		Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part D Exceptions Contact		Mr	Tannery	Bob							sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active	8882787770				PACE - Nat		C	New York
H0477	Part D Price File Contact (Back-up)			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part D Price File Contact (Primary)			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part D Quality Assurance Contact		Ms	Bessarabova	Daniella		4137342416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Part D Reporting Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Patient Safety Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Payment Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Pharmacy Director		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Pharmacy Network Management Contact		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Pharmacy Technical Help Desk Contact		Mr	Tannery	Bob							sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active	8882787770				PACE - Nat		C	New York
H0477	Plan Directory Contact for Public Website		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Plan to Plan Reconciliation Contact		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Processor Contact		Mr	Tannery	Bob		8882787000					sales@pharmastarpbm.com	P.O.Box		Eau Claire	WI	54702	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Quality Contact		Ms	Bessarabova	Daniella		4137342416					daniella.bessarabova@serenitypace.org	P.O.Box2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Reconciliation Contact			Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Recovery Audit Contact	Administrator	Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Surveillance Contact	Administrator	Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	System Contact	Administrator	Mrs	Frost	Susan	N	6178167558					sfrost@ihserv.org	P.O.Box 2006		Andover,	MA	01810	06/16/2025	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Third Party Administrator (TPA) Liaison		Mrs	Frost	Susan	N	6178167558					sfrost@ihserv.org	P.O.Box 2006		Andover,	MA	01810	06/16/2025	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	User Access Contact	Administrator	Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Utilization Management Contact	Administrator	Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0477	Utilization Review Contact	Administrator	Mrs	Blanter	Margarita		6176050727					rita.blanter@ihserv.org	P.O.Box 2006		Andover	MA	01810	05/24/2022	2026	SERENITY CARE, INC.	National PACE	Serenity Care PACE	National PACE		Serenity Care, Inc.	561	Yes	Active					PACE - Nat		C	New York
H0504	Agent/Broker Compensation Data Contact	Director, Medicare Compliance		Mata	Marcos		5626135249					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Automated TrOOP Balance Transfer Contact	Business Analyst, Consultant		Escobedo	Karina		5626135532					karina.escobedo@blueshieldca.com	3021 Reynolds Ranch Pkwy		Lodi	CA	94607	12/17/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Backup User Access Contact	Director, Medicare Compliance		Mata	Marcos	R	5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Best Available Evidence Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Bid Audit Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Bid Audit Site Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Bid Primary Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	CAP Report Contact for Public Website	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	CEO - CMS Administrator Contact	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	CEO - Senior Official for Contracting	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Chief Financial Officer	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Chief Operating Officer	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Chief Information Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/30/2020	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Chief Information Security Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/30/2020	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Complaints Tracking Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Contact for Fraud Investigations	Director, Medicare Compliance		Mata	Marcos		5626135249					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Coordination of Benefits Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Corporate Mailing						5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Customer Service Operations Contact	Manager- Program and Project Management		Zuelke	Erica		5626135004					erica.zuehlke@blueshieldca.com	3021 Reynolds Ranch Pkwy		Lodi	CA	95240	11/14/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	DIR Contact	Senior Director, Phamacy Markets		Yang	Winnie		8054058599					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	DIR Contact (Secondary)	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Discount Program Payment Contact	Director, Actuary		Shah	Dimple		5106072597					dimple.shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/17/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Emergency Part D Contact	Senior Director, Phamacy Markets		Yang	Winnie		8054058599					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Emergency Part D Contact (Secondary)	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Employer Waiver Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland HIlls	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Actuary		Rodgers	John		3107442643					John.Rodgers@blueshieldca.com	100 N. Sepulveda Boulevard		El Segundo	CA	90245	12/30/2020	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Enrollment Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	EOB Transfer Contact	Business Analyst, Consultant		Escobedo	Karina		5626135532				8558953519	karina.escobedo@blueshieldca.com	3021 Reynolds Ranch Pkwy		Lodi	CA	95240	12/16/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Financial Audit Contact	Director, Medicare Compliance	Mr.	Mata	Marcos		5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Financial Reporting Contact	Director, Actuary		Shah	Dimple		5106072597					dimple.shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/17/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Formulary Contact	Director, Formulary Strategy and P&T		Nguyen	Nhi		9168410342					Nhi.Nguyen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/30/2020	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Formulary Contact (Secondary)	Senior Manager, Formulary Management		Trinh	Andy		5625806080					andy.trinh@blueshieldca.com	3840 Kilroy Airport Way		Long Beach	CA	90806	11/14/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	General Contact	Director, Medicare Compliance		Mata	Marcos	R	5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Government Relations Contact	Director, Medicare Compliance		Mata	Marcos	R	5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	HIPAA Privacy Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	HIPAA Security Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Hospice Contact	Senior Program Manager		Fields	Torrie		4152295839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	02/02/2018	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Interoperability Contact	VP, Customer Experience and Digital Transformation		McKinney	Christine		5109521278					christine.mckinney@blueshieldca.com	601 12th Street		Oakland	CA	94607	11/24/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	MA Appeals/Grievances Contact	Supervisor, Medicare Appeals and Grievances		Lopez	Celina		8182286183				9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/02/2015	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	MA Claims Processing Contact for Public Website	Business Analyst, Consultant		Escobedo	Karina		5626135532					karina.escobedo@blueshieldca.com	3021 Reynolds Ranch Pkwy		Lodi	CA	94607	12/17/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Marketing Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Medical Director	VP,  Medicare Chief Medical Officer- QI	Dr.	Judge	Kay		9166591737					kay.judge@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Medicare Coordinator	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Medicare Part D Opioid Overutilization Contact	Pharmacist, Principal, Pharmacy Services		Becker-Ellison	Dawn		9167024489					opioidDUR@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Medication Therapy Management Contact	Pharmacist, Principal, Pharmacy Services		Becker-Ellison	Dawn		9167024489					dawn.becker-ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	OffShore Subcontractor Contact	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Online Enrollment Center Contact (Back-up)	Director, Medicare Compliance		Mata	Marcos	R	5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Online Enrollment Center Contact (Optional)	IT Product Manager, Consultant		Skuta	Paul		9168660922					Paul.Skuta2@blueshieldca.com	601 12th Street		Oakland	CA	94607	10/02/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Online Enrollment Center Contact (Primary)	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part C Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part C Reporting Contact	Director, Medicare Compliance		Mata	Marcos	R	5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Appeals	Supervisor, Medicare Appeals and Grievances		Lopez	Celina						9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/02/2015	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Appeals Contact (Secondary)	Senior Manager, Operations		Salam	Shahid							Shahid.Salam@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	12/30/2020	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Benefits Contact	Senior Director, Phamacy Markets		Yang	Winnie		8054058599					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Claims Submission Contact	Lead Medicare Rx Benefits & Claims Specialist		Campbell	Leslie		5306263838					leslie.campbell@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/18/2016	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Exceptions Contact (Secondary)	Director, Medicare Compliance		Mata	Marcos							marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Price File Contact (Back-up)	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Price File Contact (Primary)	Business Analyst, Rx Benefit/Claims Implementation		Ng	Alvin		5109396404					alvin.ng@blueshieldca.com	601 12th Street		Oakland	CA	94607	10/30/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Quality Assurance Contact	Senior Director, Phamacy Markets		Yang	Winnie		8054058599					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Part D Reporting Contact	Director, Medicare Compliance		Mata	Marcos		5626135249					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Patient Safety Contact	Pharmacist, Principal, Pharmacy Services		Becker-Ellison	Dawn		9167024489					dawn.becker-ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Payment Contact	Director, Actuary		Shah	Dimple		5106072597					dimple.shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/17/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Pharmacy Director	Senior Director, Phamacy Markets		Yang	Winnie		8054058599					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	10/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/20/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8003757924				HMO - Health Maintenance Organization		C	Dallas
H0504	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager		Nordby	Christina							cnordb01@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/30/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	5626135252				HMO - Health Maintenance Organization		C	Dallas
H0504	Plan Directory Contact for Public Website			Services	Member		8007764466					membersvcs@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Plan to Plan Reconciliation Contact	Sr. Dir., Corp Tax & Producer Accounting		Larsen	Cynthia		5109396360					cynthia.larsen@blueshieldca.com	601 12th Street, 22nd floor		Oakland	CA	94607	05/14/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Processor Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106073281					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Quality Contact	Director, Clinical Quality		Barrad	Laetitia		8186321280					laetitia.barrad@blueshieldca.com	24233 Hillhurst Drive		West Hills	CA	91307	11/24/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Reconciliation Contact	Director, Actuary		Shah	Dimple		5106072597					dimple.shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/17/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Reconciliation Contact (Secondary)	Director, Medicare Compliance		Mata	Marcos	R	5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Recovery Audit Contact	Director, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	04/04/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	SNP Application Contact			Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Surveillance Contact	Director, Medicare Compliance		Mata	Marcos	R	5626135249					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	12/01/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	System Contact	Sr. Director, IT Product Management		Chambers	Shelley		1916866073					Shelley.Chambers@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Third Party Administrator (TPA) Liaison	Director, Actuary		Shah	Dimple		5106072597					dimple.shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	User Access Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/21/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Utilization Management Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0504	Utilization Review Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0523	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/18/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/18/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/18/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/05/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/29/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/18/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/21/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/18/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/29/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/18/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/18/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H0523	PHR Beneficiary Contact																	11/27/2013	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H0523	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/10/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/12/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0523	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0524	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Backup User Access Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	09/05/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Bid Primary Contact	Actuarial Consultant		Chong	Evelyn		8183319738					KPMedicareBids@kp.org	393 E Walnut St.		Pasadena	CA	91188	06/27/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	CAP Report Contact for Public Website	Medicare Compliance Lead		Piper	Kimberly		2064739504					Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	PO Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	2064739504				HMO - Health Maintenance Organization		C	Dallas
H0524	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					mark.c1.stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	CMMI Model Point of Contact	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	CMS Casework Communication Contact	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Complaints Tracking Contact	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Corporate Mailing						8004430815					mscc@kp.org	P.O. Box 12916		Oakland	CA	946042916	03/28/2013	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Customer Service Operations Contact			Services	Member		8004430815					mscc@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/03/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	03/09/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	07/17/2018	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/06/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/03/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/04/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John		5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	05/25/2018	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/19/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	General Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	03/28/2013	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	One Kaiser Plaza	16th Floor	Oakland	CA	94612	10/03/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	HIPAA Security Officer	Senior Director	Mr.	Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/25/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					Cathy.P.Plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	11/03/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	MA Appeals/Grievances Contact	Executive Director, Member Relations	Ms	Osborne	Susan		5038133924					susan.a.osborne@kp.org	500 NE Multnomah Street	Suite 100	Portland	OR	97232	08/28/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Marketing Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	08/22/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	11/16/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Medicare Compliance Officer	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Medicare Coordinator	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					jovan.robinson@kp.org	10740 Fourth Street	2nd Floor, Cubicle 023W02	Rancho Cucamonga	CA	91730	08/26/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/05/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part C Application Contact	Project Manager Lead		Morgan	Emily	M	5104072515					emily.m.morgan@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/03/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part C Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Appeals	Executive Director, Member Relations		Osborne	Susan							Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	08/28/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8774083496				HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Application Contact	Project Manager Lead		Morgan	Emily	M	5104072515					emily.m.morgan@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/03/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Benefits Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	04/16/2019	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Claims Submission Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	04/16/2019	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	05/21/2018	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/26/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Part D Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Pharmacy Director	National Pharmacy Benefits, Vice President		Miller	Wayne		5626583674					wayne.i.miller@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	04/16/2019	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Pharmacy Network Management Contact	National Pharmacy Benefits, Project Manager II		Munoz	Vanessa		5624477739					Vanessa.L.Munoz@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	04/16/2019	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Pharmacy Network Management Contact (Secondary)	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	04/16/2019	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8776451282				HMO - Health Maintenance Organization		C	Dallas
H0524	Physician Incentive Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Plan Directory Contact for Public Website			Services	Member		8004430815					mscc@kp.org	10740 Fourth St., Second Floor		Rancho Cucamonga	CA	91730	10/10/2014	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/19/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	05/25/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/03/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	SNP Application Contact	Project Manager Lead		Morgan	Emily	M	5104072515					emily.m.morgan@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/03/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	SNP State Contact	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	01/02/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Surveillance Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	User Access Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	03/15/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Utilization Management Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0524	Utilization Review Contact	Medicare Compliance Lead	Ms	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0542	Automated TrOOP Balance Transfer Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2022	2026	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	Backup User Access Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2022	2026	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	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	Bid Primary Contact	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		3238897354				3238897398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2026	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	CAP Report Contact for Public Website	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	CEO - CMS Administrator Contact	President and CEO	Mr.	de la Rocha	Castulo		3238897310				3238897399	cdelarocha@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/02/2017	2026	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	CEO - Senior Official for Contracting	President and CEO	Mr.	de la Rocha	Castulo		3238897310					cdelarocha@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/02/2017	2026	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		3238897320					jesparza@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/02/2017	2026	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 Operating Officer	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587660					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/04/2023	2026	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 Information Officer	Senior Vice President, Chief Information Officer	Mr.	Lowe	Raymond		3237656178					raylowe@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/21/2018	2026	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 Information Security Officer	Senior Vice President, Chief Information Officer	Mr.	Lowe	Raymond		3237656178					raylowe@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/21/2018	2026	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		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2022	2026	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	Complaints Tracking Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2022	2026	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	Contact for Fraud Investigations	SVP and Chief Compliance Officer	Mr.	Jackson	Jerry		3238897383				3238897803	jejackson@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/04/2023	2026	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	8664669722					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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	Corporate Mailing						3238897300					info@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/02/2017	2026	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	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	DIR Contact	Manager, Clinical Pharmacy - PACE	Dr.	Bravo	Juan		3232047202					Jbravo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/21/2023	2026	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	DIR Contact (Secondary)	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		3238897354				3238897398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2026	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	Discount Program Payment Contact	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		3238897354				3238897398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2026	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	Emergency Part D Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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	Emergency Part D Contact (Secondary)	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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	Enrollment Contact	AVP, Outreach & Marketing Senior Care Services		Galicia	Miriam		3233134367					mgalicia@altamed.org	2040 Camfield Ave.		Los Angeles	CA	90040	10/04/2023	2026	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	EOB Transfer Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394				3232013224	lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Financial Audit Contact	Vice President of Finance	Mr.	Flores	Fernando		3236222443					feflores@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	07/10/2018	2026	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	Financial Reporting Contact	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		3238897354				3238897398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2026	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	Formulary Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660				3232013224	ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Formulary Contact (Secondary)	Manager, Clinical Pharmacy - PACE	Dr.	Bravo	Juan		3232047202				2132175397	Jbravo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2023	2026	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	General Contact	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	HIPAA Privacy Officer	Director, Compliance & Ethics Privacy Officer		Barlev	Ofer		3232822303					obarlev@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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	HIPAA Security Officer	Senior Vice President, Chief Information Officer	Mr.	Lowe	Raymond		3237656178					raylowe@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/21/2018	2026	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	Interoperability Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2023	2026	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	MA Appeals/Grievances Contact	Director, Quality Improvement		Donato-Hernandez	Victoria		3235587628					vdonato@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	MA Claims Processing Contact for Public Website	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3232019700					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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	Marketing Contact	AVP, Outreach & Marketing Senior Care Services		Galicia	Miriam		3233134367					mgalicia@altamed.org	2040 Camfield Ave.		Los Angeles	CA	90040	10/04/2023	2026	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	Medical Director	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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	SVP and Chief Compliance Officer	Mr.	Jackson	Jerry		3238897383				3238897803	jejackson@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/04/2023	2026	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 Coordinator	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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 Part D Opioid Overutilization Contact	Manager, Clinical Pharmacy - PACE	Dr.	Bravo	Juan		3232047202					jbravo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2023	2026	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	Medication Therapy Management Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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	Online Enrollment Center Contact (Back-up)	Specialist, Data - PACE		Robles	Maria	G	3238327548					Mrobles@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Online Enrollment Center Contact (Optional)	Data Operations Manager	Mrs.	Garcia	Patricia		3233464095					pagarcia@altamed.org	2040 Camfield Ave		Los Angeles	CA	90022	02/16/2023	2026	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	Online Enrollment Center Contact (Primary)	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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 C Application Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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 Appeals	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G						ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active	3235587660				PACE - Nat		C	San Francisco
H0542	Part D Appeals Contact (Secondary)	Manager, Clinical Pharmacy - PACE	Dr.	Bravo	Juan							jbravo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2023	2026	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active	3232047202				PACE - Nat		C	San Francisco
H0542	Part D Application Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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 Benefits Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/13/2021	2026	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 Claims Submission Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Director, Data Operations - PACE		Fajardo	Lucia							lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/18/2024	2026	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active	3233848394				PACE - Nat		C	San Francisco
H0542	Part D Exceptions Contact (Secondary)	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G						ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/17/2023	2026	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active	3235587660				PACE - Nat		C	San Francisco
H0542	Part D Price File Contact (Back-up)	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/17/2023	2026	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 Price File Contact (Primary)	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/18/2024	2026	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 Quality Assurance Contact	Director, Quality Improvement		Donato-Hernandez	Victoria		3235587628					vdonato@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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 Reporting Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Patient Safety Contact	Director, Quality Improvement		Donato-Hernandez	Victoria		3235587628					vdonato@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Payment Contact	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		3238897354				3238897398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2026	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	Personal Health Record Contact	Director, Health Recs Sys & PO		Jones	Shauntara		3236222444					shjones@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/02/2017	2026	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 Director	Manager, Clinical Pharmacy - PACE	Dr.	Bravo	Juan		3232047202					jbravo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/16/2023	2026	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 Network Management Contact	VP, Pharmacy		Lloyd	Genevieve		3235587666					glloyd@altamed.org	2040 Camfield Avenue		Los Angeles	CA	90040	10/04/2023	2026	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						2132175397	Jbravo@altamed.org	2040 Camfield Avenue		Los Angeles	CA	90040	02/22/2022	2026	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE		Altamed Health Services Corporation	11	Yes	Active	3232047202				PACE - Nat		C	San Francisco
H0542	PHR Beneficiary Contact																	08/17/2021	2026	ALTAMED HEALTH SERVICES CORPORATION	National PACE	AltaMed Health Services Corporation	National PACE	AltaMed Health Services Corporation	Altamed Health Services Corporation	11	Yes	Active	8884999303				PACE - Nat		C	San Francisco
H0542	Plan Directory Contact for Public Website	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	Plan to Plan Reconciliation Contact	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		3238897354				3238897398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2026	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	Processor Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394				3232013224	lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Quality Contact	Director, Quality Improvement		Donato-Hernandez	Victoria		3235587628					vdonato@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Reconciliation Contact	Director, Budgets & Planning	Mr.	Hamamoto	Jeffrey		3238897354				3238897398	jhamamoto@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	03/13/2019	2026	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	Reconciliation Contact (Secondary)	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Recovery Audit Contact	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	11/01/2024	2026	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	Surveillance Contact	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	System Contact	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	10/04/2023	2026	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	Third Party Administrator (TPA) Liaison	Director, Data Operations - PACE		Fajardo	Lucia		3233848394					lfajardo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	User Access Contact	Senior VP and Chief Operating Officer - PACE	Mrs.	Garg	Joyita		3235587750					jogarg@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	08/29/2023	2026	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	Utilization Management Contact	SVP, Chief Medical Officer PACE	Dr.	Casillas	Esiquio	G	3235587660					ECasillas@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Utilization Review Contact	Manager, Clinical Pharmacy - PACE	Dr.	Bravo	Juan		3232047202				2132175397	Jbravo@altamed.org	2040 Camfield Ave		Los Angeles	CA	90040	02/22/2022	2026	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	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0543	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0543	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0543	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0543	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0543	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UHC OF CALIFORNIA	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0544	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/21/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	04/22/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/27/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/27/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/27/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	04/24/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	04/24/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	04/28/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	04/28/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	04/22/2021	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/26/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/27/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/27/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	04/24/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/09/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/27/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/27/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/14/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/10/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/06/2021	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	10/18/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H0544	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/03/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H0544	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H0544	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/03/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H0544	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/26/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	04/24/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	04/24/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	04/22/2021	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/25/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/14/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H0544	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H0544	PHR Beneficiary Contact																	12/28/2017	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H0544	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/14/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	04/21/2021	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/09/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/11/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/08/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/12/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/14/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	04/22/2021	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/27/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0544	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/27/2024	2026	BLUE CROSS OF CALIFORNIA	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0562	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Medical Director	Chief Medical Officer	Dr.	Chen	Alex		8186766564					alex.y.chen@healthnet.com	21281 Burbank Blvd		Woodland Hills	CA	91367	03/30/2021	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0562	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0562	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0562	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0562	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0562	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/02/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0562	PHR Beneficiary Contact																	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H0562	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0562	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	HEALTH NET OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0571	Agent/Broker Compensation Data Contact	Chief Operations Officer	Mr.	Gima	Ketan		6282283241					ketan.gima@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	08/07/2024	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Manosca	Nova		8587905873					partdcat@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Backup User Access Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Best Available Evidence Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Ave	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Bid Audit Contact	CFO	Mr.	Choi	Ken		6282283251					ken.choi@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	02/14/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Bid Audit Site Contact	CFO	Mr.	Choi	Ken		6282283251					ken.choi@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Bid Primary Contact	CFO	Mr.	Choi	Ken		6282283251					Ken.Choi@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	CAP Report Contact for Public Website	Chief Executive Officer	Mr.	Loo	Larry		4159558832					larry.loo@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	01/04/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Loo	Larry		4159558832				4159558818	larry.loo@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/22/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Loo	Larry		4159558832				4159558818	larry.loo@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	01/04/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Chief Financial Officer	CFO	Mr.	Choi	Ken		6282283251					ken.choi@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Chief Operating Officer	Chief Operations Officer	Mr.	Gima	Ketan		6282283241				4159558818	ketan.gima@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	08/07/2024	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Chief Information Officer	IT Director	Mr.	Aguirre	Christophe		6282283357	3347			4159558818	christopher.aguirre@cchphealthplan.com	445 Grant Ave Suite 700		San Francisco	CA	94108	08/08/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Chief Information Security Officer	Security Officer / IT Director CHA	Mr.	Lai	Abel		4156772393				4159558818	abell@chasf.org	445 Grant Ave Suite 700		San Francisco	CA	94108	12/05/2022	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	CMMI Model Point of Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	CMS Casework Communication Contact	Compliance Director	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Complaints Tracking Contact	Director of PHM		Cortez	Rocio		6282283212				4159558818	rocio.cortez@cchphealthplan.com	445 Grant Avenue Suite 700		San Francisco	CA	94108	02/02/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Contact for Fraud Investigations	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Coordination of Benefits Contact	Eligbility and Enrollment Supervisor		Leung	Kenneth		6282283268					kenneth.leung@cchphealthplan.com	445 Grant Ave Suite 700		San Francisco	CA	94102	01/27/2018	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Corporate Mailing						6282283395				4159558818	catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Customer Service Operations Contact	Member Services Manager	Ms.	Soder	Sonya		6282283306				4153972129	Sonya.Soder@CCHPHEALTHPLAN.COM	445 Grant Ave. Suite 700		San Francisco	CA	94108	03/18/2020	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	DIR Contact	CFO	Mr.	Choi	Kenneth		6282283251					Ken.Choi@CCHPHEALTHPLAN.COM	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	DIR Contact (Secondary)	Compliance Director	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Discount Program Payment Contact	CFO	Mr.	Choi	Kenneth		6282283251					Ken.Choi@CCHPHEALTHPLAN.COM	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Electronic Health Record Contact	Compliance Director		Benedict	Catherine		6282283395				4159558818	catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Emergency Part D Contact	Chief Executive Officer	Mr.	Loo	Larry		4158195549				4159558818	larry.loo@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2024	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Emergency Part D Contact (Secondary)	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273					robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Encounter Data & Risk Adjustment Operations Contact	Director, Quality Improvement	Ms.	Cortez	Rocio		6282283212					rocio.cortez@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	03/04/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Enrollment Contact	Supervisor of Eligibility and Enrollment	Mr.	Leung	Kenneth		4159558800	3268			4159558817	kenneth.leung@cchphealthplan.com	445 Grant Ave.	Ste. 700	San Francisco	CA	94108	07/25/2019	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	EOB Transfer Contact	CFO	Mr.	Choi	Kenneth		6282283251				4159558817	Ken.Choi@CCHPHEALTHPLAN.COM	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Financial Audit Contact	CFO	Mr.	Choi	Kenneth		6282283251					Ken.Choi@CCHPHEALTHPLAN.COM	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Financial Reporting Contact	CFO	Mr.	Choi	Ken		6282283251					ken.choi@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	01/18/2022	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Formulary Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Formulary Contact (Secondary)	Sup Formulary Operations		Nyawabila	Christina		8587906297					FMT@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	General Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Government Relations Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	HIPAA Privacy Officer	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	HIPAA Security Officer	Security Officer		Lai	Abel		4152174142				4152174142	abell@chasf.org	445 Grant Ave Suite 700		San Francisco	CA	94108	07/07/2022	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Hospice Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273					robertp@chasf.org	445 Grant Ave Suite 700		San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Interoperability Contact	Director of IT		Aguirre	Christophe		4159558857					christopher.aguirre@cchphealthplan.com	445 Grant Avenue, suite 700		San Francisco	CA	94108	08/28/2024	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	MA Appeals/Grievances Contact	Director of PHM		Cortez	Rocio		6282283212					rocio.cortez@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	02/02/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	MA Claims Processing Contact for Public Website	Director of Claims		Johnson	Dee		4159558800	3342				dee.johnson@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	06/09/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Marketing Contact	Chief Operations Officer	Mr.	Gima	Ketan		6282283241					ketan.gima@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	01/03/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Medical Director	Medical Director	Dr.	Pretzlaff	Robert		4159558800	3273				robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Medicare Compliance Officer	Compliance Officer/Director of Compliance	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	03/17/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Medicare Coordinator	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	OffShore Subcontractor Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Online Enrollment Center Contact (Back-up)	Eligibility & Enrollment Processor		Wang	Lisa		6282283262					lisa.wang@cchphealthplan.com	445 Grant Ave.	Ste. 700	San Francisco	CA	94108	06/09/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Online Enrollment Center Contact (Optional)	Eligibility and Enrollment Supervisor		Leung	Kenneth		4159558800	3268				kenneth.leung@cchphealthplan.com	445 Grant Avenue		San Francisco	CA	94108	06/18/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Online Enrollment Center Contact (Primary)	Supervisor of Eligibility and Enrollment	Mr.	Leung	Kenneth		4159558800	3268			4159558817	kleung@cchphmo.com	445 Grant Ave.	Ste. 700	San Francisco	CA	94108	07/22/2019	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part C Application Contact	Compliance Director	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part C Reporting Contact	Compliance Director	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part D Appeals	Director of PHM	Ms.	Cortez	Rocio						4159558836	rocio.cortez@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	02/02/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	6282283212				HMO - Health Maintenance Organization		C	Boston
H0571	Part D Appeals Contact (Secondary)	Compliance Director		Benedict	Catherine							catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	6282283395				HMO - Health Maintenance Organization		C	Boston
H0571	Part D Application Contact	Compliance Director	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part D Benefits Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part D Claims Submission Contact	Medicare Part D PDE Analyst		Nishiyama	Christie		8582915305					PDE@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/27/2019	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	8587906682				HMO - Health Maintenance Organization		C	Boston
H0571	Part D Exceptions Contact (Secondary)	Pharmacist	Ms.	Zhang	Mary						4159558836	mary.zhang@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/28/2022	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	6282283354				HMO - Health Maintenance Organization		C	Boston
H0571	Part D Price File Contact (Back-up)	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part D Price File Contact (Optional)	Compliance Director	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part D Price File Contact (Primary)	Medicare Part D Project Manager		Niemi	Kirstin		8587906455					PlanFinderCommunications@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Part D Reporting Contact	Compliance Director	Ms.	Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Patient Safety Contact	Medical Director	Dr.	Pretzlaff	Robert		6282283273					robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Payment Contact	CFO	Mr.	Choi	Ken		6282283251					Ken.Choi@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Personal Health Record Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Pharmacy Director	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Pharmacy Network Management Contact	Manager, PNS & Claims Operations		Burke	Sharon		8587907148					sharon.burke@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Pharmacy Network Management Contact (Secondary)	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159558836	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	8448630357				HMO - Health Maintenance Organization		C	Boston
H0571	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacist	Ms.	Zhang	Mary						4159558836	mary.zhang@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/28/2022	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active	6282283354				HMO - Health Maintenance Organization		C	Boston
H0571	Physician Incentive Contact	Chief Financial Officer	Mr.	Choi	Ken		6282283251				4159558818	ken.choi@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	06/01/2022	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Plan Directory Contact for Public Website	Chief Operations Officer	Mr.	G	Ketan		6282283241				4159558818	youngsoo.cho@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	01/03/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Plan to Plan Reconciliation Contact	CFO	Mr.	Choi	Ken		6282283251					Ken.Choi@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Processor Contact	Director, Medicare Program		Davis-Jones	De'Lona		8587906229					DeLona.Davis-Jones@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/11/2017	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Quality Contact	Director, Quality Improvement		Cortez	Rocio		6282283212				4159558818	rocio.cortez@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	08/03/2020	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Reconciliation Contact	CFO	Mr.	Choi	Ken		6282283251					Ken.Choi@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Reconciliation Contact (Secondary)	CFO	Mr.	Choi	Kenneth		6282283251				4159558817	Ken.Choi@CCHPHEALTHPLAN.COM	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Recovery Audit Contact	CFO	Mr.	Choi	Ken		6282283251					Ken.Choi@cchphealthplan.com	445 Grant Avenue, suite 700	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	SNP Application Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	SNP State Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Ave	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Surveillance Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	System Contact	IT Director	Mr.	Aguirre	Christophe		6282283357				4159558818	christopher.aguirre@cchphealthplan.com	445 Grant Ave Suite 700		San Francisco	CA	94108	08/08/2023	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Third Party Administrator (TPA) Liaison	CFO	Mr.	Choi	Kenneth		6282283251					Ken.Choi@CCHPHEALTHPLAN.COM	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/01/2021	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	User Access Contact	Compliance Director		Benedict	Catherine		6282283395					catherine.benedict@cchphealthplan.com	445 Grant Avenue	Suite 700	San Francisco	CA	94108	10/29/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Utilization Management Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159553669	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0571	Utilization Review Contact	Chief Medical Officer	Dr.	Pretzlaff	Robert		6282283273				4159553669	robertp@chasf.org	445 Grant Avenue	Suite 700	San Francisco	CA	94108	12/16/2025	2026	CHINESE COMMUNITY HEALTH PLAN	Local CCP	CCHP (Chinese Community Health Plan)	HMO/HMOPOS		Chinese Hospital Association	56	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0609	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0609	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0609	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0609	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0609	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0613	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739					cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie	A	7206829848				3039961600	Lteter@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	9096779517				PACE - Nat		C	Dallas
H0613	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Chief Operating Officer	Market President	Mr.	Lohr	Clint		7206829848				3039961600	clohr@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Chief Information Security Officer	Chief Information Security Officer	Mr.	Naus	Cole		7204564635				3039961600	mnaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	12/08/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	CMS Casework Communication Contact	Director of Compliance		Griego	Stephen		7208148316				3039961600	sgriego@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Complaints Tracking Contact	Director of Compliance		Griego	Stephen		7208148316				3039961600	sgriego@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Coordination of Benefits Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Corporate Mailing						3038694664				3039961600	bgutierrez@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Customer Service Operations Contact	Director of Compliance		Griego	Stephen		7208148316				3039961600	sgriego@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	DIR Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	General Contact	Director of Compliance		Griego	Stephen		7208148316				3039961600	sgriego@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Government Relations Contact	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Interoperability Contact	SVP, Application Systems		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	MA Appeals/Grievances Contact	Director of Compliance		Griego	Stephen		7208148316				3039961600	sgriego@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Appeals	Director of Compliance		Griego	Stephen						3039961600	sgriego@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208148316				PACE - Nat		C	Dallas
H0613	Part D Appeals Contact (Secondary)	Director of Compliance		Griego	Stephen						3039961600	sgriego@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208148316				PACE - Nat		C	Dallas
H0613	Part D Application Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Dallas
H0613	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Dallas
H0613	Part D Price File Contact (Back-up)	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Quality Assurance Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Part D Reporting Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Dallas
H0613	PHR Beneficiary Contact																	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Dallas
H0613	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	AKizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/28/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Reconciliation Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	System Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Third Party Administrator (TPA) Liaison	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	User Access Contact	Director of Compliance		Griego	Stephen		7208148316					sgriego@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0613	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge Colorado PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H0624	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0624	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0624	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0624	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0624	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/29/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0624	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0628	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdake	AZ	85260	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/05/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/30/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	HIPAA Security Officer	Chief Information Security Officer	Ms.	McMahon	Chandra		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	07/05/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	06/26/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	07/02/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H0628	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/06/2018	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0628	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF OHIO INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H0629	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Automated TrOOP Balance Transfer Contact	Manager II, Membership		Miller	Karen		9205391417					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Chief Financial Officer	Staff VP & Actuary, Medicare Finance and Risk Adj	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Chief Information Security Officer	VP and Chief Information Security Officer	Mr.	Wilcox	Dustin		4632245212					dustin.wilcox@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/29/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Financial Audit Contact	Staff VP & Actuary, Medicare Finance and Risk Adj	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Financial Reporting Contact	Staff VP & Actuary, Medicare Finance and Risk Adj	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	HIPAA Security Officer	VP and Chief Information Security Officer	Mr.	Wilcox	Dustin		4632245212					dustin.wilcox@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/29/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	05/29/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Appeals Contact (Secondary)	Director, PharmD Medicare Part D CAG		Zanolli	Mindy						8884581406	mindy.zanolli@elevancehealth.com	4361 Irwin Simpson Rd.	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8144498744				HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Exceptions Contact (Secondary)	Medicare Product Innovation Director		Floyd	Cari							cari.floyd@anthem.com	1226 Sigler Street		Nashville	TN	37203	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5407984087				HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Pharmacy Director	Clinical Pharmacy Program Director	Ms.	Gibson	Cathy		5132550202					cathy.j.gibson@carelon.com	4592 Whispering Oak Trail		Cincinnati	OH	45247	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H0629	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H0629	PHR Beneficiary Contact																	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H0629	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/29/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/29/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0629	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0630	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	09/01/2017	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Backup User Access Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					Lynn.M.Cooper@kp.org	10350 E Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Bid Primary Contact	Actuary		Hedgecock	Peter		5035679087					KPMedicareBids@kp.org	500 NE Multnomah #100		Portland	OR	97232	09/05/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	CAP Report Contact for Public Website	Medicare Compliance Lead	Ms.	Cooper	Lynn		7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Chief Financial Officer	SVP, CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Complaints Tracking Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Corporate Mailing						7205279215					lynn.m.cooper@kp.org	10350 East Dakota Avenue		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Customer Service Operations Contact	Ex Director, Member Services Contact Centers, Denv		Martin	Norman	K	3039124673					NK.Martin@kp.org	7901 East Lowry Blvd, Ste 150 and 400		Denver	CO	80230	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	DIR Contact	Manager Financial Reporting & Analysis		Hsiue	Tony		5626583836				5626583866	tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	03/21/2018	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	07/17/2018	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/06/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	07/02/2018	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/04/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Employer Waiver Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	03/29/2013	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/20/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	General Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	11/16/2017	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	11/06/2020	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/25/2020	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					Cathy.P.Plattner@kp.org	75 N Fair Oaks Ave		Pasadena	CA	91103	12/04/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	MA Appeals/Grievances Contact	Sr. Manager, Grievances and Appeals		McGaughy	Rachel		7206033201					Rachel.X.McGaughy@kp.org	7901 E. Lowry Blvd		Denver	CO	80230	12/04/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Marketing Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					KP-MedicareFilings@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	11/16/2020	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Medicare Compliance Officer	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Medicare Coordinator	Program Director, Medicare Market/Product Strategy	Ms.	Johnston	Stacy		7203902574					stacy.johnston@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street	2nd Floor, Cubicle 023W02	Rancho Cucamonga	CA	91730	08/26/2020	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part C Application Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part C Reporting Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Appeals	Sr. Manager, Grievances and Appeals		McGaughy	Rachel							Rachel.X.McGaughy@kp.org	7901 E. Lowry Blvd.		Denver	CO	80230	12/04/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	7206033201				HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Appeals Contact (Secondary)	Sr. Grievance and Appeals Consultant		Elkhaddari	Claudia							claudia.elkhaddari@kp.org	2500 S. Havana Street		Aurora	CO	80014	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	3032832813				HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Application Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Benefits Contact	PO PS, National Rx Programs & Servics		Bonvie	Claudette		5623199392					Claudette.R.Bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90042	07/20/2018	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Claims Submission Contact	PO PS, National Rx Programs & Servics		Bonvie	Claudette		5623199392					Claudette.R.Bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90042	07/20/2018	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	07/02/2018	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Price File Contact (Primary)	Pharmacy Benefits Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Part D Reporting Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Patient Safety Contact	Medical Safety & Quality Coordinator		Rasmussen	Jon		3039903890					Jon.Rasmussen@kp.org	10350 East Dakota Ave.		Denver	CO	80247	11/21/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Pharmacy Director	Chief Pharmacist		Reed	Leah		3037393623				3037393660	leah.k.reed@kp.org	16601 E. Centretech Parkway		Aurora	CO	80011	12/04/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Pharmacy Network Management Contact	Chief Pharmacist		Reed	Leah		3037393623					leah.k.reed@kp.org	16601 E. Centretech Parkway		Aurora	CO	80011	12/04/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8887917255				HMO - Health Maintenance Organization		C	Dallas
H0630	Plan Directory Contact for Public Website			Services	Member		8004762167					colorado.cs@kp.org	10350 E. Dakota Ave.		Denver	CO	80247	11/21/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/20/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	05/25/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Reconciliation Contact (Secondary)	Manager Financial Reporting & Analysis		Hsiue	Tony		5626583836				5626583866	tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/03/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	SNP Application Contact	Director Accreditation, Regulatory & Licensing		Beagle	Robin	E	2063272431					robin.e.beagle@kp.org	10350 East Dakota Ave		Denver	CO	80247	02/14/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	SNP State Contact	Director Accreditation, Regulatory & Licensing		Beagle	Robin		2063272431				8776328502	Robin.e.beagle@kp.org	10350 East. Dakota Ave		Denver	CO	80247	02/14/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Surveillance Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/16/2023	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	User Access Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	01/21/2022	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Utilization Management Contact	Director, Utilization Management		Mills	Greg		3036495229					Gregory.Mills@kp.org	10240 Park Meadows Drive		Lone Tree	CO	80124	11/21/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0630	Utilization Review Contact	Director, Utilization Management		Mills	Greg		3036495229					Gregory.Mills@kp.org	10240 Park Meadows Drive		Lone Tree	CO	80124	11/21/2025	2026	KAISER FOUNDATION HP OF CO	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0672	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	07/03/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H0672	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H0672	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H0672	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H0672	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H0672	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H0672	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0672	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	CIGNA HEALTHCARE OF COLORADO, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H0710	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H0710	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0710	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0710	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H0710	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0710	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0712	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0712	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0712	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0712	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0712	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H0712	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H0712	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H0712	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0712	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	WELLCARE OF CONNECTICUT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	03/30/2021	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0724	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0724	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0724	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0724	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0724	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/02/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H0724	PHR Beneficiary Contact																	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H0724	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0724	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0725	Automated TrOOP Balance Transfer Contact	VP of TPA Operations		Allen	Kim		5016902985					kallen@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Backup User Access Contact	VP of Technical Operations		Harrington	Paige		5016974557				5013721932	pharrington@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Best Available Evidence Contact	Member Service Manager		Campbell	Brittany		5012550873				8667053652	brittanyc@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	07/22/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Bid Primary Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	CAP Report Contact for Public Website	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	CEO - CMS Administrator Contact	Executive Director	Mrs.	Clark	Patty		4795493441					pclark@wellquestpace.com	500 President Clinton Ave.	Suite Suite 200	Little Rock	AR	72201	07/22/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	CEO - Senior Official for Contracting	Executive Director	Mrs.	Clark	Patty		4795493441					pclark@wellquestpace.com	500 President Clinton Ave.	Suite Suite 200	Little Rock	AR	72201	07/22/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Chief Financial Officer	CFO of Ancillary Services	Mr.	Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Chief Operating Officer	CFO of Ancillary Services	Mr.	Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Chief Information Officer	VP of Technical Operations	Mrs.	Harrington	Paige		5016974557				5013721932	pharrington@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Chief Information Security Officer	VP of Technical Operations	Mrs.	Harrington	Paige		5013721922				5013721932	pharrington@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	CMS Casework Communication Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Complaints Tracking Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Contact for Fraud Investigations	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Coordination of Benefits Contact	VP of TPA Operations		Allen	Kim		5016902985					kallen@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Corporate Mailing						5013721922					agable@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Customer Service Operations Contact	Member Service Manager		Campbell	Brittany		5012550873				8667053652	brittanyc@accesshealthservices.com	500 President Clinton Ave.	Suite 200-A	Little Rock	AR	72201	07/22/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	DIR Contact	Dir. Customer Contact Services		Brewer	Kathy		0000000000					Customerservice@Medimpact.com	7835 Freedom Avenue NW North		Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Discount Program Payment Contact	Finance Manager		Smith	Leslie		5018596625				5013721932	lsmith@superiorselectinc.com	500 President Clinton Ave.	Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Emergency Part D Contact	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida		5018596316					mmaxenberger@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Encounter Data & Risk Adjustment Operations Contact	AHS Quality and Risk Manager		Shock	Lauri		5014047811					lshock@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Enrollment Contact	Member Service Manager		Campbell	Brittany		5012550873				8667053652	brittanyc@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	07/22/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	EOB Transfer Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Financial Audit Contact	CFO of Ancillary Services	Mr.	Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Financial Reporting Contact	CFO of Ancillary Services		Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Formulary Contact	Manager, Formulary Administration & Maintenance		Nyawabila	Christina		8587906297					FAS@MedImpact.com	7835 Freedom Avenue NW		North Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	General Contact	PACE Executive Director		Clark	Patty		4794593441				5013721932	pclark@wellquestpace.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/16/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Government Relations Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	HIPAA Privacy Officer	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	HIPAA Security Officer	Information Security Officer		Moran	Tracy		5012953444				5013721932	tmoran@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Interoperability Contact	VP of Technical Operations		Harrington	Paige		5013721922					pharrington@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	MA Appeals/Grievances Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	MA Claims Processing Contact for Public Website			Service	Customer		5013721922					info@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Marketing Contact	Director of Sales and Business Development		Pollock	James		5014104450				5013721932	jpollock@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Medical Director	Medical Director	Dr.	Chaffee	Kristen		4794419491				4794419343	kchaffee@wellquestpace.com	330 13TH ST		BARLING	AR	72943	11/03/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite 600	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Medicare Coordinator	CFO of Ancillary Services		Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Medication Therapy Management Contact	Clinical Solutions Mgr III		Nguyen	Linh		8587906627					MTMP@MedImpact.com	7835 Freedom Avenue NW North	Suite 201	Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part C Application Contact			Norsworthy	David		5019445633					David@norsworthyconsulting.com	P.O. Box 180		Gateway	AR	72733	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Appeals	Clinical Pharmacist		Stephenson	Sarah							sstephenson@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending	5016211503				PACE - Nat		C	New York
H0725	Part D Appeals Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida							mmaxenberger@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending	8773721033				PACE - Nat		C	New York
H0725	Part D Application Contact			Norsworthy	David		5019445633					David@norsworthyconsulting.com	P.O. Box 180		Gateway	AR	72733	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Benefits Contact	VP of TPA Operations		Allen	Kim		5016902985					kallen@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Claims Submission Contact	Medicare Operations Supervisor		Distel	Chris		8587906376					PDE@MedImpact.com	7835 Freedom Avenue NW North		Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Exceptions Contact	Clinical Pharmacist		Stephenson	Sarah							sstephenson@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending	5016211503				PACE - Nat		C	New York
H0725	Part D Exceptions Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida							mmaxenberger@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending	5018596316				PACE - Nat		C	New York
H0725	Part D Price File Contact (Back-up)			Horn	Tina		6029802747					thorn@elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Price File Contact (Optional)	VP of TPA Operations		Allen	Kim		5016902985					kallen@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Price File Contact (Primary)	Medicare Part D Project Manager		Keller	Shanon		8587907104					PlanFinderCommunications@MedImpact.com	7835 Freedom Avenue NW North		Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Quality Assurance Contact	Pharmacy Operations Manager		Maxenberger	Melida		5018596316					mmaxenberger@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Part D Reporting Contact	VP of TPA Operations		Allen	Kim		5016902985					pharmacysupport@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Patient Safety Contact	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Payment Contact	CFO of Ancillary Services		Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Personal Health Record Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Pharmacy Director	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Pharmacy Network Management Contact	Dir. Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.Hunt@MedImpact.com	7835 Freedom Avenue NW North	Suite 201	Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Pharmacy Network Management Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida		5018596316					mmaxenberger@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Pharmacy Technical Help Desk Contact	Dir. Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	7835 Freedom Avenue NW North	Suite 201	Canton	OH	44720	06/21/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending	0000000000				PACE - Nat		C	New York
H0725	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida							mmaxenberger@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending	8773721033				PACE - Nat		C	New York
H0725	Plan Directory Contact for Public Website			Service	Customer		5013721922					info@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Plan to Plan Reconciliation Contact	CFO of Ancillary Services		Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Processor Contact	Vice President of TPA Operations		Allen	Kim		5012619573				5013721932	kallen@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Quality Contact	Director of Quality and Utilization		Stell	Kaitlyn		5016902906					kstell@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Reconciliation Contact	CFO of Ancillary Services		Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Recovery Audit Contact	CFO of Ancillary Services	Mr.	Reaper	Joshua	D	5013584758					jreaper@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	02/20/2025	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Surveillance Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	System Contact	VP of Technical Operations		Harrington	Paige		5019122085					pharrington@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Third Party Administrator (TPA) Liaison	Senior Account Executive		Campbell	Brad		5019935269					bcampbell@accesshealthservices.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	User Access Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-A	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Utilization Management Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0725	Utilization Review Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave.	Suite Suite 200-C	Little Rock	AR	72201	06/14/2024	2026	WELLQUEST RIVER VALLEY, LLC	National PACE	WellQuest River Valley	National PACE		WellQuest River Valley, LLC	855	Yes	Pending					PACE - Nat		C	New York
H0738	Agent/Broker Compensation Data Contact	National Director Retail Sales	Mr.	Javor	Chris		2159378396					cjavor@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Automated TrOOP Balance Transfer Contact	Business Systems Analyst	Ms.	Murray	Karla		2672985899					kdmurray@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Backup User Access Contact	Medicare Compliance Sr Operations Analyst	Ms	Morris	Gail		2158635141					gpmorris@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Bid Audit Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Bid Audit Site Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Bid Primary Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	05/07/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	CEO - CMS Administrator Contact	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	CEO - Senior Official for Contracting	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Chief Operating Officer	President, Medicare Markets	Mr.	McDade	Chris		5704179770					cmcdad@amerihealthcaritas.com	AmeriHealth Caritas Families of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Chief Information Officer	Exec. Vice President, Chief Information Officer	Mr.	Dickson	Fred		2158636570					fdickson@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	CMS Casework Communication Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Complaints Tracking Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Contact for Fraud Investigations	Director, SIU	Mr.	McCall	Trevor		4844971241					tmccall2@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Coordination of Benefits Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Corporate Mailing						2159378725					KGrimmett@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive, 1st Floor	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		2672981794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	DIR Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/07/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	DIR Contact (Secondary)	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2824045991					AKindred@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Discount Program Payment Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Electronic Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Emergency Part D Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Emergency Part D Contact (Secondary)	VP, Corporate Pharmacy		Cherian	Sheena		2158635768					scherian@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare ACA and Risk Adjustment	Mr.	Greer	Kevin		2159378761					kgreer@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Enrollment Contact	Manager, Enrollment Operations	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	EOB Transfer Contact	VP, Medicare Claims	Mr.	Boyer	Joseph		2158636668				2159375321	jboyer@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Financial Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					ak16850@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Financial Reporting Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Formulary Contact	Director of Clinical Services, Formulary/DUR	Ms.	Megargell	Lauren		2159374135					Lauren.megargell@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	General Contact	VP, Medicare Strategy & Execution	Mr.	Sukhu	Chistopher		4844233175					csukhu@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	06/27/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Government Relations Contact	VP, Public Policy	Mr.	Cozzo	Steven		2159378236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	100 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	HIPAA Privacy Officer	Director Privacy	Ms.	Desipio	Nicole		4844971132					ndesipio@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Hospice Contact	Dir.  Medicare Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Interoperability Contact	Director, Medicare Performance Management		Kindred	Amanda		2484045991					akindred@amerihealthcaritas.com	4000 Town Center	Suite 1300	Southfield	MI	48075	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	MA Appeals/Grievances Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	MA Claims Processing Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Marketing Contact	Medicare Compliance Sr Operations Analyst	Ms.	Morris	Gail	P	2158635141					gpmorris@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Medical Director	Chief Medical Officer, Population Health	Dr.	Wright	Julia		2159378000					jwright6@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Medicare Coordinator	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Medication Therapy Management Contact	Director, Clinical Outcomes & Therapeutic Optimiz	Ms.	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	OffShore Subcontractor Contact	Esquire	Ms.	Sitner	Roni		8602149125					rsitner@ameriheathcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Online Enrollment Center Contact (Primary)	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part C Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part C Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Appeals	Director,  Medicare Appeals and Grievances	Ms.	Lopez	Yismell							yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158635677				HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Appeals Contact (Secondary)	Manager, Medicare Appeals & Grievance	Ms.	Smith-Cooks	Tiarra							tsmithcooks@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2151112917				HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Benefits Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Claims Submission Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Prior Auth	Mr.	McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Price File Contact (Back-up)	Claims Processor Associate	MS	Reed	Lindsay		8473466370					lindsay.reed@abarcahealth.com	650 Avenue Munoz Rivera	Suite 701,	San Juan	PR	00918	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Price File Contact (Optional)	Claims Processor Associate	Ms	Canales	Desiree		7875231212	1107				desiree.canales@abarcahealth.com	Abarca Health	650 Ave Munoz Rivera	San Juan	PR	00918	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Price File Contact (Primary)	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Part D Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Patient Safety Contact	Director,Clinical Outcomes &Therap Optimization	Ms	Patel	Binal		2159374188					bpatel1@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Payment Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Personal Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Pharmacy Director	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Pharmacy Network Management Contact	Director	Ms.	Leal	Avelina		2158636540					aleal@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Pharmacy Network Management Contact (Secondary)	Network Operations Analyst	Mr.	Kramerov	Allen		2159374120					akramerov@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Pharmacy Technical Help Desk Contact	Manager, Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H0738	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H0738	PHR Beneficiary Contact																	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS	AmeriHealth Caritas	Independence Health Group, Inc.	609	Yes	Active	2672985710				HMO - Health Maintenance Organization		C	Chicago
H0738	Physician Incentive Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Plan Directory Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Plan to Plan Reconciliation Contact	Director, Finance	Ms	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	P.O. 7137	London	KY	40742	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Processor Contact	Director of Clincal Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerFormrx	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Quality Contact	Director, Quality Management	Ms.	Popiolek	Rose		6107234450					rpopiolek@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Reconciliation Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Reconciliation Contact (Secondary)	Manager, Medicare Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Recovery Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	SNP Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	SNP State Contact	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Surveillance Contact	Director, Retail Sales Operations	Ms.	Bech	Mary		4146875533					mbech@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	System Contact	Manager, Medicare IS	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Third Party Administrator (TPA) Liaison	Manager, MCR Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/06/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	User Access Contact	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Utilization Management Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0738	Utilization Review Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AmeriHealth Caritas VIP Next, Inc.	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0755	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H0755	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0755	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H0755	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H0755	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0755	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H0764	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H0764	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0764	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H0764	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H0764	Plan Directory Contact for Public Website			Customer Service	UHC		8887028425					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/29/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0764	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H0777	Agent/Broker Compensation Data Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Automated TrOOP Balance Transfer Contact	Vice President, Business Operations		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Backup User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Best Available Evidence Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Bid Audit Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Bid Primary Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	CAP Report Contact for Public Website	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	CEO - CMS Administrator Contact	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	CEO - Senior Official for Contracting	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Chief Financial Officer	Chief Financial Officer	Ms	Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Chief Operating Officer	Chief Operations Officer	Mr	Mcormick	Mark		8572823180					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Chief Information Officer	Chief Information Officer	Mr	Bundela	Yogi		8572822863					ybundela@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Chief Information Security Officer	Chief Information Security and Privacy Officer	Mr	Tsuchida	Toby		8572823518					ttsuchida@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	CMS Casework Communication Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Complaints Tracking Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Contact for Fraud Investigations	Director, Special Investigation Unit		Roy	Jessica		6179594150					jroy22@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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
H0777	Coordination of Benefits Contact	Manager, Recoveries		Ryan	Cathy		8572829131					cryan17@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Corporate Mailing						8572823348					bbowen1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Customer Service Operations Contact	Director, Customer Services		Armstrong	Carolyn		4134270087					carmstrong6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	DIR Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Discount Program Payment Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Emergency Part D Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Encounter Data & Risk Adjustment Operations Contact	Vice President, Risk Adjustment		Keefe	Kevin		8572826420					kkeefe6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Enrollment Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	EOB Transfer Contact	Manager, Reporting		Devereux	Mary		8472244888				1111111111	mary.devereux@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/13/2025	2026	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
H0777	Financial Audit Contact	Finance Director	Ms.	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Financial Reporting Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Formulary Contact	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	09/23/2025	2026	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
H0777	Formulary Contact (Secondary)	Director of Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	09/23/2025	2026	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
H0777	General Contact	Senior Duals Compliance Program Manager		Perkins	Sarah		7814549116					sperkins4@mgb.org	399 Revolution Dr		Somerville	MA	02145	07/07/2025	2026	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
H0777	Government Relations Contact	Director, Government Affairs		Sullivan	John		8572823376					jsullivan77@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	HIPAA Privacy Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	HIPAA Security Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Hospice Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Interoperability Contact	Vice President, Legal and Regulatory Affairs		Richardson	Stephanie		5087760489					srichardson1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	MA Appeals/Grievances Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	MA Claims Processing Contact for Public Website	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Marketing Contact	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Medical Director	Chief Medical Director	Dr	Yoon	Ed		2074581035					ebyoon@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/03/2025	2026	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
H0777	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Medicare Coordinator	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Drive		Somerville	MA	02145	02/13/2025	2026	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
H0777	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy		Gallagher	Angela		8572823348					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	03/14/2025	2026	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
H0777	Medication Therapy Management Contact	MTM Contact		Carter	Cimone		7633481324					cimone_carter@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/13/2025	2026	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
H0777	Part C Application Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfunchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Part C Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Part D Appeals	Manager, Prior Authorization Appeals		Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/13/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Boston
H0777	Part D Appeals Contact (Secondary)	Pharmacy Technician Lead		Jackson	Shannon							shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/13/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7633615070				HMO - Health Maintenance Organization		C	Boston
H0777	Part D Application Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Part D Benefits Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Part D Claims Submission Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Part D Exceptions Contact	Manager, Prior Authorization Appeals		Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/13/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Boston
H0777	Part D Exceptions Contact (Secondary)	Pharmacy Technician Lead		Jackson	Shannon							shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/13/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7633615070				HMO - Health Maintenance Organization		C	Boston
H0777	Part D Price File Contact (Back-up)	Senior Business Analyst		Lyman	Dorothy		6514955369					dorothy.lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/13/2025	2026	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
H0777	Part D Price File Contact (Optional)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Part D Price File Contact (Primary)	Director		Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/13/2025	2026	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
H0777	Part D Quality Assurance Contact	Director, Pharmacy		Gallagher	Angela		8572822438					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Part D Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Patient Safety Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Payment Contact	Chief Financial Officer		Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Pharmacy Director	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Pharmacy Network Management Contact	Manager, Retail Network Operations		Perez	Felix		3053313044					felix.perez@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/13/2025	2026	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
H0777	Pharmacy Network Management Contact (Secondary)	Director, Retail Network Operations		Ashby	JoLynn		4696470504					jashby@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/13/2025	2026	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
H0777	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Gallagher	Angela							agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8443688732				HMO - Health Maintenance Organization		C	Boston
H0777	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen							mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8572825333				HMO - Health Maintenance Organization		C	Boston
H0777	Plan Directory Contact for Public Website	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Plan to Plan Reconciliation Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Processor Contact	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Quality Contact	Sr. Director, Clinical Operations		Gargasz	Reagan		2079394468					rgargasz@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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
H0777	Reconciliation Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Recovery Audit Contact	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	SNP Application Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	SNP State Contact	Senior Duals Compliance Program Manager		Perkins	Sarah		7814549116					sperkins4@mgb.org	399 Revolution Dr		Somerville	MA	02145	07/07/2025	2026	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
H0777	Surveillance Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	System Contact	Director, Business Systems Configuration		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Third Party Administrator (TPA) Liaison	Lead Financial Analyst		Boyadjian	James		2018323300					jboyadjian@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Utilization Management Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0777	Utilization Review Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H0783	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0783	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H0783	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0783	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H0783	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H0783	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H0783	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0783	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0809	Automated TrOOP Balance Transfer Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Backup User Access Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Best Available Evidence Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Bid Primary Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	CAP Report Contact for Public Website	Executive Director	Ms	Szymczyk	Dawn		4137487223				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	CEO - Senior Official for Contracting	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Chief Financial Officer	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Chief Operating Officer	COO	Ms	Lewis	Anne		4066472980				4134932024	Anne.Lewis@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/22/2020	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Chief Information Officer	Director Enterprise IT Operations	Mr	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Chief Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083					preston.jennings@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	CMS Casework Communication Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Complaints Tracking Contact	Director QI/Compliance Interim	Mrs	Groff	Kira		2153004965				4134932024	kira.groff@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	12/11/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Contact for Fraud Investigations	Director QI/Compliance Interim	Mrs	Groff	Kira		2153004965				4134932024	kira.groff@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	12/11/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Coordination of Benefits Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Corporate Mailing						4137487223				4134932024	Kevin.LeClaire@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	10/04/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Customer Service Operations Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	DIR Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Discount Program Payment Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Emergency Part D Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/03/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Enrollment Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	EOB Transfer Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		4138274243				4134932024	Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Financial Audit Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Financial Reporting Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	General Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Government Relations Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Interoperability Contact	Director Enterprise IT Operations		Gillespie	Jeff		7343433079					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	MA Appeals/Grievances Contact	Director QI/Compliance Interim	Mrs	Groff	Kira		2153004965				4134932024	kira.groff@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	12/11/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	MA Claims Processing Contact for Public Website	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Marketing Contact	Director Marketing & Communication	Ms	Lark	Azia		9735182754					azia.lark@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	02/03/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Medical Director	Medical Director		Morissette	Sabina		4137487223				4134932024	Sabina.Morissette@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/03/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Medicare Compliance Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Medicare Coordinator	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part C Application Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part D Appeals	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	New York
H0809	Part D Application Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part D Benefits Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part D Claims Submission Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part D Exceptions Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	New York
H0809	Part D Price File Contact (Back-up)	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part D Price File Contact (Primary)	Regional Director Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part D Quality Assurance Contact	Interim Director QI/Compliance	Mrs.	Groff	Kira		2153004965				4134932024	Kira.Groff@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	12/11/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Part D Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Patient Safety Contact	Director QI/Compliance Interim	Mrs	Groff	Kira		2153004965				4134932024	kira.groff@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	12/11/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Pharmacy Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Pharmacy Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Pharmacy Technical Help Desk Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	09/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	New York
H0809	Plan Directory Contact for Public Website	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Plan to Plan Reconciliation Contact	Regional, Director of Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Processor Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Quality Contact	Director QI/Compliance Interim	Mrs	Groff	Kira		2153004965				4134932024	kira.groff@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	12/11/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Reconciliation Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Recovery Audit Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Surveillance Contact	Executive Director	Ms	Szymczyk	Dawn		4138274231				4134932024	Dawn.Szymczyk@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Third Party Administrator (TPA) Liaison	Regional Director, Finance	Ms	Fuhrmeister	Nicole		4138274231					Nicole.Fuhrmeister@trinity-health.org	200 Hillside Circle		West Springfield	MA	01089	11/24/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Utilization Management Contact	Medical Director		Morissette	Sabina		4137487223				4134932024	Sabina.Morissette@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/03/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0809	Utilization Review Contact	Medical Director		Morissette	Sabina		4137487223				4134932024	Sabina.Morissette@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	03/03/2025	2026	MERCY LIFE, INC.	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H0816	Agent/Broker Compensation Data Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Backup User Access Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Best Available Evidence Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Bid Audit Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Bid Audit Site Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Bid Primary Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	CAP Report Contact for Public Website	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8007525863				HMO - Health Maintenance Organization		C	Dallas
H0816	CEO - CMS Administrator Contact	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	CEO - Senior Official for Contracting	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Chief Financial Officer	Chief Financial Officer	Mr.	Custis	Stephen		6129649158					Stephen.Custis@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Chief Operating Officer	Vice President of Operations	Ms.	Foemmel	Sara		7153836634					foemmel.sara@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Chief Information Officer	Cheif Information Officer	Mr.	Reimer	Brad		6053287937					Brad.Reimer@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Chief Information Security Officer	Vice President - Information Security Officer	Ms.	Hogstad	Kimberly		6053287410					Kimberly.Hogstad@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	CMMI Model Point of Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	CMS Casework Communication Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Complaints Tracking Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Contact for Fraud Investigations	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Coordination of Benefits Contact	Director of Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Corporate Mailing						8007525863					memberservices@sanfordhealth.org	PO BOX 91110		Sioux Falls	SD	57109	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Customer Service Operations Contact	Director of Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	DIR Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/24/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	DIR Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Discount Program Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Emergency Part D Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Emergency Part D Contact (Secondary)	Senior Pharmacist	Mr.	Reuman	Reed		6053122761					Reed.Reuman@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Employer Waiver Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Encounter Data & Risk Adjustment Operations Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Enrollment Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	EOB Transfer Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		6053287182				6053286811	Aleesa.Jansick@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Financial Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	09/24/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Financial Reporting Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Formulary Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Formulary Contact (Secondary)	Principal Pharmacy Benefits Specialist		Chen	Honghua		2242312740					Christine.Chen2@optum.com	1600  McConnor Parkway	Suite 201	Schaumburg	IL	601736801	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	General Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	07/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Government Relations Contact	Head of Government Affairs	Mr.	Wheeler	Dylan		6053287186					Dylan.Wheeler@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	HIPAA Privacy Officer	Lead Privacy Officer	Ms.	Sundby	Jennifer		6053625407					Jennifer.Sundby@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	HIPAA Security Officer	Information Security Compliance Officer	Mr.	Otte	Brody		6053126563					Brody.Otte@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Hospice Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Interoperability Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	MA Appeals/Grievances Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	MA Claims Processing Contact for Public Website	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Marketing Contact	Director of Marketing	Ms.	McCloskey	Diana		6053122762					Diana.Mccloskey@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Medical Director	Chief Medical Officer	Dr.	Faber	Kevin		6053287192					Kevin.Faber@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Medicare Coordinator	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	02/07/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Medication Therapy Management Contact	Clinical Pharmacy Specialist		Wittig	Kurt		7152219261				7152219719	wittig.kurt@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/24/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	OffShore Subcontractor Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Online Enrollment Center Contact (Back-up)	Manager of Inside Sales	Mr.	Arnett	Jack		6053286886					Jack.Arnett@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Online Enrollment Center Contact (Optional)	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Online Enrollment Center Contact (Primary)	Director of Medicare Programs	Mr.	Ovenden	Nathan		6053122606					Nathan.Ovenden@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part C Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part C Reporting Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Appeals	Manager, Prior Authorization Appeals	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Appeals Contact (Secondary)	Pharmacy Technician, PA Appeals	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Application Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Benefits Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Claims Submission Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Exceptions Contact	Manager, Prior Authorization	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Exceptions Contact (Secondary)	Pharmacy Technician, PA	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms.	Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Price File Contact (Optional)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Price File Contact (Primary)	Senior Business Analyst	Ms.	Lam	Annie		6124286588					Annie.Lam@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Quality Assurance Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Part D Reporting Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Patient Safety Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Personal Health Record Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Pharmacy Director	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Perez	Felix		7632833503					Felix.Perez@optum.com	1600 McConnor Parkway , IL 601736801		Schaumburg	IL	601736801	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations	Ms.	Ashby	Jolynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Pharmacy Technical Help Desk Contact	Pharmacy Technical Help Desk	Sr.	Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8446429090				HMO - Health Maintenance Organization		C	Dallas
H0816	PHR Beneficiary Contact																	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS	Sanford Health Plan	Sanford Health	740	Yes	Active	8882786485				HMO - Health Maintenance Organization		C	Dallas
H0816	Physician Incentive Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Plan Directory Contact for Public Website	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Processor Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Quality Contact	Director of Quality and STARS Strategy	Ms.	Kanta	Misty		6053122788					Misty.Kanta@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Reconciliation Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Recovery Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	SNP Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	SNP State Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Surveillance Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	System Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Third Party Administrator (TPA) Liaison	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	User Access Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Utilization Management Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0816	Utilization Review Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	01/30/2025	2026	BESHP, INC.	Local CCP	MyAdvocate Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H0819	Automated TrOOP Balance Transfer Contact	None		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Backup User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Bid Primary Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	CAP Report Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	CEO - Senior Official for Contracting	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Chief Operating Officer	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Chief Information Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Chief Information Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Complaints Tracking Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Contact for Fraud Investigations	Executive Director	Mr	Mitrzyk	Susan		7177575433	20953				SMitrzyk@SeniorLifeYork.com	1500 Memory Lane Extended		York	PA	17402	04/21/2025	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Corporate Mailing						8145356000	22101			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	DIR Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Discount Program Payment Contact	CFO		Dodson	David	M	8145356000	22102				Ddodson@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/14/2025	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Emergency Part D Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Encounter Data & Risk Adjustment Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	10/18/2019	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Enrollment Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	EOB Transfer Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Financial Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Formulary Contact			N/A	N/A		1234567890	123				N/A@n/a.com	N/A		N/A	PA	15906	01/22/2013	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	General Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	HIPAA Privacy Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	HIPAA Security Officer	Chief Information Officer		Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Interoperability Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	MIrwin@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	02/16/2022	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	MA Appeals/Grievances Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Marketing Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Medical Director	Medical Director		Emesue	Evangeline		7177575433					Eemesue@PhysicianSolutionsGRP.com	1500 Memory Lane Ext		York	PA	17402	04/18/2023	2026	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	Ms	Mitrzyk	Susan		7177575433	20953				SMitrzyk@SeniorLifeYork.com	1500 Memory Lane Extended		York	PA	17402	04/21/2025	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Medicare Coordinator	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Medicare Part D Opioid Overutilization Contact	Medical Director		Emesue	Evangeline		7177575433					Eemesue@PhysicianSolutionsGRP.com	1500 Memory Lane Ext		York	PA	17402	04/18/2023	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Medication Therapy Management Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/13/2019	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Part C Application Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Appeals	Chief Financial Officer	Mr	Dodson	David						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H0819	Part D Appeals Contact (Secondary)	Chief Executive Officer	Mr.	Irwin	Mark						8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	12/29/2020	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active	8145356000	22101			PACE - Nat		C	Philadelphia
H0819	Part D Application Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Benefits Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Claims Submission Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H0819	Part D Price File Contact (Back-up)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Price File Contact (Primary)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Quality Assurance Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Patient Safety Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Payment Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Pharmacy Director			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Pharmacy Network Management Contact			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active	7242751203	219			PACE - Nat		C	Philadelphia
H0819	Plan Directory Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Processor Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	11/13/2025	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Quality Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Reconciliation Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Recovery Audit Contact	CFO	Mr	Dodson	David	M	8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Surveillance Contact			Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	System Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Third Party Administrator (TPA) Liaison	VP Grane PBM		Baker	John		3306968345					jebaker@granepbm.com	209 Sigma Drive		Pittsburgh	PA	15238	03/14/2025	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Utilization Management Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0819	Utilization Review Contact	ChieExecutive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE YORK, INC.	National PACE	Senior LIFE York	National PACE		Senior LIFE York, Inc.	544	Yes	Active					PACE - Nat		C	Philadelphia
H0828	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Backup User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Best Available Evidence Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	CAP Report Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H0828	CEO - CMS Administrator Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Chief Operating Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Complaints Tracking Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Contact for Fraud Investigations	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Coordination of Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Customer Service Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	DIR Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Encounter Data & Risk Adjustment Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Enrollment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Financial Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	General Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Government Relations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	HIPAA Privacy Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	HIPAA Security Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	MA Appeals/Grievances Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Marketing Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Medical Director	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Medicare Compliance Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Medicare Coordinator	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Medicare Part D Opioid Overutilization Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part C Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part D Appeals	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H0828	Part D Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part D Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part D Claims Submission Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H0828	Part D Price File Contact (Back-up)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part D Price File Contact (Primary)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part D Quality Assurance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Part D Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H0828	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Quality Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Reconciliation Contact (Secondary)	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	System Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0828	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF PALM BEACH, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H0839	Automated TrOOP Balance Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Backup User Access Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	CAP Report Contact for Public Website	Executive Director	Ms	Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	10/23/2024	2026	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	CEO - CMS Administrator Contact	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	CEO - Senior Official for Contracting	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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 Operating Officer	Executive Director	Ms	Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	10/23/2024	2026	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 Information Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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 Information Security Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	08/08/2024	2026	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	Complaints Tracking Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	08/08/2024	2026	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	Contact for Fraud Investigations	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	08/08/2024	2026	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	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	DIR Contact (Secondary)	Director of Health Plan Operations		Gallagher	Tierney		9705950523				9708295842	tgallagher@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	10/23/2024	2026	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	Discount Program Payment Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	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	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Emergency Part D Contact (Secondary)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Enrollment Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	General Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	HIPAA Privacy Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	HIPAA Security Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	MA Appeals/Grievances Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	10/23/2024	2026	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	MA Claims Processing Contact for Public Website	Claims Administrator	Ms	Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	09/21/2023	2026	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	Marketing Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	Medical Director	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	10/23/2024	2026	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 Quality	Ms	Peterson	Nora		9709643500				9705250166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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 Coordinator	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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 Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Medication Therapy Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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 C Application Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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 Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	9709643500				PACE - Nat		C	Atlanta
H0839	Part D Application Contact	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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 Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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 Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	9709643500				PACE - Nat		C	Atlanta
H0839	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	9709643500				PACE - Nat		C	Atlanta
H0839	Part D Price File Contact (Back-up)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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 Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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 Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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 Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Patient Safety Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	08/08/2024	2026	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	Payment Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Personal Health Record Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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 Director	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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 Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	9709643500				PACE - Nat		C	Atlanta
H0839	Plan Directory Contact for Public Website	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Processor Contact	Claims Administrator		Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Quality Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	08/08/2024	2026	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	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9709643500				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations		Nilsen	Eric		6124257858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/07/2023	2026	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	Surveillance Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	System Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	Third Party Administrator (TPA) Liaison	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	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	User Access Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	Utilization Management Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	Utilization Review Contact	Executive Director		Venick	Jane		9194253022				9194253001	jvenick@voa.org	5400 S. Miami Blvd. ,Ste 150		Durham	NC	27703	10/23/2024	2026	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	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Backup User Access Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Best Available Evidence Contact	Enrollment Coordinator		Butler	Amanda		5403139333					abutler@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Bid Primary Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	CAP Report Contact for Public Website	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	CEO - CMS Administrator Contact	CEO	Mr.	Parsons	Jason		5403139200					jparsons@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	CEO - Senior Official for Contracting	CEO	Mr.	Parsons	Jason		5403139200					jparsons@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Chief Financial Officer	CFO	Ms	Costello	Jennifer		5403139200					jcostello@blueridgehospice.org	160 Wincrest Drive		Winchester	VA	22602	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Chief Operating Officer	COO	Ms	Garrett	Altonia		5403139200					agarrett@blueridgehospice.org	333 Cork St Suite 405		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Chief Information Officer	VP of IT	Mr	Hamad	Mohamad		5403139200					mhamad@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Chief Information Security Officer	Director of IT	Mr	Hamad	Mohamad		5403139200					mhamad@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	CMS Casework Communication Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Complaints Tracking Contact	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Contact for Fraud Investigations	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Coordination of Benefits Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Corporate Mailing						5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Customer Service Operations Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	DIR Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	DIR Contact (Secondary)	CFO	Ms	Costello	Jennifer		5403139200					jcostello@blueridgehospice.org	160 Wincrest Drive		Winchester	VA	22602	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Discount Program Payment Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Emergency Part D Contact	Executive Director		Myers	SueAnn		5403139233					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Emergency Part D Contact (Secondary)	VP FP&A		Lanza	Jared		5403139200					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Encounter Data & Risk Adjustment Operations Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Enrollment Contact	Enrollment Coordinator		Butler	Amanda		5403139333					abutler@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	EOB Transfer Contact	Finance Representative		Lanza	Jared		5403139208				5406780772	jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Financial Audit Contact	Finance Representative	Ms	Costello	Jennifer		5403139200					jcostello@blueridgehospice.org	160 Wincrest Drive		Winchester	VA	22602	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Financial Reporting Contact	Finance Representative	Ms	Costello	Jennifer		5403139200					jcostello@blueridgehospice.org	160 Wincrest Drive		Winchester	VA	22602	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Formulary Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Formulary Contact (Secondary)	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	General Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Government Relations Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	HIPAA Privacy Officer	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	HIPAA Security Officer	VP of IT	Mr	Hamad	Mohamad		5403139200					mhamad@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Interoperability Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	MA Appeals/Grievances Contact	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	MA Claims Processing Contact for Public Website	Finance Representative		Lanza	Jared		5403139200					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Marketing Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Medical Director	Medical Director	Dr	Landrio	Julie		5403139333					jlandrio@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Medicare Compliance Officer	VP FP&A	Mr	Lanza	Jared		5403139333					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/22/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Medicare Coordinator	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr	Landrio	Julie		5403139333					jlandrio@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Medication Therapy Management Contact	Medical Director	Dr	Landrio	Julie		5403139333					jlandrio@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Online Enrollment Center Contact (Primary)	Enrollment Coordinator		Butler	Amanda		5403139333					abutler@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part C Application Contact	Enrollment Coordinator		Butler	Amanda		5403139333					abutler@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part D Appeals	VP of Quality		DeHaven	Angel							adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active	5403139333				PACE - Nat		C	Philadelphia
H0870	Part D Application Contact	VP of Finance		Lanza	Jared		5403139333					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	02/24/2025	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part D Benefits Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part D Claims Submission Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part D Exceptions Contact	Medical Director	Dr	Landrio	Julie							jlandrio@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active	5403139333				PACE - Nat		C	Philadelphia
H0870	Part D Exceptions Contact (Secondary)	VP of Quality		DeHaven	Angel							adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active	5403139333				PACE - Nat		C	Philadelphia
H0870	Part D Price File Contact (Back-up)	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part D Price File Contact (Primary)	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part D Quality Assurance Contact	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Part D Reporting Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Patient Safety Contact	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Payment Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Personal Health Record Contact	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Pharmacy Director	Medical Director	Dr	Landrio	Julie		5403139333					jlandrio@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Pharmacy Network Management Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Pharmacy Technical Help Desk Contact	VP of Quality		DeHaven	Angel							adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active	5403139333				PACE - Nat		C	Philadelphia
H0870	Plan Directory Contact for Public Website	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Plan to Plan Reconciliation Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Processor Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Quality Contact	VP of Quality		DeHaven	Angel		5403139333					adehaven@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Reconciliation Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Recovery Audit Contact	Finance Representative	Ms	Costello	Jennifer		5403139245					jcostello@blueridgehospice.org	160 Wincrest Drive		Winchester	VA	22602	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Surveillance Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	System Contact	VP of IT	Mr	Hamad	Mohamad		5403139200					mhamad@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Third Party Administrator (TPA) Liaison	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	User Access Contact	Finance Representative		Lanza	Jared		5403139208					jlanza@blueridgehospice.org	2333 Valor Dr		Winchester	VA	22601	08/14/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Utilization Management Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0870	Utilization Review Contact	Executive Director		Myers	SueAnn		5403139333					samyers@brih.org	2333 Valor Dr		Winchester	VA	22601	08/01/2024	2026	BLUE RIDGE INDEPENDENCE AT HOME, INC.	National PACE	Blue Ridge Independence at Home	National PACE		Blue Ridge Hospice, Inc.	849	Yes	Active					PACE - Nat		C	Philadelphia
H0885	Agent/Broker Compensation Data Contact	Regulatory Compliance Assoc.	Ms.	Jenkins	Nicole		9734668149					nicole_jenkins@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	06/05/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Automated TrOOP Balance Transfer Contact	Director, PBM Ops.	Ms.	Cain	Christina		6127776722				6127771330	EOBP2P@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Backup User Access Contact	Medicare Program Analyst		Vargas	Mario		9734666379					mario_vargas@horizonblue.com	3 Penn Plaza East	16-C	Newark	NJ	07105	01/22/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Best Available Evidence Contact	Supervisor, Govt. Programs		Achoe	Kisha		9734667328					Kisha_Achoe@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	07/27/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Bid Audit Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319				7322565428	jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Bid Audit Site Contact	Chief Compliance Officer	Ms.	Keehn	Lisa		6462214210					Lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Bid Primary Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319				7322565428	jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	CAP Report Contact for Public Website	VP, Regulatory Compliance	Mr	McGrady	Daniel		6095373066					Daniel_McGrady@horizonblue.com	3 Penn Plaza	PP-16F	Newark	NJ	07105	02/05/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active	6095372317				PPO - BBA		C	Dallas
H0885	CEO - CMS Administrator Contact	CEO	Ms.	Mahoney	Audrey		7329957148					audrey.mahoney@bravenhealth.com	3 Penn Plaza	14th Floor	Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	CEO - Senior Official for Contracting	CEO	Ms.	Mahoney	Audrey		7329957148					audrey.mahoney@bravenhealth.com	3 Penn Plaza	14th Floor	Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Chief Financial Officer	CFO	Mr.	Dalessio	James		6095372900					James_Dalessio@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	02/05/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Chief Operating Officer	Chief Operating Officer	Ms.	Mahoney	Audrey		7329957148					Audrey.Mahoney@Bravenhealth.com	3 Penn Plaza	PP-16	Newark	NJ	07105	08/09/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Chief Information Officer	Chief Information Officer	Ms.	Lavoie	Heather		9734664650					heather_lavoie@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	07/02/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Chief Information Security Officer	Chief Information Security Officer	Mr.	Patel	Niraj		9734664409					niraj_patel@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	CMS Casework Communication Contact	Director, GP Operations		Maramraju	Venkata		6095372113					venkata.maramraju@horizonblue.com	1700 American Boulevard		Pennington	NJ	08534	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Complaints Tracking Contact	Mgr, Exec DOBI Compl & Appls		Mestres	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Contact for Fraud Investigations	Sr. Director, Special Investigations		Dineen	Timothy		9734668723					timothy_dineen@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Coordination of Benefits Contact	Director, PBM Ops	Ms.	Cain	Christina		6127776722				6127771330	COBMedD@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Corporate Mailing						6095373066					scott_johnson@horizonblue.com	1700 American Blvd. HL-03	Hopewell Campus	Pennington	NJ	08534	04/30/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Customer Service Operations Contact	Director, Operations - GP		Yanek	John		5182208000					john_yanek@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	06/13/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	DIR Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					Athena_Patrikios@horizonblue.com	3 Penn Plaza	PP-12Q	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	DIR Contact (Secondary)	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	3 Penn Plaza East	PP-12	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Discount Program Payment Contact	Supervisor-Accounting		Fuentes	Yunetsi		2018895531					yunetsi_fuentes@horizonblue.com	3 Penn Plaza E		Newark	NJ	07101	09/17/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Emergency Part D Contact	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	01/06/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Emergency Part D Contact (Secondary)	Manager, Clinical Pharmacy		Sun	Jane		9734665044					jane_sun@horizonblue.com	3 Penn Plaza	PP 12-Q	Newark	NJ	07105	12/13/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Encounter Data & Risk Adjustment Operations Contact	Mgr, Medicare & Medicaid Risk Assessment		Goryachkovsky	Jenny		9734665956					jenny_goryachkovsky@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	12/02/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Enrollment Contact	Director, G. P. Operations		Maramraju	Venkata		6095372113					venkata_maramraju@horizonblue.com	1700 American Blvd. HL-03		Pennington	NJ	08534	01/22/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	EOB Transfer Contact	Director, PBM Ops.	Ms.	Cain	Christina		6127776722				6127771330	EOBP2P@primetherapeutics.com	2990 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Financial Audit Contact	Chief Compliance Officer	Ms.	Keehn	Lisa		6462214210					Lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Financial Reporting Contact	Corporate Controller		Concepcion	Ivan		9734664188					Ivan_Concepcion@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	05/01/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Formulary Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					athena_patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	06/09/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	General Contact	Chief Compliance Officer	Ms.	Keehn	Lisa		6462214210					lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Government Relations Contact	Chief Compliance Officer	Ms.	Keehn	Lisa		6462214210					lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	HIPAA Privacy Officer	Director, Privacy Official		Dates	Chris		9734667669					Chris_Dates@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	01/22/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	HIPAA Security Officer	Chief Information Security Officer	Mr.	Patel	Niraj		9734664409					niraj_patel@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Hospice Contact	Manager, Clinical Pharmacy		Sun	Jane		9734665044					Jane_Sun@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Interoperability Contact	Manager, Mandate Implementation		Victory	Jacqueline		9734668759					Jacqueline_Victory@horizonblue.com	3 Penn Plaza	PP-09	Newark	NJ	07105	01/07/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	MA Appeals/Grievances Contact	Manager, MA DOBI Appeals & Grievances		Mestres	Suze		9734665503					Suze_Mestres@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	06/13/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	MA Claims Processing Contact for Public Website	Mgr, Exec DOBI Compl & Appls		Mestress	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Marketing Contact	Sales Manager II		Cennamo	Steven		9084160480					Steven_Cennamo@horizonblue.com	3 Penn Plaza	PP-12F	Newark	NJ	07105	02/24/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Medical Director	Senior Medical Director	Dr.	Abidi	Fatema		8566383042					fatema_abidi@horizonblue.com	1700 American Blvd	HL-01	Pennington	NJ	08534	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Keehn	Lisa		6462214210					lisa.keehn@bravenhealth.com	3 Penn Plaza		Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Medicare Coordinator	VP, Regulatory Compliance	Mr	McGrady	Daniel		6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza	PP-16F	Newark	NJ	07105	04/18/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Medicare Part D Opioid Overutilization Contact	Supv Pharmacists		Schons	Allison		8554570763				8557297221	PartDoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	01/03/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Medication Therapy Management Contact	Supervisor, MTM and Case/Care Management		Heibling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55120	12/27/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	OffShore Subcontractor Contact	Manager, Regulatory Requirements		Johnson	Scott		6095373066					Scott_Johnson@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/22/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Online Enrollment Center Contact (Back-up)	Supervisor		Johnson	Cheryl		9734666931					cheryl_johnson@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Online Enrollment Center Contact (Optional)	Team Leader		Johnson	Cheryl		9734666931					Cheryl_Johnson@horizonblue.com	3 Penn Plaza - PP12L		Newark	NJ	07105	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Santiago-Mercado	Nitza		9734667346					Nitza_Santiago-mercado@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part C Application Contact	Chief Compliance Officer	Ms.	Keehn	Lisa		6462214210					Lisa.keehn@bravenhealth.com	3 Penn Plaza East	PP-14A	Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part C Reporting Contact	Manager, Audit Readiness	Mrs.	Santoro	Cynthia		9734668395					cynthia_santoro@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Appeals	Regulatory Director	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	04/15/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active	6127775393				PPO - BBA		C	Dallas
H0885	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kimberly	Emerson						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd	Clinical Review	Eagan	MN	55121	07/21/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active	8006936651				PPO - BBA		C	Dallas
H0885	Part D Application Contact	Chief Compliance Officer	Ms.	Keehn	Lisa		6462214210					Lisa.keehn@bravenhealth.com	3 Penn Plaza East	PP-14A	Newark	NJ	07105	07/01/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Benefits Contact	Director, Benefits Ops.	Ms.	Gergen	Ashley		6127772506					agergen@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	10/06/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Claims Submission Contact	Functional Business Consultant - Govt. Programs	Mr.	Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	PRIME Therapeutics, LLC	2655 Eagan Woods Drive	Eagan	MN	55122	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Exceptions Contact	Director, Reg/Audit Response	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd		Eagan,	MN	55121	04/15/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active	8006936651				PPO - BBA		C	Dallas
H0885	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Kimberly	Emerson						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagen	MN	55120	07/21/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active	8006936651				PPO - BBA		C	Dallas
H0885	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699					Emily.Tastad@PrimeTherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	11/28/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Price File Contact (Optional)	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	Horizon Blue Cross Blue Shield of NJ	3 Penn Plaza, PP-12	Newark	NJ	07105	01/06/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Price File Contact (Primary)	Sr. Business Solutions Analyst	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	PRIME Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/28/2023	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Quality Assurance Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					Athena_Patrikios@horizonblue.com	3 Penn Plaza	PP-12Q	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Part D Reporting Contact	Manager, Audit Readiness	Mrs.	Santoro	Cynthia		9734668395					cynthia_santoro@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Patient Safety Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					Athena_Patrikios@horizonblue.com	3 Penn Plaza	PP-12Q	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Payment Contact	Supervisor-Accounting		Fuentes	Yunetsi		2018895531					yunetsi_fuentes@horizonblue.com	3 Penn Plaza E		Newark	NJ	07101	09/17/2025	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Pharmacy Director	Director, Pharmacy - Medicare		Patrikios	Athena		9734664654					athena_patrikios@horizonblue.com	3 Penn Plaza	PP-12Q	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Pharmacy Network Management Contact	AVP, Network Mgmt	Ms	Conlin	Marci		6127772842					Marci.Conlin@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	04/15/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Pharmacy Network Management Contact (Secondary)	Sr. Director Network Client Svcs.	Ms	Hanley	Megan		6127773969				8778236373	Megan.Hanley@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55122	01/05/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Pharmacy Technical Help Desk Contact	Director, Member Services		Shultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/12/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active	8554570005				PPO - BBA		C	Dallas
H0885	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Exp. & Member Ops		Bunch	Jonathan							jonathan.bunch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/12/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active	8554570005				PPO - BBA		C	Dallas
H0885	Plan Directory Contact for Public Website	Mgr, Exec DOBI Compl & Appls		Mestres	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Plan to Plan Reconciliation Contact	Pharmacy Business Admin		Cunningham	Theresa		9734667886				9734664665	theresa_cunningham@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Processor Contact	Manager, PBM Ops	Ms.	Hanson	Michelle		6127776755					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	04/15/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Quality Contact	Director, Quality Improvement Operations		Harris	Andrea		6095373027					andrea_harris@horizonblue.com	1700 American Blvd	HL-02	Pennington	NJ	08534	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Reconciliation Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319				7322565428	jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Reconciliation Contact (Secondary)	Manager, Actuarial		Muellers	Barbara		7322565313				7322565428	barbara_muellers@horizonblue.com	1427 Wyckoff Road	WL-03R	Wall	NJ	07727	03/03/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Recovery Audit Contact	Sr. Director, Special Investigations	Mr.	Dineen	Timothy		9734668723					timothy_dineen@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	SNP Application Contact			CONTACT	NO		9734664015					NOEMAIL@HORIZONBLUE.COM	3 Penn Plaza	12-H	Newark	NJ	07105	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	SNP State Contact			CONTACT	NO		9734664015					NOEMAIL@HORIZONBLUE.COM	3 Penn Plaza	12-H	Newark	NJ	07105	01/23/2020	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Surveillance Contact	Manager, Medicare Requirements	Mr.	Johnson	Scott		6095373066					scott_johnson@horizonblue.com	1700 American Blvd. HL-03	Hopewell Campus	Pennington	NJ	08534	04/30/2021	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	System Contact	Manager, Information Security Risk Management		Andreano	Matthew		9734664124					matthew_andreano@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	06/13/2022	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Third Party Administrator (TPA) Liaison	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					athena_patrikios@horizonblue.com	3 Penn Plaza	PP-12Q	Newark	NJ	07105	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	User Access Contact	Regulatory Compliance Assoc.	Mr.	Vargas	Mario		9734666379					Mario_Vargas@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	06/05/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Utilization Management Contact	VP, Clinical Operations		Rush	Lisa		7322565016					Lisa_Rush@horizonblue.com	250 Century Parkway	3-D	Mount Laurel	NJ	08054	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0885	Utilization Review Contact	VP, Clinical Operations		Rush	Lisa		7322565016					Lisa_Rush@horizonblue.com	250 Century Parkway	3-D	Mount Laurel	NJ	08054	12/13/2024	2026	HEALTHIER NEW JERSEY INSURANCE COMPANY	Local CCP	Braven Health	Local PPO		Horizon Mutual Holdings, Inc	126	Yes	Active					PPO - BBA		C	Dallas
H0907	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	01/29/2020	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/11/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/06/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H0907	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H0907	PHR Beneficiary Contact																	01/29/2020	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H0907	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0907	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT IOWA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0908	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	03/30/2021	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0908	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0908	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0908	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0908	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337503760				HMO - Health Maintenance Organization		C	Denver
H0908	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337503760				HMO - Health Maintenance Organization		C	Denver
H0908	PHR Beneficiary Contact																	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H0908	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0908	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H0913	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H0913	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H0913	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H0913	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H0913	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H0913	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H0913	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0913	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H0934	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Backup User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/28/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	CEO - CMS Administrator Contact		Ms.	George	Jennifer		6263793654					jennifer.george@welbehealth.com	50 Alessandro Place, Suite A20		Pasadena	CA	91105	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	CEO - Senior Official for Contracting		Ms.	George	Jennifer		6263793654					jennifer.george@welbehealth.com	50 Alessandro Place, Suite A20		Pasadena	CA	91105	06/16/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Chief Financial Officer		Ms.	George	Jennifer		6263793654					jennifer.george@welbehealth.com	50 Alessandro Place, Suite A20		Pasadena	CA	91105	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Chief Operating Officer		Ms.	George	Jennifer		6263793654					jennifer.george@welbehealth.com	50 Alessandro Place, Suite A20		Pasadena	CA	91105	06/16/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/19/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/19/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Contact for Fraud Investigations			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Customer Service Operations Contact			George	Jennifer		6263793654					jennifer.george@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	DIR Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	DIR Contact (Secondary)			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N Barranca Ave	#4051	Covina	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Emergency Part D Contact (Secondary)			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	General Contact			George	Jennifer		6263793654					jennifer.george@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Government Relations Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	HIPAA Privacy Officer			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	HIPAA Security Officer			Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Medical Director			Robinson	Colin		6266577704					colin.robinson@welbehealth.com	50 Alessandro Place, Suite A20		Pasadena	CA	91105	07/29/2025	2026	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		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Medicare Coordinator			George	Jennifer		6263793654					jennifer.george@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	2192106392				PACE - Nat		C	San Francisco
H0934	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H0934	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H0934	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Quality Assurance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Patient Safety Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/03/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H0934	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Surveillance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	User Access Contact		Mr.	Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0934	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	PACIFIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H0963	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Best Available Evidence Contact	Manager, Enrollment		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Chief Financial Officer	Chief Financial Officer	Ms.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Government Relations Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H0963	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H0963	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0963	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H0976	Agent/Broker Compensation Data Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189				mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Best Available Evidence Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	CEO - CMS Administrator Contact	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	CEO - Senior Official for Contracting	Chief Executive Officer	Dr,	Jain	Sachin		5929898314				5629895225	sjain@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Chief Financial Officer	Chief Financial Officer	Mr	Plumb	Michael		5629971589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Chief Information Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	CMS Casework Communication Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Complaints Tracking Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189				mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459				5629890101	tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	DIR Contact (Secondary)	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/27/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/31/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Employer Waiver Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Encounter Data & Risk Adjustment Operations Contact	Chief Medical Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	04/17/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Enrollment Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Financial Audit Contact	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/21/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	General Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Government Relations Contact	VP of Government Relations		Kazan	Matt		8005593500				5629899439	m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	MA Appeals/Grievances Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Medical Director	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Medicare Compliance Officer	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/19/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195					c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	OffShore Subcontractor Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part C Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part C Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Appeals	Sr. Director of Grievances and Appeals	Ms.	Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5629895100	1290			HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization		Herbert	Joshua						5629890958	Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	1290			HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization	Mr.	Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	733326			HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4347				a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Part D Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	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	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H0976	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Processor Contact	Senior Director Government Programs, Medicare	Ms.	Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St. Louis	MO	63121	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Recovery Audit Contact	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	SNP Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	SNP State Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Surveillance Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	User Access Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0976	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Agent/Broker Compensation Data Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	CEO - CMS Administrator Contact	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	CEO - Senior Official for Contracting	CEO	Dr.	Jain	Sachin		5629898314	8314				sjain@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/11/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Chief Financial Officer	CFO	Mr.	Plumb	Michael		5629971589	1589				mplumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/11/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Chief Information Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	CMS Casework Communication Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Complaints Tracking Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459				5629890101	tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	DIR Contact (Secondary)	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/27/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/31/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/21/2022	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Employer Waiver Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Encounter Data & Risk Adjustment Operations Contact	Chief Data Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	03/10/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Enrollment Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Financial Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	1331			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/21/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	General Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Government Relations Contact	VP of Government Relations		Kazan	Matt		8005593500					m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	MA Appeals/Grievances Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/02/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Medical Director	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Medicare Compliance Officer	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/19/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195					c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	OffShore Subcontractor Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part C Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part C Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Appeals	Sr. Director of Grievances and Appeals	Ms.	Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5629895100	1290			HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization	Ms.	Herbert	Joshua						5629890958	Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	1290			HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	One Express Way		St Louis	MO	63121	10/13/2022	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization	Mr.	Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	733326			HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	12/01/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4348			5629973196	a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Part D Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/23/2023	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H0978	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Processor Contact	Senior Director Government Programs, Medicare	Ms.	Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Recovery Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	SNP Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	SNP State Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Surveillance Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	User Access Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0978	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN NEVADA, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Agent/Broker Compensation Data Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Automated TrOOP Balance Transfer Contact	VP of Pharmacy Ops		Romay	Alfred		7864274923					aromay@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	05/29/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Backup User Access Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Best Available Evidence Contact	Enrollment Manager		Lopez	Consuelo		7864867983					clopez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/31/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Bid Audit Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Bid Audit Site Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Bid Primary Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	CAP Report Contact for Public Website	Director of Compliance		Gomez	Dais	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Duarte	Efrain		3054203047					eduarte@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	09/15/2022	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Duarte	Efrain		3054203047					eduarte@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	09/15/2022	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Chief Financial Officer	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Chief Operating Officer	Chief Operating Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	09/15/2022	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Chief Information Officer	Chief Technology Officer	Ms.	Hernandez	Raquel		3057999347					rhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Chief Information Security Officer	Director Data Integration	Ms.	Hernandez	Raquel		3057999347				3056750139	rhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	05/19/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	CMS Casework Communication Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Complaints Tracking Contact	Compliance Specialist		Moreno	Juan		3057857748					jmoreno@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	11/14/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Contact for Fraud Investigations	SIU/FWA Lead		Moreno	Juan		3057857748					jmoreno@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	11/21/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Coordination of Benefits Contact	Enrollment Manager		Lopez	Consuelo		7864867983					clopezs@solishealthplans.com	9250 NW 36th Street	# 400	Miami	FL	33178	11/03/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Corporate Mailing						8444476547					info@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	08/20/2018	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Customer Service Operations Contact	Senior Manager of Member Services		Oliva	Zackary		8444416547					zoliva@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	12/04/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	DIR Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	DIR Contact (Secondary)	Controller		Mirabal	Duniel	M	7865878643					dmirabal@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	03/06/2024	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Discount Program Payment Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Electronic Health Record Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Emergency Part D Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	05/29/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Emergency Part D Contact (Secondary)	Part D Analyst		Nodal	Raul		3057338374					rnodal@solishealthplans.com	9250 NW 36th Suite 400		Miami	FL	33178	03/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Encounter Data & Risk Adjustment Operations Contact	Chief Technology Officer		Hernandez	Raquel		3057999347					rhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Enrollment Contact	Enrollment Manager		Lopez	Consuelo		7864867983					clopez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/31/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	EOB Transfer Contact	Chief Operating Officer		Lynch	Michael		9546474259				8336159263	mlynch@solishealthplans.com	9250 NW 36th Street	# 400	Miami	FL	33178	11/03/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Financial Audit Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Financial Reporting Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Formulary Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	05/29/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Formulary Contact (Secondary)	Clinical Program Manager		Warnke	DW		6127776921					Dw.warnke@primetherapeutics.com	2900 Ames Crossing		Eagan	MN	55121	01/22/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	General Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Government Relations Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	HIPAA Privacy Officer	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	HIPAA Security Officer	Chief Technology Officer	Mr.	Hernandez	Raquel		3057999347				3056750139	rhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Hospice Contact	Chief Medical Officer	Dr.	Hernandez	Francisco		7862863409					fhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Interoperability Contact	Chief Technology Officer		Hernandez	Raquel		3057999347					rhernandez@solishealthplans.com	9250 NW 36th Street Suite 400		Miami	FL	33178	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	MA Appeals/Grievances Contact	Senior Manager of Customer Service		Oliva	Zackary		3053364023					zoliva@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	05/29/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	MA Claims Processing Contact for Public Website	Chief Operating Officer		Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	11/03/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Marketing Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Medical Director	Chief Medical Officer	Dr.	Hernandez	Francisco		7862863409					fhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Medicare Compliance Officer	Director of Compliance	Ms.	Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	05/19/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Medicare Coordinator	Chief Executive Officer	Mr.	Duarte	Efrain		3054203047					eduarte@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	09/15/2022	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	12/04/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Medication Therapy Management Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	05/29/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Online Enrollment Center Contact (Primary)	Enrollment Manager		Lopez	Consuelo		7864867983					clopez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/31/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part C Application Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part C Reporting Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Appeals	Sr. Regulatory Pharmacist		Emerson	Kimberly							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing		Appleton	WI	54913	01/22/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Appeals Contact (Secondary)	VP of Pharmacy Operations		Romay	Alfred							aromay@solishealthplans.com	9250 NW 36th Suite 400	Suite 400	Miami	FL	33178	12/04/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active	7864274923				HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Application Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Benefits Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	13620 SW 20th Street	Suite 400	Miami	FL	33127	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Claims Submission Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					claimspecialist@Primetherapeutics.com	13620 SW 20th Street	Suite 400	Miami	FL	33127	01/22/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Exceptions Contact	Sr. Regulatory Pharmacist		Emerson	Kimberly							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing		Appleton	WI	54913	01/22/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Exceptions Contact (Secondary)	Part D Analyst		Nodal	Raul							rnodal@solishealthplans.com	9250 NW 36th Suite 400	Suite 400	Miami	FL	33178	03/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active	3057338374				HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Price File Contact (Back-up)	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	13620 SW 20th Street	Suite 400	Doral	FL	33127	05/29/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Price File Contact (Optional)	Part D Analyst		Nodal	Raul		3057338374					rnodal@solishealthplans.com	9250 NW 36th Suite 400		Miami	FL	33178	03/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@navitus.com	2601 West Beltline Highway, Suite 600		Madison	WI	53713	01/29/2019	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Quality Assurance Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	13620 SW 20th Street	Suite 400	Miami	FL	33127	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Part D Reporting Contact	Part D Analyst		Nodal	Raul		3057338374					rnodal@solishealthplans.com	9250 NW 36th Suite 400	Suite 400	Miami	FL	33178	03/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Patient Safety Contact	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	13620 SW 20th Street	Suite 400	Miami	FL	33127	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Payment Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Personal Health Record Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Pharmacy Director	VP of Pharmacy Operations		Romay	Alfred		7864274923					aromay@solishealthplans.com	9250 SW 36th Street	Suite 400	Doral	FL	33178	05/29/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Pharmacy Network Management Contact	Network CLient Services		Scoll	Adam		6127775354				9202214589	adam.scoll@primetherapeutics.com	2900 Ames Crossing		eagan	MN	55121	01/22/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Pharmacy Network Management Contact (Secondary)	Part D Analyst		Nodal	Raul		3057338374					rnodal@solishealthplans.com	9250 NW 36th Suite 400	Suite 400	Miami	FL	33178	03/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Pharmacy Technical Help Desk Contact	VP of Pharmacy Operations		Romay	Alfred							aromay@solishealthplans.com	9250 SW 36th Street	Suite 400	Doral	FL	33178	12/09/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active	8554571209				HMO - Health Maintenance Organization		C	Chicago
H0982	Physician Incentive Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Plan Directory Contact for Public Website	Provider Services Department		Services	Provider		8336159259					providerrelations@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	08/20/2019	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Processor Contact	Enrollment Manager		Lopez	Consuelo		7864867983					clopez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/31/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Quality Contact	Director of Quality Operations	Mrs.	Megias	Lisette		3055108344					lmegias@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Reconciliation Contact	Chief Financial Officer	Mr.	Lynch	Michael		9546474259					mlynch@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Reconciliation Contact (Secondary)	Controller	Ms.	Knez	Paula		3054203028					pknez@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	07/17/2018	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Recovery Audit Contact	Director of Compliance	Ms.	Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	11/20/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	SNP Application Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	SNP State Contact	Chief Executive Officer		Duarte	Efrain		3054203047					eduarte@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	09/15/2022	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Surveillance Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	System Contact	Chief Technology Officer		Hernandez	Raquel		3057999347					rhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	07/28/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Third Party Administrator (TPA) Liaison	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33027	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	User Access Contact	Director of Compliance		Gomez	Daisy	M	3057857748					daisy.gomez@solishealthplans.com	9250 NW 36th Street	Suite 400	Doral	FL	33178	02/28/2025	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Utilization Management Contact	Chief Medical Officer	Dr.	Hernandez	Francisco		7862863409					fhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H0982	Utilization Review Contact	Chief Medical Officer	Dr.	Hernandez	Francisco		7862863409					fhernandez@solishealthplans.com	9250 NW 36th Street	Suite 400	Miami	FL	33178	02/22/2023	2026	SOLIS HEALTH PLANS, INC.	Local CCP	Solis Health Plans	HMO/HMOPOS		Athena Healthcare Holdings, LLC	662	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1019	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	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	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	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	Director	Mrs.	Gay	Tiffany		8136952581				8135601398	tgay@careplus-hp.com	4030 Boy Scout Blvd	Suite #1000	Tampa	FL	33607	12/18/2024	2026	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	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	07/02/2024	2026	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	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	07/02/2024	2026	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	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5025805926					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	07/02/2024	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	07/02/2024	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	12/29/2022	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	03/10/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Senior Compliance		Arteaga	Karla		5025807929				8009564288	karteaga1@humana.com	6101 Blue Lagoon Drive	Suite #195	Miami	FL	33126	07/02/2024	2026	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	Complaints Tracking Contact	Senior Compliance		Arteaga	Karla		5025807929				8009564288	karteaga1@humana.com	6101 Blue Lagoon Drive	Suite #195	Miami	FL	33126	07/02/2024	2026	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	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	12/29/2022	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	12/18/2024	2026	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	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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		5029942678				5025086297	aford@humana.com	500 West Main Street	Floor 22	Louisville	KY	40204	04/13/2022	2026	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	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	07/02/2024	2026	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	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	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	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	12/29/2022	2026	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	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	12/29/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact			Wanstrath	Bryon		8134395005					BWanstrath@humana.com	4925 Independence Pkwy	Suite 300	Tampa	FL	33634	07/17/2025	2026	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	Enrollment Contact	Director	Mrs.	Gay	Tiffany		8136952581				8135601398	tgay@careplus-hp.com	4030 Boy Scout Blvd	Suite #1000	Tampa	FL	33607	12/18/2024	2026	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	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Financial Audit Contact	Associate Director	Mrs	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	07/02/2024	2026	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	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/18/2024	2026	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	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	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	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	07/02/2024	2026	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	MA Appeals/Grievances Contact	Senior Compliance		Arteaga	Karla		5025807929				8009564288	karteaga1@humana.com	6101 Blue Lagoon Drive	Suite #195	Miami	FL	33126	07/02/2024	2026	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	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2026	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	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	04/04/2025	2026	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	Medical Director	Regional VP	Dr.	Rodriguez-Alonso	Madeleine		7865263041				3053706799	madeleinrodriguez@careplus-hp.com	6101 Blue Lagoon Drive	Suite 195	Miami	FL	33126	03/09/2023	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	01/24/2024	2026	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	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	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	Online Enrollment Center Contact (Back-up)	Manager	Mrs.	Cordova	Janelys		8134395006				8135601398	janelys.jimenez@careplus-hp.com	4925 Independence Pkwy	Ste # 300	Tampa	FL	33634	06/21/2022	2026	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	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	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	Online Enrollment Center Contact (Primary)	Director	Mrs.	Gay	Tiffany		8136952581				8135601398	tgay@careplus-hp.com	4030 Boy Scout Blvd	Suite #1000	Tampa	FL	33607	12/18/2024	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	04/04/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	12/29/2022	2026	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 Appeals	Senior Compliance		Arteaga	Karla							karteaga1@humana.com	6101 Blue Lagoon Drive	Suite #195	Miami	FL	33126	07/02/2024	2026	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025807929				HMO - Health Maintenance Organization		C	Kansas City
H1019	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	04/04/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	12/29/2022	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	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	12/18/2024	2026	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1019	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H1019	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	07/13/2023	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	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 Reporting Contact	Senior Compliance		Arteaga	Karla		5025807929				8009564288	karteaga1@humana.com	6101 Blue Lagoon Drive	Suite #195	Miami	FL	33126	07/02/2024	2026	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	Patient Safety Contact	Sr Compliance Professional		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	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	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	07/13/2023	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	12/18/2024	2026	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H1019	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	CAREPLUS HEALTH PLANS, INC.	Local CCP	CarePlus Health Plans, Inc.	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H1019	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2026	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	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/19/2025	2026	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	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	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	Quality Contact	Director		Shephard	Angela		3124415345					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	07/13/2023	2026	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	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	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	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	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	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	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	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	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	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	12/29/2022	2026	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	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	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	Utilization Management Contact	Director, UM/Compliance (UM)		Nieto	Javier		3052022942					jnieto@careplus-hp.com	6101 Blue Lagoon Drive	Suite 195	Miami	FL	33126	03/09/2023	2026	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	Utilization Review Contact	Medical Director	Dr.	Seleznick	Mitchel		8138298300	1021036				mseleznick@humana.com	4925 Independence Pkwy	Suite 300	Tampa	FL	33634	03/09/2022	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/28/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/13/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H1032	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H1032	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H1032	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H1032	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H1032	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H1032	PHR Beneficiary Contact																	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H1032	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1032	Utilization Review Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	12/17/2025	2026	Sunshine State Health Plan, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1035	Agent/Broker Compensation Data Contact	VP Product, Growth and Operations		Davis	Andrea		8478265793					andrea.davis@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	11/01/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Automated TrOOP Balance Transfer Contact	Manager, PBM operations	Ms.	Hanson	Michelle		6127776755				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/27/2020	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Backup User Access Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	04/11/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Best Available Evidence Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Bid Audit Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Bid Audit Site Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Bid Primary Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	CAP Report Contact for Public Website	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	CEO - CMS Administrator Contact	EVP, Medicare Chief Innovation& Experience Officer	Mrs	Harrison	Camille		9049051801					Camille.Harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr.	Jacksonville	FL	32246	01/06/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	CEO - Senior Official for Contracting	EVP, Medicare, Chief Innovation&Experience Officer	Mrs.	Harrison	Camille		9049051801					camille.harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	01/13/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Chief Financial Officer	VP Medicare CFO	Mrs	Dorsett	Kareen		4048087542					Kareen.Dorsett@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400,	Jacksonville	FL	32246	02/15/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Chief Operating Officer	Senior Vice President Medicare	Ms.	Pieraccini	Alisha		7164659217					Alisha.Pieraccini@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	11/01/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Chief Information Officer	SVP Chief Information Officer	Mr.	Anderson	Gary		9049050180					gary.anderson@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 8th Floor	Jacksonville	FL	32246	01/02/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Raymond	Jason		9049050070					jason.raymond@floridablue.com	4800 Deewood Campus Parkway	DCC Building 600, 2nd Floor	Jacksonville	FL	32246	04/04/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	CMS Casework Communication Contact	Sr Manager Med Ops & Integrity		Irizarry	Haydee		3212330635					Haydee.Irizarry@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	04/25/2023	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Complaints Tracking Contact	Sr Manager Med Ops & Integrity		Irizarry	Haydee		3212330635					Haydee Irizarry@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	04/25/2023	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Contact for Fraud Investigations	Sr. Manager Fraud Investigation		Ramos	Jose		9049055835					jose.romas@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 400, 6th Floor	Jacksonville	FL	32246	04/04/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Coordination of Benefits Contact	Manager PBM Operations		Hanson	Michelle		6127776755				3127776706	COBMedD@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	02/16/2021	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Corporate Mailing						9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	12/29/2021	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Customer Service Operations Contact	Sr Director Member Contact		Gamble	LaTonya		9049052057					latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/04/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	DIR Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	DIR Contact (Secondary)	Medicare Actuary Director		Dougherty	Emily		9049053894					Emily.Dougherty@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Discount Program Payment Contact	Accountant I, Corporate Receivables		Lance	Deavon		8134162412					Deavon.Lance@bcbsfl.com	4800 Deerwood Campus Pkwy	Bldg 100, 5th Floor	Jacksonville	FL	32246	12/03/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Emergency Part D Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9045259651					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Emergency Part D Contact (Secondary)	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Employer Waiver Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4thFloor	Jacksonville	FL	32246	04/04/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Encounter Data & Risk Adjustment Operations Contact	FBM Sr. Dir. RA Strategy & PM		Nair	Sudhir		2484175129					sudhir.nair@bcbsfl.com	4800 Deerwood Parkway		Jacksonville	FL	32246	02/18/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Enrollment Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	EOB Transfer Contact	Sr Director Member Contact		Gamble	LaTonya		9049052057				9043576121	latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/08/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Financial Audit Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Financial Reporting Contact	VP Medicare CFO		Dorsett	Kareen		9049051754					Kareen.Dorsett@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400	Jacksonville	FL	32246	08/20/2021	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Formulary Contact	Medicare Clinical Pharmacist		Keaton	Stephanie		9049050114					stephanie.keaton@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	12/06/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Formulary Contact (Secondary)	Manager of Medicare Products and Reporting		Laks	Christine		3866154050					claks@fhcp.com	1340 Ridgewood Avenue		Holly Hill	FL	32117	11/01/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	General Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Government Relations Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	HIPAA Privacy Officer	Sr. Counsel		Resnick	Steven		9049055025					steven.resnick@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	05/08/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	HIPAA Security Officer	VP Chief Information Security Officer		Raymond	Jason		9049050070					jason.raymond@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 600, 2nd Floor	Jacksonville	FL	32246	01/04/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Hospice Contact	Sr. Manager Pharmacy		Adams	Tangela		9049050002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Interoperability Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th FL	Jacksonville	FL	32246	06/13/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	MA Appeals/Grievances Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	MA Claims Processing Contact for Public Website	FBM Dir. Claims		Stephens	Anquenette		2053353002					Anquenette.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Marketing Contact	FBM Spec.IV Product Operations		Lilly	Wanda		9043573900					wanda.lilly@bcbsfl.com	4800 Deerwood Campus Parkway	Building 400, 3rd Floor	Jacksonville	FL	32246	04/27/2023	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Medical Director	VP & CMO FBM	Dr.	Graf	Thomas		5704496647					Thomas.Graf@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	01/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Medicare Compliance Officer	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Medicare Coordinator	EVP, Medicare, Chief Innovation&Experience Officer	Mrs.	Harrison	Camille		9049051801					camille.harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	11/17/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Medicare Part D Opioid Overutilization Contact	Sr. Manager Pharmacy		Adams	Tangela		9049050002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Medication Therapy Management Contact	Sr. Manager Pharmacy		Martinez	Diony		9049058882					Diony.Martinez@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	OffShore Subcontractor Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Online Enrollment Center Contact (Back-up)	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Online Enrollment Center Contact (Optional)	Sr. Manager Medicare Regulatory Ops		Stephens	Kate		9049055131					Kate.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 300 4th Flr	Jacksonville	FL	32246	08/04/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Online Enrollment Center Contact (Primary)			EMB Analysts	FBM Ops		9049051711					FB_Medicare_Ops_EMB_Analysts@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 2nd Floor	Jacksonville	FL	32246	05/06/2021	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part C Application Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part C Reporting Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th floor	Jacksonville	FL	32246	04/11/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Appeals	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773736	56307			HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Appeals Contact (Secondary)	Spec IIIb Business Support		Barr	Shamika						9043011849	Shamika.Barr@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773636	54283			HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Application Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Benefits Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Claims Submission Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Exceptions Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773736	56307			HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Exceptions Contact (Secondary)	Administrator of Member & Clinical Services		Siciliano	Daria							dsiciliano@fhcp.com	1340 Ridgewood Avenue		Holly Hill	FL	32117	01/08/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8003529824	7200			HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Price File Contact (Back-up)	Business Support Specialist IIIb		Blackshear	Venetia		9049055235					Venetia.Blackshear@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Price File Contact (Optional)	Director Business Support		Chaney	Saraye		9049055878					saraye.chaney@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Price File Contact (Primary)	Business Support Specialist IIIb		Barr	Shamika		9049054283					Shamika.Barr@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Quality Assurance Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Part D Reporting Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th floor	Jacksonville	FL	32246	04/11/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Patient Safety Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Payment Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Pharmacy Director	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Pharmacy Network Management Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Pharmacy Network Management Contact (Secondary)	Pharmacy Administrator		Spitz	Benjamin		8886767173					bspitz@fhcp.com	1340 Ridgewood Avenue		Holly Hill	FL	32117	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Pharmacy Technical Help Desk Contact			HelpDesk	Prime Part	D					8882452422	pharmacyops@primetherapeutics.com	Prime Therapeutics, LLC	1305 Corporate Center Drive	Eagan	MN	55121	12/18/2018	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8888776420				HMO - Health Maintenance Organization		C	Dallas
H1035	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Administrator		Spitz	Benjamin						3866154045	bspitz@fhcp.com	1340 Ridgewood Avenue		Holly Hill	FL	32117	01/04/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	3866767105				HMO - Health Maintenance Organization		C	Dallas
H1035	Physician Incentive Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Plan Directory Contact for Public Website			Mbr Svcs	Medicare		8009266565					Chrissy.This@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	12/10/2020	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Plan to Plan Reconciliation Contact	Accounting Specialist		Williams	Lynn		9049054568					lynn.williams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	01/04/2019	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Processor Contact	FBM Dir. Claims		Stephens	Anquenette		2053353002					Anquenette.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Quality Contact	VP Medicare Quality		Neal	Leigh Anne		8037608701					leighanne.neal@bcbsfl.com	1388 Beechfern Circle		Elgin	SC	29045	07/11/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Reconciliation Contact	Medicare Actuary Director		Dougherty	Emily		9049053894					emily.dougherty@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Reconciliation Contact (Secondary)	Managing Actuary		Scott	Branson		9049054691					Branson.Scott2@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Recovery Audit Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Surveillance Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	System Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Third Party Administrator (TPA) Liaison	Sr. Manager Pharmacy		Adams	Tangela		9049050002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	User Access Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Utilization Management Contact	Sr. Manager - Case Management, Health Management		Wiggins	Dawn		9048858813					Dawn.Wiggins@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	11/10/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1035	Utilization Review Contact	Sr. Manager - Case Management, Health Management		Wiggins	Dawn		9048858813					Dawn.Wiggins@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	11/10/2025	2026	FLORIDA BLUE MEDICARE, INC.	Local CCP	Florida Blue HMO	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1036	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/14/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H1036	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H1036	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1036	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	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		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Backup User Access Contact	Quality and Compliance Manager	Mr.	Berry	Shane		3057621410					SBerry@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	05/21/2025	2026	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		3057958442				3057621431	SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Bid Primary Contact	EVP-PACE & President, Florida PACE Centers	Mr.	Hess	Steve		3057958442				3057621488	SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	CAP Report Contact for Public Website	AVP of PACE	Ms.	Lane	Maria		3057951890				3057621538	mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	CEO - CMS Administrator Contact	COO	Ms.	Lane	Maria		3057951890				3057621538	MLane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	CEO - Senior Official for Contracting	EVP President PACE	Mr.	Hess	Steve		3057958442				3057951855	shess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	AVP of Finance	Mr.	Sanchez	Juan		3055148554					JSanchez@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Operating Officer	COO	Ms.	Lane	Maria		3057951890					Mlane@miamijewishhealth.org	5200 NE 2nd /avenue		Miami	FL	33137	10/16/2025	2026	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 Information Officer	Chief Informaton Officer	Mr.	Larralde	Bernie		3057621361					Blarralde@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Larralde	Bernie		3057621361					BLarralde@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	COO	Ms.	Lane	Maria		3057951890				3057951855	mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Complaints Tracking Contact	Director of Compliance	Ms.	Resch	Lashondra		3057621407					LResch@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	07/01/2024	2026	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	Contact for Fraud Investigations	COO	Ms.	Lane	Maria		3057951890				3057951855	MLane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	COO	Ms.	Lane	Maria		3057951890				3057621538	mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Corporate Mailing						3057951890				3057623847	mlane@miamijewithhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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		3057958442				3057621538	SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	DIR Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	DIR Contact (Secondary)	COO	Ms.	Lane	Maria		3057951890				3057621538	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Discount Program Payment Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3056750494	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Emergency Part D Contact	Pharmacy Manager	Mr.	Martinez	Mario		3057623846					MMartinez1@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Emergency Part D Contact (Secondary)	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942					JJohnson@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	04/17/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942					JJohnson@miamijewishhealth.org	5200 NE 2ND AVENUE		MIAMI	FL	33137	04/17/2024	2026	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	Enrollment Contact	COO	Ms.	Lane	Maria		3057951890				3057621538	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	EOB Transfer Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Financial Audit Contact	COO	Ms.	Lane	Maria		3057951890					mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Financial Reporting Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942					JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Formulary Contact	Manager of Pharmacy Services	Mr.	Martinez	Mario		3057623846					MMartinez1@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Formulary Contact (Secondary)	Associate Vice President PACE Medical Director	Dr.	Alzugaray	Edilia		3057951911					EAlzugaray@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	04/17/2024	2026	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	General Contact	COO	Ms.	Lane	Maria		3057951890				3057951855	MLane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	COO	Ms.	Lane	Maria		3057951890				3057621488	MLane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	HIPAA Privacy Officer	Quality and Compliance Manager	Mr.	Berry	Shane		3057621410					SBerry@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	05/21/2025	2026	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	HIPAA Security Officer	IT Director	Mr.	Larralde	Bernie		3057621361				3056723802	BLarralde@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Interoperability Contact	Quality and Compliance Manager	Mr.	Berry	Shane		3057621410					SBerry@miamijewishhealth.org	5200 NE 2nd Ave.		Miami	FL	33137	05/21/2025	2026	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	MA Appeals/Grievances Contact	Quality and Compliance Manager	Mr.	Berry	Shane		3057621410				3057951855	SBerry@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	05/21/2025	2026	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	MA Claims Processing Contact for Public Website	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Marketing Contact	VP Marketing and Brand Strategy Marketing	Ms.	Broderick	Leah		3057621390				3057621538	LBroderick@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Medical Director	Associate Vice President PACE Medical Director	Dr.	Alzugaray	Edilia		3057951911					EAlzugaray@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	COO	Ms.	Lane	Maria		3057951890				3057951855	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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 Coordinator	COO	Ms.	Lane	Maria		3057951890				3057621538	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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 Part D Opioid Overutilization Contact	Manager of Pharmacy	Mr.	Martinez	Mario		3057623846					MMartinez1@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Medication Therapy Management Contact	Associate Vice President PACE Medical Directo	Dr.	Alzugaray	Edilia		3057951911					EAlzugaray@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 C Application Contact	COO	Ms.	Lane	Maria		3057951890				3057621538	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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 Appeals	Director of Compliance	Ms.	Resch	Lashondra							LResch@MiamiJewishHealth.org	5200 NE 2nd Avenue		Miami	FL	33137	05/21/2025	2026	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active	3057621407				PACE - Nat		C	Atlanta
H1043	Part D Application Contact	EVP-PACE & President, Florida PACE Centers	Mr.	Hess	Steve		3057958442				3057621488	SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Benefits Contact		Mr.	Martinez	Mario		3057623846					MMartinez1@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Claims Submission Contact	COO	Ms.	Lane	Maria		3057951890				3057951855	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	COO	Ms.	Lane	Maria							Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active	3057951890				PACE - Nat		C	Atlanta
H1043	Part D Price File Contact (Back-up)	IT Director	Mr.	Larralde	Bernie		3057621361				3056723802	Blarralde@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Price File Contact (Primary)	EVP-PACE & President, Florida PACE Centers	Mr.	Hess	Steve		3057958442				3057621431	Shess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Quality Assurance Contact	Quality and Compliance Manager	Mr.	Berry	Shane		3057621410					SBerry@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	05/21/2025	2026	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 Reporting Contact	Manager of Pharmacy Services	Mr.	Martinez	Mario		3057623846					MMartinez1@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Patient Safety Contact	Quality & Compliance Manager	Mr.	Berry	Shane		3057951918					SBerry@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Payment Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Director	Pharmacy Director	Mr.	Martinez	Mario		3057623846					MMartinez1@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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 Network Management Contact	Associate Vice President PACE Medical Director	Dr.	Alzugaray	Edilia		3057951911					EAlzugaray@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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.	Larralde	Bernie							BLarralde@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	FLORIDA PACE CENTERS, INC.	National PACE	Florida Pace Centers, Inc.	National PACE		Miami Jewish Health Systems, Inc.	654	Yes	Active	3057621361				PACE - Nat		C	Atlanta
H1043	Plan Directory Contact for Public Website	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057951855	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Processor Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Quality Contact	Quality and Compliance Manager	Mr.	Berry	Shane		3057621410					SBerry@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	05/21/2025	2026	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	Reconciliation Contact	Sr. Claims Adjudicator	Ms.	Johnson	Julie		3057623942				3057621431	JJohnson@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Reconciliation Contact (Secondary)	EVP-PACE & President, Florida PACE Centers	Mr.	Hess	Steve		3057958442					SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Recovery Audit Contact	EVP-PACE & President, Florida PACE Centers	Mr.	Hess	Steve		3057958442				3057621538	SHess@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Surveillance Contact	Director of Compliance	Ms.	Resch	Lashondra		3057621407					LResch@MiamiJewishHealth.org	5200 NE 2nd Avenue		Miami	FL	33137	05/21/2025	2026	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	System Contact	IT Director	Mr.	Larralde	Bernie		3057621361				3056723802	BLarralde@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	Third Party Administrator (TPA) Liaison	Business Office Manager	Ms.	Johnson	Julie		3057623942				3056750494	JJohnson@miamijewishhealth.org	5200 N E 2nd Avenue		Miami	FL	33137	04/17/2024	2026	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	User Access Contact	COO	Ms.	Lane	Maria		3057951890					mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Utilization Management Contact	COO	Ms.	Lane	Maria		3057951890				3057621538	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Utilization Review Contact	COO	Ms.	Lane	Maria		3057951890				3057621538	Mlane@miamijewishhealth.org	5200 NE 2nd Avenue		Miami	FL	33137	10/16/2025	2026	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	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H1045	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1045	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1045	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H1045	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1045	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	PREFERRED CARE PARTNERS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1099	Agent/Broker Compensation Data Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Backup User Access Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	Bid Audit Contact	Chief Financial Officer	Mr.	Pulver	Joshua	P	3214344269					Joshua.Pulver@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/30/2020	2026	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	Bid Audit Site Contact	Chief Financial Officer	Mr.	Pulver	Joshua	P	3214344269					Joshua.Pulver@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/30/2020	2026	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	Bid Primary Contact	Chief Financial Officer	Mr.	Pulver	Joshua	P	3214344269					Joshua.Pulver@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/30/2020	2026	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	CAP Report Contact for Public Website	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	CEO - CMS Administrator Contact	Acting, CEO - CMS Administrator	Mrs.	Forrest	Jamie	R	3214325832					Jamie.Forrest@hf.org	6450 US Highway 1		Rockledge	FL	32955	08/11/2025	2026	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	CEO - Senior Official for Contracting	Acting, CEO - Senior Official for Contracting	Mrs.	Forrest	Jamie	R	3214325832					Jamie.Forrest@hf.org	6450 US Highway 1		Rockledge	FL	32955	08/11/2025	2026	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		3152895913					Joshua.Pulver@HF.org	6450 US Highway 1		Rockledge	FL	329555747	12/28/2022	2026	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 Operating Officer	Chief Operating Officer	Mrs.	Forrest	Jamie	R	3214325832					Jamie.Forrest@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/28/2022	2026	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 Information Officer	System VP Chief Technology Officer	Mr.	Carr	Michael		3214345559					michael.carr@hf.org	6450 US Highway 1		Rockledge	FL	32955	06/16/2023	2026	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 Information Security Officer	System Director Enterprise Risk Mangement	Ms.	Magar	Kathryn	J	3214344383					Kathryn.Magar@HF.org	3300 S. Fiske Boulevard		Rockledge	FL	32955	07/19/2024	2026	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 Complaints, Grievances and Appeals		Holden	Michelle		3214348701					Michelle.Holden@hf.org	6450 US Highway 1		Rockledge	FL	32955	08/11/2025	2026	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	Complaints Tracking Contact	Director, Complaints, Grievances, and Apeals		Holden	Michelle		3214348701					Michelle.Holden@hf.org	6450 US Highway 1		Rockledge	FL	32955	08/11/2025	2026	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	Contact for Fraud Investigations	Director of Payment Integrity		Davanzo	Nicole	E	3214344340					nicole.davanzo@hf.org	6450 US Highway 1		Rockledge	FL	32955	05/04/2020	2026	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		8007167737					hfhppharmacy@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/13/2022	2026	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	Corporate Mailing						3214344443					jamie.forrest@hf.org	6450 US Highway 1		Rockledge	FL	32955	08/26/2019	2026	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		3214344478					Brian.Gerace@hf.org	6450 US Highway 1		Rockledge	FL	32955	10/08/2021	2026	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	DIR Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	DIR Contact (Secondary)	Director Pharmaceutical Services		Dickey	Jason		3214344650					jason.dickey@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/01/2025	2026	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	Discount Program Payment Contact	Sr. Rev Reimbursement Analyst		Liu	Ye		3214197769					ye.liu@hf.org	6450 US Highway 1		Rockledge	FL	32955	05/20/2024	2026	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	Electronic Health Record Contact	Corporate Integrity Analyst		Gutierrez	Dalia		3214345632					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	Emergency Part D Contact	Vice President, Clinical Operations		Sooknanan	Kamela		4045425842					Kamela.Sooknanan@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Emergency Part D Contact (Secondary)	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Employer Waiver Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	Encounter Data & Risk Adjustment Operations Contact	Supervisor Performance Improvement Analytics		Peake	Michelle	L	3214344741					Michelle.Peake@HF.org	6450 US Hwy #1		Rockledge	FL	32955	05/04/2020	2026	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	Enrollment Contact	Director, Enrollment & Billing		Wynn	Sherri		3214344325					Sherri.Wynn@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/30/2021	2026	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	EOB Transfer Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769				3214344798	dalia.gutierrez@hf.org	6450 US Hwy #1		Rockledge	FL	32955	09/05/2020	2026	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	Financial Audit Contact	Manager, Integrity Audit & Monitoring	Ms.	Kerrigan	Susan	D	3214344062					Susan.D.Kerrigan@hf.org	6450 US Highway 1		Rockledge	FL	329555747	10/01/2025	2026	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	Financial Reporting Contact	Corporate Integrity Analyst	Ms.	Gutierrez	Dalia		3214345632					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	329555747	12/22/2020	2026	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	Formulary Contact	Director Pharmaceutical Services		Dickey	Jason		3214344650					jason.dickey@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/01/2025	2026	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	Formulary Contact (Secondary)	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	General Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	HIPAA Privacy Officer	Privacy Officer	Ms.	Bouanis	Ghizlane		3214341249					Ghizlane.Bouanis@hf.org	3300 S. Fiske Boulevard		Rockledge	FL	32955	07/19/2024	2026	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	HIPAA Security Officer	System Director Enterprise Risk Mangement	Ms.	Magar	Kathryn	J	3214344383					Kathryn.Magar@HF.org	3300 S. Fiske Boulevard		Rockledge	FL	32955	07/19/2024	2026	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	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	Interoperability Contact	Manager, Medicare Corporate Integrity		Eickholt	Molly		3214345632					molly.eickholt@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/01/2022	2026	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	MA Appeals/Grievances Contact	Director, Complaints, Grievances and Appeals		Holden	Michelle		3214348701					Michelle.Holden@hf.org	6450 US Highway 1		Rockledge	FL	32955	08/11/2025	2026	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	MA Claims Processing Contact for Public Website	Vice President of Network Operations & Engagement		Fleming	Katie		8445225282					HFHPinfo@hf.org	6450 US Highway 1		Rockledge	FL	32955	10/21/2020	2026	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	Marketing Contact	Manager, Medicare Corporate Integrity		Eickholt	Molly		3214344524					Molly.Eickholt@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/15/2025	2026	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	Medical Director	Medical Director	Dr.	Koraibaa	Khadidja		4045425842					khadidja.koraibaa@hf.org	6450 US Highway 1		Rockledge	FL	329555747	09/09/2022	2026	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 Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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 Coordinator	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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 Part D Opioid Overutilization Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/21/2021	2026	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	Medication Therapy Management Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	OffShore Subcontractor Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	Online Enrollment Center Contact (Back-up)	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Online Enrollment Center Contact (Optional)	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Online Enrollment Center Contact (Primary)	Director, Enrollment & Billing		Wynn	Sherri		3214344325					Sherri.Wynn@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/30/2021	2026	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 C Application Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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 C Reporting Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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 Appeals	Director, Complaints, Grievances & Appeals		Holden	Michelle							Michelle.Holden@hf.org	6450 US Highway 1		Rockledge	FL	32955	08/11/2025	2026	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active	8007167737				HMO - Health Maintenance Organization		C	Atlanta
H1099	Part D Application Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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 Benefits Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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 Claims Submission Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	2026	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active	8007167737				HMO - Health Maintenance Organization		C	Atlanta
H1099	Part D Exceptions Contact (Secondary)	Medicare Integrity Officer	Ms.	Perritt	Maggie							Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active	8007167737				HMO - Health Maintenance Organization		C	Atlanta
H1099	Part D Price File Contact (Back-up)			Williams	Stephanie	A	5035091549					SAWilliams@express-scripts.com	One Express Scripts Way		St. Louis	MO	63121	01/08/2024	2026	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 Price File Contact (Primary)	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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 Quality Assurance Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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 Reporting Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	Patient Safety Contact	System Director Enterprise Risk Mangement	Ms.	Magar	Kathryn	J	3214344383					Kathryn.Magar@HF.org	3300 S. Fiske Boulevard		Rockledge	FL	32955	07/19/2024	2026	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	Payment Contact	Chief Financial Officer	Mr.	Pulver	Joshua	P	3214344269					Joshua.Pulver@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/30/2020	2026	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	Personal Health Record Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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 Director	Director of Pharmaceutical Services		Dickey	Jason		3214344650					Jason.Dickey@HF.org	6450 US Highway 1		Rockledge	FL	32955	12/01/2025	2026	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 Network Management Contact	Director of Pharmaceutical Services		Dickey	Jason		3214344650					Jason.Dickey@HF.org	6450 US Highway 1		Rockledge	FL	32955	12/01/2025	2026	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 Network Management Contact (Secondary)	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Director of Pharmaceutical Services		Dickey	Jason							Jason.Dickey@hf.org	6450 US Highway 1		Rockledge	FL	32940	12/01/2025	2026	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active	8007167737				HMO - Health Maintenance Organization		C	Atlanta
H1099	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Integrity Analyst		Gutierrez	Dalia							dalia.gutierrez@hf.org	6450 US Hwy #1		Rockledge	FL	32955	05/18/2021	2026	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS		Health First Shared Services, Inc.	112	Yes	Active	8007167737				HMO - Health Maintenance Organization		C	Atlanta
H1099	PHR Beneficiary Contact																	09/13/2007	2026	HEALTH FIRST HEALTH PLANS	Local CCP	Health First Health Plans, Inc.	HMO/HMOPOS	Health First Health Plans	Health First Shared Services, Inc.	112	Yes	Active	8007167737				HMO - Health Maintenance Organization		C	Atlanta
H1099	Physician Incentive Contact	Vice President, Network Operations/Engagement		Fleming	Katie		3214345607					Katie.Fleming@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/24/2020	2026	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	Plan Directory Contact for Public Website	Vice President, Network Operations/Engagement		Fleming	Katie		8445225282					HFHPinfo@hf.org	6450 US Highway 1		Rockledge	FL	32955	05/07/2020	2026	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	Plan to Plan Reconciliation Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	Processor Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Quality Contact	Chief Operating Officer	Mrs.	Forrest	Jamie	R	3214344443					Jamie.Forrest@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/24/2020	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Pulver	Joshua	P	3214344269					Joshua.Pulver@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/30/2020	2026	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	Reconciliation Contact (Secondary)	Lead, Medicare Integrity Analyst		Gutierrez	Dalia		3214345632					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/18/2024	2026	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	Recovery Audit Contact	Corporate Integrity Analyst	Ms.	Gutierrez	Dalia		3214345632					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	329555747	12/22/2020	2026	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	SNP Application Contact	Chief Financial Officer	Mr.	Pulver	Joshua	P	3214344269					Joshua.Pulver@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/30/2020	2026	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	SNP State Contact	Medicare Integrity Officer	Ms.	Perritt	Maggie		3214345622					Maggie.Perritt@hf.org	6450 US Highway 1		Rockledge	FL	32955	07/19/2024	2026	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	Surveillance Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	12/22/2020	2026	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	System Contact	Chief Operating Officer	Mrs.	Forrest	Jamie	R	3214344443					Jamie.Forrest@hf.org	6450 US Highway 1		Rockledge	FL	32955	04/24/2020	2026	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	Third Party Administrator (TPA) Liaison	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	User Access Contact	Medicare Integrity Analyst		Gutierrez	Dalia		3214197769					dalia.gutierrez@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Utilization Management Contact	Vice President, Clinical Operations		Sooknanan	Kamela		4045425842					Kamela.Sooknanan@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Utilization Review Contact	Vice President, Clinical Operations		Sooknanan	Kamela		4045425842					Kamela.Sooknanan@hf.org	6450 US Highway 1		Rockledge	FL	32955	09/05/2020	2026	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	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/30/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	11/26/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H1109	PHR Beneficiary Contact																	11/15/2012	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H1109	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1109	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC.(GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1112	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H1112	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H1112	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H1112	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H1112	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H1112	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H1112	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H1112	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1112	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF GEORGIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1119	Agent/Broker Compensation Data Contact	Chief Financial Officer	Mr.	Film	George		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	07/07/2021	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Automated TrOOP Balance Transfer Contact	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Backup User Access Contact	Technical Development Director		Cook	Donna		5016211469				8667053692	dcook@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	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		Campbell	Brittany		5012550873				8667053652	BrittanyC@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Bid Audit Contact	Principal and Consulting Actuary, Milliman		Johnson	Nick		2065945941				2066825946	nick.johnson@milliman.com	301 Fifth Avenue, Suite 3800		Seattle	WA	981012605	05/10/2019	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Bid Primary Contact	Chief Financial Officer	Mr.	Film	George		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	07/07/2021	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	CAP Report Contact for Public Website	Compliance Officer	Ms.	Ferrara	Donna		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/02/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	CEO - CMS Administrator Contact	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	CEO - Senior Official for Contracting	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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 Operating Officer	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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 Information Officer	Chief Information Officer	Mr.	Marcoguiseppe II	Martin		3304985114					Martin.Marcoguiseppe@tsgrinc.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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 Information Security Officer	Chief Information Officer	Mr.	Marcoguiseppe II	Martin		3304985114					Martin.Marcoguiseppe@tsgrinc.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/02/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Complaints Tracking Contact	Compliance Officer	Ms.	Ferrara	Donna		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/02/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Contact for Fraud Investigations	Compliance Officer		Ferrara	Donna		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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	VP of Clinical Operations		Smith	Melissa		3304988236					melissa.smith@valorclinicalpartners.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Corporate Mailing						3304988101					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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	Technical Development Director		Cook	Donna		5016211469				8667053692	dcook@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	DIR Contact	Manager Health Plans Finance		Parkin	Frank		3308886098					fparkin@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	DIR Contact (Secondary)	Director Reporting & Analytics		Campbell	Tim		9547672633					tcampbell@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Discount Program Payment Contact	Finance Director	Mr.	Haines	Nathan		3304985273				3304988171	Nathan.Haines@TSGrinc.com	7171 Keck Park Circle NW		North Canton	OH	44720	12/05/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Emergency Part D Contact	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Emergency Part D Contact (Secondary)	Pharmacy Operations		Husted	Beth		3304983721				3304988158	beth.husted@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Encounter Data & Risk Adjustment Operations Contact	Technical Development Director		Cook	Donna		5016211469				8667053652	dcook@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Enrollment Contact	Member Service Manager		Cambell	Brittany		5012550873				8667053652	BrittanyC@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	EOB Transfer Contact	Claims Monitoring Manager		Boyd	Sarah		5012324522	522			8667053652	sboyd@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Financial Audit Contact	Chief Financial Officer	Mr.	Film	George		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Financial Reporting Contact	Chief Financial Officer	Mr.	Film	George		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Formulary Contact	Clinical Formulary Pharmacist		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/09/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Formulary Contact (Secondary)	Director Clinical Audits		Rossi	David		3304866311					drossi@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	General Contact	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/02/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	HIPAA Privacy Officer	Compliance Officer	Ms.	Ferrara	Donna		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/02/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	HIPAA Security Officer	Compliance Officer	Ms.	Ferrara	Donna		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/16/2022	2026	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		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Interoperability Contact	Chief Information Officer		Marcoguiseppe	Mr. Martin		3304985114					Martin.Marcoguiseppe@tsgrinc.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/13/2023	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	MA Appeals/Grievances Contact	Appeals and Grievances Manager		Boyd	Sarah		5012324522	522			8667053652	sboyd@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	MA Claims Processing Contact for Public Website	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Marketing Contact	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Medical Director	Medical Director	Dr.	Smith	Mark		3308012208					smithhickoryrun@sbcglobal.net	7171 Keck Park Circle NW		North Canton	OH	44720	07/06/2021	2026	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		2342151042					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	04/13/2020	2026	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 Coordinator	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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 Part D Opioid Overutilization Contact	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Medication Therapy Management Contact	Director of Clinical Programs		Smith	Melissa		3304988236					melissa.smith@valorhealthplan.com	7171 Keck Park Circle NW		N Canton	OH	44720	12/05/2024	2026	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 C Application Contact	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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 C Reporting Contact	Technical Development Director		Cook	Donna		5016211469				8667053652	dcook@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	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 Appeals	VP of Clinical Operations		Smith	Melissa							melissa.smith@valorclinicalpartners.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	3304988236				HMO - Health Maintenance Organization		C	Chicago
H1119	Part D Appeals Contact (Secondary)	Clinical Operations		Hatfield	Lindsay						3304058081	Appeals@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	3303449574	0414			HMO - Health Maintenance Organization		C	Chicago
H1119	Part D Application Contact	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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 Benefits Contact	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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 Claims Submission Contact	Account Manager		Voss	Laurie		2342123780					lvoss@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	12/14/2022	2026	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		Riggle	Susan							susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	7249872149				HMO - Health Maintenance Organization		C	Chicago
H1119	Part D Exceptions Contact (Secondary)	VP of Clinical Operations		Smith	Melissa							melissa.smith@valorclinicalpartners.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	3304988236				HMO - Health Maintenance Organization		C	Chicago
H1119	Part D Price File Contact (Back-up)	Director Reporting and Analytics		Campbell	Tim		9457672633					tcampbell@elixirsolutions.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/05/2024	2026	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 Price File Contact (Optional)	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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 Price File Contact (Primary)	Manager Reporting & Analytics		Wentz	Christophe		3308886988					cwentz@elixirsolutions.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/05/2024	2026	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 Quality Assurance Contact	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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 Reporting Contact	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Patient Safety Contact	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Payment Contact	Chief Financial Officer	Mr.	Film	George		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	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 Director	Director of Part D Operations		Riggle	Susan		7249872149					susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	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 Network Management Contact	Director Pharmacy Network		Profio	Lauren		3304864864				3304058094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		N Canton	OH	44720	12/14/2022	2026	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	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	8334594423				HMO - Health Maintenance Organization		C	Chicago
H1119	Pharmacy Technical Help Desk Contact (Secondary)	Director of Part D Operations		Riggle	Susan							susan.riggle@abshealth.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active	7249872149				HMO - Health Maintenance Organization		C	Chicago
H1119	Plan Directory Contact for Public Website			Service	Customer		8004853793					providerservices@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/08/2022	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Plan to Plan Reconciliation Contact	Financial Manager	Mr.	Haines	Nathan		3304985273					Nathan.Haines@TSGrinc.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Processor Contact	VP of Clinical Operations		Smith	Melissa		3304988236					melissa.smith@valorclinicalpartners.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Quality Contact	VP of Clinical Operations		Smith	Melissa		3304988236					melissa.smith@valorclinicalpartners.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Reconciliation Contact	Chief Financial Officer	Mr.	Film	George		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Reconciliation Contact (Secondary)	Finance Director		Haines	Nathan		3304985273					Nathan.Haines@TSGrinc.com	7171 Keck Park Circle NW		N Canton	OH	44720	12/11/2025	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Recovery Audit Contact	Chief Financial Officer	Mr.	Film	George		3304988203					george.film@altercareonline.net	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	SNP Application Contact	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/23/2020	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Surveillance Contact	Compliance Officer		Ferrara	Donna		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW	Suite 200-A	North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	System Contact	Information Services Director		Harrington	Paige		5012957666					pharrington@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72201	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Third Party Administrator (TPA) Liaison	Vice President of Managed Care	Mr.	Haas	Scott		3304988178					scott.haas@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	01/30/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	User Access Contact	Compliance Officer	Ms.	Ferrara	Donna		3304988220					donna.ferrara@valorhealthplan.com	7171 Keck Park Circle NW		North Canton	OH	44720	03/16/2022	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Utilization Management Contact	VP of Clinical Operations		Smith	Melissa		3304988236					melissa.smith@valorclinicalpartners.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1119	Utilization Review Contact	VP of Clinical Operations		Smith	Melissa		3304988236					melissa.smith@valorclinicalpartners.com	7171 Keck Park Circle NW		North Canton	OH	44720	07/26/2024	2026	TSG GUARD, INC.	Local CCP	Valor Health Plan	HMO/HMOPOS		The Schroer Group, Inc.	702	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1170	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	09/01/2017	2026	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	Dallas
H1170	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2026	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	Dallas
H1170	Backup User Access Contact	Regional Compliance Officer		Stewart	Sean	L	4043644707				4042794642	sean.l.stewart@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	01/13/2021	2026	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	Dallas
H1170	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	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	Dallas
H1170	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	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	Dallas
H1170	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H1170	Bid Primary Contact	Managing Actuary		Hu	Shelley	J	4043647109					KPMedicareBids@kp.org	3495 Piedmont Rd. NE	Nine Piedmont Center	Atlanta	GA	30305	06/27/2024	2026	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	Dallas
H1170	CAP Report Contact for Public Website	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	11/13/2025	2026	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	Dallas
H1170	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	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	Dallas
H1170	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	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	Dallas
H1170	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	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	Dallas
H1170	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	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	Dallas
H1170	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	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	Dallas
H1170	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	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	Dallas
H1170	CMS Casework Communication Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	11/13/2025	2026	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	Dallas
H1170	Complaints Tracking Contact	Medicare Contract Compliance Manager		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road N.E.	Nine Piedmont Center	Atlanta	GA	30305	01/03/2025	2026	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	Dallas
H1170	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	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	Dallas
H1170	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2026	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	Dallas
H1170	Corporate Mailing						4049850135				4042794642	chandra.walden@kp.org	3495 Piedmont Road	Nine Piedmont Center	Atlanta	GA	303051736	03/20/2015	2026	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	Dallas
H1170	Customer Service Operations Contact	Executive Director		Osborne	Susan	A	5034576663				4049495001	susan.a.osborne@kp.org	Nine Piedmont Center	3495 Piedmont Road, NE	Atlanta	GA	30305	10/17/2023	2026	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	Dallas
H1170	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	03/09/2020	2026	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	Dallas
H1170	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	07/17/2018	2026	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	Dallas
H1170	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/06/2023	2026	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	Dallas
H1170	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	07/02/2018	2026	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	Dallas
H1170	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/04/2022	2026	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	Dallas
H1170	Emergency Part D Contact (Secondary)	Pharmacy Compliance Manager		Sanders	Diane		5102091877					Diane.Sanders@kp.org	3495 Piedmont Road, NE	Ten Piedmont Center	Atlanta	GA	30305	12/28/2018	2026	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	Dallas
H1170	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	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	Dallas
H1170	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H1170	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/12/2012	2026	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	Dallas
H1170	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H1170	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H1170	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/20/2023	2026	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	Dallas
H1170	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	06/01/2023	2026	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	Dallas
H1170	General Contact	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	11/13/2025	2026	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	Dallas
H1170	Government Relations Contact	Manager, Government Relations		Fauver	Amy	K	5036793577				4043644136	amy.k.fauver@kp.org	500 NE Multnomah Street		Portland	OR	97232	12/03/2024	2026	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	Dallas
H1170	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	11/06/2020	2026	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	Dallas
H1170	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					bill.d.vourthis@kp.og	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/25/2020	2026	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	Dallas
H1170	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	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	Dallas
H1170	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					Cathy.P.Plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	11/03/2021	2026	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	Dallas
H1170	MA Appeals/Grievances Contact	Executive Director, Member Relations		Osborne	Susan		5038133924					susan.a.osborne@kp.org	500 NE Multnomah Street	Suite 100	Portland	OR	97232	01/20/2023	2026	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	Dallas
H1170	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	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	Dallas
H1170	Marketing Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					KP-MedicareFilings@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	11/16/2020	2026	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	Dallas
H1170	Medicare Compliance Officer	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road	Nine Piedmont Center	Atlanta	GA	303051736	11/13/2025	2026	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	Dallas
H1170	Medicare Coordinator	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	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	Dallas
H1170	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	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	Dallas
H1170	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street		Rancho Cucamonga	CA	91730	08/26/2020	2026	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	Dallas
H1170	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H1170	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H1170	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H1170	Part C Application Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	Part C Reporting Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road N.E.	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	Part D Appeals	Executive Director		Osborne	Susan	A					4043644743	susan.a.osborne@kp.org	3495 Piedmont Center	Ten Piedmont Center	Atlanta	GA	30305	10/17/2023	2026	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5034576663				HMO - Health Maintenance Organization		C	Dallas
H1170	Part D Application Contact	Executive Director		Robinson	Tanya	M	3013950877					tanya.m.robinson@kp.org	111 S Calvert Street	Suite 1850	Baltimore	MD	21202	10/28/2021	2026	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	Dallas
H1170	Part D Benefits Contact	Manager, Pharmacy Benefits and Training		Gosnell	Nicole		4043647120					nicole.gosnell@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	06/03/2011	2026	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	Dallas
H1170	Part D Claims Submission Contact	Pharmacy Benefits Manager		Gosnell	Nicole		4043647120					nicole.gosnell@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	11/21/2008	2026	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	Dallas
H1170	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H1170	Part D Exceptions Contact (Secondary)	Manager, Pharmcy Compliance		Sanders	Diane							diane.sanders@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	7707125654				HMO - Health Maintenance Organization		C	Dallas
H1170	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	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	Dallas
H1170	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	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	Dallas
H1170	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/26/2023	2026	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	Dallas
H1170	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	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	Dallas
H1170	Part D Reporting Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road N.E.	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	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	Dallas
H1170	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H1170	Pharmacy Director	Executive Director		Madill	Chad	M	4042014421					chad.m.madill@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	10/17/2023	2026	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	Dallas
H1170	Pharmacy Network Management Contact	Pharmacy Benefits Manager		Gosnell	Nicole		4043647120					nicole.gosnell@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	01/13/2012	2026	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	Dallas
H1170	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Okalahoma City	OK	73104	11/02/2016	2026	KAISER FOUNDATION HP OF GA, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8882773914				HMO - Health Maintenance Organization		C	Dallas
H1170	Physician Incentive Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	11/13/2025	2026	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	Dallas
H1170	Plan Directory Contact for Public Website			Services	Member		8002324440				4043644939	kpnet@kp.org	3495 Piedmont Road NE	Ten Piedmont Center	Atlanta	GA	30305	06/03/2011	2026	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	Dallas
H1170	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/20/2023	2026	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	Dallas
H1170	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	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	Dallas
H1170	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	05/25/2022	2026	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	Dallas
H1170	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H1170	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	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	Dallas
H1170	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/03/2022	2026	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	Dallas
H1170	SNP Application Contact	Medicare Contract Compliance Manager	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	01/13/2021	2026	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	Dallas
H1170	SNP State Contact	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	10/28/2021	2026	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	Dallas
H1170	Surveillance Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H1170	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	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	Dallas
H1170	User Access Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	Utilization Management Contact	Sr Program Mgr, UM Compliance		Fountain	Tracy	F	4703163624					tracy.f.fountain@kp.org	3495 Piedmont Road NE	Building 10, 5th Floor	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1170	Utilization Review Contact	Sr Program Mgr, UM Compliance		Fountain	Tracy	F	4703163624					tracy.f.fountain@kp.org	3495 Piedmont Road NE	Building 10, 5th Floor	Atlanta	GA	30305	10/28/2021	2026	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	Dallas
H1181	Agent/Broker Compensation Data Contact	Director, Individual Sales		Gehrke	Kimberly		9207201569					kgehrke@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/28/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Backup User Access Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Bid Audit Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Bid Audit Site Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Bid Primary Contact	Manager, Actuarial Pricing		Lanier	Eric		9207201636				9207201912	elanier@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/28/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	CAP Report Contact for Public Website	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	CEO - CMS Administrator Contact	President & CEO	Mrs.	Dicus-Johnson	Coreen		2628259689					Coreen.DicusJohnson@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/28/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	CEO - Senior Official for Contracting	President & CEO	Mrs.	Dicus-Johnson	Coreen		2628259689					Coreen.DicusJohnson@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/28/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Chief Financial Officer	Chief Financial Officer	Mr	Ollech	Brian		9207201886					bollech@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/29/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Chief Operating Officer	Vice President, Operations	Ms.	Vander Zanden	Jessica		9207201652					jvanderz@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/29/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Chief Information Officer	Chief Information Officer	Mr	Riley	Timothy		9207201895					triley@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Chief Information Security Officer	Chief Information Security Officer	Mr	Bloedorn	Dave		9207201410					dbloedor@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	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	Regulatory Support Administrator		Lee	Chia		9206287268					clee@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/08/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Complaints Tracking Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	08/04/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Contact for Fraud Investigations	VP, Risk Adjustment & Payment Integrity		Weisbrod	Josh		9207201461					jweisbro@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Corporate Mailing						9207201200					nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	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		9207201309				9207201908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Electronic Health Record Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/28/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Employer Waiver Contact	Director, Individual Sales		Gehrke	Kimberly		9207201569					kgehrke@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Encounter Data & Risk Adjustment Operations Contact	VP, Risk Adjustment & Payment Integrity		Weisbrod	Josh		9207201461					jweisbro@networkhealth.com	1570 Midway Place		Fond du Lac	WI	54935	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Enrollment Contact	Manager, Enrollment & Business Analysis Integratio		Crocker	Brian		9207201640					bcrocker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	06/26/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Financial Audit Contact	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Financial Reporting Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	03/29/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	General Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	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		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Interoperability Contact	Director, IT Development		Zirbel	Justin		9207201202					jzirbel@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/29/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	MA Appeals/Grievances Contact	Manager, Appeals and Grievances		Skinner	Jeanne		9207201382					jskinner@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/20/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	MA Claims Processing Contact for Public Website	Manager, Claims		Adamick	Crystal		9207201547					cadamick@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Marketing Contact	VP of Marketing		Sengkhammee	David		9207201236				9207201912	dsengkha@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Medical Director	Chief Medical Officer	Dr.	Hassan	Mushir		2628259727					mhassan@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	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	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Medicare Coordinator	Vice President, Operations		Vander Zanden	Jessica		9207201573				9207201912	jvanderz@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	OffShore Subcontractor Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Part C Application Contact	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Part C Reporting Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Payment Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Personal Health Record Contact	Vice President, Care Services		Dencker	Sarah		9207201694				9207201908	sdencker@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	PHR Beneficiary Contact																	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA	Network Health Insurance Corporation	Network Health, Inc.	670	No	Active	8003785234				MSA		C	Denver
H1181	Physician Incentive Contact	Senior VP, Network Dev & Contract Management		Wille	Scott		2628259790					swille@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Plan Directory Contact for Public Website			Service	Customer		8003785234				9207201908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Quality Contact	VP, Quality and Clinical Integration		Willis	John		2628259783					jwillis@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Recovery Audit Contact	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Surveillance Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	System Contact	Manager, IT Infrastructure		Petersen	Chris		9207201445					cpeterse@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	User Access Contact	Information Security Risk Analyst		Pfefferle	Trish		9207201225					tpfeffer@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Utilization Management Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1181	Utilization Review Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	MSA	Network Health Medicare Advantage Plans	MSA		Network Health, Inc.	670	No	Active					MSA		C	Denver
H1188	Automated TrOOP Balance Transfer Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Backup User Access Contact	Director of Training and Operational Development		Sheeder	Shelby		8145927615					shelby.sheeder@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Best Available Evidence Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Bid Primary Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	CAP Report Contact for Public Website	VP, Controller		Williams	kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Chicago
H1188	CEO - CMS Administrator Contact	Interim CEO	Mr.	Worland	Craig		8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	CEO - Senior Official for Contracting	Interim CEO	Mr.	Worland	Craig		8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Chief Financial Officer	CFO	Mr.	Phillips	Jeff		8144565433					jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Chief Operating Officer	Chief Operating Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	09/09/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Chief Information Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Chief Information Security Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	CMS Casework Communication Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Complaints Tracking Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Contact for Fraud Investigations	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Coordination of Benefits Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Corporate Mailing						8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Customer Service Operations Contact	Chief Operating Officer		Worland	Craig	M	8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	DIR Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	DIR Contact (Secondary)	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Discount Program Payment Contact	CFP		Phillips	Jeffrey		4127205118					Jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	04/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Emergency Part D Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Emergency Part D Contact (Secondary)	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Encounter Data & Risk Adjustment Operations Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	04/17/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Enrollment Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	04/17/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	EOB Transfer Contact	Director Revenue Cycle		Toward	Karrie		8144565433				8144542500	Karrie.Toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	04/17/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Financial Audit Contact	VP, Controller	Ms.	Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Financial Reporting Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Formulary Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Formulary Contact (Secondary)	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	General Contact	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Government Relations Contact	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	HIPAA Privacy Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	HIPAA Security Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Interoperability Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	MA Appeals/Grievances Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	MA Claims Processing Contact for Public Website	Director of Network & Special Projects		Feldmann	William		8144565433					william.feldmann@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Marketing Contact	VP, Marketing and Intakes		Campbell	Marcie		8144565433					Marcie.Campbell@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Medical Director	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Medicare Coordinator	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Medicare Part D Opioid Overutilization Contact	Chief Compliance Officer		Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	03/31/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Medication Therapy Management Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part C Application Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part D Appeals	VP, Controller		Williams	Kelly							kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Chicago
H1188	Part D Appeals Contact (Secondary)	Chief Compliance Officer		Kennedy	Jennifer						8144542500	jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8444565433				PACE - Nat		C	Chicago
H1188	Part D Application Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part D Benefits Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part D Claims Submission Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part D Exceptions Contact	Medical Director	Dr.	Rummel	James							james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Chicago
H1188	Part D Exceptions Contact (Secondary)	Chief Compliance Officer		Kennedy	Jennifer							jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Chicago
H1188	Part D Price File Contact (Back-up)	CFO		Phillips	Jeff		8144565433					jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part D Price File Contact (Primary)	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part D Quality Assurance Contact	Chief Compliance Officer		Kennedy	Jennifer	M	8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Part D Reporting Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Patient Safety Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Payment Contact	Director of Revenue		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Personal Health Record Contact	Chief Compliance Officer		Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Pharmacy Director	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Pharmacy Network Management Contact	Director of Network & Special Projects		Feldmann	William		8144565433					wfeldmann@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Pharmacy Network Management Contact (Secondary)	Medical Director		Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Pharmacy Technical Help Desk Contact	VP, Controller		Williams	Kelly							kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Chicago
H1188	Pharmacy Technical Help Desk Contact (Secondary)	Director of Network & Special Projects		Feldmann	William							william.feldmann@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Chicago
H1188	Plan Directory Contact for Public Website	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Plan to Plan Reconciliation Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Processor Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	04/17/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Quality Contact	Chief Quality Officer		Lyons	Laura	M	8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Reconciliation Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Reconciliation Contact (Secondary)	CFO		Phillips	Jeff		8144565433					jphillips@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Recovery Audit Contact	VP, Controller	Mrs.	Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Surveillance Contact	VP, Marketing and Intake		Campbell	Marcie		8144565433					Marcie.Campbell@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	System Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	04/17/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Third Party Administrator (TPA) Liaison	CFO		Phillips	Jeffrey		4127205118					Jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	04/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	User Access Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Utilization Management Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1188	Utilization Review Contact	Medical Director		Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	01/27/2025	2026	ONE SENIOR CARE OHIO, LLC	National PACE	Buckeye PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Chicago
H1189	Agent/Broker Compensation Data Contact	VP Product Sales	Mr.	Hirasaki	Ron		4692820316					ron.hirasaki@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/05/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Automated TrOOP Balance Transfer Contact	Director of Finance		Orr	Raven		4692823217					raven.orr@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Backup User Access Contact	Manager, Reg Affairs		Barnett	Vae		4692823257					Vae.Barnett@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	04/14/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Best Available Evidence Contact	Enrollment/COB Manager		Satchell	DeMaurea		4692823224					Demaurea.Satchell@christushealh.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Bid Audit Contact	Manager, Compliance		Dowell	Juanita		4692821071					juanita.dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/26/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Bid Audit Site Contact	VP, Product Management and Marketing Sales		Hirasaki	Ron		4692820316					Ron.Hirasaki@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	03/14/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Bid Primary Contact	VP, Product Management and Marketing Sales		Hirasaki	Ron		4692820316					Ron.Hirasaki@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	03/14/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	CAP Report Contact for Public Website	Director, Compliance		Smith	Gerri		2259557748					gerri.smith@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	12/17/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	CEO - CMS Administrator Contact	CEO CHRISTUS Health Plan	Mr.	Stansbury	Shannon		2148868381					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	12/27/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	CEO - Senior Official for Contracting	CEO CHRISTUS Health Plan	Mr.	Stansbury	Shannon		4692822529					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/25/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Chief Financial Officer	VP, CFO CHRISTUS Health Plan	Mr.	Beiermann	Jim		8053680932					jim.beiermann@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Chief Operating Officer	Chief Operating Officer	Mr.	Kitzmiller	George		4692823337					george.kitzmiller@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Chief Information Officer	System Director IM Health Plans and Population Ser	Ms.	Rivas	Noel		4692822246					noel.rivas2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Chief Information Security Officer	VP, Information Security Officer	Mr.	Blanco-Dopazo	Fernando		4692822000					Fernando.blanco@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	CMMI Model Point of Contact	CEO Christus Health Plan	Mr.	Stansbury	Shannon		4692822529					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/25/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	CMS Casework Communication Contact	Director, Complaints & Appeals		Hendon	Amanda		4692823039				8664162840	amanda.hendon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Complaints Tracking Contact	Director, Complaints & Appeals		Hendon	Amanda		4692823039				8664162840	amanda.hendon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Contact for Fraud Investigations	Manager, Compliance		Dowell	Juanita		4692821071					juanita.dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/26/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Coordination of Benefits Contact	Manager Enrollment		Satchell	DeMaurea		4692823200					demaurea.satchell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Corporate Mailing						8442823026					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Customer Service Operations Contact	Director Health Plans	Ms.	Horn	Jeniffer		4692823252					jen.horn@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	DIR Contact	Director of Finance		Orr	Raven		4692822000					Raven.Orr@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	DIR Contact (Secondary)	Program Manager, Regulatory Affairs		Butler	Tiffany		4692823205					Tiffany.Butler2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	07/29/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Discount Program Payment Contact	CEO Christus Health Plan	Mr.	Stansbury	Shannon		4692822529					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/25/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Electronic Health Record Contact	Manager, Compliance		Dowell	Juanita		4692821071					juanita.dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/26/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Emergency Part D Contact	Pharmacy Benefit Specialist		Nguyen	Tina		8177063827					tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Emergency Part D Contact (Secondary)	Pharmacy Benefit Spc		Johnson	Brooke		8178996542					brooke.johnson2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Employer Waiver Contact	VP, Product Managment and Marketing Sales		Hirasaki	Ron		4692820316					Ron.Hirasaki@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	03/14/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Encounter Data & Risk Adjustment Operations Contact	Director, Complaints & Appeals		Hendon	Amanda		4692823052					Amanda.hendon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Enrollment Contact	Enrollment Manager	Mr	Satchell	DeMaurea		4692823224					demaurea.satchell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	EOB Transfer Contact	Manager, Claims		Grado	Sandra		4692823200				4692823200	sandra.grado@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Financial Audit Contact	VP, CFO CHRISTUS Health Plan	Mr.	Beiermann	Jim		8053680932					jim.beiermann@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	01/22/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Financial Reporting Contact	VP, CFO CHRISTUS Health Plan	Mr.	Beiermann	Jim		8053680932					jim.beiermann@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	01/22/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Formulary Contact	Manager Pharmacy Benefits and Services		Nguyen	Tina		8177063827					tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Formulary Contact (Secondary)	Pharmacy Benefit Mgr		Johnson	Brooke		2142885660					brooke.johnson2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	General Contact	Manager, Compliance		Dowell	Juanita		4692821071					juanita.dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/26/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Government Relations Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	HIPAA Privacy Officer	System Director Compliance Operations and Privacy		King	Jawnna		8444448440					privacy@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/22/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	HIPAA Security Officer	CIO	Mr	Blanco	Fernando		4692822000					fernando.blanco@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Hospice Contact	Vice President Chief Medical Director	Dr	Cannon	Dean		4692823073					dean.cannon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	07/31/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Interoperability Contact	Director of IM	Ms.	Rivas	Noel		4692822000					noel.rivas2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	06/17/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	MA Appeals/Grievances Contact	Director, Complaints & Appeals		Hendon	Amanda		4692823039				8664162840	amanda.hendon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	MA Claims Processing Contact for Public Website	Claims Manager		Grado	Sandra		4692823200				4692823200	sandra.grado@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Marketing Contact	VP Product Mgmt	Mr.	Hirasaki	Ron		4692820316					ron.hirasaki@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Medical Director	Vice President Chief Medical Director	Dr	Cannon	Dean		4692823073					dean.cannon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	07/31/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Medicare Compliance Officer	Director, Compliance	Ms.	Smith	Gerri		2259557748					gerri.smith@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	12/17/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Medicare Coordinator	Manager, Compliance		Dowell	Juanita		4692821071					juanita.dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/26/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Medicare Part D Opioid Overutilization Contact	Director of Clinical Trend Solutions		Muralidharan	Adrienne		3146846625					amuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	05/16/2019	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Medication Therapy Management Contact	Director, Clinical and Trend Solutions		Muralidharan	Adrienne		3143131932					amuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	03/27/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	OffShore Subcontractor Contact	Manager, Health Plans & Network Compliance	Ms.	Dowell	Juanita		4692821071					Juanita.dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/25/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Online Enrollment Center Contact (Back-up)	Director of Operations		Hendon	Amanda		4692823093					amanda.hendon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Online Enrollment Center Contact (Primary)	Manager of MA Enrollment	Mr.	Satchell	DeMaurea		4692823224					Demaurea.satchell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	06/17/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part C Application Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part C Reporting Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Appeals	Director of Operations		Hendon	Amanda						8664162840	amanda.hendon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	4692823039				HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Alvarez	Ruth						8664162840	Ruth.Alvarez@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	4692823251				HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Application Contact	Manager, Compliance		Dowell	Juanita		4692821071					juanita.dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/26/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Benefits Contact	Mgr Pharmacy Benefits and Services		Nguyen	Tina		8177063827					tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	One Expressway		St Louis	MO	63121	03/27/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Exceptions Contact	Senior Pharmacy Manager		Hollowell	Adam							adam.hollowell@evernorth.com	One Expressway Mail Stop S13NB		St Louis	MO	63121	03/27/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	9013817109				HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Exceptions Contact (Secondary)	Mgr Pharmacy Benefits and Services		Nguyen	Tina							tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	8177063827				HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Price File Contact (Back-up)	Manager, Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Highway		Fairfield	OH	45014	03/27/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Price File Contact (Optional)	Mgr Pharmacy Benefits		Nguyen	Tina		8177063827					tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Price File Contact (Primary)	Sr Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Expressway-Building 1		St Louis	MO	63121	03/27/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Quality Assurance Contact	Mgr Pharmacy Benefits		Nguyen	Tina		8177063827					Tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Part D Reporting Contact	Mgr Pharmacy Benefits		Nguyen	Tina		8177063827					tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Patient Safety Contact	Director Health Plans Corporate Services		Gomes	Kimberly		4692822000					kimberly.gomes@christushealth.org	5101 N. O Connor Blvd.		Irving	TX	75039	09/29/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Payment Contact	Director Finance	Mrs.	Orr	Raven		4692823217					raven.orr@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	06/10/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Personal Health Record Contact	Medical Director Health Plan Utilization Review	Dr.	Cannon	Dean		4692823073					dean.cannon@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Pharmacy Director	Manager Pharmacy Benefits and Services		Nguyen	Tina		4692823151					tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	12/17/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Pharmacy Network Management Contact	Director, Retail & Strategy Contracting		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	07/28/2021	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Pharmacy Network Management Contact (Secondary)	Mgr Pharmacy Benefits		Nguyen	Tina		8177063827					tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	06/17/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Pharmacy Technical Help Desk Contact	Director, Customer Service		Monroe	LaTasha							latasha_monroe@express-scripts.com	13051 North Telecom Parkway	Suite 150	Temple Terrace	FL	33617	03/27/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H1189	Pharmacy Technical Help Desk Contact (Secondary)	Mgr Pharmacy Benefits		Nguyen	Tina							tina.nguyen2@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active	8177063827				HMO - Health Maintenance Organization		C	Seattle
H1189	Physician Incentive Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Plan Directory Contact for Public Website	Chief Administrative Officer	Ms.	Hefton	Ronda		8442823026					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Plan to Plan Reconciliation Contact	CEO Christus Health Plan	Mr.	Stansbury	Shannon		4692822529					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/25/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Processor Contact	Director Government Programs, Medicare		Steffen	Jeff		6363351729					jhsteffen@express-scripts.com	One Express Way		St. Louis	MO	63121	03/27/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Quality Contact	Director Health Plans Corporate Services		Gomes	Kimberly		4692822000					kimberly.gomes@christushealth.org	5101 N. O Connor Blvd.		Irving	TX	75039	09/29/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Reconciliation Contact	CEO Christus Health Plan	Mr.	Stansbury	Shannon		4692822529					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/25/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Reconciliation Contact (Secondary)	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Recovery Audit Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	SNP Application Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	SNP State Contact	Chief Administrative Officer	Ms.	Hefton	Ronda		4692823330					ronda.hefton@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	02/06/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Surveillance Contact	Director, Compliance		Smith	Gerri		2259557748					gerri.smith@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	12/17/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	System Contact	CEO Christus Health Plan	Mr.	Stansbury	Shannon		4692822529					shannon.stansbury@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	09/25/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr.	Beiermann	Jim		8053680932					jim.beiermann@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	06/10/2025	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	User Access Contact	Manager, Health Plans & Networks Compliance		Dowell	Juanita		4692821071					Juanita.Dowell@christushealth.org	5101 N. O'Connor Blvd		Irving	TX	75039	08/26/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Utilization Management Contact	Mgr, Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	04/11/2023	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1189	Utilization Review Contact	Mgr Contact Center		Davidson	Reginia		7728128436					reginiadavidson@expressscripts.com	One Express Way		St Louis	MO	63121	06/17/2024	2026	CHRISTUS HEALTH PLAN	Local CCP	CHRISTUS Health Advantage	HMO/HMOPOS		CHRISTUS Health	576	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1206	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	07/01/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	06/27/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	06/27/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	06/27/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H1206	PHR Beneficiary Contact																	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H1206	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/04/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1206	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1212	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Automated TrOOP Balance Transfer Contact	Manager II, Membership		Miller	Karen		9205391417					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Chief Financial Officer	Staff VP & Actuary, Medicare Finance and Risk Adj	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Chief Information Security Officer	VP and Chief Information Security Officer	Mr.	Wilcox	Dustin		4632245212					dustin.wilcox@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/29/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Financial Audit Contact	Staff VP & Actuary, Medicare Finance and Risk Adj	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Financial Reporting Contact	Staff VP & Actuary, Medicare Finance and Risk Adj	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@ingenio-rx.com	4 Varesa		Irvine	CA	92620	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	HIPAA Security Officer	VP and Chief Information Security Officer	Mr.	Wilcox	Dustin		4632245212					dustin.wilcox@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/29/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	08/28/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	05/29/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Appeals Contact (Secondary)	Director, PharmD Medicare Part D CAG		Zanolli	Mindy						8884581406	mindy.zanolli@elevancehealth.com	4361 Irwin Simpson Rd.	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8144498744				HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Exceptions Contact (Secondary)	Medicare Product Innovation Director		Floyd	Cari							cari.floyd@anthem.com	1226 Sigler Street		Nashville	TN	37203	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5407984087				HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Pharmacy Director	Clinical Pharmacy Program Director	Ms.	Gibson	Cathy		5132550202					cathy.j.gibson@carelon.com	4592 Whispering Oak Trail		Cincinnati	OH	45247	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1212	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1212	PHR Beneficiary Contact																	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H1212	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/29/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/29/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1212	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	WELLPOINT WEST VIRGINIA , INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1215	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Medical Director	Medical Director	Mr	Haake	Karl		9132951245					karl.haake@sunflowerhealthplan.com	77 West Wacker Drive, 14th Floor		Chicago	IL	60601	03/30/2021	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H1215	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H1215	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H1215	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H1215	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/26/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H1215	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/02/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H1215	PHR Beneficiary Contact																	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H1215	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1215	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1219	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Backup User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	CEO - CMS Administrator Contact		Mr.	Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	1819 N. Western Ave		San Bernardino	CA	92411	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	CEO - Senior Official for Contracting		Mr.	Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	1819 N. Western Ave		San Bernardino	CA	92411	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Chief Financial Officer		Mr.	Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	1819 N. Western Ave		San Bernardino	CA	92411	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Chief Operating Officer		Ms.	Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		Pasadena	CA	91105	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Contact for Fraud Investigations			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Customer Service Operations Contact			Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 GATEWAY DR		RIVERSIDE	CA	92507	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	DIR Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	DIR Contact (Secondary)		Mr.	Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Emergency Part D Contact (Secondary)			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	General Contact			Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 GATEWAY DR		RIVERSIDE	CA	92507	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Government Relations Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	HIPAA Privacy Officer			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	HIPAA Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Medical Director			Yang	Jae		9516213001					jae.yang@welbehealth.com	1819 N. Western Ave		San Bernardino	CA	92411	07/30/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Medicare Compliance Officer		Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Medicare Coordinator			Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 GATEWAY DR		RIVERSIDE	CA	92507	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Medication Therapy Management Contact		Ms.	Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	2192106392				PACE - Nat		C	San Francisco
H1219	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1219	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1219	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part D Quality Assurance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Patient Safety Contact			Lincoln-Giang	Pam		7143925198					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1219	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Surveillance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1219	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/29/2025	2026	WELBEHEALTH SAN BERNARDINO PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1224	Agent/Broker Compensation Data Contact	Director, Sales Operations	Ms.	Quintanilla	Leslie		2134359195					LQuintanilla@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility	Ms.	Sherman	Mandy		9202214083				9202214583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	01/05/2022	2026	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	Dallas
H1224	Backup User Access Contact	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Best Available Evidence Contact	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Bid Audit Contact	Lead Product Solutions Manager, Medicare Product	Mrs.	Rodriguez	Teresa		2136065562					trodriguez1@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	03/13/2025	2026	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	Dallas
H1224	Bid Audit Site Contact	Lead Product Solutions Manager, Medicare Product	Mrs.	Rodriguez	Teresa		2136065562					trodriguez1@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	03/13/2025	2026	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	Dallas
H1224	Bid Primary Contact	Lead Product Solutions Manager, Medicare Product	Mrs.	Rodriguez	Teresa		2136065562					trodriguez1@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	03/13/2025	2026	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	Dallas
H1224	CAP Report Contact for Public Website	Director, Communications	Ms.	De Lamare	Misty		2136043457					mdelamare@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Santana-Chin	Martha		2136941250	4151				msantana-chin@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	01/06/2025	2026	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	Dallas
H1224	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Santana-Chin	Martha		2136941250	4151				msantana-chin@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	01/06/2025	2026	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	Dallas
H1224	Chief Financial Officer	Chief Financial Officer	Mr.	Shah	Syed Afzal		2136941250	4526				AShah@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Chief Operating Officer	Chief Operating Officer	Ms.	Reed	Acacia		2136941250	4230				areed@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Chief Information Officer	Chief Information Security Officer	Mr.	Magerr	Gene		3109099617					GMagerr@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Chief Information Security Officer	Chief Information and Technology Officer	Mr.	MacDougall	Tom		6177788939					TMacDougall@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	CMMI Model Point of Contact	Executive Director, Medicare Operations	Mr.	Hurtado	Victor		2134143680					vhurtado@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	CMS Casework Communication Contact	Director Customer Solution Center Appeals	Ms.	Crandall	Demetra		2136941250	4616				A&G_Intake@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Complaints Tracking Contact	Director Customer Solutions Center Appeals	Ms.	Crandall	Demetra		2136941250	4616				A&G_Intake@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Contact for Fraud Investigations	Director Investigations Unit (SIU)	Ph.D	Devine	Michael		2136941250	4415				MDevine@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/01/2024	2026	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	Dallas
H1224	Coordination of Benefits Contact	Lead Product Solutions Manager, Medicare Product	Ms.	Tisdale	Mona		2133926050					mtisdale@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Corporate Mailing						2136941250					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Customer Service Operations Contact	Director, Customer Solution Center	Ms.	Bravo	Liliana		2133341475					lmoure@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	DIR Contact	Director Pharmacy Compliance	Ms.	Lee	Diane		2133326167					DLee@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	DIR Contact (Secondary)	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann		7147265358					APhan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Discount Program Payment Contact	Director,  Commercial Revenue Premium Billing	Ms.	Espinosa	Charmaine		2134352406					Cespinosa@lacare.org	1200 West 7th Street		Los Angeles	CA	90013	05/02/2024	2026	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	Dallas
H1224	Electronic Health Record Contact	Manager Health Information Technology	Ms.	Vodela	Saikiran		2134076716					svodela@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Emergency Part D Contact	Director Pharmacy Compliance	Ms.	Lee	Diane		2133326167					DLee@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Emergency Part D Contact (Secondary)	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Employer Waiver Contact	Lead Product Solution Manager	Mrs	Tisdale	Mona		2133926050					MTisdale@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment Strategies	Ms.	Diep	Meredith		2134359896					MDiep@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Enrollment Contact	Senior Manager Medicare Enrollment	Mr.	Broussard	Dwayne		2134351249					dbroussard@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	EOB Transfer Contact	Director, Pharmacy Compliance	Ms.	Lee	Diane		2136941250	6612			2136941250	DLee@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Financial Audit Contact	Senior Director, Regulatory Compliance	Mr.	Varela	Miguel		3234858791					MVarelaMiranda@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/01/2024	2026	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	Dallas
H1224	Financial Reporting Contact	Director, Accounting Operations	Ms.	Bergman	Angela		2135058325					abergman@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/01/2024	2026	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	Dallas
H1224	Formulary Contact	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann		7147265358					aphan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	2601 W. Beltline Highway, Suite 600		Madison	WI	53717	07/19/2023	2026	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	Dallas
H1224	General Contact	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					TGower@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Government Relations Contact	Manager, Regulatory Affairs	Ms.	Diep Ko	Kimberly		9499399201					lacarecomplianceofficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	07/22/2024	2026	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	Dallas
H1224	HIPAA Privacy Officer	Senior Manager, Privacy	Mr.	Herrera	Serge		2134078995					seherrera@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	HIPAA Security Officer	Information Security Officer	Mr.	Magerr	Gene		3109099617					GMagerr@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Hospice Contact	Manager Technical Operations	Ms.	Moussa	Nicole		2132488246					nmoussa@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Interoperability Contact	Manager, Health Information Technology	Mr.	Vodela	Saikiran		2134076716					svodela@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/01/2024	2026	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	Dallas
H1224	MA Appeals/Grievances Contact	Director Customer Solution Center Appeals	Ms.	Crandall	Demetra		2133341730					A&G_Intake@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	MA Claims Processing Contact for Public Website	Senior Director Claims Integrity	Mr.	Chase	Erik		2136941250	4391				EChase@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Marketing Contact	Senior Manager Material Review Unit	Ms.	Flores	Gabriela		2136041701					gflores@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Medical Director	Chief Medical Officer	Dr.	Amin	Sameer		2137601158					SAmin@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					TGower@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Medicare Coordinator	Executive Director, Medicare Operations	Mr.	Hurtado	Victor		2134143680					vhurtado@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann		7147265358					aphan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Medication Therapy Management Contact	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann		7147265358					aphan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	OffShore Subcontractor Contact	Privacy Officer	Mr.	Herrera	Serge		8186696942					seherrera@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Online Enrollment Center Contact (Back-up)	Enrollment Services Supervisor	Mr.	Martinez	Luis		2136941250	4861			2134385736	LMartinez@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Online Enrollment Center Contact (Optional)	Enrollment Services Supervisor	Mr.	Martinez	Luis		2136941250	4861				lmartinez@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Online Enrollment Center Contact (Primary)	Senior Manager Medicare Enrollment	Mr.	Broussard	Dwayne		2136941250	4584			2134385736	dbroussard@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Part C Application Contact	Lead Product Solutions Manager, Medicare Product	Mrs.	Rodriguez	Teresa		2136065562					trodriguez1@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	03/13/2025	2026	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	Dallas
H1224	Part C Reporting Contact	Manager, Regulatory Affairs	Ms.	Diep Ko	Kimberly		9499399201					lacarecomplianceofficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	07/22/2024	2026	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	Dallas
H1224	Part D Appeals	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann							aphan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	7147265358				HMO - Health Maintenance Organization		C	Dallas
H1224	Part D Appeals Contact (Secondary)	Director, Appeals and Grievances	Ms.	Crandall	Demetra							rpaul@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	2136941250	4605			HMO - Health Maintenance Organization		C	Dallas
H1224	Part D Application Contact	Lead Product Solutions Manager, Medicare Product	Mrs.	Rodriguez	Teresa		2136065562					trodriguez1@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	03/13/2025	2026	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	Dallas
H1224	Part D Benefits Contact	Director, Pharmacy Compliance	Ms.	Lee	Diane		2136941250	6612				DLee@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Part D Claims Submission Contact	Manager, Technical Operations	Mr.	Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	01/05/2022	2026	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	Dallas
H1224	Part D Exceptions Contact	Senior Manager, Clinical Prior Authorization	Mr.	LeClair	Chris						9202214622	christopher.leclair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	01/05/2022	2026	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	9202214122				HMO - Health Maintenance Organization		C	Dallas
H1224	Part D Exceptions Contact (Secondary)	Director Pharmacy Compliance	Ms.	Lee	Diane							DLee@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	2133326167				HMO - Health Maintenance Organization		C	Dallas
H1224	Part D Price File Contact (Back-up)	Director Pharmacy Compliance	Ms.	Lee	Diane		2133326167					DLee@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Part D Price File Contact (Optional)	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Part D Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	2601 West Beltline Highway	STE 600	Madison	WI	53713	04/25/2024	2026	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	Dallas
H1224	Part D Quality Assurance Contact	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann		7147265358					aphan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Part D Reporting Contact	Manager, Regulatory Affairs	Ms.	Diep Ko	Kimberly		9499399201					lacarecomplianceofficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	07/22/2024	2026	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	Dallas
H1224	Patient Safety Contact	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann		7147265358					aphan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Payment Contact	Senior Director Medical Payment Systems	Ms.	Liu	Feven		2132002181					fliu@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Personal Health Record Contact	Manager Privacy, Compliance	Ms.	Goodman	Cindy		2134350471					privacyofficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Pharmacy Director	Chief Pharmacy Officer	Dr.	Kang	Alex	C	3232525840					akang@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Pharmacy Network Management Contact	VP, Network Management		Santos	Christina		6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	04/25/2024	2026	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	Dallas
H1224	Pharmacy Network Management Contact (Secondary)	Manager Technical Operations		Moussa	Nicole		2132488246					nmoussa@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/25/2024	2026	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	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H1224	Pharmacy Technical Help Desk Contact (Secondary)	Director, Clinical Pharmacy, Pharmacy & Formulary	Ms.	Phan	Ann							aphan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	7147265358				HMO - Health Maintenance Organization		C	Dallas
H1224	PHR Beneficiary Contact																	01/05/2022	2026	LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY	Local CCP	L.A. Care Health Plan	HMO/HMOPOS	LA Care Health Plan	Local Initiative Health Authority for LA County	334	Yes	Active	8885221298				HMO - Health Maintenance Organization		C	Dallas
H1224	Physician Incentive Contact	Manager, Incentives	Mr.	Solomon	Henock		5627146730					HSolomon@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Plan Directory Contact for Public Website	Customer Solution Center		Service Unit	Provider		8665222736					mtisdale@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Plan to Plan Reconciliation Contact	Senior Director Medical Payment Systems	Ms.	Liu	Feven		2132002181					p2padmin@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	01/13/2025	2026	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	Dallas
H1224	Processor Contact	Senior Director, Claims Operations	Mr.	Chase	Erik		2136941250	4391				EChase@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Quality Contact	Medical Director, QI	Dr.	Aguilar-Henriquez	Felix		2134078264					FAguilar-Henriquez@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Reconciliation Contact	Senior Director Medical Payment Systems	Ms.	Liu	Feven		2132002181					fliu@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Reconciliation Contact (Secondary)	Director,  Commercial Revenue Premium Billing	Ms.	Espinosa	Charmaine		2134352406					Cespinosa@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	05/02/2024	2026	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	Dallas
H1224	Recovery Audit Contact	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	SNP Application Contact	Lead Product Solutions Manager, Medicare Product	Mrs.	Rodriguez	Teresa		2136065562					trodriguez1@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	03/18/2025	2026	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	Dallas
H1224	SNP State Contact	Executive Director, Medicare Operations	Mr.	Hurtado	Victor		2134143680					vhurtado@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Surveillance Contact	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	System Contact	Director, IT Solutions Delivery	Mr.	Roman	Hector		6263796181					hroman@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Third Party Administrator (TPA) Liaison	Director Pharmacy Compliance	Ms.	Lee	Diane		2133326167					DLee@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	User Access Contact	Chief Compliance Officer	Mr.	Gower	Todd		9255951021					LACareComplianceOfficer@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Utilization Management Contact	Senior Director of Utilization Management	Ms.	Nelson	Tara		2135446216					TNelson@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1224	Utilization Review Contact	Senior Medical Director, Health Services	Dr.	Kagan	David		2136941250	5849				DKagan@lacare.org	1200 West 7th Street		Los Angeles	CA	90017	04/30/2024	2026	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	Dallas
H1225	Agent/Broker Compensation Data Contact	Executive Director Sales and Marketing	Mr.	Persons	James		8134764931					Jpersons@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Automated TrOOP Balance Transfer Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Backup User Access Contact	Sr. Director IT	Mr.	Reppas	Soterios		4104244620					sreppas@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Best Available Evidence Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Bid Audit Contact	Chief Actuary	Ms.	McAleer	Bethany		2026588702					BMcAleer@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Bid Primary Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	CEO - CMS Administrator Contact	President Medicare Advantage	Ms.	Rund	Lori		2488243735					LRund@jhhp.org	7231 Parkway Drive,	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	CEO - Senior Official for Contracting	President Medicare Advantage	Ms.	Rund	Lori		2488243735					LRund@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Chief Financial Officer	Chief Financial Officer	Mr.	Chojnowski	Daniel		2078072496					DChojnowski@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Chief Operating Officer	Chief Operating Officer	Mr.	O'Donnell	Ryan		7038876201					RODonnell@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Chief Information Officer	Vice President Information Technology	Mr.	Mukherjee	Joydeep		6038922211					JMukherjee@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Chief Information Security Officer	Assistant Director Information Security, IT/IS	Mr.	Ross	Willie		4104244642					wross@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4436180786					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Complaints Tracking Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Contact for Fraud Investigations	Director of Special Investigations	Mr.	Waugh	John		4106891079					JWaugh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Coordination of Benefits Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					Sriaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Corporate Mailing						4104244955					PGillan@jhhp.org	Johns Hopkins Health Plans	Attn:Paul Gillan, Esq., 7231 Parkway Drive, Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Customer Service Operations Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	DIR Contact	Director of  Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	DIR Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					FatoduH@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Discount Program Payment Contact	Director of  Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Emergency Part D Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4438071292					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Emergency Part D Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4109256831					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Encounter Data & Risk Adjustment Operations Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Enrollment Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	EOB Transfer Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740			4104242805	CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Financial Audit Contact	Director of  Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Financial Reporting Contact	Director of  Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Formulary Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Formulary Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	General Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Government Relations Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	HIPAA Privacy Officer	Exec Director of Compliance  & Regulatory Affairs	Ms.	Mohon	Melissa		4438570852					MMohon@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	HIPAA Security Officer	Chief Information Security Officer	Ms.	Rathod	Janet		6672088766					janet.rathod@jhu.edu	750 East Pratt Street		Baltimore	MD	21202	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Hospice Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Interoperability Contact	Exec.Director of Compliance and Regulatory Affairs	Ms.	Mohon	Melissa		4438570852					MMohon@jhhp.org	7231 Parkway Drive,	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	MA Appeals/Grievances Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	MA Claims Processing Contact for Public Website	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Marketing Contact	Manager, Marketing & Communications	Ms.	Heredia	Leslie		4104244633					LHeredia@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Medical Director	Associate Chief Medical Officer	Dr.	Gerry	Danielle		4103033422					DGerry@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/20/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Donnelly	Mary		4436180786					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Medicare Coordinator	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					SRiaz@jhhp.org	7231 Parkway Drive,	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Medication Therapy Management Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	OffShore Subcontractor Contact	Assistant Director Vendor Management	Ms.	Gomillion	Morgan		9419628261					MGomillion@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Online Enrollment Center Contact (Back-up)	Chief Operating Officer	Mr.	O'Donnell	Ryan		7038876201					RODonnell@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Online Enrollment Center Contact (Primary)	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part C Application Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part C Reporting Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					Sriaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Appeals	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1225	Part D Appeals Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1225	Part D Application Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Benefits Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Claims Submission Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Exceptions Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1225	Part D Exceptions Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1225	Part D Price File Contact (Back-up)	Senior Analyst	Ms.	Scott	Sarah		4803109219					Sarah.Scott@cvshealth.com	9501 E. Shea Blvd.	MC121	Scottsdale	AZ	85260	12/03/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Price File Contact (Optional)	Senior Analyst	Ms.	Perry	Michele		6026211682					Michele.Perry@cvshealth.com	9501 E. Shea Blvd.	MC121	Scottsdale	AZ	85260	12/03/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Price File Contact (Primary)	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Quality Assurance Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					FatoduH@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Part D Reporting Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Patient Safety Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					Fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Payment Contact	Director of  Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Pharmacy Director	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Pharmacy Network Management Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H1225	Pharmacy Technical Help Desk Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H1225	Plan Directory Contact for Public Website	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Plan to Plan Reconciliation Contact	Director of  Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Processor Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Quality Contact	Associate Chief Medical Officer, QI	Dr.	Zeltser	Marina		7323225499					MZeltser@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Reconciliation Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Recovery Audit Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	SNP Application Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Surveillance Contact	Director SIU	Mr.	Waugh	John		4106891079					JWaugh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	System Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					SRiaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	User Access Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Utilization Management Contact	Executive Director of Health Services	Ms.	Poth	Kristin		4105822700					KPoth@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1225	Utilization Review Contact	Executive Director of Health Services	Ms.	Poth	Kristin		4105822700					KPoth@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1228	Automated TrOOP Balance Transfer Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Backup User Access Contact	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	04/14/2025	2026	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		2097246000				2097246001	ndunitz@gvhc.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	01/05/2021	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Bid Primary Contact	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	04/14/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	CAP Report Contact for Public Website	Compliance Associate Director		Morgan	Barbara	N	2097246000				2097246001	bmorgan@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/07/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	CEO - CMS Administrator Contact	CEO	Mr	Quackenbush	David		2099132261				2093830136	dquackenbush@gvhc.org	2926 G St		Merced	CA	95340	06/20/2024	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	CEO - Senior Official for Contracting	CEO	Mr	Quackenbush	David		2099132261				2093830136	dquackenbush@gvhc.org	2926 G St		Merced	CA	95340	06/20/2024	2026	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	Ramirez	Trisha		2092037862				2093830136	tramirez@gvhc.org	1910 Customer Care Way		Atwater	CA	95301	12/05/2025	2026	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 Operating Officer	COO	Mrs.	Marshall	Melinda		2093854500				2093830136	mmarshall@gvhc.org	2926 G St		Merced	CA	95340	09/02/2022	2026	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 Information Officer	CIO	Mr	Mine	Wunna		2093855503				2093830136	wmine@gvhc.org	2926 G St		Merced	CA	95340	12/10/2018	2026	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 Information Security Officer	CIO	Mr	Mine	Wunna		2093855503				2093830136	wmine@gvhc.org	2926 G St		Merced	CA	95340	12/10/2018	2026	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 Manager RN	Ms.	Garcia	Rebecca		2099300930				2097246001	regarcia@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modeso	CA	95355	02/24/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Complaints Tracking Contact	Compliance Associate Director	Mrs.	Morgan	Barbara	N	2097246000				2097246001	bmorgan@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/07/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Contact for Fraud Investigations	VP		Blair	Tracy		2096203172				2093830136	tblair@gvhc.org	2926 G St		Merced	CA	95340	12/15/2020	2026	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 Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Corporate Mailing						2096176829				2093830136	cjelinek@cvpace.org	737 W Childs Ave		Merced	CA	95341	08/04/2025	2026	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 Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	DIR Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Discount Program Payment Contact	CFO	Ms	Ramirez	Trisha		2092037862				2093830136	tramirez@gvhc.org	1910 Customer Care Way		Atwater	CA	95301	12/05/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Emergency Part D Contact	Health Plan Director		Carr	Terrylyn		2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Emergency Part D Contact (Secondary)	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	04/14/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Encounter Data & Risk Adjustment Operations Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Enrollment Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	EOB Transfer Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Financial Audit Contact	CFO	Ms	Ramirez	Trisha		2092037862				2093830136	tramirez@gvhc.org	1910 Customer Care Way		Atwater	CA	95301	12/05/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Financial Reporting Contact	CFO	Ms	Ramirez	Trisha		2092037862				2093830136	tramirez@gvhc.org	1910 customer Care Way		Atwater	CA	95301	12/05/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Formulary Contact	Medical Director	Dr	Dunitz	Neal		2097246000				2097246001	ndunitz@gvhc.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	12/15/2020	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	General Contact	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	04/14/2025	2026	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		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	04/14/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	HIPAA Privacy Officer	CIO	Mr	Mine	Wunna		2093846632				2093830136	wmine@gvhc.org	847 W Childs Ave		Merced	CA	95341	11/05/2021	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	HIPAA Security Officer	CIO	Mr	Mine	Wunna		2093855503				2093830136	wmine@gvhc.org	2926 G St	Suite 201	Merced	CA	95340	05/08/2020	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Interoperability Contact	Health Plan Director	Mrs	Villa	Angelica	J	2097246000					ajvilla@cvpace.org	2401 East Oragneburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	MA Appeals/Grievances Contact	Director of Quality	Ms.	Morgan	Barbara		2097246000				2097246001	bmorgan@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	09/26/2024	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	MA Claims Processing Contact for Public Website	Health Plan Director	Ms	Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Marketing Contact	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	04/14/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Medical Director	Medical Director	Dr	Dunitz	Neal		2097246000				2097246001	ndunitz@gvhc.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2026	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	Compliance Officer	Mrs.	Morgan	Barbara		2099132697				2097246001	bmorgan@cvpace.org	2401 E Orangeburg Ave	Suite 330	Modesto	CA	95356	10/05/2023	2026	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 Coordinator	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpcae.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	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 Part D Opioid Overutilization Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Medication Therapy Management Contact	Medical Director	Dr	Dunitz	Neal		2097246000				2097246001	ndunitz@gvhc.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2026	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 C Application Contact	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	04/14/2025	2026	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 Appeals	Compliance Associate Director	Ms.	Morgan	Barbara						2097246001	bmorgan@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/07/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active	8554617223				PACE - Nat		C	San Francisco
H1228	Part D Appeals Contact (Secondary)	Health Plan Director		Villa	Angelica	J					2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active	8554617223	6001			PACE - Nat		C	San Francisco
H1228	Part D Application Contact	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	04/14/2025	2026	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 Benefits Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	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 Claims Submission Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2093830136	ajvilla@cvpace.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	08/04/2025	2026	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 Director		Villa	Angelica	J					2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active	8554617223	6001			PACE - Nat		C	San Francisco
H1228	Part D Exceptions Contact (Secondary)	Executive Director		Jelinek	Cherie						2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto Ca	CA	95355	04/14/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active	8554617223				PACE - Nat		C	San Francisco
H1228	Part D Price File Contact (Back-up)	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	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 Price File Contact (Primary)	CFO	Ms	Sandhu	Gurjeet		2093846516				2093830136	gsandhu@gvhc.org	1910 Customer Care Way		Atwater	CA	95301	09/26/2024	2026	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 Quality Assurance Contact	Compliance Associate Director		Morgan	Barbara	N	2097246000				2097246001	bmorgan@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/07/2025	2026	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 Reporting Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Patient Safety Contact	Medical Director	Dr.	Dunitz	Neal		2097246000				2097246001	ndunitz@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	10/16/2023	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Payment Contact	CFO	Ms	Ramirez	Trisha		2092037862				2093830136	tramirez@gvhc.org	1910 Customer Care Way		Atwater	CA	95301	12/05/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Personal Health Record Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East orangeburg Ave.	Suite 330	Modesto	CA	95355	08/04/2025	2026	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 Director	Medical Director	Dr	Dunitz	Neal		2097246000				2097246001	ndunitz@gvhc.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	01/05/2021	2026	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 Network Management Contact	Health Plan Director		Villa	Angelica	J	2097246000	6000			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	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 Director		Villa	Angelica	J					2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active	8554617223	6001			PACE - Nat		C	San Francisco
H1228	Plan Directory Contact for Public Website	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Plan to Plan Reconciliation Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave.	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Processor Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Quality Contact	Quality Manager RN		Garcia	Rebecca		2097246000				2097246001	regarcia@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	02/24/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Reconciliation Contact	CFO	Ms	Ramirez	Trisha		2092037862				2093830136	tramirez@gvhc.org	1910 Customer Care Way		Atwater	CA	95301	12/05/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Recovery Audit Contact	CFO	Ms	Ramirez	Trisha		2092037862				2093830136	tramirez@gvhc.org	1910 Customer Care Way		Atwater	CA	95301	12/05/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Surveillance Contact	Director of Quality		Morgan	Barbara		2097246000				2097246001	bmorgan@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	09/26/2024	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	System Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Third Party Administrator (TPA) Liaison	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	User Access Contact	Executive Director		Jelinek	Cherie		2097246000				2097246001	cjelinek@cvpace.org	2401 East Orangeburg Ave.	suite 330	Modesto	CA	95355	04/14/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Utilization Management Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1228	Utilization Review Contact	Health Plan Director		Villa	Angelica	J	2097246000	6001			2097246001	ajvilla@cvpace.org	2401 East Orangeburg Ave	Suite 330	Modesto	CA	95355	08/04/2025	2026	GOLDEN VALLEY HEALTH CENTERS	National PACE	Central Valley PACE	National PACE		Golden Valley Health Centers	742	Yes	Active					PACE - Nat		C	San Francisco
H1230	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Backup User Access Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	03/15/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Bid Primary Contact	Actuary		Shmelzer	Cameron		5038131826					KPMedicareBids@kp.org	2715 Naches Ave SW		Renton	WA	98057	06/27/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	CAP Report Contact for Public Website	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	2064739504				HMO - Health Maintenance Organization		C	Dallas
H1230	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Complaints Tracking Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Corporate Mailing						8083487832				8084325427	Kimberly.C.Piper@kp.org	711 Kapiolani Blvd.	PO Box 9010	Honolulu	HI	96813	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Customer Service Operations Contact			Services	Member		8004430815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	05/15/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	03/09/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	07/17/2018	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/06/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	07/02/2018	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/04/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/12/2012	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/20/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	General Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Government Relations Contact	Senior Vice President, Government Relations	Mr.	Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/07/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	11/06/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/25/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					cathy.p.plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	11/03/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	MA Appeals/Grievances Contact	Executive Director, Member Relations	Ms	Osborne	Susan		5038133924					susan.a.osborne@kp.org	500 NE Multnomah Street	Suite 100	Portland	OR	97232	05/15/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Marketing Contact	Marketing Consultant IV		Hollett	Gretchen		2063356869					Kimberly.C.Piper@kp.org	2715 Naches Ave., SW	PO Box 9010	Renton	WA	98057	08/22/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	11/16/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Medicare Compliance Officer	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Medicare Coordinator	Medicare Business Line		Cunningham	Pamela		8082606560					Pamela.M.Cunningham@kp.org	711 Kapiolani Boulevard		Honolulu	HI	96813	03/09/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street		Rancho Cucamonga	CA	91730	08/26/2020	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part C Application Contact	Director, Customer Service and Appeals		Devol	Michele		8084325215				8084325667	michelle.j.devol@kp.org	711 Kapiolani Blvd		Honolulu	HI	96813	01/02/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part C Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Appeals	Executive Director, Member Relations		Osborne	Susan							Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	05/15/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8774083496				HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Application Contact	Director, Customer Service and Appeals		Devol	Michele		8084325215				8084325667	michelle.j.devol@kp.org	711 Kapiolani Blvd		Honolulu	HI	96813	01/02/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Benefits Contact	Pharmacy Benefits		Goo	Jeilyn		8084325534					jeilyn.s.goo@kp.org	Kaiser Permanente - Pharmacy Services	501 Alakawa Street	Honolulu	HI	96817	04/01/2013	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Claims Submission Contact	Pharmacy Medicare Business Line Manager	Ms	Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	10/06/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Exceptions Contact (Secondary)	Pharmacy Benefits		Goo	Jeilyn	S						jeilyn.s.goo@kp.org	Kaiser Permanente Pharmacy Services	501 Alakawa St., Suite 101	Honolulu	HI	96817	10/05/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8008052739				HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/26/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Part D Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Pharmacy Director	Director, Pharmacy		Takara	Ross	T	8084325547					ross.t.takara@kp.org	501 Alakawa St, Suite 101		Honolulu	HI	96817	08/03/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Pharmacy Network Management Contact	Pharmacy Benefits		Goo	Jeilyn		8084325534					jeilyn.s.goo@kp.org	Kaiser Permanente - Pharmacy Services	501 Alakawa Street	Honolulu	HI	96817	04/01/2013	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Pharmacy Network Management Contact (Secondary)	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	10/05/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8882773917				HMO - Health Maintenance Organization		C	Dallas
H1230	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Benefits		Goo	Jeilyn							jeilyn.s.goo@kp.org	501 Alakawa St., Suite 101		Honolulu	HI	96817	06/02/2011	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8882773917				HMO - Health Maintenance Organization		C	Dallas
H1230	Plan Directory Contact for Public Website			Services	Member		8004430815					mscc@kp.org	10740 Fourth St., Second Floor		Rancho Cucamonga	CA	91730	11/12/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/20/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	05/25/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/03/2022	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	SNP Application Contact	Director, Customer Service and Appeals		Devol	Michele		8084325215				8084325667	michelle.j.devol@kp.org	711 Kapiolani Blvd		Honolulu	HI	96813	01/02/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	SNP State Contact	Director, Customer Service and Appeals		Devol	Michele		8084325215				8084325667	michelle.j.devol@kp.org	711 Kapiolani Blvd		Honolulu	HI	96813	01/02/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Surveillance Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	User Access Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	03/15/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Utilization Management Contact	Manger Utilization Management	Ms	Kon	Wendy		8082718148				8084325427	Wendy.Kon@kp.org	2828 Pa'a St.		Honolulu	HI	96819	10/06/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1230	Utilization Review Contact	Manger Utilization Management	Ms	Kon	Wendy		8082718148				8084325427	Wendy.Kon@kp.org	2828 Pa'a St.		Honolulu	HI	96819	10/06/2021	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1234	Automated TrOOP Balance Transfer Contact	Accounting Manager	Mr.	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd.		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Backup User Access Contact	Quality & Regulatory Affairs	Ms.	Shrikhande	Vrushali		6095995433				6095996203	VShrikhande@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	08/20/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Best Available Evidence Contact	Chief Compliance & Privacy Officer	Mrs	Capik McGuire	Laura		6095995478				6095996203	LMcGuire@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Bid Primary Contact	Accounting Manager	Mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	CAP Report Contact for Public Website	Accounting manager	Ms.	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	CEO - CMS Administrator Contact	COO	Mrs	John-Williams	Mary		6095995474					MJohn-Williams@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	04/30/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	CEO - Senior Official for Contracting	Interim COO	Mr	Dafilou	David		6095995474				6095996203	ddafilou@capitalhealth.org	7500 Kevin Johnson Boulevard		Bordentown	NJ	08629	04/30/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Chief Financial Officer	Accounting Manager	Mr	Stern	Gregg		6095995474					gstern@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Chief Operating Officer	COO	Mrs	John-Williams	Mary		6095995478				6095996203	MJohn-Williams@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	04/30/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Chief Information Officer	Chief Information Officer	Mr	Koganti	Ravi		6093944272					rkoganti@capitalhealth.org	2 Capital Way		Pennington	NJ	08534	09/01/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Chief Information Security Officer	Chief Information Officer	Mr	Koganti	Ravi		6093944272					rkoganti@capitalhealth.org	2 Capital Way		Pennington	NJ	08534	09/01/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	CMS Casework Communication Contact	Executive Director	Mrs	John-Williams	Mary		6095995477				6095996203	mjwilliams@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	06/19/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Complaints Tracking Contact	Accounting Manager	Mr	Stern	Gregg		6095995478				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	09/06/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Contact for Fraud Investigations	Chief Compliance & Privacy Officer	Ms	Capik McGuire	Laura		6095995474				6095996203	LMcGuire@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Coordination of Benefits Contact	Accounting Manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Corporate Mailing						6095995433				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	09/13/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Customer Service Operations Contact	Accounting Manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	DIR Contact	Accounting Manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Discount Program Payment Contact	Accounting Manager	Mr	Stern	Gregg		6095995433					gstern@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	12/04/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Emergency Part D Contact	Accounting Manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Emergency Part D Contact (Secondary)	accounting manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 Kevin Johnson Boulevard		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Encounter Data & Risk Adjustment Operations Contact	Manager of Quality & Regulatory Affairs	Ms.	Shrikhande	Vrushali		6095995433					VShrikhande@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	08/20/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Enrollment Contact	Accounting Manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	08/20/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	EOB Transfer Contact	Accountng Manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Financial Audit Contact	accounting manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Financial Reporting Contact	accounting manager	mr	stern	gregg		6095995478				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Formulary Contact	Medical Director	Dr.	Farooq	Ahmed		6094006293				6095996203	afarooq@capitalhealth.org	7500 Kevin Johnson Boulevard		Bordentown	NJ	08505	12/22/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	General Contact	Interim COO	Mr	Dafilou	David		6095995474				6095996203	ddafilou@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Government Relations Contact	Chief Compliance & Privacy Officer	Ms.	Capik McGuire	Laura		6095995474				6095996203	LMcGuire@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	HIPAA Privacy Officer	Compliance and Privacy Manager	Ms	Stahl	Marianne		6095995474					mstahl@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	01/09/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	HIPAA Security Officer	Chief Information Officer	mr	Koganti	Ravi		6093944272					rkoganti@capitalhealth.org	2 Capital Way		Pennington	NJ	08534	09/01/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Interoperability Contact	Chief Information Officer	Mr	Koganti	Ravi		6093944272					rkoganti@capitalhealth.org	2 Capital Way		Pennington	NJ	08534	09/01/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	MA Appeals/Grievances Contact	Accounting Manager	Mr	Stern	Gregg		6095995478				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	09/06/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	MA Claims Processing Contact for Public Website	accounting manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Marketing Contact	Manager Communications and Marketing	Mr	Stacchini	Jason		6095995433				6095996203	jstacchini@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	09/13/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Medical Director	Medical Director	Dr.	Farooq	Ahmed		6094006293				6095996203	afarooq@capitalhealth.org	7500 Kevin Johnson Boulevard		Bordentown	NJ	08505	12/22/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Medicare Compliance Officer	Chief Compliance & Privacy Officer	Ms.	Capik McGuire	Laura		6093946783				6093946783	LMcGuire@capitalhealth.org	750 Brunswick Ave		Trenton	NJ	08638	03/01/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Medicare Coordinator	Accounting manager	Mrs.	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Medicare Part D Opioid Overutilization Contact	Manager of Quality & Regulatory Affairs	Ms	Shrikhande	Vrushali		6095995433					VShrikhande@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	08/20/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Medication Therapy Management Contact	Manager of Quality & Regulatory Affairs	Ms	Shrikhande	Vrushali		6095995433					VShrikhande@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	08/20/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part C Application Contact	Accounting Manager	Mr	Stern	Gregg		6095995478				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part D Appeals	Manager of Quality & Regulatory Affairs	Ms	Shrikhande	Vrushali							VShrikhande@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	08/20/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active	6095995433				PACE - Nat		C	New York
H1234	Part D Appeals Contact (Secondary)	Accounting Manager	Mr	Stern	Gregg						6095996203	Gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active	6095995474				PACE - Nat		C	New York
H1234	Part D Application Contact	Accounting manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part D Benefits Contact	Accounting manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part D Claims Submission Contact	Accounting manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part D Exceptions Contact	Manager of Quality & Regulatory Affairs	Ms	Shrikhande	Vrushali							VShrikhande@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	08/20/2025	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active	6095995433				PACE - Nat		C	New York
H1234	Part D Price File Contact (Back-up)	Accounting Manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part D Price File Contact (Primary)	Chief Compliance & Privacy Officer	Mrs.	Capik McGuire	Laura		6095995474				6095996203	LMcGuire@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part D Quality Assurance Contact	Quality Manager	Ms	Howard	Cheryl		6095995433				6095996203	choward2@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	12/23/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Part D Reporting Contact	Accounting manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	08/14/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Patient Safety Contact	Chief Compliance & Privacy Officer	mrs	Capik McGuire	Laura		6095995474				6095996203	LMcGuire@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Payment Contact	Accounting Manager	Mr.	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Pharmacy Director	Interim COO	Mr	Dafilou	David		6095995474				6095996203	ddafilou@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Pharmacy Network Management Contact	Accounting Manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Pharmacy Technical Help Desk Contact	Accounting manager	Mr	Stern	Gregg						6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active	6095995474				PACE - Nat		C	New York
H1234	Plan Directory Contact for Public Website	Accounting Manager	Mr.	Stern	Gregg		6095995433				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Plan to Plan Reconciliation Contact	accounting manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Processor Contact	accounting manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Quality Contact	Quality Manager	Ms	Howard	Cheryl		6095995433				6095996203	choward2@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	12/23/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Reconciliation Contact	accounting manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Recovery Audit Contact	accounting manager	mr	stern	gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	01/10/2023	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Surveillance Contact	Accounting manager	Mr	Stern	Gregg		6095995478				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	System Contact	Accounting Manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Third Party Administrator (TPA) Liaison	Accounting Manager	Mr	Stern	Gregg		6095995433					gstern@capitalhealth.org	7500 Kevin Johnson Blvd		Bordentown	NJ	08505	12/04/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	User Access Contact	Accounting Manager	Mr	Stern	Gregg		6095995474				6095996203	gstern@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Utilization Management Contact	Accounting manager	Mr	Stern	Gregg		6095995474				6095996203	gsterni@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1234	Utilization Review Contact	Chief Compliance & Privacy Officer	mrs	Capik McGuire	Laura		6095995474				6095996203	LMcGuire@capitalhealth.org	7500 K Johnson Blvd		Bordentown	NJ	08505	11/07/2024	2026	CAPITAL HEALTH LIFE	National PACE	Capital Health LIFE	National PACE		Capital Healthcare, INC.	809	Yes	Active					PACE - Nat		C	New York
H1239	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	09/14/2023	2026	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	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie		7203929719				3039961600	lteter@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Operating Officer	Market President	Mr.	Jones	Steve		8049442904				3039961600	sjones2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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 Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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 Information Security Officer	SVP of Information Technology	Mr.	Naus	Cole		7209210443				3039961600	MNaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Complaints Tracking Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Corporate Mailing						3038694664				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	DIR Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	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	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Interoperability Contact	SVP of Applications		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	07/28/2023	2026	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	MA Appeals/Grievances Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	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	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	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 Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	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 Appeals	Director of Compliance		Licht	Hannah						3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H1239	Part D Appeals Contact (Secondary)	Director of Compliance		Licht	Hannah						3039961600	hlicht@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H1239	Part D Application Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H1239	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Philadelphia
H1239	Part D Price File Contact (Back-up)	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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 Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Quality Assurance Contact	SVP, Clinical Strategic Partnerships Clinical Oper		Cinque	Michael		7207444048				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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 Reporting Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H1239	PHR Beneficiary Contact																	02/14/2025	2026	INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC	National PACE	InnovAge Virginia PACE- Roanoke Valley	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Philadelphia
H1239	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	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	Plan to Plan Reconciliation Contact	Finance and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	akizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	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	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Reconciliation Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Recovery Audit Contact	Director of Finance	Mrs.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	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	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	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	System Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	User Access Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Agent/Broker Compensation Data Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	Automated TrOOP Balance Transfer Contact	CFO, Monroe Operations	Ms.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	Backup User Access Contact	Medicare Advantage Compliance Program Manager	Mrs.	Rainer	Sally		3183720214					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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 Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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	Bid Audit Contact	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Bid Audit Site Contact	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Bid Primary Contact	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	CAP Report Contact for Public Website	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	CEO - CMS Administrator Contact	EVP, Chief Growth Officer	Mr.	Keller	Brian		2252981582					brian.keller@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Camerlinck	Bryan		2252952537					bryan.camerlinck@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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 Operating Officer	VP, Monroe Operations	Mrs.	Self	Jessica		3183982853					jessica.self@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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 Information Officer	SVP and CIO	Mrs.	Bourgeois	Tina		2252952018					tina.bourgeois@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Sotnikov	Slava		2252987036					slava.sotnikov@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Complaints Tracking Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Contact for Fraud Investigations	Manager, Federal Investigations	Mrs.	Cowart	Kandyce		2252952073					kandyce.cowart@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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 Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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	Corporate Mailing						2252957965					wesley.miller@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Mrs.	Trichel Jones	Amy		3189982870					amy.trichel@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	DIR Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	DIR Contact (Secondary)	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Discount Program Payment Contact	CFO, Monroe Operations	Ms.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/30/2024	2026	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	Electronic Health Record Contact	SVP and CIO	Mrs.	Bourgeois	Tina		2252952018					tina.bourgeois@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	Emergency Part D Contact	Clinical Pharmacist I		Pennington	Hannah		2252987485					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Emergency Part D Contact (Secondary)	Medicare Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Employer Waiver Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of Quality Improvement	Mr.	Murphy	Paul		3189983098					paul.murphy@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Enrollment Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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	EOB Transfer Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076				3188129987	chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	Financial Audit Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Financial Reporting Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Formulary Contact	Clinical Pharmacist I	Mrs.	Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Formulary Contact (Secondary)	Clinical Pharmacist	Mrs.	Branch	Amy		3189982755					amy.branch@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	General Contact	VP, Monroe Operations	Mrs.	Self	Jessica		3189982853					jessica.self@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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.	Harvey	Korey		2252972762					korey.harvey@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	HIPAA Privacy Officer	VP, Internal Audit, Compliance & Privacy	Mrs.	Saporito	Mary		2252981742					mary.saporito@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	HIPAA Security Officer	Interim Head of Information Security	Mr.	Sotnikov	Slava		2252987036					slava.sotnikov@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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		4802818763					slmorgan@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	12/30/2020	2026	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	Interoperability Contact	VP, Digital Health	Mr.	Badinger	Brian		2252981591					brian.badinger@lablue.com	5525 Re1tz Ave		Baton Route	LA	70809	08/20/2025	2026	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	MA Appeals/Grievances Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	MA Claims Processing Contact for Public Website	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076				8665087145	chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	Marketing Contact	EVP, Chief Growth Officer	Mr.	Keller	Brian		2252981582					brian.keller@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Medical Director	Lead Medical Director	Dr.	Barfield	Deirdre	Y	2252981978					deirdre.barfield@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Coordinator	Medicare Advantage Compliance Program Manager	Mrs.	Rainer	Sally		3183720214					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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 Part D Opioid Overutilization Contact	Director, Clinical Programs		Hunziker	Simone		3143976681					SHunziker@express-scripts.com	One Express Way		St. Louis	MO	63121	07/02/2025	2026	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	Medication Therapy Management Contact	Clinical Pharmacist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	OffShore Subcontractor Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252957361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Medicare Advantage Compliance Program Manager	Mrs.	Rainer	Sally		3183720214					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Online Enrollment Center Contact (Primary)	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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 C Application Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 C Reporting Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Appeals	Sr Mgr Pharmacy PA		Herbert	Joshua							joshua.herbert@evernorth.com	One Espress Way Mail Stop S13NB		St. Louis	MO	63121	10/27/2025	2026	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	5132920563				PPO - BBA		C	Dallas
H1248	Part D Appeals Contact (Secondary)	Clinical Pharmacy Sr. Manager		Duffy	Vallery							Valerie.Duffy@evernorth.com	One Espress Way Mail Stop S13NB		St Louis	MO	63121	10/30/2024	2026	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	4437973575				PPO - BBA		C	Dallas
H1248	Part D Application Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 Benefits Contact	Clinical Pharamcist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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 Claims Submission Contact	Director Product Management	Mr.	Etherton	Jim		5133163889					jbetherton@express-scripts.com	8990 Duke Drive		Mason	OH	45040	10/12/2018	2026	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		Herbert	Joshua							joshua.herbert@evernorth.com	One Espress Way Mail Stop S13NB		St. Louis	MO	63121	10/27/2025	2026	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	5132920563				PPO - BBA		C	Dallas
H1248	Part D Exceptions Contact (Secondary)	Clinical Pharamcist I		Pennington	Hannah							hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	2252001752				PPO - BBA		C	Dallas
H1248	Part D Price File Contact (Back-up)	Sr. Manager - Government Relations	Mrs.	Dolfi	Amanda		6147613606					amanda_dolfi@express-scripts.com	One Express Way	Building 1	St. Louis	MO	63121	10/30/2024	2026	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 Price File Contact (Optional)	Clinical Pharamcist I		Pennington	Hannah		2252001752					Hannah.Pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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 Price File Contact (Primary)	Director-Government Programs	Mr.	Westrum	Josh		4807363132	433132				jwestrum@express-scripts.com	7909 S. Hardy Drive, Suite 106		Tempe	AZ	85284	02/14/2018	2026	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 Quality Assurance Contact	Clinical Pharmacist I	Ms.	Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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 Reporting Contact	Clinical Pharmacist I		Pennington	Hannah		2252987485					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Patient Safety Contact	Lead Medical Director	Dr.	Barfield	Deirdre	Y	2252981978					deirdre.barfield@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Payment Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Personal Health Record Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252957361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 Director	Clinical Pharmacist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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 Network Management Contact	Network Account Dir, Retail Strategy & Contracting	Ms.	Kelly	Heather		3146921866					Hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	02/14/2018	2026	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 Network Management Contact (Secondary)	Clinical Pharmacist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Director, Customer Service		Monroe	LaTasha							latasha_monroe@express-scripts.com	13051 N Telecom Parkway	Suite 150	Temple Terrace	FL	33637	12/18/2024	2026	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	8009221557				PPO - BBA		C	Dallas
H1248	Pharmacy Technical Help Desk Contact (Secondary)	Clinical Pharmacist I		Pennington	Hannah							hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	Local CCP	Blue Cross and Blue Shield of Louisiana	Local PPO		Louisiana Health Service & Indemnity Company	617	Yes	Active	2252001752				PPO - BBA		C	Dallas
H1248	Physician Incentive Contact	Controller	Ms.	Cupit	Chelle		8665087145					chelle.cupit@lablue.com	130 Desiard Street		Monroe	LA	71201	12/18/2024	2026	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	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8665087145					customerservice@blueadvantage.lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	Plan to Plan Reconciliation Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Processor Contact	Director, Government Programs, Medicare		Steffen	Jeff		6363351729					jhsteffen@express-scripts.com	One Express Way		St. Louis	MO	63121	10/30/2024	2026	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	Quality Contact	Director of Quality Improvement	Mr.	Murphy	Paul		3189983098					paul.murphy@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	07/03/2025	2026	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	Reconciliation Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Recovery Audit Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	SNP Application Contact	VP, Monroe Operations	Mrs.	Self	Jessica		3189982853					jessica.self@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	SNP State Contact	VP, Monroe Operations	Mrs.	Self	Jessica		3189982853					jessica.self@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	12/18/2024	2026	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	Surveillance Contact	VP, Medicare Advantage Sales	Mr.	Wagner	Dan		5048325831					dan.wagner@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	System Contact	Chief IT Programs, Monroe Ops	Mr.	Wright	Landon		2252953307					landon.wright@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Third Party Administrator (TPA) Liaison	CFO, Monroe Operations	Ms.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/30/2024	2026	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	User Access Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	708093809	08/20/2025	2026	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	Utilization Management Contact	Senior Medical Director	Dr.	Trunk	Laura		2252953307					laura.trunk@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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	Utilization Review Contact	Senior Medical Director	Dr.	Trunk	Laura		2252953307					laura.trunk@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	12/18/2024	2026	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
H1278	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H1278	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1278	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1278	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H1278	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1278	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1280	Agent/Broker Compensation Data Contact	Chief Finance Officer		Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Automated TrOOP Balance Transfer Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Backup User Access Contact	CCO		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Best Available Evidence Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Bid Audit Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Bid Audit Site Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Bid Primary Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	CAP Report Contact for Public Website	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Ika	Pooja	V	5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	CEO - Senior Official for Contracting	CEO	Mrs.	Ika	Pooja		5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	09/03/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Chief Financial Officer	Chief Financial Officer	Mr.	Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Chief Operating Officer	Chief Operating Officer	Mr.	Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Chief Information Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Chief Information Security Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	CMS Casework Communication Contact	VP Clinical Operations		Dougherty	Laurene		4149150613					laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/16/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Complaints Tracking Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Contact for Fraud Investigations	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Coordination of Benefits Contact	coo		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Corporate Mailing						5088046904					pooja.sammeta@rxadvance.com	136 Turnpike Road		Southborough	MA	01772	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Customer Service Operations Contact	Chief Operating Officer		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	DIR Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	DIR Contact (Secondary)	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Discount Program Payment Contact	CFO		Lawless	Tom		6172450509					Tom.Lawless@eternalhealth.com	31 St James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Emergency Part D Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Encounter Data & Risk Adjustment Operations Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Enrollment Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	EOB Transfer Contact	Chief Operating Officer		Price	John		2158806876				8664371627	john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Financial Audit Contact	CFO	Mr.	Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Financial Reporting Contact	CFO		Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/12/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Formulary Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Formulary Contact (Secondary)	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	32 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	General Contact	Chief Executive Officer		Ika	Pooja		5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Government Relations Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	HIPAA Privacy Officer	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	HIPAA Security Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Hospice Contact	VP Clinical Operations	Dr.	Dougherty	Laurene		8136015063					laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Interoperability Contact	Chief Compliance Officer		Ross	Cheyenne		6178404477					cheyenne.ross@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	MA Appeals/Grievances Contact	Chief Operating Officer		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	08/22/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	MA Claims Processing Contact for Public Website	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Marketing Contact	Senior Director, Marketing		Cardinal	Brittany		4136524780					brittany.cardinal@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Medical Director	Medical Director	Dr.	London	Robert		3038083311					robert.london@nirvanahealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Medicare Coordinator	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Medicare Part D Opioid Overutilization Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Medication Therapy Management Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	OffShore Subcontractor Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave		Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Online Enrollment Center Contact (Back-up)	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Online Enrollment Center Contact (Primary)			Rao	Chanukya		8565031661					chanukya.rao@rxadvance.com	136 Turnpike Rd.		Southborough	MA	01772	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part C Application Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part C Reporting Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Appeals	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	6126326838				HMO - Health Maintenance Organization		C	Boston
H1280	Part D Appeals Contact (Secondary)	Chief Operating Officer		Price	John							john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	08/22/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	2158806876				HMO - Health Maintenance Organization		C	Boston
H1280	Part D Application Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Benefits Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Claims Submission Contact	Director		Pereira	Michael		9494753456					pereira.mj@optum.com	2300 Main Street		Irvine	CA	92614	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Exceptions Contact	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	6126326838				HMO - Health Maintenance Organization		C	Boston
H1280	Part D Price File Contact (Back-up)			Moore-Elliot	Shalandria		6514955363					MedOps-Planfinder_DL@ds.uhc.com	1600 McConnor Pkwy		Schaumburg	IL	60173	12/15/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Price File Contact (Optional)			Vargas	Danielle		4437101262					MedOps-Planfinder_DL@ds.uhc.com	1600 McConnor Pkwy		Schaumburg	IL	60173	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Price File Contact (Primary)			Rx	Optum		6514955363					medops_planfinder@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Quality Assurance Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Part D Reporting Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Patient Safety Contact	VP  Pharmacy		Vellutato	John		4149150613					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/16/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Payment Contact	Chief Executive Officer		Ika	Pooja		5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Pharmacy Director	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Pharmacy Network Management Contact	Director		Ashby	JoLynn		7637326364					JAshby@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Pharmacy Technical Help Desk Contact			Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	06/04/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	8553122306				HMO - Health Maintenance Organization		C	Boston
H1280	Physician Incentive Contact	Cheif Compliance Officer		Ross	Cheyenne	L	6178404477					cheyenne.ross@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	09/26/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Plan Directory Contact for Public Website			Services	Provider		8006809255					providerrelations@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Plan to Plan Reconciliation Contact	CFO		Lawless	Tom		2158806876					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950,	Boston	MA	02116	09/09/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Processor Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Quality Contact	QM Director		Suarez	Keyla		8006804568					keyla.suarez@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/13/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Reconciliation Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Recovery Audit Contact	Chief Financial Officer	Mr.	Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	SNP Application Contact	Product Director		Cassidy	Cheryl	L	4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Surveillance Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	System Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Third Party Administrator (TPA) Liaison	Controller		Tran	Jessica		6175131910					jessica.tran@eternalHealth.com	901 St. James Ave.	Suite 950	Boston	MA	02116	12/09/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	User Access Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 Saint James Avenue	Suite 950	Boston	MA	02116	10/30/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Utilization Management Contact	Chief Medical Officer	Dr.	Himelstein	Bruce		4149150613	339				bruce.himelstein@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	03/21/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1280	Utilization Review Contact	Meidcal Director	Dr.	London	Robert		3038083311					robert.london@nirvanahealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H1285	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1285	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1285	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H1285	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/13/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1285	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	Local CCP	UnitedHealthcare Community Plan	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1290	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	02/02/2022	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/06/2023	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/06/2023	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/06/2023	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/14/2023	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/06/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/06/2023	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/14/2023	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/06/2023	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H1290	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H1290	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H1290	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H1290	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H1290	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H1290	PHR Beneficiary Contact																	02/09/2018	2026	DEVOTED HEALTH PLAN OF FLORIDA, INC.	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H1290	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	08/25/2020	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/06/2023	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	03/23/2021	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	06/09/2022	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	10/21/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/15/2024	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	09/12/2024	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	02/19/2021	2026	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	Agent/Broker Compensation Data Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Automated TrOOP Balance Transfer Contact	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Backup User Access Contact	Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Best Available Evidence Contact	MA EBS Supervisor Service Operations		Sherman	Missy		9862243236					Missy.Sherman@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Bid Audit Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Bid Audit Site Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Bid Primary Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	CAP Report Contact for Public Website	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	CEO - CMS Administrator Contact	President and CEO	Mr.	Zurlo	Paul		9862243779					Paul.zurlo@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	CEO - Senior Official for Contracting	President and CEO	Mr.	Zurlo	Paul		9862243779					Paul.zurlo@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Chief Financial Officer	Vice President and CFO	Mr.	Ward	David		9862243438					dave.ward@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Chief Operating Officer	Chief Information Officer, Interim COO	Mr.	Yoo	David		9862246363					David.Yoo@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Chief Information Officer	Chief Information Officer	Mr.	Yoo	David		9862246363					david.yoo@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Chief Information Security Officer	Chief Information Security Officer	Mr.	Hatfield	Lance		9862243545					lance.hatfield@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	CMS Casework Communication Contact	Manager, Grievances & Appeals		Jones	Liz		9862243293					Liz.Jones@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Complaints Tracking Contact	Manager, Grievances & Appeals		Jones	Liz		9862243293					Liz.Jones@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Contact for Fraud Investigations	Manager SIU		Wendler	Mindy		9862243721					mindy.wendler@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Coordination of Benefits Contact			Service	Customer		2083958200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Corporate Mailing						9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Customer Service Operations Contact	Director, Customer Service		Teater	Martin		9862244480					martin.teater@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	DIR Contact	Actuarial Analyst		McNassar	Conor		9862245795					Conor.McNassar@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	DIR Contact (Secondary)	Senior Director, Government Funding Operations		Hougaard	Kirsten		9862243916					Kirsten.Hougaard@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Discount Program Payment Contact	Accounting Services Supervisor		Hayes	Shannon		9862243529					shannon.hayes@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Emergency Part D Contact	VP, Pharmacy Management		Olson	Steve		9862243308					Steve.Olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Government Funding Operations		Hougaard	Kirsten		9862243916					Kirsten.Hougaard@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Enrollment Contact	Director, Operational Performance & Implementation		Davis	Natasha		9862246973					Natasha.Davis@bcidaho.com	3000 E Pine St		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	EOB Transfer Contact	Claims Manager		Curtis	Laura		9862243192				2083317451	laura.curtis@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Financial Audit Contact	Compliance Director, Medicare Compliance Officer	Ms.	Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Financial Reporting Contact	Manager Financial Reporting		Gale	Alison		9862244004					alison.gale@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Formulary Contact	Director Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	3080 Bristol Street		Costa Mesa	CA	92626	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Formulary Contact (Secondary)	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	General Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Government Relations Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	HIPAA Privacy Officer	Director, Compliance and Privacy		Maciejewski	Karen		9862243987					karen.maciejewski@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	HIPAA Security Officer	Chief Information Security Officer	Mr.	Hatfield	Lance		9862243545					lance.hatfield@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Hospice Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Interoperability Contact	VP IT Business Transformation	Ms.	Belvoir	Kate		9862243106					Kate.Belvoir@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	MA Appeals/Grievances Contact	Manager, Grievances & Appeals		Jones	Liz		9862243293					Liz.Jones@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	MA Claims Processing Contact for Public Website	Medicare Advantage Provider Support		Support	Provider		8664822250				2083876811	csproviderinquiries@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Marketing Contact	Manager, Gov't Programs Documentation		Webster	Tiffani		9862245148					tiffani.webster@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Medical Director	Medical Director	Dr.	Saperston	Adam		9862243244					Adam.Saperston@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Medicare Compliance Officer	Compliance Director, Medicare Compliance Officer	Ms.	Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Medicare Coordinator	Director, Operational Performance & Implementation		Davis	Natasha		9862246973					Natasha.Davis@bcidaho.com	3000 E Pine St		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Medicare Part D Opioid Overutilization Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Medication Therapy Management Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	OffShore Subcontractor Contact	Director, Compliance and Privacy		Maciejewski	Karen		9862243987					karen.maciejewski@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Online Enrollment Center Contact (Back-up)	Manager, Enrollment and Billing Services		Wheeler	Clark		9862243087					clark.wheeler@bcidaho.com	3000 E Pine St		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Online Enrollment Center Contact (Optional)	Enrollment Specialist		Davis	Brenda		9862245066					brenda.davis@bcidaho.com	3000 E Pine St		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Online Enrollment Center Contact (Primary)	MA EBS Supervisor Service Operations		Sherman	Missy		9862243236					Missy.Sherman@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part C Application Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part C Reporting Contact	Compliance Specialist Sr		Shade	Shannon		9862243727					shannon.shade@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Appeals	Clinical Pharmacist Senior		Casals	Karla							RxGrievanceandAppeals@carelon.com	11430 NW 20TH ST STE 300		Miami	FL	33172	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active	3054841845				PPO - BBA		C	Boston
H1302	Part D Appeals Contact (Secondary)	Quality Improvement Performance Specialist		Kober	Ashley							ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active	9862243495				PPO - BBA		C	Boston
H1302	Part D Application Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Benefits Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Claims Submission Contact			Service	Customer		8884942583					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Exceptions Contact	VP Pharmacy		Olson	Steve							steve.olson@bcidaho.com	3000 E Pine Ave Meridian		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active	9862243308				PPO - BBA		C	Boston
H1302	Part D Price File Contact (Back-up)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					amanda.nicholson-sampson@carelon.com	2716 Brewer St.		Lakewood	CA	90712	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Price File Contact (Optional)	Business Change Manager		Mendez	Daniela		3232193390					daniela.mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Price File Contact (Primary)	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					Ashley.Kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Quality Assurance Contact	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Part D Reporting Contact	Compliance Specialist Sr		Shade	Shannon		9862243727					shannon.shade@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Patient Safety Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Payment Contact	Manager Financial Reporting		Gale	Alison		9862244004					alison.gale@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Pharmacy Director	VP, Pharmacy Management		Olson	Steve		9862243308					Steve.Olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Pharmacy Network Management Contact (Secondary)	VP of Pharmacy Management		Decembrele	Stacey		3393682432					stacey.decembrele@carelon.com	220 Virginia Avenue		Indianapolis	IN	46204	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Pharmacy Technical Help Desk Contact	Program Manager		Wilson	Chad							chad.wilson@carelon.com	1960 Ivy Creek Blvd		Durham	NC	27707	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active	8333774266				PPO - BBA		C	Boston
H1302	Pharmacy Technical Help Desk Contact (Secondary)	Quality Improvement Performance Specialist		Kober	Ashley							ashley.kober@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active	9862243495				PPO - BBA		C	Boston
H1302	Physician Incentive Contact	VP Provider Partnerships		York	Todd		9862243399					todd.york@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Plan Directory Contact for Public Website			Service	Customer		2083958200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Plan to Plan Reconciliation Contact	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Processor Contact			Service	Customer		2083958200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Quality Contact	Director of Clinical Quality		Blackledge	Amy		9862244484					amy.blackledge@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Reconciliation Contact	Actuarial Analyst		McNassar	Conor		9862245795					Conor.McNassar@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Reconciliation Contact (Secondary)	Senior Director, Government Funding Operations		Hougaard	Kirsten		9862243916					Kirsten.Hougaard@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Recovery Audit Contact	Compliance Director, Medicare Compliance Officer	Ms.	Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	SNP Application Contact	Director, Medicare Markets		Scoresby	Royce		9862244650					Royce.Scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Surveillance Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	System Contact	Sr IT Operations Analyst		Reichert	Dean		9862243084					dean.reichert@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Third Party Administrator (TPA) Liaison	Supervisor Accounting Services		Hayes	Shannon		9862243529					shannon.hayes@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	User Access Contact	Sr Compliance Specialist		Schwartz	Leanne		9862243984					leanne.schwartz@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Utilization Management Contact	Director, Utilization Management		Loya	Sophie		9862243753					sophie.loya@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1302	Utilization Review Contact	Director, Utilization Management		Loya	Sophie		9862243753					sophie.loya@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	Local PPO		Gemstone Holdings, Inc.	29	Yes	Active					PPO - BBA		C	Boston
H1304	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	07/06/2023	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	05/07/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	11/11/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Encounter Data & Risk Adjustment Operations Contact	AD Risk Adjustment Analytics		Aryal	Binaya		5032255305					Binaya.Aryal@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/06/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/19/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	MA Appeals/Grievances Contact	Healthcare Svcs Program Mgr Sr	Ms.	Huque	Nita		5035531462					Nita.Huque@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	MA Claims Processing Contact for Public Website	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	12/05/2022	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	09/14/2023	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	07/17/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part C Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part C Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Kansas City
H1304	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Kansas City
H1304	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Kansas City
H1304	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				PPO - BBA		C	Kansas City
H1304	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	11/07/2023	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	11/07/2023	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/14/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/19/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				PPO - BBA		C	Kansas City
H1304	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/19/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				PPO - BBA		C	Kansas City
H1304	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	04/19/2023	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Quality Contact	Director, Quality Management	Mr.	Mcclure	Andy		5032206189					Andrew.Mcclure@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	02/10/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	02/10/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/15/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/23/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	01/23/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Utilization Management Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1304	Utilization Review Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	10/30/2024	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Kansas City
H1310	Automated TrOOP Balance Transfer Contact	CFO	Mr.	De Gyves	Jorge		2698886106					j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	Backup User Access Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Best Available Evidence Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Bid Primary Contact	CFO	Mr.	De Gyves	Jorge		2698886106					j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	CAP Report Contact for Public Website	Chief Executive Officer	Mrs.	Harrison	Qiana		2694419300					q.harrison@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	04/29/2024	2026	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	Kansas City
H1310	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs.	Harrison	Qiana		2698886143					q.harrison@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	09/24/2025	2026	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	Kansas City
H1310	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs.	Harrison	Qiana		2698886143					q.harrison@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	09/24/2025	2026	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	Kansas City
H1310	Chief Financial Officer	CFO	Mr.	De Gyves	Jorge		2698886106					j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	Chief Operating Officer	CEO	Ms.	Harrison	Qiana		2698886143					q.harrison@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	04/29/2024	2026	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	Kansas City
H1310	Chief Information Officer	CFO	Mr.	De Gyves	Jorge		2698886106					j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	Chief Information Security Officer	IT Systems Administrator	Ms.	Tindol	Julie		2698886105					j.tindol@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	10/02/2023	2026	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	Kansas City
H1310	CMS Casework Communication Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Complaints Tracking Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Contact for Fraud Investigations	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Coordination of Benefits Contact	CFO	Mr.	De Gyves	Jorge		2698886106					j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	Corporate Mailing						2692519218				2694883615	q.harrison@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/17/2025	2026	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	Kansas City
H1310	Customer Service Operations Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	DIR Contact	CFO	Mr.	De Gyves	Jorge		2698886106					j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	DIR Contact (Secondary)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	11/26/2024	2026	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	Kansas City
H1310	Discount Program Payment Contact	CEO	Mrs.	Harrison	Qiana		2698886143				2694883615	q.harrison@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/24/2025	2026	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	Kansas City
H1310	Emergency Part D Contact	CFO	Mr.	De Gyves	Jorge		2698886106					j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	Emergency Part D Contact (Secondary)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Encounter Data & Risk Adjustment Operations Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Enrollment Contact	COO	Mrs.	Harrison	Qiana		2698886143				2694883615	q.harrison@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/24/2025	2026	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	Kansas City
H1310	EOB Transfer Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/05/2025	2026	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	Kansas City
H1310	Financial Audit Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Financial Reporting Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Formulary Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Formulary Contact (Secondary)	Pharmacy Department Leader/Lead Clinical Pharmacis	Ms.	Balazs	Gianna		2698886137					g.balazs@seniorcarepartnersmi.org	200 Michigan Ave W Ste 103		Battle Creek	MI	49017	03/20/2023	2026	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	Kansas City
H1310	General Contact	CEO	Mrs.	Harrison	Qiana		2698886143				2694883615	q.harrison@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/17/2025	2026	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	Kansas City
H1310	Government Relations Contact	CEO	Mrs.	Harrison	Qiana		2698886143				2694883615	q.harrison@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/17/2025	2026	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	Kansas City
H1310	HIPAA Privacy Officer	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	HIPAA Security Officer	Director of Finance	Ms.	Tindol	Julie		2698886105					j.tindol@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	10/02/2023	2026	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	Kansas City
H1310	Interoperability Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	MA Appeals/Grievances Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	MA Claims Processing Contact for Public Website	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Marketing Contact	COO	Ms.	Harrison	Qiana		2698886143					q.harrison@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	08/10/2022	2026	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	Kansas City
H1310	Medical Director	Medical Director	Dr.	Schreiner	Rebecca		2698886115				2694419329	r.schreiner@seniorcarepartnersmi.org	200 West Michigan, Suite 103		Battle Creek	MI	49017	08/10/2022	2026	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	Kansas City
H1310	Medicare Compliance Officer	Director of Program Integrity	Ms.	Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Medicare Coordinator	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Medicare Part D Opioid Overutilization Contact	Lead Clinical Pharmacist	Ms.	Balazs	Gianna		2694885475					g.balazs@seniorcarepartnersmi.org	445 West Michigan Avenue		Kalamazoo	MI	49007	11/21/2019	2026	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	Kansas City
H1310	Medication Therapy Management Contact	Lead Clinical Pharmacist	Ms.	Balazs	Gianna		2694885475					g.balazs@seniorcarepartnersmi.org	445 West Michigan Avenue		Kalamazoo	MI	49007	11/21/2019	2026	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	Kansas City
H1310	Part C Application Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Part D Appeals	CFO	Mr.	De Gyves	Jorge						2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active	2698886106				PACE - Nat		C	Kansas City
H1310	Part D Appeals Contact (Secondary)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul							p.apodaca@seniorcarepartnersmi.org	200 W. Michigan Suite 103		Battle Creek	MI	49017	09/26/2025	2026	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active	2698886159				PACE - Nat		C	Kansas City
H1310	Part D Application Contact	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159				2698886106	p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Part D Benefits Contact	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Part D Claims Submission Contact	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Part D Exceptions Contact	CFO	Mr.	De Gyves	Jorge						2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active	2698886106				PACE - Nat		C	Kansas City
H1310	Part D Exceptions Contact (Secondary)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul							p.apodaca@seniorcarepartnersmi.org	200 Michigan Ave W Ste 103		Battle Creek	MI	49017	09/26/2025	2026	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active	2698886159				PACE - Nat		C	Kansas City
H1310	Part D Price File Contact (Back-up)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Part D Price File Contact (Optional)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159				2698886106	p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Part D Price File Contact (Primary)	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Part D Quality Assurance Contact	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Part D Reporting Contact	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Patient Safety Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Payment Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Pharmacy Director	Lead Clinical Pharmacist	Ms.	Balazs	Gianna		2694885475					g.balazs@seniorcarepartnersmi.org	445 West Michigan Avenue		Kalamazoo	MI	49007	11/21/2019	2026	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	Kansas City
H1310	Pharmacy Network Management Contact	Lead Clinical Pharmacist	Ms.	Balazs	Gianna		2694885475					g.balazs@seniorcarepartnersmi.org	445 West Michigan Avenue		Kalamazoo	MI	49007	11/21/2019	2026	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	Kansas City
H1310	Pharmacy Network Management Contact (Secondary)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 Michigan Ave W Ste 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
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	2026	COMPREHENSIVE SENIOR CARE CORPORATION	National PACE	Senior Care Partners P.A.C.E.	National PACE		Comprehensive Senior Care Corporation	396	Yes	Active	8004885860				PACE - Nat		C	Kansas City
H1310	Plan Directory Contact for Public Website	Chief Executive Officer	Ms.	Harrison	Qiana		2698886107					q.harrison@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	04/29/2024	2026	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	Kansas City
H1310	Plan to Plan Reconciliation Contact	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Processor Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Quality Contact	Quality Manager	Ms.	Montague	Melissa		2698886160				2698886160	m.montague@seniorcarepartnersmi.org	200 West Michigan Avenue	Suite 103	Battle Creek	MI	49017	02/10/2022	2026	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	Kansas City
H1310	Reconciliation Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Reconciliation Contact (Secondary)	Finance Manager & Pharmacy Controller	Mr.	Apodaca	Paul		2698886159					p.apodaca@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	09/26/2025	2026	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	Kansas City
H1310	Recovery Audit Contact	CFO	Mr.	De Gyves	Jorge		2698886106				2698886106	j.degyves@seniorcarepartnersmi.org	200 W. Michigan Avenue, Suite 103		Battle Creek	MI	49017	03/09/2025	2026	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	Kansas City
H1310	Surveillance Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	System Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Third Party Administrator (TPA) Liaison	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	User Access Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Utilization Management Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1310	Utilization Review Contact	Director of Program Integrity		Solis-Sherman	Adrienne		2698886109					a.solis-sherman@seniorcarepartnersmi.org	200 W. Michigan, Suite 103		Battle Creek	MI	49017	01/12/2024	2026	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	Kansas City
H1312	Automated TrOOP Balance Transfer Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Backup User Access Contact	Executive Director	Mr.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Best Available Evidence Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Bid Primary Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	CAP Report Contact for Public Website	Executive Director		Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	CEO - Senior Official for Contracting	Executive Director	Ms	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Chief Financial Officer	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Chief Operating Officer	Chief Operating Officer	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	6113 Norma Jean Lane		Billings	MT	59101	09/26/2022	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Chief Information Officer	Enterprise Director of IT Operations	Mr.	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	10/25/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Chief Information Security Officer	VP Information Security	Ms.	Jennings	Preston		7343432671					Preston.Jennings@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	10/25/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	CMS Casework Communication Contact	Executive Director	Ms	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Complaints Tracking Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Contact for Fraud Investigations	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Coordination of Benefits Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Corporate Mailing						2489245892					murphysa@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/27/2022	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Customer Service Operations Contact	Executive Director	Ms.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	DIR Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Discount Program Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Emergency Part D Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Enrollment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	EOB Transfer Contact	Regional director Finance	Ms.	Fuhrmeister	Nicole		2157788707				9104834930	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Financial Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Financial Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	General Contact	Executive Director	Ms.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Government Relations Contact	Executive Director	Ms.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Interoperability Contact	Enterprise Director of IT Operations	Mr.	Gillespie	Jeff		6142348686					gillespj@trinity-health.org	20255 Victor Parkway		Livonia	MI	48125	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	MA Appeals/Grievances Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	MA Claims Processing Contact for Public Website	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Marketing Contact	Director Marketing and Communication	Ms.	Lark	Azia		9735182754					azia.lark@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	02/03/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Medical Director	Medical Director	Dr	Barton	Bruce		5045592350					Bruce.Barton@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/08/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Medicare Compliance Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Medicare Coordinator	Executive Director	Ms.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Part C Application Contact	Chief Operating Officer	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/26/2022	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Part D Appeals	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.garbarino@trinity-health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H1312	Part D Application Contact	Chief Operating Officer	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	09/26/2022	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Part D Benefits Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Part D Claims Submission Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	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	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H1312	Part D Price File Contact (Back-up)	Executive Director	Ms.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Part D Price File Contact (Primary)	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Part D Quality Assurance Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Part D Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Patient Safety Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Pharmacy Director	Manager Part D Compliance	Mr.	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Pharmacy Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Pharmacy Technical Help Desk Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H1312	Plan Directory Contact for Public Website	Executive Director	Ms.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Plan to Plan Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Processor Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Quality Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Recovery Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Surveillance Contact	Executive Director	Ms.	Knowles	Brandi		5045592350					Brandi.Knowles@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/17/2025	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Third Party Administrator (TPA) Liaison	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Utilization Management Contact	Medical Director	Dr	Barton	Bruce		5045592350					bruce.barton@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/08/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1312	Utilization Review Contact	Medical Director	Dr	Barton	Bruce		5045592350					bruce.barton@trinity-health.org	3403 Government Street		Alexandria	LA	71301	04/08/2024	2026	TRINITY HEALTH PACE OF ALEXANDRIA	National PACE	Trinity Health PACE of Alexandria	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H1339	Agent/Broker Compensation Data Contact	Executive Director of Sales and Marketing	Mr.	Persons	James		8134764931					Jpersons@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Automated TrOOP Balance Transfer Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Backup User Access Contact	Sr. Director IT	Mr.	Reppas	Soterios		4104244620					sreppas@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Best Available Evidence Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Bid Audit Contact	Chief Actuary	Ms.	McAleer	Bethany		2026588702					BMcAleer@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Bid Primary Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	CEO - CMS Administrator Contact	President Medicare Advantage	Ms.	Rund	Lori		2488243735					LRund@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	CEO - Senior Official for Contracting	President Medicare Advantage	Ms.	Rund	Lori		2488243735					LRund@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Chief Financial Officer	Chief Financial Officer	Mr.	Chojnowski	Daniel		2078072496					dchojnowski@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Chief Operating Officer	Chief Operating Officer	Mr.	O'Donnell	Ryan		7038876201					rodonnell@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Chief Information Officer	Vice President Information Technology	Mr.	Mukherjee	Joydeep		6038922211					JMukherjee@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Chief Information Security Officer	Assistant Director of Information Security  IT/IS	Mr.	Ross	Willie		4104244642					wross@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Complaints Tracking Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Contact for Fraud Investigations	Director of Special Investigations	Mr.	Waugh	John		4106891079					jwaugh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Coordination of Benefits Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					sriaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Corporate Mailing						4104244955					pgillan@jhhp.org	Johns Hopkins Health Plans Attn: Paul Gillan Esq.,	7231 Parkway Drive, Suite 100	Hanover	MD	21076	09/27/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Customer Service Operations Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	DIR Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	DIR Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Discount Program Payment Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Emergency Part D Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4438071292					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Emergency Part D Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4109256831					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Encounter Data & Risk Adjustment Operations Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Enrollment Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	EOB Transfer Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740			4104242805	CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Financial Audit Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Financial Reporting Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Formulary Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Formulary Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	General Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Government Relations Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	HIPAA Privacy Officer	Exec Director of Compliance and Regulatory Affairs	Ms.	Mohon	Melissa		4438570852					MMohon@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/24/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	HIPAA Security Officer	Chief Information Security Officer	Ms	Rathod	Janet		6672088766					janet.rathod@jhu.edu	750 East Pratt Street		Baltimore	MD	21202	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Hospice Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Interoperability Contact	Exec.Director of Compliance and Regulatory Affairs	Ms.	Mohon	Melissa		4438570852					MMohon@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	MA Appeals/Grievances Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	MA Claims Processing Contact for Public Website	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Marketing Contact	Manager Marketing & Communications	Ms.	Heredia	Leslie		4104244633					LHeredia@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Medical Director	Associate Chief Medical Officer	Dr.	Gerry	Danielle		4103033422					DGerry@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Donnelly	Mary		4436180786					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/22/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Medicare Coordinator	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					SRiaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Medication Therapy Management Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	OffShore Subcontractor Contact	Assistant Director Vendor Management	Ms.	Gomillion	Morgan		9419628261					MGomillion@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Online Enrollment Center Contact (Back-up)	Chief Operating Officer	Mr.	O'Donnell	Ryan		7038876201					rodonnell@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Online Enrollment Center Contact (Primary)	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part C Application Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part C Reporting Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					sriaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Appeals	Director, Pharmacy	Ms.	Wexler	Mary Beth							MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1339	Part D Appeals Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1339	Part D Application Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Benefits Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Claims Submission Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Exceptions Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1339	Part D Exceptions Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				HMO - Health Maintenance Organization		C	Boston
H1339	Part D Price File Contact (Back-up)	Senior Analyst	Ms.	Scott	Sarah		4803109219					Sarah.Scott@cvshealth.com	9501 E. Shea Blvd.	MC121	Scottsdale	AZ	85260	12/03/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Price File Contact (Optional)	Senior Analyst	Ms.	Perry	Michele		6026211682					Michele.Perry@cvshealth.com	9501 E. Shea Blvd.	MC121	Scottsdale	AZ	85260	12/03/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Price File Contact (Primary)	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Quality Assurance Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Part D Reporting Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Patient Safety Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Payment Contact	Director  of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Pharmacy Director	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Pharmacy Network Management Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H1339	Pharmacy Technical Help Desk Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H1339	Plan Directory Contact for Public Website	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Processor Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Quality Contact	Associate Chief Medical Officer, QI	Dr.	Zeltser	Marina		7323225499					MZeltser@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Reconciliation Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Recovery Audit Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Surveillance Contact	Director SIU	Mr.	Waugh	John		4106891079					JWaugh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	System Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					sriaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	User Access Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Utilization Management Contact	Executive Director of Health Services	Ms.	Poth	Kristin		4105822700					KPoth@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1339	Utilization Review Contact	Executive Director of Health Services	Ms.	Poth	Kristin		4105822700					KPoth@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.	Local CCP	Johns Hopkins Advantage MD	HMO/HMOPOS		Johns Hopkins Healthcare LLC	616	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1347	Agent/Broker Compensation Data Contact	Consumer Sales Manager		Carter	Brent		2052207681					bcarter@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/23/2023	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Backup User Access Contact	Compliance Analyst I		Blevins	Dominique		2052206984					dominique.blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/30/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Best Available Evidence Contact	Sr. Business Analyst		Hurst	Terri		2052202695					Terri.Hurst@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/01/2023	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Bid Audit Contact	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Bid Audit Site Contact	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Bid Primary Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	CAP Report Contact for Public Website	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	CEO - CMS Administrator Contact	President and Chief Executive Officer	Mr	Vines	Tim		2052206363					TVines@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	CEO - Senior Official for Contracting	Executive Vice President	Mr.	Briggs III	Dick	D	2052206952					dbriggs@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/11/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Chief Financial Officer	SVP & Chief Financial Officer	Mr.	Carden	Noel		2052207741					ncarden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Chief Operating Officer	SVP Business Operations	Mr.	Hill	James	S	2052202196					Jim.Hill@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Chief Information Officer	SVP and CIO	Mr.	Dunsmore	Joe		2052202441					jdunsmore@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	04/08/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Chief Information Security Officer	Chief Info Security Officer	Mr.	Parton	Chris		2052207421					cparton@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	CMMI Model Point of Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	CMS Casework Communication Contact	Compliance Analyst		Stoudemire	Danielle		2052205678					Danielle.Stoudemire@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/14/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Complaints Tracking Contact	Compliance Analyst		Stoudemire	Danielle		2052205678					Danielle.Stoudemire@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/14/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Contact for Fraud Investigations	Special Investigations Manager		Ellison	Amy		2052202573					AELLISON@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	07/16/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Coordination of Benefits Contact	Manager Claims Processing		Cole	Jason		2052202490					Jason.Cole@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/02/2023	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Corporate Mailing						2052206655					Laney.ODell@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/28/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Customer Service Operations Contact	Dept Manager Customer Service		Pearson	Latreta		2052207905					llpearson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	DIR Contact	VP Controller		DeLawrence	Jennifer		2052207282				2052202795	JDeLawrence@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	DIR Contact (Secondary)	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Discount Program Payment Contact	Sr. Accountant		Lambert	Christophe		2052206593					CLambert@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Electronic Health Record Contact	Compliance Analyst II		Blevins	Dominique		2052207984					Dominique.Blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/25/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Emergency Part D Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/23/2023	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Emergency Part D Contact (Secondary)	Pharmacy Services Manager		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Employer Waiver Contact	Manager Enrollment Service		Sexton	Missy		2052206589					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/02/2023	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Encounter Data & Risk Adjustment Operations Contact	MAQM Department Manager		Baggs	Sarah		2052207286					Sbaggs@bcbsal.org	450 Riverchase Pkwy East		Hoover	AL	35244	04/10/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Enrollment Contact	Manager Enrollment Service		Sexton	Missy		2052206589					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2023	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	EOB Transfer Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2052200803	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Financial Audit Contact	Dept Manager Internal Audit	Ms.	Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Financial Reporting Contact	Dept Mgr Accounting/Reporting		O'Neal	Keith		2052206202					Keith.ONeal@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Formulary Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/17/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	General Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					RGregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Government Relations Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	HIPAA Privacy Officer	Manager Corporate Compliance		Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	HIPAA Security Officer	Manager Corporate Compliance		Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Hospice Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					WStevens@BCBSAL.ORG	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Interoperability Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					rgregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	MA Appeals/Grievances Contact	Health Management Unit Mgr		Mattioli	Jared		2052205315					jmattioli@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	MA Claims Processing Contact for Public Website	Manager Claims Operations		Corley	Jeff		2052206367					jcorley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Marketing Contact	Senior Compliance Analyst		Parham	Andrea	M	2052207206					AParham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/24/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Medical Director	Associate Medical Director	Dr.	Darden	Barry		2052206605					James.Darden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Medicare Compliance Officer	Manager Corporate Compliance	Mr.	Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Medicare Coordinator	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacists		Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	01/13/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Medication Therapy Management Contact	VP Pharmacy Services		Cale	Dorinda		2052202655					dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	OffShore Subcontractor Contact	Compliance Analyst II		Blevins	Dominique		2052207984					dominique.blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35243	06/30/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Online Enrollment Center Contact (Back-up)	Sr. Business Analyst		Johnson	Geraldine		2052206077					gejohnson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Online Enrollment Center Contact (Optional)	Manager Enrollment Service		Sexton	Missy		2052207276					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2023	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Online Enrollment Center Contact (Primary)	Sr Business Analyst		Hurst	Terri		2052202695					Terri.Hurst@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part C Application Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part C Reporting Contact	Senior Compliance Analyst		Parham	Andrea		2052207206					aparham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/10/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	01/13/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	8006936651				PPO - BBA		C	New York
H1347	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	8006936651				PPO - BBA		C	New York
H1347	Part D Application Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Benefits Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Claims Submission Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/21/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	8006936651				PPO - BBA		C	New York
H1347	Part D Exceptions Contact (Secondary)	Pharmacy Services Manager		Matthews	Ginny							Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	2052206558				PPO - BBA		C	New York
H1347	Part D Price File Contact (Back-up)	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593				2052202939	Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Price File Contact (Optional)	Business Solution Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/17/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Price File Contact (Primary)	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2057337486	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Quality Assurance Contact	Clinical Program Manager		Hamid	Samer		2055639884					samer.hamid@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/13/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Part D Reporting Contact	Senior Compliance Analyst		Parham	Andrea		2052207206					aparham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/10/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Patient Safety Contact	VP Pharmacy Services		Cale	Dorinda		2052202655				2052208739	dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Payment Contact	VP Controller		DeLawrence	Jennifer		2052207282					JDeLawrence@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Pharmacy Director	VP Pharmacy Services		Cale	Dorinda		2052202655					dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Pharmacy Network Management Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2054034052	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Pharmacy Network Management Contact (Secondary)	AVP Network Relations		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	12/17/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Pharmacy Technical Help Desk Contact	Pharmacy Services Mgr		Matthews	Ginny							Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/28/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	8444501988				PPO - BBA		C	New York
H1347	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/17/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active	8444501988				PPO - BBA		C	New York
H1347	Physician Incentive Contact	VP Provider Engagement/Support		Weaver	Darrel		2052207007					darrel.weaver@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/23/2025	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Plan Directory Contact for Public Website	Manager Claims Operations		Corley	Jeff		8005176425					jcorley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Plan to Plan Reconciliation Contact	In-charge Analyst Cash Mgmt		Prince	Jonathan		2052207723					jonathan.prince@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	03/18/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Processor Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2052208739	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Quality Contact	Quality Improvement Manager		Kendrick	Brooke		2052207251					Brooke.Kendrick@BCBSAL.ORG	450 Riverchase Parkway East		Birmingham	AL	35244	03/13/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Reconciliation Contact	Manager Financial Accounting		Williamson	Amanda		2052207289					Amanda.Williamson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Reconciliation Contact (Secondary)	Sr. Accountant		Lambert	Christophe		2052206593				2052202795	CLambert@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Recovery Audit Contact	Manager Corporate Compliance	Mr.	Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Surveillance Contact	Consumer Sales Manager		Carter	Brent		2052207681					bcarter@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	System Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					RGregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Third Party Administrator (TPA) Liaison	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/16/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	User Access Contact	Regulatory Compliance Manager		O'Dell	Laney		2052206655					laney.odell@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Utilization Management Contact	Health Management Unit Mgr		Daniel	Charlotte		2052204673					CHDaniel@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/27/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1347	Utilization Review Contact	Health Management Unit Mgr		Daniel	Charlotte		2052204673					CHDaniel@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/27/2024	2026	PATRIUS HEALTH, INC.	Local CCP	Patrius Health	Local PPO		BlueCross BlueShield of Alabama	32	Yes	Active					PPO - BBA		C	New York
H1350	Agent/Broker Compensation Data Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Automated TrOOP Balance Transfer Contact	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Backup User Access Contact	Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	05/22/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Best Available Evidence Contact	MA EBS Supervisor Service Operations		Sherman	Missy		9862243236					Missy.Sherman@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Bid Audit Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Bid Audit Site Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Bid Primary Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	CAP Report Contact for Public Website	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	CEO - CMS Administrator Contact	President and CEO	Mr.	Zurlo	Paul		9862243779					Paul.zurlo@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/11/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	CEO - Senior Official for Contracting	President and CEO	Mr.	Zurlo	Paul		9862243779					Paul.zurlo@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/11/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Chief Financial Officer	Vice President and CFO	Mr.	Ward	David		9862243438					dave.ward@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Chief Operating Officer	Chief Information Officer, Interim COO	Mr.	Yoo	David		9862246363					David.Yoo@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	11/25/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Chief Information Officer	Chief Information Officer	Mr.	Yoo	David		9862246363					david.yoo@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	04/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Chief Information Security Officer	Chief Information Security Officer	Mr.	Hatfield	Lance		9862243545					lance.hatfield@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/22/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	CMS Casework Communication Contact	Manager, Grievances & Appeals		Jones	Liz		9862243293					Liz.Jones@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	08/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Complaints Tracking Contact	Manager, Grievances & Appeals		Jones	Liz		9862243293					Liz.Jones@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	08/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Contact for Fraud Investigations	Manager SIU		Wendler	Mindy		9862243721					mindy.wendler@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	10/23/2024	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Coordination of Benefits Contact			Service	Customer		2083958200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Corporate Mailing						9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Customer Service Operations Contact	Director, Customer Service		Teater	Martin		9862244480					martin.teater@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	10/25/2024	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	DIR Contact	Actuarial Analyst		McNassar	Conor		9862245795					Conor.McNassar@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/30/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	DIR Contact (Secondary)	Senior Director, Government Funding Operations		Hougaard	Kirsten		9862243916					Kirsten.Hougaard@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	08/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Discount Program Payment Contact	Accounting Services Supervisor		Hayes	Shannon		9862243529					shannon.hayes@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Emergency Part D Contact	VP, Pharmacy Management		Olson	Steve		9862243308					Steve.Olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/31/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Government Funding Operations		Hougaard	Kirsten		9862243916					Kirsten.Hougaard@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	08/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Enrollment Contact	Director, Operational Performance & Implementation		Davis	Natasha		9862246973					Natasha.Davis@bcidaho.com	3000 E Pine St		Meridian	ID	83642	08/29/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	EOB Transfer Contact	Claims Manager		Curtis	Laura		9862243192				2083317451	laura.curtis@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Financial Audit Contact	Compliance Director, Medicare Compliance Officer	Ms.	Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Financial Reporting Contact	Manager Financial Reporting		Gale	Alison		9862244004					alison.gale@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Formulary Contact	Director Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	3080 Bristol Street		Costa Mesa	CA	92626	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Formulary Contact (Secondary)	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	General Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Government Relations Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	HIPAA Privacy Officer	Director, Compliance and Privacy		Maciejewski	Karen		9862243987					karen.maciejewski@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/22/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	HIPAA Security Officer	Chief Information Security Officer	Mr.	Hatfield	Lance		9862243545					lance.hatfield@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/22/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Hospice Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/09/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Interoperability Contact	VP IT Business Transformation	Ms.	Belvoir	Kate		9862243106					Kate.Belvoir@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/17/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	MA Appeals/Grievances Contact	Manager, Grievances & Appeals		Jones	Liz		9862243293					Liz.Jones@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	08/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	MA Claims Processing Contact for Public Website	Medicare Advantage Provider Support		Support	Provider		8664822250				2083876811	csproviderinquiries@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Marketing Contact	Manager, Gov't Programs Documentation		Webster	Tiffani		9862245148					tiffani.webster@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/15/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Medical Director	Medical Director	Dr.	Saperston	Adam		9862243244					Adam.Saperston@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Medicare Compliance Officer	Compliance Director, Medicare Compliance Officer	Ms.	Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Medicare Coordinator	Director, Operational Performance & Implementation		Davis	Natasha		9862246973					Natasha.Davis@bcidaho.com	3000 E Pine St		Meridian	ID	83642	08/29/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Medicare Part D Opioid Overutilization Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/09/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Medication Therapy Management Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/09/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	OffShore Subcontractor Contact	Director, Compliance and Privacy		Maciejewski	Karen		9862243987					karen.maciejewski@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/22/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Online Enrollment Center Contact (Back-up)	Manager, Enrollment and Billing Services		Wheeler	Clark		9862243087					clark.wheeler@bcidaho.com	3000 E Pine St		Meridian	ID	83642	12/07/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Online Enrollment Center Contact (Optional)	Enrollment Specialist		Davis	Brenda		9862245066					brenda.davis@bcidaho.com	3000 E Pine St		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Online Enrollment Center Contact (Primary)	MA EBS Supervisor Service Operations		Sherman	Missy		9862243236					Missy.Sherman@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part C Application Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part C Reporting Contact	Compliance Specialist Sr		Shade	Shannon		9862243727					shannon.shade@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/31/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Appeals	Clinical Pharmacist Senior		Casals	Karla							RxGrievanceandAppeals@carelon.com	11430 NW 20TH ST STE 300		Miami	FL	33172	12/05/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active	3054841845				HMO - Health Maintenance Organization		C	Boston
H1350	Part D Appeals Contact (Secondary)	Quality Improvement Performance Specialist		Kober	Ashley							ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active	9862243495				HMO - Health Maintenance Organization		C	Boston
H1350	Part D Application Contact	Director Medicare Markets		Scoresby	Royce		9862244650					royce.scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Benefits Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/09/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Claims Submission Contact			Service	Customer		8884942583					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Exceptions Contact	VP Pharmacy		Olson	Steve							steve.olson@bcidaho.com	3000 E Pine Ave Meridian		Meridian	ID	83642	06/09/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active	9862243308				HMO - Health Maintenance Organization		C	Boston
H1350	Part D Price File Contact (Back-up)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					amanda.nicholson-sampson@carelon.com	2716 Brewer St.		Lakewood	CA	90712	12/11/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Price File Contact (Optional)	Business Change Manager		Mendez	Daniela		3232193390					daniela.mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Price File Contact (Primary)	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					Ashley.Kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Quality Assurance Contact	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Part D Reporting Contact	Compliance Specialist Sr		Shade	Shannon		9862243727					shannon.shade@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/31/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Patient Safety Contact	VP Pharmacy		Olson	Steve		9862243308					steve.olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/09/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Payment Contact	Manager Financial Reporting		Gale	Alison		9862244004					alison.gale@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Pharmacy Director	VP, Pharmacy Management		Olson	Steve		9862243308					Steve.Olson@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/31/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	11/03/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Pharmacy Network Management Contact (Secondary)	VP of Pharmacy Management		Decembrele	Stacey		3393682432					stacey.decembrele@carelon.com	220 Virginia Avenue		Indianapolis	IN	46204	11/03/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Pharmacy Technical Help Desk Contact	Program Manager		Wilson	Chad							chad.wilson@carelon.com	1960 Ivy Creek Blvd		Durham	NC	27707	12/15/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Boston
H1350	Pharmacy Technical Help Desk Contact (Secondary)	Quality Improvement Performance Specialist		Kober	Ashley							ashley.kober@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active	9862243495				HMO - Health Maintenance Organization		C	Boston
H1350	Physician Incentive Contact	VP Provider Partnerships		York	Todd		9862243399					todd.york@bcidaho.com	3000 E Pine Ave		Meridian	ID	83642	01/02/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Plan Directory Contact for Public Website			Service	Customer		2083958200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Plan to Plan Reconciliation Contact	Quality Improvement Performance Specialist		Kober	Ashley		9862243495					ashley.kober@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Processor Contact			Service	Customer		2083958200					macs@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Quality Contact	Director of Clinical Quality		Blackledge	Amy		9862244484					amy.blackledge@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/27/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Reconciliation Contact	Actuarial Analyst		McNassar	Conor		9862245795					Conor.McNassar@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	08/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Reconciliation Contact (Secondary)	Senior Director, Government Funding Operations		Hougaard	Kirsten		9862243916					Kirsten.Hougaard@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	08/28/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Recovery Audit Contact	Compliance Director, Medicare Compliance Officer	Ms.	Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	SNP Application Contact	Director, Medicare Markets		Scoresby	Royce		9862244650					Royce.Scoresby@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	12/15/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Surveillance Contact	Compliance Director, Medicare Compliance Officer		Martin	Julie		9862245030					julie.martin@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	System Contact	Sr IT Operations Analyst		Reichert	Dean		9862243084					dean.reichert@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Third Party Administrator (TPA) Liaison	Supervisor Accounting Services		Hayes	Shannon		9862243529					shannon.hayes@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	06/02/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	User Access Contact	Sr Compliance Specialist		Schwartz	Leanne		9862243984					leanne.schwartz@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	07/31/2023	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Utilization Management Contact	Director, Utilization Management		Loya	Sophie		9862243753					sophie.loya@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/18/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1350	Utilization Review Contact	Director, Utilization Management		Loya	Sophie		9862243753					sophie.loya@bcidaho.com	3000 E. Pine Ave.		Meridian	ID	83642	11/18/2025	2026	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.	Local CCP	Blue Cross of Idaho	HMO/HMOPOS		Gemstone Holdings, Inc.	29	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1357	Automated TrOOP Balance Transfer Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Backup User Access Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Best Available Evidence Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Bid Primary Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	CAP Report Contact for Public Website	Quality Manager		Wingate	LaToya		3367463513				3367463565	lwingate@everyage.org	802 East Center Street		Lexington	NC	27292	12/20/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	8332234476				PACE - Nat		C	Atlanta
H1357	CEO - CMS Administrator Contact	Chief Operating Officer	Ms	Reimann	Aimee		3367463500				3367463565	areimann@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	CEO - Senior Official for Contracting	Chief Operating Officer	Ms	Reimann	Aimee		3367463500				3367463565	areimann@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Chief Financial Officer	Chief Financial Officer	Ms.	Jones	Tammy		8284658007				8284658015	tjones@EveryAge.org	100 Leonard Ave		Newton	NC	28658	02/01/2023	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Chief Operating Officer	Chief Operating Officer	Ms	Reimann	Aimee		8284658007				8284658015	areimann@EveryAge.org	100 Leonard Ave		Newton	NC	27292	10/03/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Chief Information Officer	IT Director	Mr.	Larew	Brantley		8284658022				8284658537	blarew@EveryAge.org	100 Leonard Ave		Newton	NC	28658	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Chief Information Security Officer	IT Director	Mr.	Larew	Brantley		8284658022				8284658537	blarew@EveryAge.org	100 Leonard Ave		Newton	NC	28658	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	CMS Casework Communication Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Complaints Tracking Contact	Quality Manager		Wingate	LaToya		3367463513					lwingate@everyage.org	802 E. Center Street		Lexington	NC	27292	12/20/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Contact for Fraud Investigations	Dir. Quality and Compliance	Mrs.	Forney	Harriet		9107670928				9107650188	hforney@everyage.org	1380 N. College Rd.	Elderhaus, Inc.	Wilmington	NC	28405	08/08/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Coordination of Benefits Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Corporate Mailing						8284658017				8284658015	tchang@EveryAge.org	100 Leonard Ave		Newton	NC	28658	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Customer Service Operations Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463519				3367463523	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	02/27/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	DIR Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	DIR Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Discount Program Payment Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Emergency Part D Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Emergency Part D Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463519					tchang@everyage.org	802 E. Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Encounter Data & Risk Adjustment Operations Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Enrollment Contact	Marketing/Enrollment Coordinator	Ms.	Smithdeal	Gwynn		3367463512				3367463565	gsmithdeal@everyage.org	802 East Center Street		Lexington	NC	27292	04/14/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	EOB Transfer Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Financial Audit Contact	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington, NC  27292	NC	27292	10/03/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Financial Reporting Contact	Chief Financial Officer	Mrs.	Jones	Tammy		8284658007				8284658015	tjones@EveryAge.org	100 Leonard Ave		Newton	NC	28658	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Formulary Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Formulary Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	General Contact	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463565	tchang@everyage.org	802 E. Center Street		GREENSBORO	NC	27292	03/28/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Government Relations Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	HIPAA Privacy Officer	Quality Manager		Wingate	LaToya		3367463513					lwingate@everyage.org	802 E. Center Street		Lexington	NC	27292	12/20/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	HIPAA Security Officer	Quality Manager		Wingate	LaToya		3367463513					lwingate@everyage.org	802 E. Center Street		Lexington	NC	27292	12/20/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Interoperability Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	MA Appeals/Grievances Contact	Quality Manager		Wingate	LaToya		3367463513					lwingate@everyage.org	802 E. Center Street		Lexington	NC	27292	12/20/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	MA Claims Processing Contact for Public Website	Claims Coordinator	Ms.	Austin	Melissa		3367463500				3367463565	meaustin@everyage.org	802 East Center Street		Lexington	NC	27292	11/28/2023	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Marketing Contact	Marketing/Enrollment Coordinator	Ms.	Smithdeal	Gwynn		3367463512				3367463523	gsmithdeal@everyage.org	802 East Center Street		Lexington	NC	27292	04/14/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Medical Director	Medical Director	Dr.	Roddy	David		3367463500				3367463526	droddy@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Medicare Compliance Officer	Dir. Quality and Compliance	Mrs.	Forney	Harriet		9107670928				9107650188	hforney@everyage.org	1380 N. College Rd.	Elderhaus, Inc.	Wilmington	NC	28405	08/08/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Medicare Coordinator	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@everyage.org	802 East Center Street		Lexington	NC	27292	04/14/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Roddy	David		3367463500				3367463526	droddy@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Medication Therapy Management Contact	Medical Director	Dr.	Roddy	David		3367463500				3367463526	droddy@EveryAge.org	802 East Center Street		Lexington	NC	27292	04/05/2022	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Online Enrollment Center Contact (Back-up)	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463565	tchang@everyage.org	802 E. Center Street		GREENSBORO	NC	27292	03/28/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Online Enrollment Center Contact (Optional)	Marketing/Enrollment Coordinator	Mr.	Smithdeal	Gwynn	T	3367463512					gsmithdeal@everyage.org	802 E. Center Street		Lexington	NC	27292	04/14/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Online Enrollment Center Contact (Primary)	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463565	tchang@everyage.org	802 E. Center Street		GREENSBORO	NC	27292	03/28/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part C Application Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Appeals	Sr. Director of HCBS	Mr.	Chang	Thomas						3367463523	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/27/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	3367463519				PACE - Nat		C	Atlanta
H1357	Part D Application Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463519				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Benefits Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463500				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	11/28/2023	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Claims Submission Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Exceptions Contact	Sr. Director of HCBS	Mr.	Chang	Thomas						3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	8332234476				PACE - Nat		C	Atlanta
H1357	Part D Exceptions Contact (Secondary)	Business Office Team Lead	Mr.	Cornell	Jacob						3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	8332234476				PACE - Nat		C	Atlanta
H1357	Part D Price File Contact (Back-up)	Business Office Team Lead	Mr.	Cornell	Jacob		3363006661				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	11/28/2023	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Price File Contact (Optional)	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Price File Contact (Primary)	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		802 E. Center Street	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Quality Assurance Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463519				3367463523	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	02/27/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Part D Reporting Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Patient Safety Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463519				3367463523	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	02/27/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Payment Contact	Business Office Team Lead	Mrs.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	11/28/2023	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Personal Health Record Contact	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463523	tchang@everyage.org	802 East Center Street		Choose	NC	27292	04/14/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Pharmacy Director	Medical Director	Dr.	Roddy	David		3367463500				3367463526	droddy@EveryAge.org	802 East Center Street		Lexington	NC	27292	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Pharmacy Network Management Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Pharmacy Network Management Contact (Secondary)	Business Analyst	Mr.	Cornell	Jacob		3367463500				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	11/28/2023	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Pharmacy Technical Help Desk Contact	Business Team Lead	Mr.	Cornell	Jacob						3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	3367463547				PACE - Nat		C	Atlanta
H1357	Pharmacy Technical Help Desk Contact (Secondary)	Business Team Lead	Mr.	Cornell	Jacob						3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active	3367463547				PACE - Nat		C	Atlanta
H1357	PHR Beneficiary Contact																	01/04/2019	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE	Carolina SeniorCare	EveryAge	797	Yes	Active	8332234476				PACE - Nat		C	Atlanta
H1357	Plan Directory Contact for Public Website	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463565	tchang@everyage.org	802 E. Center Street		GREENSBORO	NC	27292	03/28/2025	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Plan to Plan Reconciliation Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Processor Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Quality Contact	Quality Manager		Wingate	LaToya		3367463513					lwingate@everyage.org	802 E. Center Street		Lexington	NC	27292	12/20/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Reconciliation Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Reconciliation Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463519				3367463565	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Recovery Audit Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463519				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Surveillance Contact	Sr. Director of HCBS	Mr.	Chang	Thomas		3367463500				3367463565	tchang@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	System Contact	IT Director	Mr.	Larew	Brantley		8284658022				8284658537	blarew@EveryAge.org	100 Leonard Ave		Newton	NC	28658	08/26/2021	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Third Party Administrator (TPA) Liaison	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	User Access Contact	IT Director	Mr.	Larew	Brantley		8284658022				8284658537	blarew@EveryAge.org	100 Leonard Ave		Newton	NC	28658	04/05/2022	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Utilization Management Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1357	Utilization Review Contact	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547				3367463565	jcornell@EveryAge.org	802 East Center Street		Lexington	NC	27292	02/23/2024	2026	CAROLINA SENIORCARE	National PACE	Carolina SeniorCare	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H1360	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H1360	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1360	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1360	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H1360	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/29/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1360	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1365	Agent/Broker Compensation Data Contact	Director, Medicare Sales		Cestaro	Connor		2077313136					connor.cestaro@martinspoint.org	P.O. Box 9746	891 Washington Ave.	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Backup User Access Contact	MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04014	08/05/2024	2026	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	Boston
H1365	Best Available Evidence Contact	Manager, Member Operations		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Bid Audit Contact			Ledbetter	Joe		2072536271					joe.ledbetter@martinspoint.org	331 Veranda Street		Portland	ME	04104	09/09/2024	2026	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	Boston
H1365	Bid Audit Site Contact			Ledbetter	Joe		2072536271					joe.ledbetter@martinspoint.org	331 Veranda Street		Portland	ME	04104	09/09/2024	2026	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	Boston
H1365	Bid Primary Contact			Ledbetter	Joe		2072536271					joe.ledbetter@martinspoint.org	331 Veranda Street		Portland	ME	04104	09/09/2024	2026	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	Boston
H1365	CAP Report Contact for Public Website	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	CEO - CMS Administrator Contact	President and Chief Executive Officer	Dr.	Kasuba	Paul		2077913710					paul.kasuba@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	01/04/2025	2026	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	Boston
H1365	CEO - Senior Official for Contracting	President and Chief Executive Officer	Dr.	Kasuba	Paul		2077913710					paul.kasuba@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Chief Financial Officer	Chief Financial Officer	Ms	Jackson	Amanda		2072536115					amanda.jackson@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Chief Operating Officer	MD	Mr	Kasuba	Paul		2077913710					paul.kasuba@martinspoint.org	331 Veranda Street - Building 4		Portland	ME	04104	02/03/2025	2026	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	Boston
H1365	Chief Information Officer	VP Information Technology	Ms	Downs	Amie		2072536184					amie.downs@martinspoint.org	331 Veranda Street		Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Chief Information Security Officer	MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04014	08/05/2024	2026	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	Boston
H1365	CMS Casework Communication Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Complaints Tracking Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	PO Box 9746	331 Veranda Street	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Contact for Fraud Investigations	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	PO Box 9746	331 Veranda Street	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Coordination of Benefits Contact	Manager, Member Operations		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Corporate Mailing						2077913710					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Customer Service Operations Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	DIR Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	DIR Contact (Secondary)	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Discount Program Payment Contact	Accountant III		Allard	Kathleen		2078282490					kathleen.allard@martinspoint.org	P. O. Box 9746		Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Emergency Part D Contact	Manager, Pharmacy Operations		Theriault	Anne		2076500662					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	12/27/2024	2026	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	Boston
H1365	Emergency Part D Contact (Secondary)	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	12/27/2024	2026	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	Boston
H1365	Encounter Data & Risk Adjustment Operations Contact			Dockendorf	Megan		2072536250					megan.dockendorf@martinspoint.org	PO Box 9746		Portland	ME	04104	10/07/2024	2026	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	Boston
H1365	Enrollment Contact	Manager, Member Operations		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	EOB Transfer Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535				2072536202	elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Financial Audit Contact	MCO	Ms	Loomis	Elizabeth		5182290535				2072536303	elizabeth.loomis@martinspoint.org	P.O. Box 9746		Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Financial Reporting Contact	Corporate Controller	Ms.	Tsay	Tatiana		2072536106				2072536227	tatiana.tsay@martinspoint.org	P.O. Box 9746		Portland	ME	04103	12/09/2024	2026	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	Boston
H1365	Formulary Contact	Medicare Clinical Pharmacist		Brown	Nancy	J	4013333987	7941			8003730238	njbrown@pharmacare.com	695 George Washington Highway		Lincoln	RI	02865	01/04/2024	2026	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	Boston
H1365	Formulary Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	General Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Government Relations Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	HIPAA Privacy Officer	Interim Privacy Officer		True	Erica		2077913848					erica.true@martinspoint.org	331 Veranda Street		Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	HIPAA Security Officer	MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04104	08/05/2024	2026	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	Boston
H1365	Hospice Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	331 Veranda Street	PO Box 9746	Portland	ME	04104	06/20/2024	2026	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	Boston
H1365	Interoperability Contact			Reburn	Sarah		2072536966					sarah.reburn@martinspoint.org	PO Box 9746		Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	MA Appeals/Grievances Contact	MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04104	09/09/2024	2026	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	Boston
H1365	MA Claims Processing Contact for Public Website	Sr Director, Claims and Payment Operations		Kumari	Shalini		2072536220					shalini.kumari@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/16/2025	2026	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	Boston
H1365	Marketing Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Medical Director	VP Medical Director of Clinical Programs	Dr.	Virani	Avani		2072536245					avani.virani@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H1365	Medicare Compliance Officer	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Medicare Coordinator	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/16/2025	2026	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	Boston
H1365	Medication Therapy Management Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Online Enrollment Center Contact (Back-up)	Supervisor Enrollment and Premium Biling		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Online Enrollment Center Contact (Optional)	Director Member Engagement		Reburn	Sarah		2072536966					sarah.reburn@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Online Enrollment Center Contact (Primary)	Systems Analyst, Enrollment		Tucker	Thad		2072536398					thad.tucker@martinspoint.org	P.O. Box 9746	891 Washington Ave.	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Part C Application Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Part C Reporting Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Part D Appeals			Representative	Appeals							appealsmedicare@caremark.com	CVS Caremark	9501 E. Shea Blvd. MC 109	Scottsdale	AZ	85260	01/04/2024	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active	8668849479				PPO - BBA		C	Boston
H1365	Part D Appeals Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne							anne.theriault@martinspoint.org	PO Box 9746	891 Washington Ave.	Portland	ME	04101	01/04/2024	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active	2077663144				PPO - BBA		C	Boston
H1365	Part D Application Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Part D Benefits Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Part D Claims Submission Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Part D Exceptions Contact	Appeals Representative		Representative	Appeals							appealsmedicare@caremark.com	CVS Caremark	9501 E. Shea Blvd MC 109	Scottsdale	AZ	85260	01/04/2024	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active	8688849479				PPO - BBA		C	Boston
H1365	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne							anne.theriault@martinspoint.org	PO Box 9746	891 Washington Ave.	Portland	ME	04101	01/04/2024	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active	2077663144				PPO - BBA		C	Boston
H1365	Part D Price File Contact (Back-up)	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Part D Price File Contact (Primary)	Medicare Operations		Loveland	Chet		4806064873					Chet.Loveland@CVSHealth.com	CVS Caremark	9501 E. Shea Blvd.	Scottsdale	AZ	85260	01/04/2024	2026	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	Boston
H1365	Part D Quality Assurance Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Part D Reporting Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Patient Safety Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Payment Contact	Corporate Controller	Ms	Tsay	Tatiana		2072536106					tatiana.tsay@martinspoint.org	P. O. Box 9746		Portland	ME	04104	12/09/2024	2026	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	Boston
H1365	Pharmacy Director	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Pharmacy Network Management Contact	Director, Network Operations		Smith	Shawn		4803914844				4803146964	Shawn.Smith@caremark.com	CVS Caremark	9501 E. Shea Blvd. MC143	Scottsdale	AZ	85260	01/04/2024	2026	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	Boston
H1365	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Palmieri	Mike							mike.palmieri@caremark.com	CVS Caremark	2401 Cherahala Blvd. MC650	Knoxville	TN	37932	01/04/2024	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	Local PPO		Martin's Point Health Care, Inc.	287	Yes	Active	8666934620				PPO - BBA		C	Boston
H1365	Plan Directory Contact for Public Website	Director Compliance & MCO	Ms	Loomis	Elizabeth		8887327364					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Plan to Plan Reconciliation Contact	Accountant II		Ayub	Rehema		2072536991					rehema.ayub@martinspoint.org	P. O. Box 9746	891 Washington Ave	Portland	ME	04103	01/04/2024	2026	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	Boston
H1365	Processor Contact	Sr Director, Claims and Payment Operations		Kumari	Shalini		2072536220					shalini.kumari@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/16/2025	2026	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	Boston
H1365	Quality Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	PO Box 9746	331 Veranda Street	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Reconciliation Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Reconciliation Contact (Secondary)	Corporate Controller	Ms.	Tsay	Tatiana		2072536106					tatiana.tsay@martinspoint.org	P. O. Box 9746		Portland	ME	04104	12/09/2024	2026	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	Boston
H1365	Recovery Audit Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		8887327364					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Surveillance Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	System Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535				2072536303	elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Third Party Administrator (TPA) Liaison	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	01/04/2024	2026	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	Boston
H1365	User Access Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	01/04/2024	2026	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	Boston
H1365	Utilization Management Contact	Director, Clinical Programs		VanEtten	Sara		2072536989					sara.vanetten@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/24/2025	2026	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	Boston
H1365	Utilization Review Contact	Director, Clinical Programs		VanEtten	Sara		2072536989					sara.vanetten@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/24/2025	2026	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	Boston
H1372	Agent/Broker Compensation Data Contact	Chief Operating Officer	Ms.	Schaub	Lindsey		9712065179					lindsey.schaub@agerightadvantage.com	4560 SE International Way	Suite 100	Milwaukie	OR	97222	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	CAP Report Contact for Public Website			Kleckner	Patty		5037010202					patty.kleckner@agerightadvantage.com	4560 SE International Way	#100	Milwaukie	OR	97222	04/25/2022	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	CEO - CMS Administrator Contact	CEO	ms	Brown	Jonalyn		9712062069					jbrown@agerightcs.com	4560 SE International Way #100		Milwaukie	OR	97222	03/28/2023	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	CEO - Senior Official for Contracting	CEO	ms	Brown	Jonalyn		9712062069					jbrown@agerightcs.com	4560 SE International Way #100		Milwaukie	OR	97222	03/28/2023	2026	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	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/19/2023	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Chief Operating Officer	Chief Operating Officer	Ms.	Schaub	Lindsey		9712065179					lindsey.schaub@agerightadvantage.com	4560 SE International Way	Suite 100	Milwaukie	OR	97222	03/03/2022	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Chief Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Contact for Fraud Investigations			Kleckner	Patty		5037010202					patty.kleckner@agerightadvantage.com	4560 SE International Way	#100	Milwaukie	OR	97222	04/25/2022	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Corporate Mailing						8448546885				8005036095	customerservice@agerightadvantage.com	P.O. Box 4440		Glen Allen	VA	230584440	01/29/2017	2026	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		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Discount Program Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	EOB Transfer Contact			Lowry	Kristy		8448546886				8336102390	kristy.lowry@curanahealth.com	P.O. Box 5849		Glen Allen	VA	23058	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Financial Audit Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/19/2023	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Financial Reporting Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/19/2023	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	General Contact			Brown	Jonalyn		9712062069					jbrown@agerightcs.com	4560 SE International Way #100		Milwaukie	OR	97222	03/28/2023	2026	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			Brown	Jonalyn		9712062069					jbrown@agerightcs.com	4560 SE International Way #100		Milwaukie	OR	97222	03/28/2023	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	HIPAA Privacy Officer			Kleckner	Patty		5037010202					pkleckner@marquiscompanies.com	4560 SE International Way #100		Milwaukie	OR	97222	03/28/2023	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	HIPAA Security Officer		Ms.	Kleckner	Patty		5037010202					patty.kleckner@agerightadvantage.com	4560 SE International Way	#100	Milwaukie	OR	97222	04/25/2022	2026	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		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Marketing Contact	Marketing Director		Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Medical Director	Medical Director		Gaskill	William		9712802993					wmgaskill@agerightcs.com	4560 SE International Way	Suite 100	Milwaukie	OR	97222	03/17/2022	2026	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		5037010202					compliance@agerightadvantage.com	4560 SE International Way	#100	Milwaukie	OR	97222	04/25/2022	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Medicare Coordinator	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Part C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Appeals	Supervisor, Grievance and Appeals		LaCrosse	Justin						8442689791	Justin.LaCrosse@navitus.com	Navitus Health Solutions,	P.O. Box 1039	Appleton	WI	54912	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	9202214149				HMO - Health Maintenance Organization		C	Seattle
H1372	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Seattle
H1372	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	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						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Seattle
H1372	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Seattle
H1372	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	01/03/2025	2026	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 Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	01/03/2025	2026	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 Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Pharmacy Network Management Contact			Robinson	Jan		6087291688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Seattle
H1372	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Seattle
H1372	Physician Incentive Contact			Howells	Heather		8049215196					heather.howells@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/14/2021	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Plan Directory Contact for Public Website			Sidlinger	Rocio		8558550489	1664				rocio.sidlinger@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Reconciliation Contact (Secondary)	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/19/2023	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Recovery Audit Contact	Chief Compliance Officer	Ms.	Kleckner	Patty		5037010202					patty.kleckner@agerightadvantage.com	4560 SE International Way	Suite 100	Milwaukie	OR	97222	04/25/2022	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Surveillance Contact	Chief Operating Officer	Ms.	Schaub	Lindsey		9712065179					lindsey.schaub@agerightadvantage.com	4560 SE International Way	Suite 100	Milwaukie	OR	97222	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	User Access Contact		Ms.	Kleckner	Patty		5037010202					patty.kleckner@agerightadvantage.com	4560 SE International Way	#100	Milwaukie	OR	97222	04/25/2022	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1372	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	MARQUIS ADVANTAGE, INC.	Local CCP	AgeRight Advantage	HMO/HMOPOS		Marquis Companies I, Inc.	636	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H1395	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Medical Director	Medical Director	Mr	Haake	Karl		9132951245					karl.haake@sunflowerhealthplan.com	77 West Wacker Drive, 14th Floor		Chicago	IL	60601	03/30/2021	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/07/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H1395	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H1395	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H1395	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H1395	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H1395	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/02/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H1395	PHR Beneficiary Contact																	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8665498289				PPO - BBA		C	Denver
H1395	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1395	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	NEBRASKA TOTAL CARE, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1396	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Best Available Evidence Contact	Manager, Enrollment		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Chief Financial Officer	Chief Financial Officer	Ms.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Government Relations Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H1396	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H1396	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1396	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1416	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H1416	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/08/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H1416	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H1416	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H1416	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H1416	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H1416	PHR Beneficiary Contact																	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H1416	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1416	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	HARMONY HEALTH PLAN,  INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1423	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	06/27/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	10/14/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	10/14/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	01/30/2020	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	01/22/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	07/05/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	06/27/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/10/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/06/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1423	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1423	PHR Beneficiary Contact																	01/30/2020	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H1423	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	03/21/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1423	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT HEALTH PLANS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1468	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1468	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H1468	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1468	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H1468	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/18/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H1468	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H1468	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1468	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1486	Agent/Broker Compensation Data Contact	Manager, Sales Operations	Mr.	Demos	John		6174260600					jdemos@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Automated TrOOP Balance Transfer Contact	Sr. Analyst		Diaz	Yamilca		4016513856					Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02896	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Backup User Access Contact	Director, Health Plan Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Best Available Evidence Contact	Director Enrollment		Millette	Maria		4012453047					mmillette@commonwealthcare.org	30 Winter St		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Bid Audit Contact	Vice President, Actuarial Services		Jesik	David		6174260600	51808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Bid Audit Site Contact	Vice President, Actuarial Services	Mr.	Jesik	David		6144260600	1808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Bid Primary Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	CAP Report Contact for Public Website	General Manager, Market Lead - Massachusetts		Waggoner	Mark		6174260600	51606				mwaggoner@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	CEO - CMS Administrator Contact	President	Mr.	Koehn	John		7328098761					jkoehn@commonwealthcare.org	30 Winter St		Boston	MA	02108	06/30/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	CEO - Senior Official for Contracting	President	Mr.	Koehn	John		7328098761					jkoehn@commonwealthcare.org	30 Winter St		Boston	MA	02108	06/30/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Chief Financial Officer	Interim Chief Financial Officer	Mr.	Peary	Matthew		8605029592					mpeary@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Chief Operating Officer	Chief Operating Officer	Ms.	Cassel Kraft	Amanda		3143045870					acasselkraft@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Chief Information Officer	SVP & Chief Information Officer	Ms.	O'Rorke	Beth		6174260600	2485				bororke@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Chief Information Security Officer	VP, IT Governance and Cyber Security	Mr.	Jacobs	Tim		6174260600	52258				tjacobs@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	CMMI Model Point of Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	CMS Casework Communication Contact	Director, Appeals& Grievances		Schenk	Tyrone		8573273320				8574534517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Complaints Tracking Contact	Director, Appeals& Grievances		Schenk	Tyrone		8573271953	1652			8574534517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Contact for Fraud Investigations	Director, FWA Program and SIU		Vasconcelos	Nadia		6174260600	52733				nvasconcelos@commonwealthcare.org	2 Lafayette	5th Floor	Boston	MA	02111	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Coordination of Benefits Contact	Sr Director Claims Ops		Sottilotta	Lori		6174260600	1194				lsottilotta@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/27/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Corporate Mailing						6174260600	1991				elgray@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Customer Service Operations Contact	Director Contact Center		Cuevas	Sabrina		6174260600	51004				scuevas@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/20/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	DIR Contact	Vice President, Actuarial Services		Jesik	David		6174260600	51808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	DIR Contact (Secondary)	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Discount Program Payment Contact	Sr. Director Treasury Operations		Jabre	Joe		6175642953					jjabre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Electronic Health Record Contact	Director Clinical Informatics		Phan	Phuong		6174260600	52247				pphan@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Emergency Part D Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations		Lee	Annie		7819158014					alee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Encounter Data & Risk Adjustment Operations Contact	Director Revenue Cycle		Soones	Michael		6174260600	54925				msoones@commonwealthcare.org	30 Winter St		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Enrollment Contact	Director Enrollment		Millette	Maria		4012453047					mmillette@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	EOB Transfer Contact	Director, Claims Operations		Sottilotta	Lori		6174260600	1194			6174260600	lsottilotta@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/17/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Financial Audit Contact	Director, Regulatory Audit	Ms	Patterson	Kathryn		6174260600	51404				kpatterson@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Financial Reporting Contact	VP & Controller	Mr.	Heath	Alan		8572602839					aheath@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Formulary Contact	Pharmacy Analyst		Perry	Michele		6026211682					michele.perry@cvshealth.com	9501 E. Shea Blvd.	MC 080	Scottsdale	AZ	85260	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Formulary Contact (Secondary)	Sr Director Pharmacy		Berman	Tova		6174260600	51289				tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/29/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	General Contact	General Manager, Market Lead - Massachusetts		Waggoner	Mark		6174260600	51606				mwaggoner@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Government Relations Contact	Federal Policy Medicare Director		Waickman	Nicole		6174260600	51412				nwaickman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	HIPAA Privacy Officer	Sr Director Regulatory Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	HIPAA Security Officer	Sr Director Regulatory Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Hospice Contact	VP Utilization Management		Dardompre	Donna		6175079344					ddardompre@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Interoperability Contact	SVP & Chief Information Officer		O'Rorke	Beth		6174260600	52444				bororke@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	MA Appeals/Grievances Contact	Director, Appeals& Grievances		Schenk	Tyrone		8573273320				8574534517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	MA Claims Processing Contact for Public Website			Services	Provider		8664209332	1194				providerservices@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Marketing Contact	SVP, Marketing		Kubilus	Melissa		6174260600	52448			6174263019	mkubilus@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Medical Director	VP National Medical Director		Lewin	Roxanne		6175812434					rlewin@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Medicare Compliance Officer	VP, Medicare Compliance Officer	Ms.	Charron	Katherine		4013785409					kcharron@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/10/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Medicare Coordinator	General Manager, Market Lead - Massachusetts		Waggoner	Mark		6174260600	51606				mwaggoner@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/11/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Medication Therapy Management Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	OffShore Subcontractor Contact	Sr Director Regulatory Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Online Enrollment Center Contact (Back-up)	Director, Member Enrollment and Retention		Millette	Maria		4012453047					mmillette@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Online Enrollment Center Contact (Primary)	Director Enrollment		Millette	Maria		4012453047					mmillette@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part C Application Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part C Reporting Contact	Medicare Compliance Officer		Charron	Katherine		4013785409					kcharron@commonwealthcare.org	30 Winter Street		Boston	MA	02111	08/13/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Appeals	Director, Appeals & Grievances		Schenk	Tyrone						8574534517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active	8573273320				HMO - Health Maintenance Organization		C	Boston
H1486	Part D Appeals Contact (Secondary)	Manager, Clinical Appeals and Grievances		Mancuso	Jeremiah							jmancuso@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active	6082985781	51222			HMO - Health Maintenance Organization		C	Boston
H1486	Part D Application Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Benefits Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Claims Submission Contact	Sr Analyst		Diaz	Yamilca		4016513856					Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02896	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Exceptions Contact	Sr. Analyst		Diaz	Yamilca							Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02895	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active	4016513856				HMO - Health Maintenance Organization		C	Boston
H1486	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Operations		Lee	Annie						6174263109	alee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active	6174260600				HMO - Health Maintenance Organization		C	Boston
H1486	Part D Price File Contact (Back-up)	Manager Finance Ops		Loveland	Chet		8018363750					chet.loveland@cvshealth.com	9501 E. Shea Blvd.	MC 080	Scottsdale	AZ	85260	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Price File Contact (Optional)	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Price File Contact (Primary)	Sr. Analyst Finance Ops		Scott	Sarah		4803109219					sarah.scott@cvshealth.com	9501 E. Shea Blvd.	MC 080	Scottsdale	AZ	85260	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Quality Assurance Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Part D Reporting Contact	Medicare Compliance Officer		Charron	Katherine		4013785409					kcharron@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/13/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Patient Safety Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Payment Contact	VP & Controller		Heath	Alan		8572602839					aheath@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Personal Health Record Contact	Director, Health Information Management		Tandoh	Shirley		2679792990					standoh@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Pharmacy Director	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd.	MC 080	Scottsdale	AZ	85260	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Pharmacy Technical Help Desk Contact	Sr. Analyst		Diaz	Yamilca							Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02896	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H1486	PHR Beneficiary Contact																	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS	Commonwealth Care Alliance	CareSource	321	Yes	Active	8666102273				HMO - Health Maintenance Organization		C	Boston
H1486	Physician Incentive Contact	Director, Hospital & Physician Contracting	Mr.	Driscoll	Terence		6174260600	56886				tdriscoll@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Plan Directory Contact for Public Website			Services	Member		8664209332					memberservices@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Plan to Plan Reconciliation Contact	Manager, Accounts Payable		Reeves	Jennifer		6174260600	51632				jreeves@commonwealthcare.org	30 Winter St		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Processor Contact	Director Claims		Sottilotta	Lori		6174260600	51194				lsottilotta@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/17/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Quality Contact	Sr Director Quality		Wagner	Michael		6174260600	58803				ahelwig@commonwealthcare.org	30 Winter Street		Boston	MA	02108	10/20/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Reconciliation Contact	Vice President, Actuarial Service		Jesik	David		6174260600	1808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Reconciliation Contact (Secondary)	Director Revenue Cycle		Soones	Michael		6174260600	54925				msoones@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Recovery Audit Contact	Director External Audit	Ms.	Patterson	Kathryn		6174260600	51404				kpatterson@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	SNP Application Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	SNP State Contact	SCo and One Care Conract Director		Friedmann	Heather		6175716907					hfriedmann@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Surveillance Contact	Director, National Sales		Joyce	Joe		6174260600	52179				jjoyce@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	System Contact	Secure File Movement Sr. Administrator		Lou	Bryan		6174260600	51997				blou@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Third Party Administrator (TPA) Liaison	Sr. Director Treasury Operations		Jabre	Joe		6175642953					jjabre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	User Access Contact	Director Medicare Compliance Officer		Charron	Katherine		4013785409					KCharron@commonwealthcare.org	30 Winter St		Boston	MA	02108	08/13/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Utilization Management Contact	VP UM and A&G		Dardompre	Donna		6175079344					ddardompre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1486	Utilization Review Contact	VP UM and A&G		Dardompre	Donna		6175079344					ddardompre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/07/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance, Inc.	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1500	Automated TrOOP Balance Transfer Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Backup User Access Contact	Executive Director	Mrs	Alexander-Hines	Joyce		9104297202					joyce.alexander-hines@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Bid Primary Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	CAP Report Contact for Public Website	Executive Director	Ms.	Alexander-Hines	JOyce		9104297202				9104834930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	CEO - Senior Official for Contracting	Executive Director	Mrs	Alexander-Hines	Joyce		9104297202					joyce.alexander-hines@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	05/06/2022	2026	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	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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 Operating Officer	COO	Mrs	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	120555 Victor Parkway		Livonia	MI	48152	09/22/2020	2026	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 Information Officer	Director Enterprise IT Operations	Mr	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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 Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083					Preston.Jennings@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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		9104297202				9104834930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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	Complaints Tracking Contact	Director QI/Compliance	Ms.	Pennington	Danielle		9104297210				9104834930	Danielle.Pennington@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	03/13/2024	2026	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	Contact for Fraud Investigations	Director QI/Compliance	Ms.	Pennington	Danielle		9104297210				9104834930	Danielle.Pennington@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	03/13/2024	2026	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	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Corporate Mailing						9104297255				9104834930	joyce-alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	09/15/2023	2026	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		9104297202				9104834930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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	DIR Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Discount Program Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Emergency Part D Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Emergency Part D Contact (Secondary)	Business Manager		Reed	Melissa		9104297204				9104834930	Melissa.Reed001@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	03/10/2020	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	10/25/2019	2026	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	Enrollment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	EOB Transfer Contact	Executive Director	Ms.	Alexander-Hines	Joyce		9104297202				9104834930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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	Financial Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				9104834930	nicole.fuhrmeister@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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	Financial Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	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	General Contact	Executive Director	Ms.	Alexander-Hines	Joyce		9104297202				9104834930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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		9104297202				9104834930	Joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	Interoperability Contact	Director Enterprise IT Operations		Gillespies	Jeff		7343433079					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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	MA Appeals/Grievances Contact	Director QI/Compliance	Ms.	Pennington	Danielle		9104297210				9104834930	Danielle.Pennington@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	03/13/2024	2026	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	MA Claims Processing Contact for Public Website	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Marketing Contact	Director Marketing & Communications	Ms	Lark	Azia		9735182754					azia.lark@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	02/03/2023	2026	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	Medical Director	Medical Director	Dr.	Marigowda	Lokesh		9104297226				9104834930	Lokesh.Marigowda@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	03/18/2024	2026	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	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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 Coordinator	Executive Director	Mrs	Alexander-Hines	Joyce		9104297202					joyce.alexander-hines@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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 Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/27/2023	2026	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	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/27/2023	2026	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 C Application Contact	Executive Director	Ms.	Alexander-Hines	Joyce		9104297202				9104834930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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 Appeals	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	09/15/2023	2026	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H1500	Part D Application Contact	Executive Director	Mrs	Alexander-Hines	Joyce		9104297202					joyce.alexander-hines@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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 Benefits Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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 Claims Submission Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	2026	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H1500	Part D Price File Contact (Back-up)	Executive Director	Mrs	Alexander-Hines	Joyce		9104297202					joyce.alexander-hines@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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 Price File Contact (Primary)	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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 Quality Assurance Contact	Director QI/Compliance	Ms.	Pennington	Danielle		9104297210				9104834930	Danielle.Pennington@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	03/13/2024	2026	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 Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Patient Safety Contact	Director QI/Compliance	Ms.	Pennington	Danielle		9104297210				9104834930	Danielle.Pennington@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	03/13/2024	2026	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	Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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 Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	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 Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	08/04/2023	2026	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	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/04/2023	2026	LIFE ST. JOSEPH OF THE PINES, INC.	National PACE	LIFE St. Joseph of the Pines	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H1500	Plan Directory Contact for Public Website	Executive Director	Mrs	Alexander-Hines	Joyce		9104297202					joyce.alexander-hines@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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	Plan to Plan Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Processor Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	Quality Contact	Director QI/Compliance	Ms.	Pennington	Danielle		9104297210				9104834930	Danielle.Pennington@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	03/13/2024	2026	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	Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				9104834930	nicole.fuhrmeister@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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	Recovery Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				9104834930	nicole.fuhrmeister@trinity-health.org	4900 Raeford Rd		Fayetteville	NC	28304	08/04/2023	2026	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	Surveillance Contact	Executive Director	Ms.	Alexander-Hines	Joyce		9104297202				9104834930	joyce.alexander-hines@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	04/28/2022	2026	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	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	Third Party Administrator (TPA) Liaison	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	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	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	Utilization Management Contact	Medical Director	Dr.	Marigowda	Lokesh		9104297226				9104834930	Lokesh.Marigowda@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	03/18/2024	2026	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	Utilization Review Contact	Medical Director	Dr.	Marigowda	Lokesh		9104297226				9104834930	Lokesh.Marigowda@trinity-health.org	4900 Raeford Road		Fayetteville	NC	28304	03/18/2024	2026	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	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Backup User Access Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Bid Primary Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	CAP Report Contact for Public Website	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	CEO - CMS Administrator Contact	President & CEO PACE	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	CEO - Senior Official for Contracting	President & CEO PACE	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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		7169232968					redwards@chsbuffalo.org	144 Genesee St.	4th Floor - Finance	Buffalo	NY	14203	08/09/2022	2026	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 Operating Officer	President & CEO PACE	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Information Officer	Chief Information Officer	Dr.	Galang	Michael		7168621779					mgalang@chsbuffalo.org	144 Genesee St.		Buffalo	NY	14203	03/23/2016	2026	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 Information Security Officer	VP IT Security & CISO	Mr.	Witherell	Eric		7168621777					ewitherell@chsbuffalo.org	144 Genesee St.		Buffalo	NY	14203	03/05/2024	2026	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	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Complaints Tracking Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Contact for Fraud Investigations	Compliance & Privacy Officer	Mrs	Whistler	Kimberly	E	7168214471					kwhistler@chsbuffalo.org	144 Genesee St	6th Floor	Buffalo	NY	14203	05/19/2022	2026	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	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Corporate Mailing						7168195101					arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	09/24/2019	2026	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	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	DIR Contact	President & CEO	Ms.	Ruddick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	DIR Contact (Secondary)	Finance Manager	Ms.	Saunders Uldrich	Jennifer		7168195080				7168195099	jsaundersuldrich@chsbuffalo.org	55 Melroy Ave	Ground Floor	Lackawanna	NY	14218	02/26/2024	2026	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	Discount Program Payment Contact	Finance Manager	Ms.	Saunders Uldrich	Jennifer		7168195080				7168195099	jsaundersuldrich@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	12/17/2024	2026	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	Emergency Part D Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Emergency Part D Contact (Secondary)	Finance Manager	Ms.	Saunders Uldrich	Jennifer		7168195080				7168195099	jsaundersuldrich@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Lackawanna	NY	14218	02/26/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Enrollment Contact	Community Liaison	Mrs.	Shalke	Karen		7168195100					kshalke@chsbuffalo.org	55 Melroy Av		Lackawanna	NY	14218	01/11/2022	2026	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	EOB Transfer Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Financial Audit Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Financial Reporting Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Formulary Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	General Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	HIPAA Privacy Officer	Compliance & Privacy Officer	Mrs.	Whistler	Kimberly	E	7168214471					kwhistler@chsbuffalo.org	144 Genesee St	6th Floor	Buffalo	NY	14203	05/19/2022	2026	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	HIPAA Security Officer	Compliance & Privacy Officer	Mrs.	Whistler	Kimberly		7168214471					kwhistler@chsbuffalo.org	144 Genesee St	6th Floor	Buffalo	NY	14203	05/19/2022	2026	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	Interoperability Contact	President & CEO		Rudick	Ashley		7168195101				7168195099	alw3617@gmail.com	55 Melroy Ave		Lackawanna	NY	14218	07/08/2025	2026	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	MA Appeals/Grievances Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	MA Claims Processing Contact for Public Website	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Marketing Contact	Community Liaison	Mrs.	Shalke	Karen		7168195100					kshalke@chsbuffalo.org	55 Melroy Av		Lackawanna	NY	14218	01/11/2022	2026	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	Medical Director	Medical Director	Dr.	Naughton	Bruce		7168195025					bnaughto@buffalo.edu	55 Melroy Ave.		Lackawanna	NY	14218	03/05/2015	2026	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	7168214471					kwhistler@chsbuffalo.org	144 Genesee St	6th Floor	Buffalo	NY	14203	05/19/2022	2026	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 Coordinator	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr.	Naughton	Bruce		7168195025					bnaughton@chsbuffalo.org	55 Melroy Av.		Lackawanna	NY	14218	12/14/2018	2026	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	Medication Therapy Management Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 C Application Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Appeals	President & CEO	Ms.	Rudick	Ashley						7168195101	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active	8556713341				PACE - Nat		C	New York
H1518	Part D Appeals Contact (Secondary)	President & CEO	Ms.	Rudick	Ashley						7168195099	arudick@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Buffalo	NY	14218	07/08/2025	2026	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active	7168195101				PACE - Nat		C	New York
H1518	Part D Application Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Benefits Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Claims Submission Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	President & CEO	Ms.	Rudick	Ashley						7168195101	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active	8556713341				PACE - Nat		C	New York
H1518	Part D Price File Contact (Back-up)	Finance Manager	Ms.	Uldrich	Jennifer		7168195080				7168195099	jsaundersuldrich@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Price File Contact (Primary)	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Quality Assurance Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue		Lackawanna	NY	14218	07/08/2025	2026	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 Reporting Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue		Lackawanna	NY	14218	07/08/2025	2026	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	Patient Safety Contact	QI Manager	Mrs.	Azzopardi	Susan		7168195319				7168195099	sazzopar@chsbuffalo.org	55 Melroy Ave	Ground Floor LIFE	Lackawanna	NY	14218	09/24/2019	2026	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	Payment Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Director	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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 Network Management Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	President & CEO	Ms.	Rudick	Ashley						7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active	8556713341				PACE - Nat		C	New York
H1518	Plan Directory Contact for Public Website	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Plan to Plan Reconciliation Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Processor Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Quality Contact	QI Manager	Mrs.	Azzopardi	Susan		7168195319				7168195099	sazzopar@chsbuffalo.org	55 Melroy Ave	Ground Floor LIFE	Lackawanna	NY	14218	09/24/2019	2026	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	Reconciliation Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Reconciliation Contact (Secondary)	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Ave.	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Recovery Audit Contact	Compliance & Privacy Officer	Mrs	Whistler	Kimberly	E	7168214471					kwhistler@chsbuffalo.org	144 Genesee St	6th Floor	Buffalo	NY	14203	05/19/2022	2026	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	Surveillance Contact	Compliance & Privacy Officer	Mrs	Whistler	Kimberly	E	7168214471					kwhistler@chsbuffalo.org	144 Genesee St	6th Floor	Buffalo	NY	14203	05/19/2022	2026	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	System Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Third Party Administrator (TPA) Liaison	Finance Manager	Ms.	Saunders Uldrich	Jennifer		7168195080				7168195099	jsaundersuldrich@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	12/17/2024	2026	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	User Access Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Utilization Management Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	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	Utilization Review Contact	President & CEO	Ms.	Rudick	Ashley		7168195101				7168195099	arudick@chsbuffalo.org	55 Melroy Avenue	Ground Floor	Lackawanna	NY	14218	07/08/2025	2026	CATHOLIC HEALTH SYSTEM BUFFALO PACE	National PACE	Catholic Health LIFE	National PACE		Catholic Health System, Inc.	403	Yes	Active					PACE - Nat		C	New York
H1526	Agent/Broker Compensation Data Contact	Director of Sales Technology		Wandoloski	Matthew		5203602585					matthew.wandoloski@goldkidney.com	4600 E Washington St, #300	Apt 711	Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Automated TrOOP Balance Transfer Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Backup User Access Contact	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Best Available Evidence Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Bid Audit Contact	Medicare Product Director		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Bid Primary Contact	Medicare Product Director		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	CAP Report Contact for Public Website	CEO		Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	CEO - CMS Administrator Contact	CEO	Mr,	Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	CEO - Senior Official for Contracting	CEO	Mr,	Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Chief Financial Officer	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Chief Operating Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Chief Information Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Chief Information Security Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	CMMI Model Point of Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	CMS Casework Communication Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Complaints Tracking Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Contact for Fraud Investigations	Medicare Compliance Officer		Smith	Nakia		8442946535					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Coordination of Benefits Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Corporate Mailing						8442946535					dominic.henriques@goldkidney.com	PO 285		Portsmouth	NH	03802	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Customer Service Operations Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	DIR Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Discount Program Payment Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Emergency Part D Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Encounter Data & Risk Adjustment Operations Contact	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Enrollment Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	EOB Transfer Contact	Senior Business Analyst		Taylor	Jay		8442946535				8559156513	jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Financial Audit Contact	Controller/CFO	Mr.	Becker	Ryan		8442946535					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Financial Reporting Contact	Controller/CFO	Mr,	Becker	Ryan		8442946535					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Formulary Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	General Contact	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Government Relations Contact	CEO	Mr,	Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	HIPAA Privacy Officer	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	HIPAA Security Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Hospice Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Interoperability Contact	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	MA Appeals/Grievances Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	MA Claims Processing Contact for Public Website	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Marketing Contact	Senior Compliance Analyst		Tran	Triet		8442946535					Triet.Tran@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Medical Director	CMO		Sahani	Mandeep		6023202916					mandeep.sahani@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Medicare Coordinator	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Medicare Part D Opioid Overutilization Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Medication Therapy Management Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part C Application Contact	Product Manager		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part C Reporting Contact	Senior Compliance Analyst		Tran	Triet		8442946535					Triet.Tran@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part D Appeals	Senior Director of Value Based Care		Abduljabbar	Fawaz							fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	8442946535				HMO - Health Maintenance Organization		C	Boston
H1526	Part D Application Contact	Product Manager		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part D Benefits Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part D Claims Submission Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part D Exceptions Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz							fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	8442946535				HMO - Health Maintenance Organization		C	Boston
H1526	Part D Price File Contact (Back-up)	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part D Price File Contact (Primary)	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part D Quality Assurance Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Part D Reporting Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Patient Safety Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Payment Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Pharmacy Director	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Pharmacy Network Management Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/23/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	8886727206				HMO - Health Maintenance Organization		C	Boston
H1526	Plan Directory Contact for Public Website	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Plan to Plan Reconciliation Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Processor Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Quality Contact	CMO		Sahani	Mandeep		6023202916					mandeep.sahani@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Reconciliation Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Surveillance Contact	Medicare Compliance Officer		Smith	Nakia		8442946535					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	System Contact	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Third Party Administrator (TPA) Liaison	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	User Access Contact	Sr. Compliance Specialist	Mr.	Tran	Triet		3072502082					triet.tran@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Utilization Management Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1526	Utilization Review Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	08/04/2025	2026	GOLD KIDNEY OF FLORIDA INC	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1533	Automated TrOOP Balance Transfer Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Backup User Access Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Bid Primary Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	CAP Report Contact for Public Website	Marketing Director	Mr	Edwards	Cody		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	04/14/2025	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	CEO - CMS Administrator Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	CEO - Senior Official for Contracting	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Chief Operating Officer	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Chief Information Officer	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Chief Information Security Officer	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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		3366284215				3366284235	janine.conrad@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Complaints Tracking Contact	Quality Assurance and Performance Improvement Coor	Mrs	Conrad	Janine		3366284215				3366284235	janine.conrad@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Contact for Fraud Investigations	Quality Assessment Performance Improvement Coor.	Mrs	Conrad	Janine		3366284215				3366284235	janine.conrad@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Corporate Mailing						3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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		3366284200				3366284235	janine.conrad@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	DIR Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Discount Program Payment Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Emergency Part D Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Enrollment Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	EOB Transfer Contact	Executive Director	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	04/14/2025	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Financial Audit Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Financial Reporting Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Formulary Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	General Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	HIPAA Privacy Officer	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	HIPAA Security Officer	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Interoperability Contact			Martin	Karen		3366284200					karen.martin@amhealthsystems.com	809 Curry Drive		ASHEBORO	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	MA Appeals/Grievances Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	MA Claims Processing Contact for Public Website	Executive Director	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Marketing Contact	Marketing Coordinator	Mr	Edwards	Cody		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	04/14/2025	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Medical Director		MD	Thomas	Brad		3366284200					brad.thomas@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Medicare Coordinator	ED	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Medicare Part D Opioid Overutilization Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Medication Therapy Management Contact		MD	Thomas	Brad		3366284200					brad.thomas@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Part C Application Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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 Appeals	Executive Director	Mrs	Martin	Karen						3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active	3366284200				PACE - Nat		C	Atlanta
H1533	Part D Application Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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 Benefits Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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 Claims Submission Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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						3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active	8008005555				PACE - Nat		C	Atlanta
H1533	Part D Price File Contact (Back-up)	ED	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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 Price File Contact (Optional)	Executive Director	Mrs.	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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 Price File Contact (Primary)	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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 Quality Assurance Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	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 Reporting Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Patient Safety Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Payment Contact	ED	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Pharmacy Director	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Pharmacy Network Management Contact			Tanner	Robert		8778423210					rtanner@pharmastar.com	PO Box 3217		Eau Claire	WI	54702	11/21/2013	2026	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	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active	8778423210				PACE - Nat		C	Atlanta
H1533	Plan Directory Contact for Public Website	ED	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Plan to Plan Reconciliation Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Processor Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Quality Contact	QAPI Coordinator	Ms	Conrad	Janine		3366284200				3366284235	janine.conrad@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Reconciliation Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Recovery Audit Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Surveillance Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	System Contact	Executive Director	Mrs	Martin	Karen		3366284200				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Third Party Administrator (TPA) Liaison	ED	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	User Access Contact	ED	Ms.	Martin	Karen		3366284210				3366284235	karen.martin@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Utilization Management Contact	QAPI Coordinator	Mrs	Conrad	Janine		3366284200				3366284235	janine.conrad@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1533	Utilization Review Contact	QAPI Coordinator	Mrs	Conrad	Janine		3366284200				3366284235	janine.conrad@amhealthsystems.com	809 Curry Dr.		Asheboro	NC	27205	10/04/2023	2026	STAYWELL SENIOR CARE, INC.	National PACE	StayWell Senior Care	National PACE		American Healthcare Systems, LLC	605	Yes	Active					PACE - Nat		C	Atlanta
H1537	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H1537	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1537	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1537	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H1537	Plan Directory Contact for Public Website			Customer Service	UHC		8004578506					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1537	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1544	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Backup User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/24/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	CEO - CMS Administrator Contact		Ms.	Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	CEO - Senior Official for Contracting		Ms.	Jaques	Clara		3102000576					clara.jaques@welbehealth.com	1220 E 4th Street		Long Beach	CA	90802	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Chief Financial Officer		Ms.	Jaques	Clara		3102000576					clara.jaques@welbehealth.com	1220 E 4th Street		Long Beach	CA	90802	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Chief Operating Officer		Ms.	Jaques	Clara		3102000576					clara.jaques@welbehealth.com	1220 E 4th Street		Long Beach	CA	90802	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/06/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Contact for Fraud Investigations			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Customer Service Operations Contact			Jaques	Clara		3102000576					clara.jaques@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	DIR Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	DIR Contact (Secondary)			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Emergency Part D Contact (Secondary)			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	General Contact			Jaques	Clara		3102000576					clara.jaques@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Government Relations Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	HIPAA Privacy Officer			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	HIPAA Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Medical Director			Villalba	Sabrina		7146086457					sabrina.villalba@welbehealth.com	1220 E 4th Street		Long Beach	CA	90802	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Medicare Compliance Officer		Ms.	Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Medicare Coordinator		Ms.	Jaques	Clara		3102000576					clara.jaques@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/18/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	2192106392				PACE - Nat		C	San Francisco
H1544	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1544	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1544	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Quality Assurance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Patient Safety Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1544	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Surveillance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/29/2025	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1544	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/20/2023	2026	LA COAST PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1587	Agent/Broker Compensation Data Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Automated TrOOP Balance Transfer Contact	VP of TPA Operations		Allen	Kim		5016902985					pharmacysupport@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Backup User Access Contact	VP of Technical Operations		Harrington	Paige		5016974557				5013721932	pharrington@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Best Available Evidence Contact	Member Service Manager		Campbell	Brittany		5012550873				8667053652	brittanyc@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Bid Audit Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Bid Audit Site Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Bid Primary Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	CAP Report Contact for Public Website	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	CEO - CMS Administrator Contact	Executive Director	Mr.	Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	CEO - Senior Official for Contracting	Executive Director	Mr.	Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select 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		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Chief Operating Officer	CFO/Director of Finance	Mr.	Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Chief Information Officer	VP of Technical Operations	Mrs.	Harrington	Paige		5016974557				5013721932	pharrington@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Chief Information Security Officer	VP of Technical Operations	Mrs.	Harrington	Paige		5013721922				5013721932	pharrington@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	CMS Casework Communication Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Complaints Tracking Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Contact for Fraud Investigations	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Coordination of Benefits Contact	VP of TPA Operations		Allen	Kim		5016902985					pharmacysupport@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Corporate Mailing						5013721922					info@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Customer Service Operations Contact	Member Service Manager		Campbell	Brittany		5012550873				8667053652	brittanyc@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	DIR Contact	Manager Health Plans Finance		Parkin	Frank		0000000000					fparkin@elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	11/29/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	DIR Contact (Secondary)	Director Reporting and Analytics, Govt Programs		Campbell	Tim		0000000000					tcampbell@elixirsolutions.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/10/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Discount Program Payment Contact	Finance Manager		Smith	Leslie		5018596625				5013721932	lsmith@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Electronic Health Record Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Emergency Part D Contact	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida		5018596316					mvasquez@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Encounter Data & Risk Adjustment Operations Contact	AHS Quality and Risk Manager		Shock	Lauri		5014047811					lshock@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Enrollment Contact	Member Service Manager		Campbell	Brittany		5012550873				8667053652	brittanyc@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	EOB Transfer Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Financial Audit Contact	CFO/Director of Finance	Mr.	Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Financial Reporting Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Formulary Contact	Formulary Operations Clinical Pharmacist		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/30/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	General Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Government Relations Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	HIPAA Privacy Officer	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	HIPAA Security Officer	Information Security Officer		Moran	Tracy		5012953444				5013721932	tmoran@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Hospice Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Interoperability Contact	VP of Technical Operations		Harrington	Paige		5013721922					pharrington@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	MA Appeals/Grievances Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	MA Claims Processing Contact for Public Website			Service	Customer		5013721922					info@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Marketing Contact	Director of Sales and Business Development		Pollock	James		5014104450				5013721932	jpollock@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Medical Director	Medical Director	Dr.	Garner	Kimberly		5013721922				5013721932	kgarner@superiorselectinc.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select 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		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Medicare Coordinator	Executive Director		Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Medication Therapy Management Contact	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part C Application Contact	Executive Director		Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part C Reporting Contact	Data Integrity and Reporting Director		Pearce	Leah		5013478773					lpearce@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Appeals	Clinical Pharmacist		Stephenson	Sarah							sstephenson@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	5016211503				HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Appeals Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida							mvasquez@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	8773721033				HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Application Contact	Executive Director		Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Benefits Contact	VP of TPA Operations		Allen	Kim		5016902985					pharmacysupport@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3304102633					ethan.prunty@medimpact.com	7835 Freedom Avenue NW North		Canton	OH	44720	01/09/2025	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Exceptions Contact	Clinical Pharmacist		Stephenson	Sarah							sstephenson@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	5016211503				HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Exceptions Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida							mvasquez@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	5018596316				HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Price File Contact (Back-up)	Director Reporting and Analytics, Govt Programs		Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/09/2025	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Price File Contact (Optional)	VP of TPA Operations		Allen	Kim		5016902985					pharmacysupport@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Price File Contact (Primary)	Manager Reporting and Analytics, Govt Program		Wentz	Christophe		0000000000					cwentz@elixirsolutions.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/10/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Quality Assurance Contact	Pharmacy Operations Manager		Maxenberger	Melida		5018596316					mvasquez@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Part D Reporting Contact	VP of TPA Operations		Allen	Kim		5016902985					pharmacysupport@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Patient Safety Contact	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Payment Contact	Executive Director		Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Personal Health Record Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Pharmacy Director	Clinical Pharmacist		Stephenson	Sarah		5016211503					sstephenson@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Pharmacy Network Management Contact	Director of Pharmacy Network Administration		Hunt	Brian		8587906229					Brian.hunt@medimpact.com	7835 Freedom Avenue NW North	Suite 201	Canton	OH	44720	01/09/2025	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Pharmacy Network Management Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida		5018596316					mvasquez@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select 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							Todd.Conn@medimpact.com	7835 Freedom Avenue NW North	Suite 201	Canton	OH	44720	01/16/2025	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	8335026756				HMO - Health Maintenance Organization		C	Dallas
H1587	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Operations Manager		Maxenberger	Melida							mvasquez@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active	8773721033				HMO - Health Maintenance Organization		C	Dallas
H1587	Plan Directory Contact for Public Website			Service	Customer		5013721922					info@superiorselectinc.com	500 President Clinton Ave	Suite 212	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Plan to Plan Reconciliation Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	12/28/2023	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Processor Contact	Vice President of TPA Operations		Allen	Kim		5012619573				5013721932	kallen@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Quality Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Reconciliation Contact	CFO/Director of Finance		Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Recovery Audit Contact	CFO/Director of Finance	Mr.	Gable	Alan		5016974560				5013721932	agable@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	SNP Application Contact	Executive Director		Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	SNP State Contact	Executive Director		Lee	Jason	W	5013721922				5013721932	jlee@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Surveillance Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	System Contact	VP of Technical Operations		Harrington	Paige		5019122085					pharrington@accesshealthservices.com	500 President Clinton Ave	Suite 200-A	Little Rock	AR	72202	03/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Third Party Administrator (TPA) Liaison	ASSI Operations Director		Campbell	Brad		5019935269					bcampbell@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	11/07/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	User Access Contact	Medicare Compliance Officer		Morgan	Tara		5019442642				5013721932	tmorgan@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Utilization Management Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1587	Utilization Review Contact	Clinical Director		Stell	Kaitlyn		5016900463					kstell@superiorselectinc.com	500 President Clinton Ave	Suite 200-C	Little Rock	AR	72201	02/21/2024	2026	ARKANSAS SUPERIOR SELECT, INC.	Local CCP	Arkansas Superior Select Health Plans	HMO/HMOPOS		Select Founders, LLC	541	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1607	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/06/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H1607	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H1607	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H1607	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H1607	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H1607	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H1607	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H1607	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/30/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H1608	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H1608	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H1608	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H1608	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H1608	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1608	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H1609	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/30/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H1609	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1609	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (FL)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1610	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	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	Atlanta
H1610	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	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	Atlanta
H1610	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	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	Atlanta
H1610	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	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	Atlanta
H1610	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	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	Atlanta
H1610	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	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	Atlanta
H1610	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	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	Atlanta
H1610	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	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	Atlanta
H1610	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	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	Atlanta
H1610	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	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	Atlanta
H1610	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	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	Atlanta
H1610	CMS Casework Communication Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	04/14/2023	2026	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	Atlanta
H1610	Complaints Tracking Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	04/14/2023	2026	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	Atlanta
H1610	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	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	Atlanta
H1610	Coordination of Benefits Contact	Director of Pharmacy		Stekol	Ilona		3478806082					StekolI@aetna.com	P.O. Box 30017		Pittsburg	PA	152220330	11/18/2025	2026	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	Atlanta
H1610	Corporate Mailing						4107525721				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/01/2020	2026	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	Atlanta
H1610	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		6146537335					PhillipsL1@aetna.com	7400 Campus Road		New Albany	OH	43054	11/18/2025	2026	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	Atlanta
H1610	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H1610	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H1610	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/30/2024	2026	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	Atlanta
H1610	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	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	Atlanta
H1610	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	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	Atlanta
H1610	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	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	Atlanta
H1610	Encounter Data & Risk Adjustment Operations Contact	Director, Informatics		Sevchik	Melissa		6026591404					sevchikm@aetna.com	4750 S. 44th Place		Phoenix	AZ	85040	07/08/2024	2026	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	Atlanta
H1610	Enrollment Contact	Lead Director Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	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	Atlanta
H1610	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H1610	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/30/2022	2026	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	Atlanta
H1610	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	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	Atlanta
H1610	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H1610	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/05/2022	2026	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	Atlanta
H1610	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	06/18/2025	2026	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	Atlanta
H1610	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	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	Atlanta
H1610	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H1610	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	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	Atlanta
H1610	Hospice Contact	Lead Director, Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	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	Atlanta
H1610	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	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	Atlanta
H1610	MA Appeals/Grievances Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	04/14/2023	2026	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	Atlanta
H1610	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	09/06/2023	2026	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	Atlanta
H1610	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	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	Atlanta
H1610	Medical Director	Medical Director		Grandrimo, MD	Danielle		3129658868					GrandrimoD@aetna.com	PO Box 818007		Cleveland	OH	44181	11/27/2025	2026	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	Atlanta
H1610	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	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	Atlanta
H1610	Medicare Coordinator	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	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	Atlanta
H1610	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	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	Atlanta
H1610	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2021	2026	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	Atlanta
H1610	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	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	Atlanta
H1610	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	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	Atlanta
H1610	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	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	Atlanta
H1610	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	Part D Appeals	Supervisor, Clinical Pharmacy	Ms.	Spencer	Tiffane						8772700148	MedicareCoverageDeterminationMMP-SNP@AETNA.com	4750 South 44th Place		Phoenix	AZ	85040	11/18/2025	2026	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	6025589172				HMO - Health Maintenance Organization		C	Atlanta
H1610	Part D Appeals Contact (Secondary)	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	P.O. Box 30017		Pittsburgh	PA	152220330	11/18/2025	2026	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	3478806082				HMO - Health Maintenance Organization		C	Atlanta
H1610	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	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	Atlanta
H1610	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H1610	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H1610	Part D Exceptions Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	P.O. Box 30017		Pittsburgh	PA	152220330	11/18/2025	2026	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	3478806082				HMO - Health Maintenance Organization		C	Atlanta
H1610	Part D Exceptions Contact (Secondary)	Pharmacy Director		Vergil	Gina							Vergilg@aetna.com	7400 West Campus Road		New Albany	OH	43054	01/12/2022	2026	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4026997768				HMO - Health Maintenance Organization		C	Atlanta
H1610	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H1610	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	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	Atlanta
H1610	Part D Quality Assurance Contact	Director, Pharmacy		Stekol	Ilona		3478806082					StekolI@aetna.com	P.O. Box 30017		Pittsburgh	PA	152220330	11/18/2025	2026	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	Atlanta
H1610	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H1610	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H1610	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H1610	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	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	Atlanta
H1610	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	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	Atlanta
H1610	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	P.O. Box 30017		Pittsburgh	PA	152220330	11/18/2025	2026	COVENTRY HEALTH CARE OF VIRGINIA, INC.	Local CCP	Aetna Better Health of Virginia	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H1610	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	06/26/2024	2026	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	Atlanta
H1610	Plan Directory Contact for Public Website	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/08/2025	2026	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	Atlanta
H1610	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	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	Atlanta
H1610	Processor Contact	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	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	Atlanta
H1610	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	01/02/2024	2026	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	Atlanta
H1610	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H1610	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	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	Atlanta
H1610	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H1610	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	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	Atlanta
H1610	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	System Contact	Executive Director, Duals Market Enablement	Ms.	Tanzillo	Hollie	M	7407398501					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	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	Atlanta
H1610	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H1610	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	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	Atlanta
H1610	Utilization Management Contact	AVP, Clinical Health Services		McKenna	Judith		2157758411					mckennaja@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	06/27/2024	2026	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	Atlanta
H1610	Utilization Review Contact	Director Clinical Health Services		Patel	Parul	P	2243633232					patelp12@aetna.com	7400 W. Campus Road		New Albany	OH	43054	01/03/2024	2026	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	Atlanta
H1611	Agent/Broker Compensation Data Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H1611	Automated TrOOP Balance Transfer Contact	Vice President, Business Operations		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Backup User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Best Available Evidence Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Bid Audit Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Bid Primary Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H1611	CAP Report Contact for Public Website	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	CEO - CMS Administrator Contact	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	CEO - Senior Official for Contracting	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Chief Financial Officer	Chief Financial Officer	Ms	Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Chief Operating Officer	Chief Operations Officer	Mr	Mcormick	Mark		8572823180					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Chief Information Officer	Chief Information Officer	Mr	Bundela	Yogi		8572822863					ybundela@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Chief Information Security Officer	Chief Information Security and Privacy Officer	Mr	Tsuchida	Toby		8572823518					ttsuchida@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	CMS Casework Communication Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Complaints Tracking Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Contact for Fraud Investigations	Director, Special Investigation Unit		Roy	Jessica		6179594150					jroy22@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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
H1611	Coordination of Benefits Contact	Manager, Recoveries		Ryan	Cathy		8572829131					cryan17@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Corporate Mailing						8572823348					bbowen1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Customer Service Operations Contact	Director, Customer Services		Armstrong	Carolyn		4134270087					carmstrong6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	DIR Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Discount Program Payment Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Emergency Part D Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Encounter Data & Risk Adjustment Operations Contact	Vice President, Risk Adjustment		Keefe	Kevin		8572826420					kkeefe6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Enrollment Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	EOB Transfer Contact	Manager, Reporting		Devereux	Mary		8472244888				1111111111	mary.devereux@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/05/2025	2026	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
H1611	Financial Audit Contact	Finance Director	Ms.	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Financial Reporting Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Formulary Contact	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	09/23/2025	2026	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
H1611	Formulary Contact (Secondary)	Director of Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	09/23/2025	2026	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
H1611	General Contact	Senior Duals Compliance Program Manager		Perkins	Sarah		7814549116					sperkins4@mgb.org	399 Revolution Dr		Somerville	MA	02145	07/07/2025	2026	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
H1611	Government Relations Contact	Director, Government Affairs		Sullivan	John		8572823376					jsullivan77@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	HIPAA Privacy Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	HIPAA Security Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Hospice Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Interoperability Contact	Vice President, Legal and Regulatory Affairs		Richardson	Stephanie		5087760489					srichardson1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	MA Appeals/Grievances Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	MA Claims Processing Contact for Public Website	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Marketing Contact	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Medical Director	Chief Medical Director	Dr	Yoon	Ed		2074581035					ebyoon@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/03/2025	2026	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
H1611	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Medicare Coordinator	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Drive		Somerville	MA	02145	02/05/2025	2026	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
H1611	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy		Gallagher	Angela		8572823348					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/12/2025	2026	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
H1611	Medication Therapy Management Contact	MTM Contact		Carter	Cimone		7633481324					cimone_carter@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/05/2025	2026	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
H1611	Part C Application Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfunchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Part C Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Part D Appeals	Manager, Prior Authorization Appeals		Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/05/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Boston
H1611	Part D Appeals Contact (Secondary)	Pharmacy Technician Lead		Jackson	Shannon							shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/05/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7633615070				HMO - Health Maintenance Organization		C	Boston
H1611	Part D Application Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H1611	Part D Benefits Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H1611	Part D Claims Submission Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Part D Exceptions Contact	Manager, Prior Authorization Appeals		Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/05/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Boston
H1611	Part D Exceptions Contact (Secondary)	Pharmacy Technician Lead		Jackson	Shannon							shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/05/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	7633615070				HMO - Health Maintenance Organization		C	Boston
H1611	Part D Price File Contact (Back-up)	Senior Business Analyst		Lyman	Dorothy		6514955369					dorothy.lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/05/2025	2026	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
H1611	Part D Price File Contact (Optional)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Part D Price File Contact (Primary)	Director		Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/05/2025	2026	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
H1611	Part D Quality Assurance Contact	Director, Pharmacy		Gallagher	Angela		8572822438					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Part D Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Patient Safety Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Payment Contact	Chief Financial Officer		Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Pharmacy Director	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Pharmacy Network Management Contact	Manager, Retail Network Operations		Perez	Felix		3053313044					felix.perez@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/05/2025	2026	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
H1611	Pharmacy Network Management Contact (Secondary)	Director, Retail Network Operations		Ashby	JoLynn		4696470504					jashby@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/05/2025	2026	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
H1611	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Gallagher	Angela							agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8443688732				HMO - Health Maintenance Organization		C	Boston
H1611	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen							mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8572825333				HMO - Health Maintenance Organization		C	Boston
H1611	Plan Directory Contact for Public Website	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Plan to Plan Reconciliation Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Processor Contact	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Quality Contact	Sr. Director, Clinical Operations		Gargasz	Reagan		2079394468					rgargasz@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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
H1611	Reconciliation Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Recovery Audit Contact	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	SNP Application Contact	VP Dual Eligible Programs		Fulchino	Lisa		8572827469					lfulchino@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/13/2025	2026	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
H1611	SNP State Contact	Senior Duals Compliance Program Manager		Perkins	Sarah		7814549116					sperkins4@mgb.org	399 Revolution Dr		Somerville	MA	02145	07/07/2025	2026	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
H1611	Surveillance Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	System Contact	Director, Business Systems Configuration		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Third Party Administrator (TPA) Liaison	Lead Financial Analyst		Boyadjian	James		2018323300					jboyadjian@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Utilization Management Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1611	Utilization Review Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/05/2025	2026	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
H1619	Agent/Broker Compensation Data Contact	Vice President, Sales		Olmstead	Jim		2158499606					jolmstead@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Automated TrOOP Balance Transfer Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	troop@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Backup User Access Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Best Available Evidence Contact	AVP, Enrollment		Johnson	Chris		2158499606				2159679267	cjohnson@hpplans.com	1101 Market Street	Suite	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Bid Audit Contact	Director, Product Development  & Growth		Fisher	Craig		2158499606					cfisher1@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Bid Audit Site Contact	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market St	STE 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Bid Primary Contact	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market St	STE 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	CAP Report Contact for Public Website	Compliance Officer		Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	CEO - CMS Administrator Contact	President and Senior Official for Contracting	Mrs.	Hoglund	Krista		2158454747					krista.hoglund@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	CEO - Senior Official for Contracting	President and Senior Official for Contracting	Mrs.	Hoglund	Krista		2158454747					krista.hoglund@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Gregory	J	2152873338					gregory.czar@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	06/10/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Chief Operating Officer	Chief Operating Officer	Mr.	McTiernan	Chris		2157797914					cmctiernan@jeffersonhealthplans.com	1101 Market Street	30th Floor	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Chief Information Officer	Vice President, Information Services & Technology	Mr.	Yetter	Mike		2155035110					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Chief Information Security Officer	Vice President, Information Security	Mr.	Odom	Mark		2155032439					Mark.Odom@jefferson.edu	833 Chestnut		Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	CMMI Model Point of Contact	Director, Product Development  & Growth		Fisher	Craig		2159914090					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	CMS Casework Communication Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2159914023					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Complaints Tracking Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2158499606					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Contact for Fraud Investigations	Director, SIU		Sondergaard	Christian		2159914046					csondergaard@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Coordination of Benefits Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	cob@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Corporate Mailing						2158499606				2155921034	jbaker@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Customer Service Operations Contact	General Manager, Health Plan Operations		Dans	Kim		2158499606					kdans@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	DIR Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					DIR@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	DIR Contact (Secondary)	Director Actuarial Services		Rudi	Brian		2159914077					brudi@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Discount Program Payment Contact	Manager, Pharmacy Regulations and Implementations		McCaffrey	Hannah		2159657142				2159679263	hlivengood@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	09/02/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Emergency Part D Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	rvangala@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Emergency Part D Contact (Secondary)	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					pharmacymedicare@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Encounter Data & Risk Adjustment Operations Contact	Director, Encounter Data Reporting		Raupp	Mike		2158499606					mraupp@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Enrollment Contact	AVP, Enrollment		Johnson	Chris		2158499606					cjohnson@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	EOB Transfer Contact	AVP, Claims		McConaghy	Sandy		2158499606				2159679261	smcconaghy@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Financial Audit Contact	Chief Financial Officer	Mr.	Czar	Gregory	J	2152873338					gregory.czar@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	10/13/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Financial Reporting Contact	Vice President, Finance	Mr.	Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Formulary Contact	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					Formulary@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Formulary Contact (Secondary)	Formulary Pharmacist		Vaisberg	Fallan		2158499606					fvaisberg@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	General Contact	AVP Compliance		Bellito	Lisa		2159914090					lbellito@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Government Relations Contact	SVP, Government Affairs		Jones	Kearline		2158499606					kdjones@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	HIPAA Privacy Officer	Manager, Privacy		Dahiya	Prerna		2158499606					pdahiya@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	HIPAA Security Officer	Manager, Privacy		Dahiya	Prerna		2158499606					pdahiya@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Hospice Contact	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					pharmacymedicare@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Interoperability Contact	Vice President, Health Plan Systems		Yetter	Michael		2152729971					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	MA Appeals/Grievances Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2158499606					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	MA Claims Processing Contact for Public Website	AVP, Claims		McConaghy	Sandy		2158499606					smcconaghy@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Marketing Contact	Director, Marketing Communications		Grzyb	Sarah		2158499606					sgrzyb@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Medical Director	Senior Medical Director		Harris-Williams	Merleen		2158499606					mhwilliams@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Medicare Compliance Officer	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Medicare Coordinator	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Medicare Part D Opioid Overutilization Contact	Clinical Programs Pharmacist		Olchowecky	Kateryna		2158499606				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Medication Therapy Management Contact	Director, Pharmacy Services		Dolores	Danielle		2158499606				2159679270	MTM@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	OffShore Subcontractor Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Support		Polkus	Megan		2159674561					mpolkus@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Online Enrollment Center Contact (Primary)	AVP, Enrollment		Johnson	Chris		2158499606				2159679267	cjohnson@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part C Application Contact			Fisher	Craig		2159914090					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part C Reporting Contact			Fisher	Craig		2159914077					cfisher1@jeffersonhealthplans.com	1101 Market Street		Philadephia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part D Appeals	Manager, Complaints, Grievances and Appeals		Watkins	Leah							Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	2159914023				PPO - BBA		C	Chicago
H1619	Part D Appeals Contact (Secondary)	Supervisor, Complaints, Grievances and Appeals		Rostovskis	Tara							trostovskis@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	2673853491				PPO - BBA		C	Chicago
H1619	Part D Application Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part D Benefits Contact			Fisher	Craig		2159914077					cfisher1@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part D Claims Submission Contact	Manager, Pharmacy Benefit Design and Audit		Chan	Kay		2159914197				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part D Exceptions Contact	Director, Pharmacy Services		Dolores	Danielle						8663713239	Exceptions@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	2159914329				PPO - BBA		C	Chicago
H1619	Part D Price File Contact (Back-up)	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2159657142					Formulary@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part D Price File Contact (Primary)	Manager, Pharmacy Benefit Design and Audit		Chan	Kay		2159914197				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part D Quality Assurance Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					rvangala@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Part D Reporting Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					DIR@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Patient Safety Contact	Director, Pharmacy Services		Dolores	Danielle		2159914329					ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Payment Contact	Vice President, Finance		Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Pharmacy Director	Director, Pharmacy Services		Dolores	Danielle		2159914328				8663713239	ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Pharmacy Network Management Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	Pharmacynetwork@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Services		Dolores	Danielle		2159914329				8663713239	ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Pharmacy Technical Help Desk Contact	Director, Pharmacy Services		Dolores	Danielle						2159679270	Formulary@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	8666934620				PPO - BBA		C	Chicago
H1619	Pharmacy Technical Help Desk Contact (Secondary)	Supervisor Pharmacy Technician		Mahler	Brandi						2159679270	bmahler@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	8666934620				PPO - BBA		C	Chicago
H1619	Plan Directory Contact for Public Website	Director, Marketing Communications		Grzyb	Sarah		6098657999					sgrzyb@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Plan to Plan Reconciliation Contact	Pharmacy Regulatory Business Coordinator		Rutledge-Glazov	Rose	A	2159657142				2159679263	P2P@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Processor Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	rvangala@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Quality Contact	AVP Quality Improvement & Performance		Mullen	Alyssa		6095054006					amullen@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Reconciliation Contact	Vice President, Finance		Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Reconciliation Contact (Secondary)	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	DIR@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Recovery Audit Contact	SVP, Health Care Data Analytics	Mrs.	Potts	Carol		2158499606					cpotts@hpplans.com	1101 Market Street	Suite	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	SNP Application Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	SNP State Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Surveillance Contact	Vice President, Sales		Olmstead	Jim		7176093994					jolmstead@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	System Contact	Vice President, Health Plan Systems		Yetter	Michael		2152729971					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Third Party Administrator (TPA) Liaison	Manager, Pharmacy Regulations and Implementations		McCaffrey	Hannah		2159657142				2159679263	hlivengood@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	09/02/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	User Access Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Utilization Management Contact	Interim VP, Medical Management		Sinni	Jennifer		2158454757					jmsinni@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1619	Utilization Review Contact	Interim VP, Medical Management		Sinni	Jennifer		2158454757					jmsinni@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H1622	Automated TrOOP Balance Transfer Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Backup User Access Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Bid Primary Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	CAP Report Contact for Public Website	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	CEO - CMS Administrator Contact	President and CEO	Mr.	Chan	Eddie		4153919686					Eddie.Chan@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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	CEO - Senior Official for Contracting	President and CEO	Mr.	Chan	Eddie		4153919686					Eddie.Chan@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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		4153919686					Johnson.Wong@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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 Operating Officer	Chief Operating Officer	Ms.	Koh	Rachel		4153919686	5926				rachel.koh@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	08/06/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Athuluri	Murali		4153919686					Murali.Athuluri@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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 Information Security Officer	Chief Information Officer	Mr.	Athuluri	Murali		4153919686					Murali.Athuluri@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Complaints Tracking Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Contact for Fraud Investigations	Privacy and Compliance Officer		Lim	Rebecca		4153525105					Rebecca.Lim@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	11/30/2022	2026	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		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Corporate Mailing						4153919686					Diana.Kawasaki-Yee@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	09/25/2020	2026	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		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	DIR Contact	Accounting Manager		Yu	Lucy		4153919686	7772				lucy.yu@nems.org	2171 Junipero Serra	Suite 260	Daly City	CA	94014	02/22/2024	2026	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	DIR Contact (Secondary)	Accounting Supervisor II		Zhen	Yunice		4153919686	7776				yunice.zhen@nems.org	2171 Junipero Serra Blvd	Suite 260	Daly City	CA	94014	02/22/2024	2026	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	Discount Program Payment Contact	Accounting Manager		Yu	Lucy		4153919686	7772				lucy.yu@nems.org	2171 Junipero Serra Blvd	Suite 260	Daly City	CA	94133	02/22/2024	2026	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	Emergency Part D Contact	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street		San Francisco	CA	94133	01/06/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	CMCO		Tang	Linda		4153525048					Linda.Tang@nems.org	2171 Junipero Serra		Daly City	CA	94014	11/30/2022	2026	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	Enrollment Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	EOB Transfer Contact	PACE Program Director		Bernet	Janet		4153919686	5934			4152404352	janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Financial Audit Contact	Accounting Manager	Ms.	Yu	Lucy		4153919686					Lucy.Yu@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	09/26/2024	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Wong	Johnson		4153919686					Johnson.Wong@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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	Formulary Contact	Director of Pharmacy		Chan	Beverley		4153525031					Beverley.Chan@nems.org	2171 Junipero Serra		Daly City	CA	94014	02/24/2021	2026	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	General Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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		4153525105					Rebecca.Lim@nems.org	2171 Junipero Serra	Suite 300	Daly City	CA	94014	02/25/2021	2026	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	HIPAA Privacy Officer	Privacy and Compliance Officer		Lim	Rebecca		4153525105					Rebecca.Lim@nems.org	2171 Junipero Serra	Suite 300	Daly City	CA	94014	02/18/2021	2026	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	HIPAA Security Officer	Privacy and Compliance Officer		Lim	Rebecca		4153525105					Rebecca.Lim@nems.org	2171 Junipero Serra	Suite 300	Daly City	CA	94014	02/18/2021	2026	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	Interoperability Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	MA Appeals/Grievances Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	MA Claims Processing Contact for Public Website	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Marketing Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Medical Director	PACE Medical Director	Dr.	Li	David		4153919686	5890				David.Li@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	10/17/2024	2026	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		4153525105					Rebecca.Lim@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	02/18/2021	2026	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 Coordinator	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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 Part D Opioid Overutilization Contact	Director of Pharmacy		Chan	Beverley		4153525031					Beverley.Chan@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	02/24/2021	2026	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	Medication Therapy Management Contact	Director of Pharmacy		Chan	Beverley		4153525031					Beverley.Chan@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	02/24/2021	2026	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 C Application Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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 Appeals	Pharmacist		Kwok	Calvin							calvin.kwok@nems.org	1520 Stockton Street #604		San Francisco	CA	94133	02/24/2021	2026	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	4153525120				PACE - Nat		C	San Francisco
H1622	Part D Appeals Contact (Secondary)	PACE Program Director		Bernet	Janet							janet.bernet@nems.org	728 Pacific Ave	2nd Floor	San Francisco	CA	94133	11/08/2022	2026	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	4153919686	5934			PACE - Nat		C	San Francisco
H1622	Part D Application Contact	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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 Benefits Contact	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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 Claims Submission Contact	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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	2026	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	4153525120				PACE - Nat		C	San Francisco
H1622	Part D Exceptions Contact (Secondary)	Director of Pharmacy		Chan	Beverley							beverley.chan@nems.org	2171 Junipero Serra		Daly City	CA	94014	02/24/2021	2026	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	4153525031				PACE - Nat		C	San Francisco
H1622	Part D Price File Contact (Back-up)	Director of Pharmacy		Chan	Beverley		4153525031					beverley.chan@nems.org	2171 Junipero Serra		Daly City	CA	94014	02/24/2021	2026	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 Price File Contact (Primary)	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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 Quality Assurance Contact	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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 Reporting Contact	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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	Patient Safety Contact	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/25/2021	2026	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	Payment Contact	Accounting Manager		Yu	Lucy		4153919686	7772				lucy.yu@nems.org	2171 Junipero Serra	Suite 260	Daly City	CA	94014	02/22/2024	2026	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 Director	Director of Pharmacy		Chan	Beverley		4153525031					Beverley.Chan@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	02/24/2021	2026	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 Network Management Contact	Director of Pharmacy		Chan	Beverley		4153525031					beverley.chan@nems.org	2171 Junipero Serra		Daly City	CA	94014	02/24/2021	2026	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 Network Management Contact (Secondary)	Pharmacist		Kwok	Calvin		4153525120					calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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	2026	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	4153525031				PACE - Nat		C	San Francisco
H1622	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacist		Kwok	Calvin							calvin.kwok@nems.org	1520 Stockton Street, #604		San Francisco	CA	94133	02/24/2021	2026	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	4153525120				PACE - Nat		C	San Francisco
H1622	Plan Directory Contact for Public Website	CMCO		Tang	Linda		4153525048					Linda.Tang@nems.org	2171 Junipero Serra		Daly City	CA	94014	11/30/2022	2026	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	Plan to Plan Reconciliation Contact	Accounting Manager		Yu	Lucy		4153919686	7772				lucy.yu@nems.org	2171 Junipero Serra Blvd	Suite 260	Daly City	CA	94014	02/22/2024	2026	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	Processor Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Quality Contact	QI Coordinator		Chang	Claire		4153525050					Claire.Chang@nems.org	728 Pacific Ave	2nd Floor	San Francisco	CA	94133	10/17/2024	2026	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	Reconciliation Contact	Accounting Manager		Yu	Lucy		4153919686	7772				lucy.yu@nems.org	2171 Junipero Serra Blvd	Suite 260	Daly City	CA	94014	02/22/2024	2026	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	Reconciliation Contact (Secondary)	Accounting Supervisor II		Zhen	Yunice		4153919686	7776				yunice.zhen@nems.org	2171 Junipero Serra Blvd	Suite 260	Daly City	CA	94014	02/22/2024	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Wong	Johnson		4153919686					Johnson.Wong@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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	Surveillance Contact	Chief Financial Officer	Mr.	Wong	Johnson		4153919686					Johnson.Wong@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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	System Contact	Chief Financial Officer	Mr.	Wong	Johnson		4153919686					Johnson.Wong@nems.org	2171 Junipero Serra	Suite 700	Daly City	CA	94014	12/21/2023	2026	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	Third Party Administrator (TPA) Liaison	Accounting Manager		Yu	Lucy		4153919686	7772				Lucy.Yu@nems.org	2171 Junipero Serra	Suite 260	Daly City	CA	94014	12/31/2024	2026	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	User Access Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Utilization Management Contact	CMCO		Tang	Linda		4153525048					Linda.Tang@nems.org	2171 Junipero Serra		Daly City	CA	94014	11/30/2022	2026	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	Utilization Review Contact	PACE Program Director		Bernet	Janet		4153919686	5934				janet.bernet@nems.org	728 Pacific Avenue	2nd Floor	San Francisco	CA	94133	02/03/2022	2026	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	Agent/Broker Compensation Data Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Automated TrOOP Balance Transfer Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Backup User Access Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Best Available Evidence Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Bid Audit Contact			Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Bid Audit Site Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Bid Primary Contact		Mr.	Granow	Les		5614440709					Les.Granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	CAP Report Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	CEO - CMS Administrator Contact		Mr.	Lerer	Ben		5614440780					Ben.lerer@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H1644	CEO - Senior Official for Contracting		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Chief Financial Officer		Mr.	Granow	Les		5614440709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Chief Operating Officer		Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Chief Information Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Chief Information Security Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	CMS Casework Communication Contact			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Complaints Tracking Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Contact for Fraud Investigations			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Coordination of Benefits Contact		Ms.	Crowl	Lacey		7657921412					Lacey.crowl@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Corporate Mailing						5616901134					compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Customer Service Operations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	DIR Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H1644	DIR Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Discount Program Payment Contact		Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	Longevity Health Plan	485 Madison Avenue Suite 202	New York	NY	10022	05/30/2025	2026	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	Seattle
H1644	Electronic Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Emergency Part D Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Emergency Part D Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Encounter Data & Risk Adjustment Operations Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Enrollment Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	EOB Transfer Contact		Ms.	Socoski	Beth		5616901134				5616901134	Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Financial Audit Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Financial Reporting Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Formulary Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Formulary Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	General Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Government Relations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	HIPAA Privacy Officer	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	HIPAA Security Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Hospice Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Interoperability Contact	CIO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	MA Appeals/Grievances Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	MA Claims Processing Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Marketing Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Medical Director		Mr.	Orgain	Javette		3127206656					javette.orgain@longevityhealthplan.com	Longevity Health Plan	1611 Church Street	Evanston	IL	60201	05/30/2025	2026	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	Seattle
H1644	Medicare Compliance Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Medicare Coordinator	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Medicare Part D Opioid Overutilization Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Medication Therapy Management Contact		Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	OffShore Subcontractor Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part C Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part C Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H1644	Part D Appeals Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H1644	Part D Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part D Benefits Contact		Mr.	Latko	Jeff		6363352997					JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H1644	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		8002040016					Rosario_dovico@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H1644	Part D Exceptions Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H1644	Part D Price File Contact (Back-up)	Product Manager Advisor	Ms.	Williams	Stephanie		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part D Price File Contact (Optional)	Medicare Compliance Director	Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part D Price File Contact (Primary)	sr mgr, Government Programs		Dolfi	Amanda		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part D Quality Assurance Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Part D Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Patient Safety Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Payment Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Personal Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Pharmacy Director	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		8002040016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Pharmacy Network Management Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						8882358551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H1644	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Account Manager	Ms.	Lennox	Melyssa							Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF FLORIDA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H1644	Physician Incentive Contact		Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Plan Directory Contact for Public Website	Medicare Compliance Director	Ms.	Socoski	Beth		8883133609					Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Plan to Plan Reconciliation Contact		Ms.	Ajayi	Bisi		5616328915					bisi.ajayi@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Processor Contact		Mr.	Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Quality Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Reconciliation Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Reconciliation Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Recovery Audit Contact	VP Compliance	Ms.	Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	SNP Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	SNP State Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Surveillance Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	System Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Third Party Administrator (TPA) Liaison	COO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	User Access Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Utilization Management Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1644	Utilization Review Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H1651	Agent/Broker Compensation Data Contact	Medicare Compliance Analyst		Digmann	Jodi		5635568070	4836			5635565134	jdigmann@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Backup User Access Contact	Manager of Regulatory Affairs and QI		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	10/08/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Bid Primary Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	CAP Report Contact for Public Website	Manager of Regulatory Affairs and QI		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	CEO - CMS Administrator Contact	CEO	Mr.	Keeling	Zachary		5635568070					zkeeling@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Keeling	Zachary		5635568070				5635565134	zkeeling@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Chief Financial Officer	Director of Finance	Ms.	Robson	Lynee		5635844773					lrobson@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Chief Operating Officer	Chief Operating Officer	Ms	Oishi	Nicole		5635568070				5635565134	noishi@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	02/13/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Chief Information Officer	Director of Information Technology	Mr.	Wulfekuhle	Jeremy		5635844000					jwulfekuhle@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Chief Information Security Officer	Director of Information Technology	Mr.	Wulfekuhle	Jeremy		5635844000					jwulfekuhle@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	CMS Casework Communication Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Complaints Tracking Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Contact for Fraud Investigations	Manager of Regulatory Affairs and QI	Ms.	Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Corporate Mailing						5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Cost Report Contact	Director of Finance		Cook	Elizabeth		5635568070	4751			5635565134	lcook@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Customer Service Operations Contact	Member Services Supervisor		Boge	Laura		5695568070	4857			5695565134	lboge@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Encounter Data & Risk Adjustment Operations Contact	Claims Manager		Simmons	Sherie		5635568070					ssimmons@maheatlcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Enrollment Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	EOB Transfer Contact	Claims Manager		Simmons	Sherie		5635568070	4825			5635565134	ssimmons@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Financial Reporting Contact	Director of Finance		Robson	Lynee		5635843000					lrobson@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	General Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635568070	4836			5635565134	jdigmann@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Government Relations Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Interoperability Contact	Medicare Compliance Analyst		Digmann	Jodi		5635568070					jdigmann@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	MA Appeals/Grievances Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	MA Claims Processing Contact for Public Website	Claims Manager		Simmons	Sherie		5635568070	4825			5635565134	ssimmons@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Marketing Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Medical Director	Interim Chief Medical Officer	Dr.	Sullivan	Brian		5635843000				5635565134	bsullivan@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Medicare Compliance Officer	Manager of Regulatory Affairs and QI	Mr.	Walters	Richard		5635568070	4864			5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Medicare Coordinator	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Part C Application Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Part C Reporting Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Payment Contact	Director of Finance		Robson	Lynee		5635843000					lrobson@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Plan Directory Contact for Public Website	Marketing Specialist		Backhaus	Matt		5635568070	4844			5635565134	mbackhaus@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Quality Contact	MAHP Quality Improvement		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Surveillance Contact	Manager of Regulatory Affairs and QI		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	System Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	User Access Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	03/26/2024	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Utilization Management Contact	Health Care Services Manager		Wedewer	Krystal		5635568070				5635565134	kwedewer@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	02/13/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1651	Utilization Review Contact	Health Care Services Manager		Wedewer	Krystal		5635568070				5635565134	kwedewer@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	02/13/2025	2026	MEDICAL ASSOCIATES HEALTH PLAN, INC.	1876 Cost	Medical Associates Health Plan, Inc.	1876 Cost		Medical Associates Clinic, P.C.	156	No	Active					Cost1		1	Atlanta
H1659	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H1659	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1659	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1659	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H1659	Plan Directory Contact for Public Website			Customer Service	UHC		8662721967					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1659	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1664	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	09/08/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H1664	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H1664	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H1664	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H1664	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H1664	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/02/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H1664	PHR Beneficiary Contact																	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H1664	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1664	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	HOME STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1666	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/26/2025	2026	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	Chicago
H1666	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H1666	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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	Chicago
H1666	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H1666	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Chicago
H1666	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Chicago
H1666	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Chicago
H1666	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H1666	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H1666	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H1666	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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	Chicago
H1666	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H1666	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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	Chicago
H1666	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	Chicago
H1666	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H1666	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Chicago
H1666	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H1666	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	Chicago
H1666	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	Chicago
H1666	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H1666	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Chicago
H1666	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Chicago
H1666	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H1666	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/29/2025	2026	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	Chicago
H1666	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Chicago
H1666	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H1666	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Chicago
H1666	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Chicago
H1666	Formulary Contact	Director Pharmacy Medicare	Mr	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Chicago
H1666	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	Chicago
H1666	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H1666	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/26/2025	2026	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	Chicago
H1666	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2026	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	Chicago
H1666	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/29/2025	2026	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	Chicago
H1666	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	Chicago
H1666	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H1666	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Chicago
H1666	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/29/2025	2026	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	Chicago
H1666	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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	Chicago
H1666	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H1666	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Chicago
H1666	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	Chicago
H1666	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H1666	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Chicago
H1666	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H1666	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H1666	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	Part D Appeals	Regulatory Pharmacist Sr	Mr	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H1666	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H1666	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H1666	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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	Chicago
H1666	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	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	Chicago
H1666	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H1666	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H1666	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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	Chicago
H1666	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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	Chicago
H1666	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H1666	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H1666	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Chicago
H1666	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H1666	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/26/2025	2026	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	Chicago
H1666	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H1666	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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	Chicago
H1666	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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	Chicago
H1666	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8772777898				PPO - BBA		C	Chicago
H1666	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of NM, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	0000000000				PPO - BBA		C	Chicago
H1666	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	09/21/2018	2026	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	Chicago
H1666	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/29/2025	2026	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	Chicago
H1666	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Chicago
H1666	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/26/2025	2026	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	Chicago
H1666	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H1666	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Chicago
H1666	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/29/2025	2026	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	Chicago
H1666	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H1666	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H1666	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/26/2025	2026	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	Chicago
H1666	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/26/2025	2026	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	Chicago
H1666	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Chicago
H1666	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Chicago
H1666	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Chicago
H1666	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Chicago
H1671	Agent/Broker Compensation Data Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Automated TrOOP Balance Transfer Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Backup User Access Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Best Available Evidence Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Bid Audit Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Bid Audit Site Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Bid Primary Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	CAP Report Contact for Public Website	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active	8884841412				HMO - Health Maintenance Organization		C	Dallas
H1671	CEO - CMS Administrator Contact	Chief Executive Office	Mr.	Lewis	Lawrence		7603326447	101				llewis@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	CEO - Senior Official for Contracting	Chief Executive Office	Mr.	Lewis	Lawrence		7603326447	101				llewis@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Chief Financial Officer	Chief Financial Officer	Mr.	Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Chief Operating Officer	Chief Operating Officer	Ms	Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Chief Information Officer	Chief Financial Officer	Mr.	Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Chief Information Security Officer	Chief Financial Officer	Mr.	Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	CMMI Model Point of Contact			Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	CMS Casework Communication Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Complaints Tracking Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Contact for Fraud Investigations	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Coordination of Benefits Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Corporate Mailing						7603326447					compliance@chpiv.org	512 W Aten Rd		Imperial	CA	92251	01/15/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Customer Service Operations Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	DIR Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	DIR Contact (Secondary)	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten RD		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Discount Program Payment Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Electronic Health Record Contact	Executive Director of Health Services		Crenshaw	Jeanette		7603326447	155				jcrenshaw@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Emergency Part D Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Emergency Part D Contact (Secondary)	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Employer Waiver Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Enrollment Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	EOB Transfer Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151			7605635187	etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Financial Audit Contact	Chief Financial Officer	Mr.	Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Financial Reporting Contact	Chief Financial Officer	Mr.	Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Formulary Contact	Executive Director of Health Services		Crenshaw	Jeanette		7603326447	155				jcrenshaw@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Formulary Contact (Secondary)	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	General Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Government Relations Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	HIPAA Privacy Officer	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	HIPAA Security Officer	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Hospice Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Interoperability Contact	Chief Financial Officer		WIlson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	MA Appeals/Grievances Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	MA Claims Processing Contact for Public Website	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Marketing Contact	Manager of Medicare Sales and Retention		Ramirez	Michelle		7603326447	116				mramirez@chpiv.org	512 W Aten Rd		Imperial	CA	92251	10/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Medical Director	Chief Medical Officer		Arakawa	Gordon		7603326447	103				garakawa@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Medicare Coordinator	Chief of Staff		O'campo	Daniel		7603326447	111				docampo@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Medicare Part D Opioid Overutilization Contact	Executive Director of Health Services		Crenshaw	Jeanette		7603326447	155				jcrenshaw@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Medication Therapy Management Contact	Executive Director of Health Services		Crenshaw	Jeanette		7603326447	155				jcrenshaw@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Online Enrollment Center Contact (Back-up)	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Online Enrollment Center Contact (Primary)	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part C Application Contact	Chief Operating Officer		Hutchins	Julia		7603226447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part C Reporting Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Appeals	Chief Compliance Officer		Tarabola	Elysse							etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active	8884841412				HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Appeals Contact (Secondary)	Chief Operating Officer		Hutchins	Julia							jhutchins@chpiv.org	512 W Aten Rd		imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active	8884841412				HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Application Contact	Chief Operating Officer	Ms	Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Benefits Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Claims Submission Contact	Chief Financial Officer		WIlson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Exceptions Contact	Chief Medical Officer		Arakawa	Gordon							garakawa@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active	8884841412				HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Exceptions Contact (Secondary)	Executive Director of Health Services		Crenshaw	Jeanette							jcrenshaw@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active	8884841412				HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Price File Contact (Back-up)	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Price File Contact (Optional)	Chief Operating Officer		Hutchins	Julia	R	7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Price File Contact (Primary)	Chief Financial Officer		WIlson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Quality Assurance Contact	Chief Medical Officer		Arakawa	Gordon		7603326447	103				garakawa@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Part D Reporting Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Patient Safety Contact	Chief Medical Officer		Arakawa	Gordon		7603326447	103				garakawa@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Payment Contact	Chief Financial Officer		WIlson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Personal Health Record Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Pharmacy Director	Chief Medical Officer		Arakawa	Gordon		7603326447	103				garakawa@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Pharmacy Network Management Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Pharmacy Network Management Contact (Secondary)	Chief Of Staff		O'campo	Daniel		7603326447	111				docampo@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Pharmacy Technical Help Desk Contact	Chief Operating Officer		Hutchins	Julia							jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active	8884841412				HMO - Health Maintenance Organization		C	Dallas
H1671	Pharmacy Technical Help Desk Contact (Secondary)	Chief Compliance Officer		Tarabola	Elysse							etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active	8884841412				HMO - Health Maintenance Organization		C	Dallas
H1671	Physician Incentive Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Plan Directory Contact for Public Website	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Plan to Plan Reconciliation Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Processor Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Quality Contact	Chief Medical Officer		Arakawa	Gordon		7603326447	103				garakawa@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Reconciliation Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Reconciliation Contact (Secondary)	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Recovery Audit Contact	Chief Compliance Officer	Ms.	Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	SNP Application Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	SNP State Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Surveillance Contact	Chief Compliance Officer		Tarabola	Elysse		7603326447	151				etarabola@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	System Contact	Chief Financial Officer		Wilson	David		7603326447	153				dwilson@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Third Party Administrator (TPA) Liaison	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/18/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	User Access Contact	Chief Operating Officer		Hutchins	Julia		7603326447	154				jhutchins@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Utilization Management Contact	Executive Director of Health Services		Crenshaw	Jeanette		7603326447	155				jcrenshaw@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1671	Utilization Review Contact	Executive Director of Health Services		Crenshaw	Jeanette		7603326447	155				jcrenshaw@chpiv.org	512 W Aten Rd		Imperial	CA	92251	04/17/2025	2026	IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	Local CCP	Community Health Plan of Imperial Valley	HMO/HMOPOS		IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	866	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1685	Automated TrOOP Balance Transfer Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	1035 Placer Street		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Backup User Access Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Best Available Evidence Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Bid Primary Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	1035 Placer Street		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	CAP Report Contact for Public Website	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending	5302465710				PACE - Nat		C	San Francisco
H1685	CEO - CMS Administrator Contact	CEO	Mr	Thornock	Brandon		5302295074					bthornock@shastahealth.org	1035 Placer Street		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	CEO - Senior Official for Contracting	CEO	Mr	Thornock	Brandon		5302295074					bthornock@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Chief Financial Officer	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Chief Operating Officer	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Chief Information Officer	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Chief Information Security Officer	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	CMS Casework Communication Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Complaints Tracking Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Contact for Fraud Investigations	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Coordination of Benefits Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Corporate Mailing						5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Customer Service Operations Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	DIR Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Discount Program Payment Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Emergency Part D Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Encounter Data & Risk Adjustment Operations Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Enrollment Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	EOB Transfer Contact	CFO	Mr	Santi	Daniel		5302465779				5302465779	dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Financial Audit Contact	CFO	Mr	Santi	Daniel		5302465779				5302465779	dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Financial Reporting Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Formulary Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	General Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Government Relations Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	HIPAA Privacy Officer	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	HIPAA Security Officer	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Interoperability Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	MA Appeals/Grievances Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	MA Claims Processing Contact for Public Website	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Marketing Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Medical Director	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Medicare Compliance Officer	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Medicare Coordinator	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Medicare Part D Opioid Overutilization Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Medication Therapy Management Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part C Application Contact	CEO	Mr	Thornock	Brandon		5302295074					bthornock@shastahealth.org	1035 Placer Street		Redding	CA	96002	03/11/2025	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part D Appeals	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa							tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending	5302465710				PACE - Nat		C	San Francisco
H1685	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Boulevard, Suite 140		Columbia	SC	29209	10/30/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part D Benefits Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part D Claims Submission Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part D Exceptions Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa							tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending	5302465710				PACE - Nat		C	San Francisco
H1685	Part D Price File Contact (Back-up)	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part D Price File Contact (Primary)	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part D Quality Assurance Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Part D Reporting Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Patient Safety Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Payment Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Pharmacy Director	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Pharmacy Network Management Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Pharmacy Technical Help Desk Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa							tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending	5302465710				PACE - Nat		C	San Francisco
H1685	Plan Directory Contact for Public Website	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Plan to Plan Reconciliation Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Processor Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Quality Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Reconciliation Contact	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Recovery Audit Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Surveillance Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	System Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Third Party Administrator (TPA) Liaison	CFO	Mr	Santi	Daniel		5302465779					dsanti@shastahealth.org	2781 Churn Creek Road		Redding	CA	96002	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	User Access Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Utilization Management Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1685	Utilization Review Contact	Chief Strategy and Communications Officer	Mrs	Blanco	Theresa		5302465710					tblanco@shastahealth.org	1035 Placer Street		Redding	CA	96001	12/16/2024	2026	SHASTA COMMUNITY HEALTH CENTER	National PACE	Shasta Community Health Center	National PACE		Shasta Community Health Center	863	Yes	Pending					PACE - Nat		C	San Francisco
H1692	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/27/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H1692	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1692	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H1693	Automated TrOOP Balance Transfer Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Backup User Access Contact	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	08/07/2024	2026	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	Business Development Director and Center Manager		Yousif	Omar		6199524089					omary@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	04/18/2025	2026	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	Bid Primary Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	CAP Report Contact for Public Website	CFO		Roman	Ricardo		6199064603					ricardor@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Ms,	Butler-Cohen	Fran		6195152301					fran@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms,	Butler-Cohen	Fran		6195152301					fran@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2026	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		6199064603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2026	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 Operating Officer	VP PACE and Older Adults	Ms.	Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	08/07/2024	2026	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 Information Officer	CIO	Mr.	Kharodh	Harry		6195152378					harryk@fhcsd.org	5160 Federal Blvd		San Diego	CA	92105	06/12/2023	2026	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 Information Security Officer	CIO	Mr.	Kharodh	Harry		6195152378					harryk@fhcsd.org	5160 Federal Blvd		San Diego	CA	92105	06/12/2023	2026	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	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Complaints Tracking Contact	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Contact for Fraud Investigations	Chief Financial Officer		Roman	Ricardo		6199064603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2026	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	Business Development Director and Center Manager		Yousif	Omar		6199524089					omary@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	04/18/2025	2026	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	Corporate Mailing						6195152300					PACE@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2026	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	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	DIR Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	DIR Contact (Secondary)	Sr. Director of Finance		Schlagenhaft	George		6195152300	2465				georges@fhcsd.org	823 Gateway Ct Way		San Diego	CA	92102	02/11/2025	2026	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	Discount Program Payment Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Emergency Part D Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Emergency Part D Contact (Secondary)	Sr. Director of Finance		Schlagenhaft	George		6195152300	2465				georges@fhcsd.org	823 Gateway Ct Way		San Diego	CA	92102	02/11/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Associate Director, Billing and Compliance		Harford	Rochelle		6195152564	4384				rochelleh@fhcsd.org	823 Gateway Ct Way		San Diego	CA	92102	08/07/2024	2026	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	Enrollment Contact	Business Development Director and Center Manager		Yousif	Omar		6199524089					omary@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	04/18/2025	2026	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	EOB Transfer Contact	Healthcare Claims Specialist		Espinoza	Ashley		4422220780				6192690687	ashleyro@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Financial Audit Contact	Compliance Manager, PACE	Ms.	Del Castillo	Larisa		7608267223					larisad@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/11/2025	2026	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	Financial Reporting Contact	Chief Financial Officer		Roman	Ricardo		6199064603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/11/2025	2026	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	Formulary Contact	Director, Pharmacy Services		Allahwerdy	Fady		6195158675	7016				fadya@fhcsd.org	3420 College Ave		San Diego	CA	92115	02/11/2025	2026	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	Formulary Contact (Secondary)	Assistant Medical Director PACE	Dr.	Tabarsi	Hooman		6195152445					hoomant@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	06/12/2023	2026	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	General Contact	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	HIPAA Privacy Officer	Senior VP and General Counsel		Baker	Donna		6165152457					donnab@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2026	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	HIPAA Security Officer	CIO	Mr.	Kharodh	Harry		6195152378					harryk@fhcsd.org	5160 Federal Blvd		San Diego	CA	92105	02/11/2025	2026	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	Interoperability Contact	CIO	Mr.	Kharodh	Harry		6195152378					harryk@fhcsd.org	5160 Federal Blvd		San Diego	CA	92105	02/11/2025	2026	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	MA Appeals/Grievances Contact	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	MA Claims Processing Contact for Public Website	Healthcare Claims Specialist		Espinoza	Ashley		4422220780	4384				ashleyro@fhcsd.org	823 Gateway Ct Way		San Diego	CA	92102	02/11/2025	2026	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	Marketing Contact	Business Development Director and Center Manager		Yousif	Omar		6199524089					omary@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	04/18/2025	2026	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	Medical Director	Medical Director	Dr.	Tabarsi	Hooman		6195152445					hoomant@fhcsd.org	3420 College Ave		San Diego	CA	92115	12/29/2021	2026	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	Compliance Manager, PACE	Ms.	Del Castillo	Larisa		7608267223					larisad@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/11/2025	2026	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 Coordinator	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist Specialist		Allahwerdy	Fady		6195158675	7016				fadya@fhcsd.org	3420 College Ave		San Diego	CA	92115	02/11/2025	2026	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	Medication Therapy Management Contact	Clinical Pharmacist Specialist		Allahwerdy	Fady		6195158675	7016				fadya@fhcsd.org	3420 College Ave		San Diego	CA	92115	02/11/2025	2026	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	Online Enrollment Center Contact (Primary)	Business Development Director and Center Manager		Yousif	Omar		6199524089					omary@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	04/18/2025	2026	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 C Application Contact	PACE Benefit Plans Specialist		Rodriguez	Sasha		6195982957					sacharya@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	12/29/2021	2026	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 Appeals	Director, Pharmacy Services		Allahwerdy	Fady							fadya@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	8583310515				PACE - Nat		C	San Francisco
H1693	Part D Application Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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 Benefits Contact	PACE Benefit Plans Specialist		Rodriguez	Sasha		6195982957					sacharyr@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	12/29/2021	2026	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 Claims Submission Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Manager, Finance - PACE		Macaranas	Drew							andrewma@fhcsd.org	823 GATEWAY CENTER WAY		SAN DIEGO	CA	92102	02/11/2025	2026	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	6198764416				PACE - Nat		C	San Francisco
H1693	Part D Price File Contact (Back-up)	Sr. Director of Finance		Schlagenhaft	George		6195152300	2465				georges@fhcsd.org	823 Gateway Ct Way		San Diego	CA	92102	08/07/2024	2026	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 Price File Contact (Primary)	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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 Quality Assurance Contact	Coordinator, Quality Assurance RN, PACE		Santos	Fatima		6195152536					fatimasan@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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 Reporting Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Patient Safety Contact	Clinical Pharmacist Specialist		Allahwerdy	Fady		6195158675	7016				fadya@fhcsd.org	3420 College Ave		San Diego	CA	92115	02/11/2025	2026	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	Payment Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Personal Health Record Contact	Manager HIM		Garcia	Ana		6195153662					anag@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	12/29/2021	2026	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 Director	Director, Pharmacy Services		Allahwerdy	Fady		6195158675					fadya@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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 Network Management Contact	Chief Financial Officer		Roman	Ricardo		6199064603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/11/2025	2026	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	Director, Pharmacy Services		Allahwerdy	Fady							fadya@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	6193156814				PACE - Nat		C	San Francisco
H1693	Plan Directory Contact for Public Website	Business Development Director and Center Manager		Yousif	Omar		6199524089					omary@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	04/18/2025	2026	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	Plan to Plan Reconciliation Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Processor Contact	Healthcare Claims Specialist		Espinoza	Ashley		4422220780	5058				ashleyro@fhcsd.org	823 Gateway Ct Way		San Diego	CA	92102	02/11/2025	2026	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	Quality Contact	Coordinator, Quality Assurance RN, PACE		Santos	Fatima		6195152536					fatimasan@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Reconciliation Contact	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Reconciliation Contact (Secondary)	Sr. Director of Finance		Schlagenhaft	George		6195152300	2465				georges@fhcsd.org	823 Gateway Ct Way		San Diego	CA	92102	02/11/2025	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Roman	Ricardo		6199064603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/06/2018	2026	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	Surveillance Contact	Compliance Manager, PACE	Ms.	Del Castillo	Larisa		7608267223					larisad@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/11/2025	2026	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	System Contact	Manager, IT Operations		Gallup	Ben		6195154613					beng@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	02/11/2025	2026	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	Third Party Administrator (TPA) Liaison	Manager, Finance - PACE		Macaranas	Drew		6198764416					andrewma@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	User Access Contact	Chief Financial Officer	Mr.	Roman	Ricardo		6199064603					ricardor@fhcsd.org	823 Gateway Ctr Way		San Diego	CA	92102	03/23/2020	2026	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	Utilization Management Contact	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Utilization Review Contact	VP PACE & Older Adult Services		Adamian	Janet		6195152579					janeta@fhcsd.org	823 Gateway Center Way		San Diego	CA	92102	02/11/2025	2026	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	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Backup User Access Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Best Available Evidence Contact	Medical Director	Dr.	Mahdi	Khalida		3168581111	45128				khalida.mahdi@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Bid Primary Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	CAP Report Contact for Public Website	Director of Quality Improvement	Ms.	Eagles	Amber		3169465136				3169465105	amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	CEO - CMS Administrator Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	CEO - Senior Official for Contracting	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Chief Financial Officer	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Chief Operating Officer	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Chief Information Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Chief Information Security Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	CMS Casework Communication Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3169465136				3169465105	amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Complaints Tracking Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Contact for Fraud Investigations	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Coordination of Benefits Contact	Accounting	Ms.	Sanders	Rebecca		3169465270					rebecca.sanders2@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Corporate Mailing						3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Customer Service Operations Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	DIR Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Discount Program Payment Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Emergency Part D Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Emergency Part D Contact (Secondary)	Senior Director of Clinical Services-PACE	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Encounter Data & Risk Adjustment Operations Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Enrollment Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	EOB Transfer Contact	Accounting	Ms.	Sanders	Rebecca		3169465270				3169465297	rebecca.sanders2@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Financial Audit Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Financial Reporting Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/14/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Formulary Contact	Medical Director	Dr.	Mahdi	Khalida		3168581111	45128				khalida.mahdi@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	General Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Government Relations Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	HIPAA Privacy Officer	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	HIPAA Security Officer	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Interoperability Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	MA Appeals/Grievances Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238	45136				amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	MA Claims Processing Contact for Public Website	Accounting Manager	Mr.	Webster	Ty		3142702497				4236226048	ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Marketing Contact	Marketing Director	Ms.	Campbell	Jennifer		3169465107				3169465106	jennifer.campbell@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Medical Director	Medical Director	Dr.	Mahdi	Khalida		3168581111	45128				khalida.mahdi@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Medicare Compliance Officer	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Medicare Coordinator	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Medicare Part D Opioid Overutilization Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Medication Therapy Management Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3169465136				3169465105	amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part C Application Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part D Appeals	Director of Quality Improvement	Ms.	Eagles	Amber							amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active	3162072238				PACE - Nat		C	Atlanta
H1714	Part D Appeals Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff							jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active	8008814443				PACE - Nat		C	Atlanta
H1714	Part D Application Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part D Benefits Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part D Claims Submission Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part D Exceptions Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty						4236226048	ty.webster@ascension.org	250 East 10th Street		Chattanooga	TN	37402	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active	8004418883				PACE - Nat		C	Atlanta
H1714	Part D Exceptions Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff							jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active	8008814443				PACE - Nat		C	Atlanta
H1714	Part D Price File Contact (Back-up)	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part D Price File Contact (Primary)	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part D Quality Assurance Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Part D Reporting Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Patient Safety Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Payment Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/14/2023	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Pharmacy Director	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Pharmacy Network Management Contact	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Pharmacy Network Management Contact (Secondary)	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Pharmacy Technical Help Desk Contact	Executive Director	Ms	Hodge	Alison						3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active	3169465264				PACE - Nat		C	Atlanta
H1714	Plan Directory Contact for Public Website	Executive Director	Ms	Hodge	Alison		3169465264				3169465106	alison.hodge@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Plan to Plan Reconciliation Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Processor Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Quality Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Reconciliation Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Reconciliation Contact (Secondary)	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Recovery Audit Contact	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Surveillance Contact	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	System Contact	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Third Party Administrator (TPA) Liaison	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	User Access Contact	Director of Quality Improvement	Ms.	Eagles	Amber		3162072238					amber.eagles@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Utilization Management Contact	Medical Director	Dr.	Mahdi	Khalida		3168581111	45128				khalida.mahdi@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1714	Utilization Review Contact	Medical Director	Dr.	Mahdi	Khalida		3168581111	45128				khalida.mahdi@ascension.org	775 N. Edwards		Wichita	KS	67203	02/13/2025	2026	VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC.	National PACE	Ascension Living HOPE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1722	Agent/Broker Compensation Data Contact	VP, Associate General Counsel	Ms.	Jan	Munizeh		6467675166					mjan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Backup User Access Contact	Manager, LTC Programs	Ms.	Duker	Stephanie		3324554464					sduker@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Bid Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Bid Audit Site Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Bid Primary Contact	Director, Medicare Strategy	Ms.	Wheeler	Jillian		2073222422					jiwheeler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	CAP Report Contact for Public Website	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	CEO - CMS Administrator Contact	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	CEO - Senior Official for Contracting	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Chief Financial Officer	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Chief Operating Officer	SVP, Operations	Ms.	Weinseiss	Karen		6466773595					kweinseiss@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Chief Information Officer	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Chief Information Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	CMS Casework Communication Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Complaints Tracking Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Contact for Fraud Investigations	VP, Associate General Counsel	Mr.	Kianovsky	Nahum		2128013240					nkianovsky@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		9176982415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Corporate Mailing						6463138967					clogreira@healthfirst.org	Healthfirst Medicare Plan	100 Church Street, 18th Floor	New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		2128011639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	DIR Contact	Manager, Pharmacy Finance	Mr.	Sheridan	Justin		2124535509					jsheridan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	DIR Contact (Secondary)	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					Tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Discount Program Payment Contact	VP, Controller	Mr.	Barattin	Craig		2125191780					cbarattin@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Emergency Part D Contact	VP, Pharmacy	Mr.	Modi	Bhavesh		2122096442					bmodi@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Emergency Part D Contact (Secondary)	Director, Pharmacy Regulatory & Compliance	Ms.	Andreu	Kim		6462732839					kandreu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters	Mr.	Miller	Robert		2125193011					rmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Enrollment Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	EOB Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753				6463134645	jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Financial Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Financial Reporting Contact	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Formulary Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Formulary Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	General Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	HIPAA Privacy Officer	AVP, Chief Privacy Officer	Ms.	Radler	Laurie		9172863902					lradler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	HIPAA Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Hospice Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Interoperability Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	MA Appeals/Grievances Contact	VP, Appeals & Grievances	Ms.	Johnston	Meredith		6467674748					mjohnston@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	MA Claims Processing Contact for Public Website	VP Application Development	Mr.	Brexel	CJ		2128232481					cbrexel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/08/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Marketing Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Medical Director	Chief Clinical Officer	Dr.	Schechtman	Jay		2128016170					jschechtman@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		2124534495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Medicare Coordinator	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Benefits	Ms.	Baja	Melody		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/22/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Medication Therapy Management Contact	Pharmacy Manager	Ms.	Ziu	Rezarta		6463134678					rziu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Online Enrollment Center Contact (Primary)	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part C Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part C Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Appeals	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	3013464234				HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Appeals Contact (Secondary)	Sr. Manager, Pharmacy Regulatory & Compliance	Ms.	Alenkina	Karolina							kalenkina@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Benefits Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Claims Submission Contact	Manager, Pharmacy Benefits	Ms.	Grodzitsky	Janet		6467675231					jparedes@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Exceptions Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Exceptions Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie							mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Price File Contact (Back-up)	Sr. Manager, Financial Operations	Ms.	Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	CVS Health	9501 E. Shea Blvd, MC121	Scottsdale	AZ	85260	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Price File Contact (Optional)	Advisor, Med D Finance	Mr.	Pertgen	Richard		8045258502					richard.pertgen@cvshealth.com	CVS Health	9501 E Shea Blvd, MC121	Scottsdale	AZ	85260	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Price File Contact (Primary)	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Quality Assurance Contact	AVP, Pharmacy	Ms.	Kourlas	Helen		2122096456					hkourlas@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Part D Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Patient Safety Contact	Manager, Pharmacy	Ms.	Gandara Rodriguez	Alexandra		2124792775					agandararodriguez@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Payment Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Pharmacy Director	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Pharmacy Network Management Contact	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist	Ms.	An	Diana		3476911405					dan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Pharmacy Technical Help Desk Contact	AVP Customer Care	Mr.	Jackson	Scott							scott.jackson@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H1722	Plan Directory Contact for Public Website			Services	Provider		8888011660					hfprovsrvs@healthfirst.org	P.O. Box 5168		New York	NY	102745168	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					P2P@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Processor Contact	Executive Director	Mr.	Mangin	Marty		3124981167					martin.mangin@cvshealth.com	CVS Health	3100 Sanders Rd	Northbrook	IL	60062	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Quality Contact	VP, Clinical Quality	Ms.	Washington	Laisha		2128016186					lawashington@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Reconciliation Contact	VP, Actuarial Services	Ms.	Liang	Angela		2124535538					aliang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Recovery Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	SNP Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	SNP State Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Surveillance Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	System Contact	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Third Party Administrator (TPA) Liaison	Sr. Manager, Accounting	Ms.	Tyme	Denise		6462732814					dtyme@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	User Access Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Utilization Management Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1722	Utilization Review Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1742	Automated TrOOP Balance Transfer Contact	Accounting Manager	Mr	Webster	Ty		3142703497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Backup User Access Contact	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Best Available Evidence Contact	Medical Director	Dr.	Pitts	Gary		4632713726					gary.pitts1@ascension-external.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	10/01/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Bid Primary Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Rd.		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	CAP Report Contact for Public Website	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active	4632713727				PACE - Nat		C	Atlanta
H1742	CEO - CMS Administrator Contact	Interim Site Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	CEO - Senior Official for Contracting	Interim Site Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Chief Financial Officer	Accounting Manager	Mr	Webster	Ty		3142703497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Chief Operating Officer	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Chief Information Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	2622 W. Central #100		Wichita	KS	67203	04/29/2022	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Chief Information Security Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	2622 W. Central #100		Wichita	KS	67203	04/29/2022	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	CMS Casework Communication Contact	Director of Quality Management	Ms.	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Complaints Tracking Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Contact for Fraud Investigations	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/03/2022	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Coordination of Benefits Contact	Accounting	Ms.	Kennedy	Susan		3169465270				3169465105	Susan.Kennedy@ascension.org	755 N. Edwards		Wichita	KS	67203	06/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Corporate Mailing						3177544565					stvpace_executivedirector@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Customer Service Operations Contact	Executive Director	Ms.	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	DIR Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Rd.		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	DIR Contact (Secondary)	Accounting	Ms.	Kennedy	Susan		3169465270				3169465105	Susan.Kennedy@ascension.org	755 N. Edwards		Wichita	KS	67203	06/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Discount Program Payment Contact	Accounting Manager	Mr	Webster	Ty		3142703497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Emergency Part D Contact	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Emergency Part D Contact (Secondary)	Senior Director of Clinical Services-PACE	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/29/2022	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Encounter Data & Risk Adjustment Operations Contact	Claims Manager	Mr.	Stengele	Brett		8155291077				4236226048	brett.stengele@ascension.org	250 East 10th Street		Chattanooga	TN	37402	06/08/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Enrollment Contact	Accounting	Ms.	Kennedy	Susan		3169465270				3169465105	Susan.Kennedy@ascension.org	755 N. Edwards		Wichita	KS	67203	06/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	EOB Transfer Contact	Accounting	Ms.	Kennedy	Susan		3169465270				3169465105	Susan.Kennedy@ascension.org	755 N. Edwards		Wichita	KS	67203	06/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Financial Audit Contact	Accounting Manager	Mr	Webster	Ty		3142703497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Financial Reporting Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Rd.		St. Louis	MO	63134	06/08/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Formulary Contact	Medical Director	Dr.	Pitts	Gary		4632713726					gary.pitts1@ascension-external.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	10/01/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	General Contact	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Government Relations Contact	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	HIPAA Privacy Officer	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	HIPAA Security Officer	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Interoperability Contact	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	MA Appeals/Grievances Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	MA Claims Processing Contact for Public Website	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Marketing Contact	Director	Ms.	Wolfe	Latasha		3177544565					latasha.wolfe@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	10/01/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Medical Director	Medical Director	Dr.	Pitts	Gary		4632713726					gary.pitts1@ascension-external.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	10/01/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Medicare Compliance Officer	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Medicare Coordinator	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Medicare Part D Opioid Overutilization Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Medication Therapy Management Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part C Application Contact	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part D Appeals	Director of Quality Management	Ms	Sims-Hedges	Amy							asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active	4632713727				PACE - Nat		C	Atlanta
H1742	Part D Appeals Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff							jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/03/2022	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active	8008814443				PACE - Nat		C	Atlanta
H1742	Part D Application Contact	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part D Benefits Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part D Claims Submission Contact	Accounting Manager	Mr	Webster	Ty		3142703497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part D Exceptions Contact	Director of Quality Management	Ms	Sims-Hedges	Amy							asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active	4632713727				PACE - Nat		C	Atlanta
H1742	Part D Exceptions Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff							jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/03/2022	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active	8008814443				PACE - Nat		C	Atlanta
H1742	Part D Price File Contact (Back-up)	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part D Price File Contact (Primary)	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part D Quality Assurance Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Part D Reporting Contact	Accounting Manager	Mr	Webster	Ty		3142703497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Patient Safety Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Payment Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/08/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Pharmacy Director	Executive Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Pharmacy Network Management Contact	Interim Site Director	Ms	Gresham	Susan		4632713725					susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	12/13/2023	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Pharmacy Technical Help Desk Contact	Executive Director	Ms	Gresham	Susan							susan.gresham@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	12/15/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active	8339493777				PACE - Nat		C	Atlanta
H1742	Pharmacy Technical Help Desk Contact (Secondary)	Director of Quality Management	Ms.	Sims-Hedges	Amy							asimshed@ascension.org	5435West Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active	4632713727				PACE - Nat		C	Atlanta
H1742	Plan Directory Contact for Public Website	Site Director	Ms	Bowman	Lindi		4632713725					janalynn.bowman@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	12/15/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Plan to Plan Reconciliation Contact	Accounting Manager		Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Processor Contact	Accounting Manager		Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Quality Contact	Director of Quality Management	Ms	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Reconciliation Contact	Accounting Manager		Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Reconciliation Contact (Secondary)	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Recovery Audit Contact	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@asension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Surveillance Contact	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/03/2022	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	System Contact	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Third Party Administrator (TPA) Liaison	Accounting Manager		Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	User Access Contact	Director of Quality Management	Ms.	Sims-Hedges	Amy		4632713727					asimshed@ascension.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	03/11/2024	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Utilization Management Contact	Medical Director	Dr.	Pitts	Gary		4632713726					gary.pitts1@ascension-external.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	10/01/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1742	Utilization Review Contact	Medical Director	Dr.	Pitts	Gary		4632713726					gary.pitts1@ascension-external.org	5435 W Pike Plaza Rd		Indianapolis	IN	46254	10/01/2025	2026	ASCENSION LIVING ST. VINCENT PACE, INC.	National PACE	Ascension Living St. Vincent PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H1780	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Backup User Access Contact		Mr.	Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	12/18/2024	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE	#4051	COVINA	CA	91723	02/18/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	CEO - CMS Administrator Contact		Ms	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	5521 8th Ave, 2nd Floor		Brooklyn	NY	11220	02/18/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	CEO - Senior Official for Contracting		Ms	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	5521 8th Ave, 2nd Floor		Brooklyn	NY	11220	02/18/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Chief Financial Officer		Mr.	Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/02/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Chief Operating Officer		Ms.	Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 North Barranca Ave #4051		Covina	CA	91723	12/18/2024	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Contact for Fraud Investigations			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Customer Service Operations Contact			Tung	Yin		6462218525					yin.tung@welbehealth.com	5521 8th Ave, 2nd Floor		Brooklyn	NY	11220	06/29/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	DIR Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	DIR Contact (Secondary)			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Emergency Part D Contact (Secondary)			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	General Contact			Tung	Yin		6462218525					yin.tung@welbehealth.com	5521 8th Ave, 2nd Floor		Brooklyn	NY	11220	06/29/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Government Relations Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	HIPAA Privacy Officer			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	HIPAA Security Officer			Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Medical Director			Chen	Andy		6264561746					Andy.Chen@WelbeHealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Medicare Compliance Officer		Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Medicare Coordinator			Tung	Yin		6462218525					yin.tung@welbehealth.com	5521 8th Ave, 2nd Floor		Brooklyn	NY	11220	06/29/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	2192106392				PACE - Nat		C	San Francisco
H1780	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	6502948027				PACE - Nat		C	San Francisco
H1780	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	6502948027				PACE - Nat		C	San Francisco
H1780	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part D Quality Assurance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Patient Safety Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	6502948027				PACE - Nat		C	San Francisco
H1780	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/16/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Surveillance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1780	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBE HEALTH NYC PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H1787	Agent/Broker Compensation Data Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Backup User Access Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Best Available Evidence Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Bid Audit Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Bid Audit Site Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Bid Primary Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	CAP Report Contact for Public Website	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8007525863				HMO - Health Maintenance Organization		C	Dallas
H1787	CEO - CMS Administrator Contact	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	CEO - Senior Official for Contracting	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Chief Financial Officer	Chief Financial Officer	Mr.	Custis	Stephen		6129649158					Stephen.Custis@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Chief Operating Officer	Vice President of Operations	Ms.	Foemmel	Sara		7153836634					foemmel.sara@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Chief Information Officer	Cheif Information Officer	Mr.	Reimer	Brad		6053287937					Brad.Reimer@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Chief Information Security Officer	Vice President - Information Security Officer	Ms.	Hogstad	Kimberly		6053287410					Kimberly.Hogstad@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	CMMI Model Point of Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	CMS Casework Communication Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Complaints Tracking Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Contact for Fraud Investigations	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	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 Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Corporate Mailing						8007525863					memberservices@sanfordhealth.org	PO BOX 91110		Sioux Falls	SD	57109	08/28/2024	2026	SANFORD HEALTH PLAN	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		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	DIR Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/24/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	DIR Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Discount Program Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Emergency Part D Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Emergency Part D Contact (Secondary)	Senior Pharmacist	Mr.	Reuman	Reed		6053122761					Reed.Reuman@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Employer Waiver Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Encounter Data & Risk Adjustment Operations Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Enrollment Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	EOB Transfer Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		6053287182				6053286811	Aleesa.Jansick@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Financial Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	09/24/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Financial Reporting Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Formulary Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Formulary Contact (Secondary)	Principal Pharmacy Benefits Specialist		Chen	Honghua		2242312740					Christine.Chen2@optum.com	1600  McConnor Parkway	Suite 201	Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	General Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Government Relations Contact	Head of Government Affairs	Mr.	Wheeler	Dylan		6053287186					Dylan.Wheeler@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	HIPAA Privacy Officer	Lead Privacy Officer	Ms.	Sundby	Jennifer		6053625407					Jennifer.Sundby@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	HIPAA Security Officer	Information Security Compliance Officer	Mr.	Otte	Brody		6053126563					Brody.Otte@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Hospice Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Interoperability Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	MA Appeals/Grievances Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	MA Claims Processing Contact for Public Website	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Marketing Contact	Director of Marketing	Ms.	McCloskey	Diana		6053122762					Diana.Mccloskey@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Medical Director	Chief Medical Officer	Dr.	Faber	Kevin		6053287192					Kevin.Faber@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	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		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Medicare Coordinator	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	02/07/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Medication Therapy Management Contact	Clinical Program Manager	Ms.	Liaqat	Tazeen		6305440541					Tazeen.liaqat@optum.com	1240 South Pine Island Rd.		Plantation	FL	33324	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	OffShore Subcontractor Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Online Enrollment Center Contact (Back-up)	Manager of Inside Sales	Mr.	Arnett	Jack		6053286886					Jack.Arnett@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Online Enrollment Center Contact (Optional)	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Online Enrollment Center Contact (Primary)	Director of Medicare Programs	Mr.	Ovenden	Nathan		6053122606					Nathan.Ovenden@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part C Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part C Reporting Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Appeals	Manager, Prior Authorization Appeals	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Appeals Contact (Secondary)	Pharmacy Technician, PA Appeals	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Application Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Benefits Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Claims Submission Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	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						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Exceptions Contact (Secondary)	Pharmacy Technician, PA	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms.	Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Price File Contact (Optional)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Price File Contact (Primary)	Senior Business Analyst	Ms.	Lam	Annie		6124286588					Annie.Lam@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Quality Assurance Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Part D Reporting Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Patient Safety Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Personal Health Record Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Pharmacy Director	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Perez	Felix		7632833503					Felix.Perez@optum.com	1600 McConnor Parkway , IL 601736801		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations	Ms.	Ashby	Jolynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	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	Pharmacy Technical Help Desk	Sr.	Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8446429090				HMO - Health Maintenance Organization		C	Dallas
H1787	PHR Beneficiary Contact																	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS	Sanford Health Plan	Sanford Health	740	Yes	Active	8882786485				HMO - Health Maintenance Organization		C	Dallas
H1787	Physician Incentive Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Plan Directory Contact for Public Website	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Processor Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Quality Contact	Director of Quality and STARS Strategy	Ms.	Kanta	Misty		6053122788					Misty.Kanta@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Reconciliation Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Recovery Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	SNP Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	SNP State Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Surveillance Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	System Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Third Party Administrator (TPA) Liaison	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	User Access Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Utilization Management Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1787	Utilization Review Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1799	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/29/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	06/05/2023	2026	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		5022138986					Mackenzie.Wolf@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/14/2022	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/03/2023	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/28/2021	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	01/23/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	01/23/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/24/2024	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/25/2023	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	02/20/2024	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	01/28/2021	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/27/2021	2026	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	Corporate Mailing						5624564066					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	09/25/2024	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/24/2024	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/30/2023	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	04/30/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	11/03/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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	Enrollment Contact	Director, Medicare Programs		Wolf	Mackenzie		5022138986					Mackenzie.Wolf@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/14/2022	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/24/2024	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/24/2024	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	01/28/2021	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	11/03/2021	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/28/2021	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	11/21/2024	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	11/03/2022	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Programs		Wolf	Mackenzie		5022138986					Mackenzie.Wolf@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/14/2022	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	11/02/2022	2026	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H1799	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H1799	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H1799	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	11/03/2022	2026	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H1799	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	11/03/2022	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	01/28/2021	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	07/06/2022	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	01/28/2021	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	01/28/2021	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	12/12/2022	2026	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H1799	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H1799	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/24/2024	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/02/2021	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	11/21/2023	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/28/2021	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/28/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/15/2023	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	03/02/2022	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	04/16/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	11/04/2021	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	04/19/2022	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	12/21/2022	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	11/21/2024	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	11/21/2024	2026	MOLINA HEALTHCARE OF KENTUCKY, INC.	Local CCP	Passport Advantage	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H1822	Agent/Broker Compensation Data Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	CEO - CMS Administrator Contact	President	Mrs	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	CEO - Senior Official for Contracting	CEO	Dr.	Jain	Sachin		5629898314	8314				sjain@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/11/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Chief Financial Officer	CFO	Mr.	Plumb	Michael		5629971589	1589				mplumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/11/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Chief Information Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	CMS Casework Communication Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Complaints Tracking Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459				5629890101	tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	DIR Contact (Secondary)	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/27/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/31/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/21/2022	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Employer Waiver Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Encounter Data & Risk Adjustment Operations Contact	Chief Data Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	04/10/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Enrollment Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Financial Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/21/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	General Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Government Relations Contact	VP of Government Relations		Kazan	Matt		8005593500				5629899439	m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	MA Appeals/Grievances Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/02/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Medical Director	Chief Medical Officer		Kimura	Joe		5626377346				5629899439	j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Medicare Compliance Officer	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/19/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195					c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	OffShore Subcontractor Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part C Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part C Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Appeals	Sr. Director of Grievances and Appeals	Ms.	Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5629895100	1290			HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization	Ms.	Herbert	Joshua						5629890958	Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	1290			HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	04/29/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization	Mr.	Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	733326			HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	12/01/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4348			5629973196	a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Part D Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/23/2023	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H1822	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Processor Contact	Senior Director Government Programs, Medicare	Ms.	Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346	4431			5629895120	j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Recovery Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	SNP Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	SNP State Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Surveillance Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/19/2021	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	User Access Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1822	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN DESERT HEALTH PLAN, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1846	Agent/Broker Compensation Data Contact	Director of Sales		Dues	Travis		6145463157				6145463131	Travis.Dues@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		6145463183				6145463131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Backup User Access Contact	Sr. Application Specialist		Crawford	Carl		6145463215				6145463144	ccrawford@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Bid Audit Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463211	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Bid Audit Site Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Bid Primary Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	CAP Report Contact for Public Website	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	CEO - CMS Administrator Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	Jack.Randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/06/2025	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	CEO - Senior Official for Contracting	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463211				6145463131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Chief Operating Officer	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Chief Information Officer	VP Service Optimization	Mr.	Trimmer	Matt		3017547190					matt.trimmer@trinity-health.org	3100 Easton Square Place		Columbus	OH	43219	07/17/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Chief Information Security Officer	Sr Security Manager, Enterprise Information Securi	Mr.	Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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	6147068474				6142348372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Complaints Tracking Contact	Compliance Specialist	Mr	Jordan	David	A	6147068474					djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Contact for Fraud Investigations	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Corporate Mailing						4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	DIR Contact	CEO		Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square  Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	DIR Contact (Secondary)	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Discount Program Payment Contact	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Electronic Health Record Contact	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Emergency Part D Contact	Chief Compliance Officer		Suffern	Patricia		4124780244				6145463132	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/23/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Emergency Part D Contact (Secondary)	Pharmacy Director	Ms.	McGee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/17/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Employer Waiver Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Reconciliation Analyst		Sloan	Mike		6145463134					mike.sloan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Enrollment Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	EOB Transfer Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Financial Audit Contact	Chief Compliance Officer	Ms.	Suffern	Patricia	A	4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/24/2025	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Financial Reporting Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Formulary Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	General Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	HIPAA Privacy Officer	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	HIPAA Security Officer	Sr Security Manager, Enterprise Information Securi		Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Interoperability Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	MA Appeals/Grievances Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	MA Claims Processing Contact for Public Website	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Marketing Contact	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Medical Director	MD	Dr.	Wise	Greg		6145463151				6145463131	gwise@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Medicare Coordinator	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Medicare Part D Opioid Overutilization Contact	Pharmacy Data Analyst	Ms.	Houk	Kimberly		6145463183					kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Medication Therapy Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	OffShore Subcontractor Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment	Ms	Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Online Enrollment Center Contact (Optional)	Director, Enrollment and Premium Billing		Caudle	Jeff		6145463224				6145463148	jcaudle@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part C Application Contact	Director, Product Management and Business Devlpt		Mauck	Brandon		6145955681					brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part C Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part D Appeals	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H1846	Part D Appeals Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H1846	Part D Application Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part D Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part D Claims Submission Contact	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H1846	Part D Exceptions Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H1846	Part D Price File Contact (Back-up)	Formulary Consultant		Scott	Sarah		4803109219					sarah.scott@CVSHealth.com	9501 E. Shea		Scottsdale	AZ	85260	05/02/2025	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part D Price File Contact (Primary)	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part D Quality Assurance Contact	Director of Pharmacy, Health Plans	Ms.	McGhee	Anna		2165345375				6142346481	anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Part D Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Patient Safety Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Payment Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Pharmacy Director	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Pharmacy Network Management Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	8666934620				PPO - BBA		C	Chicago
H1846	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Data Analyst	Mrs	Miller	Kim							kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active	8666934620				PPO - BBA		C	Chicago
H1846	PHR Beneficiary Contact																	12/05/2016	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO	MediGold	Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H1846	Physician Incentive Contact	Interim VP, Health Services	Ms	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Plan Directory Contact for Public Website	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Processor Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Quality Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Reconciliation Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Reconciliation Contact (Secondary)	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Recovery Audit Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Surveillance Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	System Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Third Party Administrator (TPA) Liaison	Sr Finance Analyst		Fountain	Lisa		6145463220					lfountain@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	User Access Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Utilization Management Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1846	Utilization Review Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH INSURANCE COMPANY	Local CCP	MediGold	Local PPO		Trinity Health Corporation	234	Yes	Active					PPO - BBA		C	Chicago
H1862	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H1862	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H1862	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H1862	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H1862	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504170				HMO - Health Maintenance Organization		C	Denver
H1862	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504170				HMO - Health Maintenance Organization		C	Denver
H1862	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H1862	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1862	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH PLANS OF VERMONT, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H1889	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H1889	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1889	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H1889	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H1889	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1889	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H1894	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/11/2022	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/10/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1894	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1894	PHR Beneficiary Contact																	02/07/2019	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H1894	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1894	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT WASHINGTON, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H1904	Automated TrOOP Balance Transfer Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Backup User Access Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Best Available Evidence Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Bid Primary Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	CAP Report Contact for Public Website	Executive Director		Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active	5042273411				PACE - Nat		C	Philadelphia
H1904	CEO - CMS Administrator Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	CEO - Senior Official for Contracting	Executive Director	Mr.	Wootan	Kurt	D	5042273411					kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Chief Financial Officer	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Chief Operating Officer	Director of Clinical Services	Mr	Lewis	Jerry		9857100898					jdlewis@ccano.org	4201 N Rampart St		New Orleans	LA	70117	04/09/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Chief Information Officer	CIO	Mr	Zlatnicky	Terry		5043108742					tzlatnick@ccano.org	1000 Howard Ave		New Orleans	LA	70113	06/01/2016	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Chief Information Security Officer	CIO	Mr	Zlatnicky	Terry		5043108742					tzlatnick@ccano.org	1000 Howard Ave		New Orleans	LA	70113	06/01/2016	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	CMS Casework Communication Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Complaints Tracking Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Contact for Fraud Investigations	Director of Quality and Compliance		Julian	Christi		5049416054					Cjulian@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Coordination of Benefits Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Corporate Mailing						5049416057					pace@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/02/2018	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Customer Service Operations Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	DIR Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Discount Program Payment Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Emergency Part D Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Enrollment Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	EOB Transfer Contact	Executive Director	Mr	Wootan	Kurt		5042273411				5049416082	Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Financial Audit Contact	Executive Director	Mr	Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Financial Reporting Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Formulary Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	General Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Government Relations Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	HIPAA Privacy Officer	Director of Quality and Compliance		Julian	Christi		5049416054					Cjulian@ccano.org	4201 N Rampart St		New Orleans	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	HIPAA Security Officer	Director of Quality and Compliance		Julian	Christi		5049416054					Cjulian@ccano.org	4201 N Rampart St		New Orleans	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Interoperability Contact			Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N Rampart Street		New Orleans	LA	70117	06/03/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	MA Appeals/Grievances Contact	Director of Quality and Compliance		Julian	Christi		5049416054					Cjulian@ccano.org	4201 N Rampart St		New Orleans	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	MA Claims Processing Contact for Public Website	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Marketing Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Medical Director	Medical Director	Dr.	Smith	Kiernan		5049416084					Ksmith@ccano.org	4201 North Rampart Street		New Orleans	LA	70117	12/01/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Medicare Compliance Officer	Director of Quality and Compliance	Ms.	Julian	Christi		5049416054					CJulian@ccano.org	4201 N Rampart St		New Orleans	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Medicare Coordinator	Executive Director	Mr.	Wootan	Kurt		5042273411					kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Medicare Part D Opioid Overutilization Contact	Director of Quality and Compliance		Julian	Christi		5049416054					CJulian@ccano.org	4201 North Rampart Street		New Orleans	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Medication Therapy Management Contact	Medical Director	Dr.	Smith	Kiernan		5049416084					Ksmith@ccano.org	4201 North Rampart Street		New Orleans	LA	70117	12/01/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part C Application Contact	Interim Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	11/02/2021	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part D Appeals	Executive Director	Mr	Wootan	Kurt	D					5049416082	Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active	8667438778				PACE - Nat		C	Philadelphia
H1904	Part D Application Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part D Benefits Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part D Claims Submission Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part D Exceptions Contact	Executive Director	Mr	Wootan	Kurt	D					5049416082	Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active	8667438778				PACE - Nat		C	Philadelphia
H1904	Part D Price File Contact (Back-up)	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part D Price File Contact (Primary)	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part D Quality Assurance Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Part D Reporting Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Patient Safety Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	04/03/2024	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Payment Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Pharmacy Director	Interim Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	11/02/2021	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Pharmacy Network Management Contact	Interim Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	11/02/2021	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Pharmacy Technical Help Desk Contact	Interim Executive Director	Mr	Wootan	Kurt	D					5049416082	Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	11/02/2021	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active	8667438778				PACE - Nat		C	Philadelphia
H1904	Plan Directory Contact for Public Website	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Plan to Plan Reconciliation Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Processor Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Quality Contact	Director of Quality and Compliance	Ms.	Julian	Christi		5049416054					CJulian@ccano.org	4201 N Rampart St		New Orleans	LA	70117	03/06/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Reconciliation Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Recovery Audit Contact	Executive Director	Mr	Wootan	Kurt		5042273411					kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Surveillance Contact	Executive Director		Wootan	Kurt		5042273411					Kwootan@ccano.org	4201 N RAMPART ST		NEW ORLEANS	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	System Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Third Party Administrator (TPA) Liaison	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	10/16/2025	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	User Access Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Utilization Management Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1904	Utilization Review Contact	Executive Director	Mr.	Wootan	Kurt	D	5042273411					Kwootan@ccano.org	4201 N Rampart St		New Orleans	LA	70117	07/19/2022	2026	PACE GREATER NEW ORLEANS	National PACE	Pace Greater New Orleans	National PACE		Catholic Charities Archdiocese of New Orleans	471	Yes	Active					PACE - Nat		C	Philadelphia
H1914	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/14/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H1914	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H1914	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H1914	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H1914	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H1914	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H1914	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H1914	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1914	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H1917	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Backup User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	CEO - CMS Administrator Contact		Mr.	Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 Gateway Dr.		Riverside	CA	92507	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	CEO - Senior Official for Contracting		Mr.	Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 Gateway Dr.		Riverside	CA	92507	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Chief Financial Officer		Mr.	Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 Gateway Dr.		Riverside	CA	92507	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Chief Operating Officer		Mr.	Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 Gateway Dr.		Riverside	CA	92507	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Contact for Fraud Investigations			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Customer Service Operations Contact			Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 GATEWAY DR		RIVERSIDE	CA	92507	01/29/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	DIR Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	DIR Contact (Secondary)		Mr.	Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Emergency Part D Contact (Secondary)			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	General Contact			Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 GATEWAY DR		RIVERSIDE	CA	92507	01/29/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Government Relations Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	HIPAA Privacy Officer			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	HIPAA Security Officer			Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Medical Director			Yang	Jae		9516213001					jae.yang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Medicare Compliance Officer		Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Medicare Coordinator			Niehaus	Josh		2702220629					josh.niehaus@welbehealth.com	2799 GATEWAY DR		RIVERSIDE	CA	92507	01/29/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	2192106392				PACE - Nat		C	San Francisco
H1917	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1917	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1917	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part D Quality Assurance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Patient Safety Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H1917	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Reconciliation Contact (Secondary)			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	03/05/2024	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Surveillance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1917	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/13/2023	2026	WELBEHEALTH INLAND EMPIRE PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H1947	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/14/2022	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	04/07/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1947	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H1947	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H1947	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H1947	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1947	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H1947	PHR Beneficiary Contact																	02/04/2019	2026	COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.	Local CCP	Healthy Blue	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H1947	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	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	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	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	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	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	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1951	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H1951	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H1951	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H1951	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H1951	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H1951	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	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	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	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	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	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	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H1961	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1961	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H1961	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H1961	Plan Directory Contact for Public Website			Customer Service	UHC		8773671803					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1961	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1969	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Encounter Data & Risk Adjustment Operations Contact	AD Risk Adjustment Analytics		Aryal	Binaya		5032255305					Binaya.Aryal@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/06/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	MA Appeals/Grievances Contact	Healthcare Svcs Program Mgr Sr	Ms.	Huque	Nita		5035531462					Nita.Huque@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	MA Claims Processing Contact for Public Website	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part C Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part C Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				HMO - Health Maintenance Organization		C	Kansas City
H1969	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				HMO - Health Maintenance Organization		C	Kansas City
H1969	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Quality Contact	Director, Quality Management	Mr.	Mcclure	Andy		5032206189					Andrew.Mcclure@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Utilization Management Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1969	Utilization Review Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD OF IDAHO, INC.	Local CCP	Regence BlueShield of Idaho	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1980	Automated TrOOP Balance Transfer Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Backup User Access Contact	VP of Health Policy and Strategy		West	Turner		8592765344					twest@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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	VP of Health Policy and Strategy		West	Turner		8592765344					twest@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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	Bid Primary Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	CAP Report Contact for Public Website	Chief Strategy Officer		West	Turner		8592765344					twest@everenthealth.org	1733 Harrodsburg Road		Lexington	KY	40504	06/30/2025	2026	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	CEO - CMS Administrator Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	CEO - Senior Official for Contracting	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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/VP of Finance	Ms.	Hodge	Holly		8592765344					hhodge@everenthealth.org	1733 Harrodsburg Road		Lexington	KY	40504	11/25/2025	2026	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 Operating Officer	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	07/02/2024	2026	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 Information Officer	Chief Operating Officer, Administrative Services	Mr.	Chambers	Croswell		8592765344					cchambers@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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 Information Security Officer	Chief Operating Officer, Administrative Services	Mr.	Chambers	Croswell		8592765344					cchambers@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Complaints Tracking Contact	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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	Contact for Fraud Investigations	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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/VP of Finance	Ms.	Hodge	Holly		8592765344					hhodge@everenthealth.org	1733 Harrodsburg Rd.		Lexington	KY	40504	11/25/2025	2026	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	Corporate Mailing						8592765344					twest@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	09/22/2020	2026	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	PACE Center Director		Perry	Melissa		8592765344					mperry@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	07/02/2024	2026	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	DIR Contact	Chief Operating Officer, Administrative Services	Mr.	Chambers	Croswell		8592765344					cchambers@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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	DIR Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Discount Program Payment Contact	PACE Financial Specialist	Mr	Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	12/16/2024	2026	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	Emergency Part D Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Emergency Part D Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Operating Officer, Administrative Services	Mr.	Chambers	Croswell		8592765344					cchambers@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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	Enrollment Contact	PACE Center Director		Perry	Melissa		8592766212					mperry@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	06/30/2025	2026	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	EOB Transfer Contact	Chief Operating Officer, Administrative Services	Mr.	Chambers	Croswell		8592765344				8592230490	cchambers@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	07/02/2024	2026	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	Financial Audit Contact	CFO/VP of Finance	Ms.	Hodge	Holly		8592765344					hhodge@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	11/25/2025	2026	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	Financial Reporting Contact	CFO/VP of Finance	Ms.	Hodge	Holly		8592765344					hhodge@everenthealth.org	1733 Harrodsburg Road		Lexington	KY	40504	11/25/2025	2026	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	Formulary Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Formulary Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	General Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	VP of Health Policy and Strategy		West	Turner		8592765344					twest@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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	HIPAA Privacy Officer	Director, Health Information Mgmt/Privacy Officer		Thieneman	Kim		8592765344					kthieneman@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	06/30/2025	2026	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	HIPAA Security Officer	Vice President, Information Technology		Archibald	Josh		5027194160					jarchibald@everenthealth.org	1733 Harrodsburg Rd.		Lexington	KY	40504	06/30/2025	2026	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	Interoperability Contact	Chief Operating Officer, Administrative Services	Mr.	Chambers	Croswell		8592765344					cchambers@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	MA Appeals/Grievances Contact	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Strategy Officer		West	Turner		8592765344					twest@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	06/30/2025	2026	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	Marketing Contact	Chief Strategy Officer		West	Turner		8592765344					twest@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	06/30/2025	2026	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	Medical Director	PACE Medical Director		Borders	James		8592765344					jborders@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	06/30/2025	2026	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	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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 Coordinator	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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 Part D Opioid Overutilization Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Medication Therapy Management Contact	Director of Hospice Pharmacy		Short	Wendell		8592765344					wshort2@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	07/02/2024	2026	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	OffShore Subcontractor Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Online Enrollment Center Contact (Back-up)	PACE Center Director	Mr.	Perry	Melissa		8592966212					mperry@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	06/30/2025	2026	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	Online Enrollment Center Contact (Optional)	PACE Financial Specialist		Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Online Enrollment Center Contact (Primary)	PACE Center Director		Perry	Melissa		8593217484					mperry@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	06/30/2025	2026	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 C Application Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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 Appeals	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta							lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	5027194194				PACE - Nat		C	Atlanta
H1980	Part D Appeals Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin							kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	8592966827				PACE - Nat		C	Atlanta
H1980	Part D Application Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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 Benefits Contact	CFO/VP of Finance	Ms.	Hodge	Holly		8592966826					hhodge@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	11/25/2025	2026	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 Claims Submission Contact	CFO/VP of Finance	Ms.	Hodge	Holly		8592966826					hhodge@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	11/25/2025	2026	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	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta							lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	5027194194				PACE - Nat		C	Atlanta
H1980	Part D Exceptions Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin							kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	8592966827				PACE - Nat		C	Atlanta
H1980	Part D Price File Contact (Back-up)	CFO/VP of Finance	Ms.	Hodge	Holly		8592966826					hhodge@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	11/25/2025	2026	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 Price File Contact (Optional)	PACE Financial Specialist		Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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 Price File Contact (Primary)	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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 Quality Assurance Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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 Reporting Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Patient Safety Contact	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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	Payment Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Personal Health Record Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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 Director	Director of Hospice Pharmacy		Short	Wendell		8592765344					wshort2@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	07/02/2024	2026	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 Network Management Contact	Director of Hospice Pharmacy		Short	Wendell		8592765344					wshort2@bgcarenav.org	1733 Harrodsburg Rd		Lexington	KY	40504	07/02/2024	2026	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 Network Management Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta							lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	5027194194				PACE - Nat		C	Atlanta
H1980	Pharmacy Technical Help Desk Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin							kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE		Hospice of the Bluegrass, Inc.	794	Yes	Active	8592966827				PACE - Nat		C	Atlanta
H1980	PHR Beneficiary Contact																	09/23/2020	2026	HOSPICE OF THE BLUEGRASS, INC	National PACE	Bluegrass PACE Care	National PACE	Bluegrass Care Navigators	Hospice of the Bluegrass, Inc.	794	Yes	Active	8592765344				PACE - Nat		C	Atlanta
H1980	Plan Directory Contact for Public Website	Chief Strategy Officer		West	Turner		8592765344					twest@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	06/30/2025	2026	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	Plan to Plan Reconciliation Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Processor Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Quality Contact	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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	Reconciliation Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Reconciliation Contact (Secondary)	PACE Financial Specialist		Garrison	Kevin		8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Recovery Audit Contact	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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	Surveillance Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	System Contact	Chief Operating Officer, Administrative Services	Mr.	Chambers	Croswell		8592765344					cchambers@bgcarenav.org	1733 Harrodsburg Rd.		Lexington	KY	40504	07/02/2024	2026	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	Third Party Administrator (TPA) Liaison	PACE Financial Specialist	Mr	Garrison	Kevin	R	8592966827					kgarrison@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	12/16/2024	2026	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	User Access Contact	President/CEO	Ms.	Fowler	Elizabeth	D	8592966810					lfowler@bgcarenav.org	1733 Harrodsburg Road		Lexington	KY	40504	07/02/2024	2026	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	Utilization Management Contact	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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	Utilization Review Contact	VP of Compliance & Privacy Officer	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	1733 Harrodsburg Rd		Lexington	KY	40504	09/09/2025	2026	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	Agent/Broker Compensation Data Contact	VP, Marketing & Provider Relations	Mr.	Diep	Tyler		7146007836					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		8587906250					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Backup User Access Contact	Chairman of the Board/CEO	Dr.	Nguyen	Tri		8584493755				9493938879	cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Best Available Evidence Contact			Department	Enrollment		8666889021					enrollment@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Bid Audit Contact	Chairman of the Board/CEO	Dr.	Nguyen	Tri	T	8584493755				9493938879	cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Bid Primary Contact	Chairman of the Board/CEO	Dr.	Nguyen	Tri	T	8584493755				9493938879	cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	CAP Report Contact for Public Website	Controller		Tran, CPA	Son		7147669099					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	CEO - CMS Administrator Contact	Chairman of the Board/CEO	Dr.	Nguyen	Tri	T	8584493755				9493938879	tri.nguyen@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	CEO - Senior Official for Contracting	Chairman of the Board/CEO	Dr.	Nguyen	Tri	T	8584493755				9493938879	tri.nguyen@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Chief Financial Officer	Chief Financial Officer	Mr.	Nelson	Tyler		8582293755				9493938879	tyler.nelson@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	12/12/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Chief Operating Officer	Chief Information Officer/Chief Operations Officer	Mr.	Tran	Viet		8587075111				9493938879	viet.tran@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Chief Information Officer	Chief Information Officer/Chief Operations Officer	Mr.	Tran	Viet		8587075111				9493938879	viet.tran@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Chief Information Security Officer	Chief Information Officer/Chief Operations Officer	Mr.	Tran	Viet		8587075111				9493938879	viet.tran@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	CMS Casework Communication Contact	Compliance Officer	Mr.	Song	Paul		8666889021				9493938879	paul.song@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Complaints Tracking Contact	Compliance Officer	Mr.	Song	Paul		8666889021					paul.song@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Contact for Fraud Investigations	Compliance Officer	Mr.	Song	Paul	J	7144834463					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Coordination of Benefits Contact	General Counsel/Compliance Officer	Mr.	Song	Paul	J	6262607366				9493938879	cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Corporate Mailing						8666889021					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	11/17/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Customer Service Operations Contact	Manager, Member Services	Ms.	Truong	Thuy		8666889021					thuy.truong@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	DIR Contact	Part D Consultant		Department	Pharmacy		8666889021					Astiva.pharmacy@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	DIR Contact (Secondary)	Asst. Controller	Mr.	Nguyen	Peter	Q	7144175133					peterQ.Nguyen@astivahealth.com	765 The City Drive		Orange	CA	92868	08/09/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Discount Program Payment Contact	Asst. Controller	Mr.	Nguyen	Peter	Q	7144175133					peterQ.Nguyen@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	08/09/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Emergency Part D Contact	Sr Director of Pharmacy		Haggit	Brian		8666889021					brian.haggit@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	05/28/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Emergency Part D Contact (Secondary)	Pharmacy		Department	Pharmacy		8666889021					Astiva.Pharmacy@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	02/03/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Encounter Data & Risk Adjustment Operations Contact	Manager Information Technology	Mr.	Lee	Tan		8666889021				7149088122	tan.lee@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Enrollment Contact	Sr. Manager, Enrollment & Member Services	Ms.	Dao	Kery		9495229170					kery.dao@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	EOB Transfer Contact	Medicare Part D		Zlotkus	Steve		8587906250				8587906250	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Financial Audit Contact	Controller	Mr.	Tran	Son		7147669099					son.tran@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Financial Reporting Contact	Controller	Mr.	Tran	Son		7147669099				9493938879	son.tran@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Formulary Contact	Clinical Formulary PHarmacist		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/29/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Formulary Contact (Secondary)	Sr Director of Pharmacy		Haggit	Brian		8666889021					brian.haggit@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	05/28/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	General Contact	General Counsel		Song	Paul		7144834463					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	05/03/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Government Relations Contact	General Counsel	Mr.	Song	Paul	J	6262607366					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	HIPAA Privacy Officer	General Counsel	Mr.	Song	Paul	J	6262607366					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	HIPAA Security Officer	General Counsel	Mr.	Song	Paul	J	6262607366					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Hospice Contact	Pharmacy		Department	Pharmacy		8666889021				9493938879	Astiva.pharmacy@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	02/03/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Interoperability Contact	COO		Tran	Viet		8666889021					viet.tran@astivahealth.com	765 The City Drive South	SUITE 200	Orange	CA	92868	02/21/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	MA Appeals/Grievances Contact	Manager, Member Services	Ms.	Truong	Thuy		8666889021					thuy.truong@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	MA Claims Processing Contact for Public Website	AVP of Claims	Ms.	Chafar	Giomara		8666889021					claims@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Marketing Contact		Mr.	Diep	Tyler		7146007836					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Medical Director	Medical Director	Dr.	Adams	John		8666889021					john.adams@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Medicare Compliance Officer	Compliance Officer	Mr.	Song	Paul		8666889021					paul.song@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Medicare Coordinator	VP, Provider Network Mgt.	Ms.	Pham, MHA	Ann		7144678733				9493938879	ann.pham@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Medicare Part D Opioid Overutilization Contact	Part D Pharmacy Consultant		Department	Pharmacy		8666889021				7149088111	Astiva.pharmacy@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Medication Therapy Management Contact	Medicare Part D		Miller	Holly		8587906250					hrmiller@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	OffShore Subcontractor Contact	Compliance Officer	Mr.	Song	Paul		8666889021					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Online Enrollment Center Contact (Primary)	Sr. Manager, Enrollment & Member Services	Ms.	Dao	Kery		9495229170					kery.dao@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part C Application Contact	Chairman of the Board/CEO	Dr.	Nguyen	Tri	T	8584493755				9493938879	tri.nguyen@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part C Reporting Contact	COO		Tran	Viet		8666889021					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	11/17/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Appeals	Pharmacy		Department	Pharmacy							astiva.pharmacy@astivahealth.com	765 The City Drive South,	Sute 200	Orange	CA	92868	02/03/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active	8666889021				HMO - Health Maintenance Organization		C	Boston
H1993	Part D Appeals Contact (Secondary)	Manager, Appeals & Grievances		Martin	Dawn							Dawn.Martin@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active	8587907118				HMO - Health Maintenance Organization		C	Boston
H1993	Part D Application Contact	Chairman of the Board/CEO	Dr.	Nguyen	Tri	T	8584493755				9493938879	tri.nguyen@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Benefits Contact	Pharmacy		Department	Pharmacy		8666889021					Astiva.pharmacy@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Claims Submission Contact	Sup Medicare Operations		Rivera-Aquino	Denisse		8582915269					PDE@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Exceptions Contact	Dir PA & UM Programs		Emoto	Julianne							Julianne.emoto@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Boston
H1993	Part D Exceptions Contact (Secondary)	Pharmacy		Department	Pharmacy							Astiva.pharmacy@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active	8666889021				HMO - Health Maintenance Organization		C	Boston
H1993	Part D Price File Contact (Back-up)	Medicare Part D		MedImpact	MedImpact		8007882949					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Price File Contact (Optional)	Financial Analyst III		Wentx	Christophe		5304171432					cwentz@medimpact.com	8957 Canyon Falls Blvd		Twinsburg	OH	44087	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Price File Contact (Primary)	Pharmacy		Department	Pharmacy		8666889021					Astiva.pharmacy@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Quality Assurance Contact	Director Pharmacy Network Contracting		Dyer	Tim		8587906250					Tdyer@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Part D Reporting Contact	Pharmacy		Department	Pharmacy		8666889021					Astiva.pharmacy@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Patient Safety Contact	Compliance Officer		Song	Paul		8584493755				9493938879	paul.song@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Payment Contact	Asst. Controller	Mr.	Nguyen	Peter	Q	7144175133					peterQ.Nguyen@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	08/09/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Pharmacy Director	Director of Pharmacy	Dr.	Director	Pharmacy		6145965346				9493938879	Astiva.pharmacy@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	02/03/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Pharmacy Network Management Contact	Director Configuration Services		Moe	Kathleen		8587907437					kathlene.moe@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Pharmacy Network Management Contact (Secondary)	Pharmacy		Department	Pharmacy		8666889021					Astiva.pharmacy@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	11/26/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active	8336976561				HMO - Health Maintenance Organization		C	Boston
H1993	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy		Department	Pharmacy							astiva.pharmacy@astivahealth.com	765 The City Drive South,	Suite 200	Orange	CA	92868	02/07/2025	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active	8666889021				HMO - Health Maintenance Organization		C	Boston
H1993	Plan Directory Contact for Public Website			Services Department	Member		8666889021					memberservices@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Plan to Plan Reconciliation Contact	Asst. Controller	Mr.	Nguyen	Peter	Q	7144175133					peterQ.Nguyen@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	08/09/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Processor Contact	Controller	Mr.	Tran	Son		7147669099				9493938879	son.tran@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Quality Contact	UM Director	Mr.	Do	Louis		8666889021				7149088111	louis.do@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Reconciliation Contact	Asst. Controller	Mr.	Nguyen	Peter	Q	7144175133					peterQ.Nguyen@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	08/09/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Reconciliation Contact (Secondary)	Controller	Mr.	Tran	Son		7147669099					son.tran@astivahealth.com	765 The City Drive		Orange	CA	92868	09/23/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Recovery Audit Contact	General Counsel/Compliance Officer	Mr.	Song	Paul	J	6262607366					paul.song@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	09/21/2022	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	SNP Application Contact	Chairman of the Board/CEO	Dr.	Nguyen	Tri	T	8584493755					tri.nguyen@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Surveillance Contact	General Counsel/Compliance Officer	Mr.	Song	Paul	J	6262607366					cmscasework@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	System Contact	Chief Information Officer/Chief Operations Officer		Tran	Viet		8587075111				9493938879	viet.tran@astivahealth.com	765 The City Drive South	Suite 200	Orang	CA	92868	10/02/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Third Party Administrator (TPA) Liaison	Asst. Controller	Mr.	Nguyen	Peter	Q	7144175133					peterQ.Nguyen@astivahealth.com	765 The City Drive	Suite 200	Orange	CA	92868	08/09/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	User Access Contact	General Counsel	Mr.	Song	Paul	J	6262607366					paul.song@astivahealth.com	3200 Bristol St.	Suite 640	Costa Mesa	CA	92626	04/03/2023	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Utilization Management Contact	UM Director		Do	Louis		8666889021				7149088122	louis.do@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1993	Utilization Review Contact	UM Director		Do	Louis		8666889021				7149088122	louis.do@astivahealth.com	765 The City Drive South	Suite 200	Orange	CA	92868	10/01/2024	2026	ASTIVA HEALTH, INC.	Local CCP	Astiva Health	HMO/HMOPOS		Astiva Health Holdings Incorporated	828	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H1994	Agent/Broker Compensation Data Contact	Broker Relations Development Manager	Ms.	DeSpain	Amy		8014427702					amy.despain@selecthealth.org	5381 S Green St		Murray	UT	84123	04/29/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Automated TrOOP Balance Transfer Contact		Mr.	Williams	Steven		8014427801					steven.l.williams@selecthealth.org	5381 S Green St		Murray	UT	84123	09/11/2012	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Backup User Access Contact	Product Development Partner	Ms.	Christensen	Star		8014427156					star.christensen@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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		8014429842					mallory.baer@selecthealth.org	5381 S Green St		Murray	UT	84123	09/20/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Bid Audit Contact	Director of Medicare Products	Mr.	Holt	Kaleb		8014427954					kaleb.holt@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Bid Primary Contact	Director of Medicare Products	Mr.	Holt	Kaleb		8014427954					kaleb.holt@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Schmidt	Clifton		8014427249					clifton.schmidt@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	CEO - CMS Administrator Contact	President and CEO	Mr.	Hitchcock	Rob		8014427249					rob.hitchcock@selecthealth.org	5381 S. Green Street		Murray	UT	84123	12/30/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	CEO - Senior Official for Contracting	President and CEO	Mr.	Hitchcock	Rob		8014427889					rob.hitchcock@selecthealth.org	5381 S. Green Street		Murray	UT	84123	03/20/2023	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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		8014427760					todd.trettin@selecthealth.org	5381 S. Green Street		Murray	UT	84123	01/25/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Chief Operating Officer	Vice President of Operations	Mr.	Griffith	Jon		8014427566					jon.griffith@selecthealth.org	5381 S. Green Street		Murray	UT	84123	04/29/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Chief Information Officer	Vice President of Operations	Mr.	Griffith	Jon		8014427566					jon.griffith@selecthealth.org	5381 S. Green Street		Murray	UT	84123	04/29/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Chief Information Security Officer	Chief Information Security Officer	Mr.	West	Karl		8014425662					karl.west@imail.org	4646 W Lake Park Blvd		West Valley City	UT	84130	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	CMMI Model Point of Contact	Medicare Product Manager	Ms.	Chazarreta	Caitlin		8014427658					caitlin.chazarreta@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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		8014427650					emily.johnson@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Complaints Tracking Contact	Appeals and Grievances Director	Ms.	Johnson	Emily		8014427650					emily.johnson@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Contact for Fraud Investigations	General Counsel	Mr.	Nielsen	Bryan		8014427259					bryan.nielsen@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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		8014427006					Rxcob@imail.org	5381 S Green St		Murray	UT	84123	04/29/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Corporate Mailing						8014425000					marketing@selecthealth.org	5381 S Green St		Murray	UT	84123	01/16/2012	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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		8014428173					jj.richins@selecthealth.org	5381 S Green St		Murray	UT	84123	05/10/2016	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	DIR Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	DIR Contact (Secondary)	Actuary Chief	Mr.	Heitman	Bob		8014429928					bob.heitman@selecthealth.org	5381 S Green St		Murray	UT	84123	04/09/2014	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Discount Program Payment Contact	Accounting Supervisor	Mr.	Applegarth	John		8014427980					john.applegarth@selecthealth.org	5381 S Green St		Murray	UT	84123	04/22/2016	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Emergency Part D Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Emergency Part D Contact (Secondary)		Mr.	Williams	Steven		8014427801					steven.l.williams@selecthealth.org	5381 S Green St		Murray	UT	84123	09/11/2012	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Employer Waiver Contact	Director of Medicare Products	Mr.	Holt	Kaleb		8014427954					kaleb.holt@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment and Coding AVP	Ms.	Welling	Rebecca		8014427760					rebecca.welling@selecthealth.org	5381 S. Green Street		Murray	UT	84123	11/16/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Enrollment Contact	Medicare Enrollment Supervisor	Ms.	Baer	Mallory		8014429842					mallory.baer@selecthealth.org	5381 S Green St		Murray	UT	84123	09/20/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	EOB Transfer Contact		Mr.	Williams	Steven		8014427801				8014426870	steven.l.williams@selecthealth.org	5381 S Green St		Murray	UT	84123	09/11/2012	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Financial Audit Contact	Controller	Ms.	Peterson	Nicole		8014427989					nicole.peterson@selecthealth.org	5381 S Green St		Murray	UT	84123	12/15/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Financial Reporting Contact	Controller	Ms.	Peterson	Nicole		8014427989					nicole.peterson@selecthealth.org	5381 S Green St		Murray	UT	84123	12/15/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Formulary Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Formulary Contact (Secondary)	Government Programs Clinical Coordinator	Mrs.	Eshelman	Samantha		8014427816					Samantha.Eshelman@selecthealth.org	5381 S Green St		Murray	UT	84123	07/01/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	General Contact	Director of Medicare Products	Mr.	Holt	Kaleb		8014427954					kaleb.holt@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Government Relations Contact	General Counsel	Mr.	Nielsen	Bryan		8014427259					bryan.nielsen@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Mendoza	Melinda		8014421502					melinda.mendoza@imail.org	36 South State Street, 10th Floor		Salt Lake City	UT	84111	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	HIPAA Security Officer	Chief Information Security Officer	Mr.	West	Karl		8014425662					karl.west@imail.org	4646 Lake Park Boulevard		Salt Lake City	UT	84120	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Interoperability Contact	Medicare Compliance Officer	Mr.	Schmidt	Clifton		8014427249					Clifton.Schmidt@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	MA Appeals/Grievances Contact	Appeals and Grievances Director	Ms.	Johnson	Emily		8014427650					emily.johnson@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	MA Claims Processing Contact for Public Website	Claims AVP	Ms.	White	Marianne		8014428206					marianne.white@selecthealth.org	5381 S Green St		Murray	UT	84123	02/20/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Marketing Contact	Compliance Partner	Ms.	Hagman	Dee		8014429331					dee.hagman@selecthealth.org	5381 S. Green Street		Murray	UT	84123	09/20/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Medical Director	Chief Medical Officer	Dr.	O'Toole	Heather		8014427775					heather.otoole@selecthealth.org	5381 S Green St		Murray	UT	84123	04/29/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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		8014427249					clifton.schmidt@selecthealth.org	5381 S Green St		Murray	UT	84123	09/17/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Medicare Coordinator	Director of Medicare Products	Mr.	Holt	Kaleb		8014427954					kaleb.holt@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Medicare Part D Opioid Overutilization Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Medication Therapy Management Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	OffShore Subcontractor Contact	Medicare Compliance Consultant	Ms.	Aumua	Portia		8014428186					portia.aumua@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Online Enrollment Center Contact (Primary)	Medicare Enrollment Supervisor	Ms.	Baer	Mallory		8014429842					mallory.baer@selecthealth.org	5381 S Green St		Murray	UT	84123	09/20/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part C Application Contact	Medicare Product Manager	Ms.	Chazarreta	Caitlin		8014427658					caitlin.chazarreta@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part C Reporting Contact	Compliance Consultant	Ms.	Prokopis	Callee		8015182562					callee.prokopis@selecthealth.org	5381 Green Street		Murray	UT	84123	02/20/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Appeals	Appeal and Grievances Director	Ms.	Johnson	Emily							emily.johnson@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	8442089012				HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Appeals Contact (Secondary)	Appeals Specialist	Ms.	Park	Marina							marina.park@selecthealth.org	5381 S Green St		Murray	UT	84123	02/20/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	8014427498				HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Application Contact	Medicare Product Manager	Ms.	Chazarreta	Caitlin		8014427658					caitlin.chazarreta@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Benefits Contact	Medicare Product Manager	Ms.	Chazarreta	Caitlin		8014427658					caitlin.chazarreta@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Claims Submission Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	8554429900				HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Exceptions Contact (Secondary)	Operations Supervisor	Ms.	Morgan	Laura							laura.morgan@selecthealth.org	5381 S Green St		Murray	UT	84123	09/05/2018	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	8554429900				HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Price File Contact (Back-up)	Business Analyst	Ms.	Robinson	Elisabeth		8014428091					Elisabeth.Robinson@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Price File Contact (Optional)	Medicare Program/Business Analyst Team Lead	Ms.	Nkansah	Cheryl		8014427818					Cheryl.Nkansah@selecthealth.org	5381 Green Street		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Price File Contact (Primary)	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Quality Assurance Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	09/20/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Part D Reporting Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Patient Safety Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Payment Contact	Accounts Receivable Manager	Ms.	Worsley	Tracy		8014427624					tracy.worsley@selecthealth.org	5381 S Green St		Murray	UT	84123	01/21/2012	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Pharmacy Director	Pharmacy Benefit Services AVP	Mr.	Cannon	Eric		8014427816					eric.cannon@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Pharmacy Network Management Contact	Pharmacy Government Programs Director	Mr.	Eaton	Mike		8014427797					mike.eaton@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Pharmacy Network Management Contact (Secondary)	Pharmacy Benefit Services AVP	Mr.	Cannon	Eric		8014427816					eric.cannon@selecthealth.org	5381 S Green St		Murray	UT	84123	01/23/2020	2026	SELECTHEALTH, INC.	Local CCP	Select Health	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.	Turner	Tiffany							tiffany.turner@selecthealth.org	5381 S Green St		Murray	UT	84123	02/20/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	8554429900				HMO - Health Maintenance Organization		C	Dallas
H1994	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Government Specialist-Team Lead	Ms.	Rodriguez	Cody							Cody.Rodriguez@selecthealth.org	5381 S Green St		Murray	UT	84123	04/21/2025	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active	8554429900				HMO - Health Maintenance Organization		C	Dallas
H1994	Plan Directory Contact for Public Website	Director of Medicare Products	Mr.	Holt	Kaleb		8014427954					kaleb.holt@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Plan to Plan Reconciliation Contact	Accounting Supervisor	Mr.	Applegarth	John		8014427980					john.applegarth@selecthealth.org	5381 S Green St		Murray	UT	84123	11/20/2012	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Processor Contact		Mr.	Williams	Steven		8014427801					steven.l.williams@selecthealth.org	5381 S Green St		Murray	UT	84123	09/11/2012	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Quality Contact	Clinical and Outcomes Management Director	Ms.	Barrus	Kim		8014427399					kim.barrus@selecthealth.org	5381 S Green St		Murray	UT	84123	09/20/2021	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Reconciliation Contact	Controller	Ms.	Peterson	Nicole		8014427989					nicole.peterson@selecthealth.org	5381 S Green St		Murray	UT	84123	12/15/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Reconciliation Contact (Secondary)	Actuary Chief	Mr.	Heitman	Bob		8014429928					bob.heitman@selecthealth.org	5381 S Green St		Murray	UT	84123	08/27/2014	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Recovery Audit Contact	Controller	Ms.	Peterson	Nicole		8014427989					nicole.peterson@selecthealth.org	5381 S Green St		Murray	UT	84123	12/15/2022	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	SNP Application Contact	Medicare Product Manager	Ms.	Chazarreta	Caitlin		8014427658					caitlin.chazarreta@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Surveillance Contact	Medicare Compliance Officer	Mr.	Schmidt	Cliff		8014427249					clifton.schmidt@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	System Contact	Director of Medicare Products	Mr.	Holt	Kaleb		8014427954					kaleb.holt@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Third Party Administrator (TPA) Liaison	Accounting Supervisor	Mr.	Applegarth	John		8014427980					john.applegarth@selecthealth.org	5381 S Green St		Murray	UT	84123	04/22/2016	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	User Access Contact	Medicare Product Manager	Ms.	Chazarreta	Caitlin		8014427658					caitlin.chazarreta@selecthealth.org	5381 S. Green Street		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Utilization Management Contact	Health Services Director	Ms.	Owens	Mary Ann		8014428171					maryann.owens@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1994	Utilization Review Contact	Health Services Director	Ms.	Owens	Mary Ann		8014428171					maryann.owens@selecthealth.org	5381 S Green St		Murray	UT	84123	06/07/2024	2026	SELECTHEALTH, INC.	Local CCP	Select Health	HMO/HMOPOS		Intermountain Health Care, Inc.	480	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H1997	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Encounter Data & Risk Adjustment Operations Contact	AD Risk Adjustment Analytics		Aryal	Binaya		5032255305					Binaya.Aryal@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/06/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	MA Appeals/Grievances Contact	Healthcare Svcs Program Mgr Sr	Ms.	Huque	Nita		5035531462					Nita.Huque@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	MA Claims Processing Contact for Public Website	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part C Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part C Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				HMO - Health Maintenance Organization		C	Kansas City
H1997	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				HMO - Health Maintenance Organization		C	Kansas City
H1997	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Quality Contact	Director, Quality Management	Mr.	Mcclure	Andy		5032206189					Andrew.Mcclure@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Utilization Management Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H1997	Utilization Review Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2001	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Formulary Contact (Secondary)	Sr. Clinical Program Consultant		Murtaugh	Tracy		9529315138					tracy_murtaugh@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	10/24/2017	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H2001	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2001	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2001	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H2001	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2001	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2029	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	03/12/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	03/12/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	03/12/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Enrollment Contact	Director, Enrollment		Bailey	Christy		5025804944					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	04/04/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	03/12/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	04/04/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H2029	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	07/17/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024989871				PPO - BBA		C	Kansas City
H2029	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	04/04/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	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	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H2029	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024682494				PPO - BBA		C	Kansas City
H2029	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8008658715				PPO - BBA		C	Kansas City
H2029	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5025800475				PPO - BBA		C	Kansas City
H2029	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	07/17/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2029	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE OF PUERTO RICO, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H2032	Agent/Broker Compensation Data Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Backup User Access Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Best Available Evidence Contact	Director, HP Enrollment		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Bid Audit Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Bid Audit Site Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Bid Primary Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	CAP Report Contact for Public Website	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	CEO - CMS Administrator Contact	CFO	Mr.	Bush	Stephen		2542986090					stephen.bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	CEO - Senior Official for Contracting	CFO	Mr.	Bush	Stephen		2542986090					stephen.bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Chief Financial Officer	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Chief Operating Officer	Chief Operating Officer	Mr.	Richey	Victor		2148204200					Vic.Richey@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Chief Information Officer	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Chief Information Security Officer	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	CMMI Model Point of Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	CMS Casework Communication Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Complaints Tracking Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Contact for Fraud Investigations	Manager, Corporate Compliance		Serrano	Gabriela		2148206970					Gabriela.Serrano@BSWHealth.org	301 N. Washington Avenue		Dallas	TX	75246	09/29/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Coordination of Benefits Contact	Director, Enrollment Operations		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Corporate Mailing						2542986088					Jeffrey.Ingrum@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Customer Service Operations Contact	Director, Customer Advocacy		Perkins	Michelle		2542983393					Michelle.Perkins@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	DIR Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	DIR Contact (Secondary)	VP, Finance		Cutroni	Michael		2542983085					Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Discount Program Payment Contact	VP, Finance		Cutroni	Michael		2542983085				2542983005	Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Electronic Health Record Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Emergency Part D Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2546243358					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations	Ms	Symm	Sheila		2542929095					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Employer Waiver Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment		Coakley	Deborah		5059342320					Deborah.Coakley@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Enrollment Contact	Director, HP Enrollment		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	EOB Transfer Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Financial Audit Contact	VP, Finance	Mr.	Cutroni	Michael		2542983085					Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Financial Reporting Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Formulary Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Formulary Contact (Secondary)	Manager, RX Operations		Symm	Sheila		2542986173					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	General Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Government Relations Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Von Sehrwald	Margaret		2542986062					Margaret.VonSehrwald@BSWHealth.org	301 N. Washington Avenue		Dallas	TX	75201	09/29/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	HIPAA Security Officer	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Hospice Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Interoperability Contact	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	MA Appeals/Grievances Contact	Director, Appeals and Grievances		Saravia	Sharon		2542986156					Sharon.Saravia@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	MA Claims Processing Contact for Public Website	Director - Claims		Barnes Hervey	Patricia		7374019216					Patricia.BarnesHervey@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Marketing Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Medical Director	Chief Medical Officer	Dr.	Waterhouse	Robert		2148652763					robert.waterhouse@BSWHealth.org	301 N Washington Ave		Dallas	TX	75246	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Medicare Compliance Officer	SVP, Ethics & Compliance	Ms	Von Sehrwald	Margaret		2148202851					Margaret.VonSehrwald@BSWHealth.org	301 N Washington Avenue		Dallas	TX	75201	07/09/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Medicare Coordinator	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Medication Therapy Management Contact	Manager, Managed Care Pharmacy		Thomas	Megan		2542986154					Megan.Cunningham@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	OffShore Subcontractor Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Online Enrollment Center Contact (Primary)	Director, HP Enrollment		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part C Application Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part C Reporting Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Appeals	Director, Appeals and Grievances		Saravia	Sharon							Sharon.Saravia@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active	2542986156				PPO - BBA		C	Denver
H2032	Part D Appeals Contact (Secondary)	Manager, Appeals and Grievances		Banks	Rametria						2542983086	Rametria.Banks@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active	2542983490				PPO - BBA		C	Denver
H2032	Part D Application Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Benefits Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Claims Submission Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Exceptions Contact	Manager, Managed Care Pharmacy		Thomas	Megan							Megan.Cunningham@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active	2542986108				PPO - BBA		C	Denver
H2032	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations		Luebbert	Charlotte							Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active	2542986151				PPO - BBA		C	Denver
H2032	Part D Price File Contact (Back-up)	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Price File Contact (Optional)	Manager, Rx Operations		Symm	Sheila		2542986173					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Price File Contact (Primary)			Rx	Capital		6154231269					governmentprograms@cap-rx.com	228 Park Avenue South	Suite 87234	New York	NY	10003	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Quality Assurance Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Part D Reporting Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Patient Safety Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Payment Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Pharmacy Director	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Pharmacy Network Management Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Pharmacy Network Management Contact (Secondary)	Manager, RX Operations		Symm	Sheila		2542986173					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Pharmacy Technical Help Desk Contact			Rx	Capital							giajernigan@cap-rx.com	228 Park Avenue South	Suite 87234	New York	NY	10003	12/11/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active	8442309357				PPO - BBA		C	Denver
H2032	Physician Incentive Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Plan Directory Contact for Public Website	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Plan to Plan Reconciliation Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Processor Contact	Chief Financial Officer		Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Quality Contact	Director, QI & Clinical Analytics		Lanns	Brandy		2256102502				2542983005	Brandy.Lanns@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Reconciliation Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Reconciliation Contact (Secondary)	Manager, Finance		Albright	Irina		7374019254					Irina.Albright@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Recovery Audit Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	SNP Application Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	SNP State Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Surveillance Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	System Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Third Party Administrator (TPA) Liaison	VP, Finance		Cutroni	Michael		2542983085				2542983005	Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	User Access Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Utilization Management Contact	Director, Health Services		Adda	Kimberley		2542983674				2542983005	kimberley.adda@bswhealth.org	1206 West Campus Drive		Temple	TX	76502	08/27/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2032	Utilization Review Contact	Director, Health Services		Adda	Kimberley		2542983674				2542983005	Kimberley.Adda@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	08/27/2025	2026	Baylor Scott & White Insurance Company	Local CCP	Baylor Scott & White Health Plan	Local PPO		Baylor Scott & White Health	588	Yes	Active					PPO - BBA		C	Denver
H2034	Agent/Broker Compensation Data Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Automated TrOOP Balance Transfer Contact	Director of Operations	Mrs.	Slowiak	Andrea		7158522983					aslowiak@pharmastar.com	2427 Hillcrest Parkway		Altoona	WI	54720	02/19/2021	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Backup User Access Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	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		2622079374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Bid Audit Contact	Financial Planning Manager	Mr	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/22/2021	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Bid Audit Site Contact	Financial Planning Manager	Mr.	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/22/2021	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Bid Primary Contact	Financial Planning Manager	Mr.	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	11/18/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	CAP Report Contact for Public Website	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Munson	Kenneth		4142314000					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfiedl	WI	53005	08/14/2013	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	CEO - Senior Official for Contracting	CEO	Mr	Munson	Kenneth		4142314000					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	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	Mr.	Newmeister	Troy		4142314000					troy.newmeister@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/25/2025	2026	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 Operating Officer	Chief Program Officer	Ms.	Carter	Kelly		4142314000					kelly.carter@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	03/07/2025	2026	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 Information Officer	Chief Information Officer	Ms.	Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet St.		Milwaukee	WI	53208	02/26/2016	2026	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 Information Security Officer	Chief Information Officer	Ms.	Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet St.		Milwaukee	WI	53208	02/26/2016	2026	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		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Complaints Tracking Contact	Member Rights Specialist		Olson	Chris		2622079325					MemberRights@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Contact for Fraud Investigations	Compliance Specialist		Frazer	Amanda		2622079326					amanda.frazer@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	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	Mr	Hau	Jeremy		2629538627					jeremy.hau@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	11/30/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Corporate Mailing						4142314000					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2013	2026	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		2622079323					kelly.carter@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	11/13/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	DIR Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/21/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	DIR Contact (Secondary)	Chief Financial Officer	Mr.	Newmeister	Troy		2622079371					troy.newmeister@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/25/2025	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Discount Program Payment Contact	Director of Financial Planning	Mr.	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	04/04/2025	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Electronic Health Record Contact	Director, Clinical Informatics		Cowie	Cindy		4142314250					cindy.cowie@communitycareinc.org	3220 W. Vliet St.		Milwaukee	WI	53208	04/12/2016	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Emergency Part D Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	10/02/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Emergency Part D Contact (Secondary)	Pharmacy Manager	Mr.	Hamdan	Mohammad		4149022475					mohammad.hamdan@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	10/02/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Encounter Data & Risk Adjustment Operations Contact			Schlei	Matthew		4142314258					Matthew.Schlei@communitycareinc.org	205 Bishop's Way		Brookfield	WI	53005	03/10/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Enrollment Contact	Claims Manager	Mr	Hau	Jeremy		2629538627					jeremy.hau@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	11/30/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	EOB Transfer Contact	Operations Support Supervisor	Ms.	Biren	Alicia		8882987770				7158367683	abiren@pharmastarpbm.com	P.O. Box 3217		Eau Claire	WI	54702	11/24/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Financial Audit Contact	Chief Financial Officer	Mr.	Newmeister	Troy		2622079371					troy.newmeister@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/25/2025	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Financial Reporting Contact	Chief Financial Officer	Mr.	Newmeister	Troy		2622079371					troy.newmeister@communitycareinc.org	205 Bishops Way.		Brookfield	WI	53005	06/25/2025	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Formulary Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	10/02/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Formulary Contact (Secondary)	Pharmacy Manager	Mr.	Hamdan	Mohammad		4149022475					mohammad.hamdan@communitycareinc.org	1555 S. Layton Blvd.		Milwaukee	WI	53215	10/02/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	General Contact	Chief Compliance and Quality Officer	Mr	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/04/2024	2026	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		2622079339					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	03/23/2015	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	HIPAA Privacy Officer	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	HIPAA Security Officer	Chief Information Officer	Ms.	Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet St.		Milwaukee	WI	53208	03/26/2025	2026	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 Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Interoperability Contact	Chief Information Officer	MS.	Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet Street		Milwaukee	WI	53208	02/16/2022	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	MA Appeals/Grievances Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	MA Claims Processing Contact for Public Website	Claims Manager	Mr	Hau	Jeremy		2629538627					jeremy.hau@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	06/04/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Marketing Contact	Marketing & Communications Manager		Yank	Sarah		2622079337					sarah.yank@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Medical Director	Medical Director	Dr.	Almas	Rakhshinda		2622079338					rakhshinda.almas@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	01/24/2014	2026	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		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	03/10/2020	2026	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 Coordinator	Chief Compliance & Quality Officer	Mr	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Medication Therapy Management Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	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 C Application Contact	Chief Compliance and Quality Officer	Mr	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/04/2024	2026	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 C Reporting Contact	Chief Compliance and Quality Manager	Mr	Garlie	Garlie		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/04/2024	2026	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 Appeals	Member Rights Specialist		Olson	Chris							MemberRights@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active	2622079325				HMO - Health Maintenance Organization		C	Chicago
H2034	Part D Appeals Contact (Secondary)	Director of Quality		Baker	Theresa							theresa.bake@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active	8669926600	79308			HMO - Health Maintenance Organization		C	Chicago
H2034	Part D Application Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brokfield	WI	53005	06/21/2024	2026	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 Benefits Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/29/2023	2026	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 Claims Submission Contact	Client Support Supervisor	Ms	Vang	Jane		8882987770					jvang@pharmastar.com	2503 N. Hillcrest Parkway		Altoona	WI	54720	03/02/2021	2026	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	Mrs.	Farley-Snieg	Megan							megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/29/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active	8669926600	22527			HMO - Health Maintenance Organization		C	Chicago
H2034	Part D Price File Contact (Back-up)	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	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 Price File Contact (Optional)	Client Support Manager	Ms	Slowiak	Andrea		7158522983					aslowiak@pharmastar.com	Pharmastar	P.O. Box 3217	Eau Claire	WI	54702	03/02/2021	2026	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 Price File Contact (Primary)	Formulary & Plan Benefit Coordinator	Ms	Biren	Alicia		7158522061					abiren@pharmastar.com	Pharmastar	P.O. Box 3217	Eau Claire	WI	54702	03/02/2021	2026	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 Quality Assurance Contact	Director of Quality		Baker	Theresa		2622079308					theresa.baker@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	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 Reporting Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michale.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/21/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Patient Safety Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Payment Contact	Financial Planning Manager	Mr.	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/22/2021	2026	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 Director	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/29/2023	2026	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 Network Management Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	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	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active	8882987770				HMO - Health Maintenance Organization		C	Chicago
H2034	Physician Incentive Contact	Medical Director	Dr.	Almas	Rakhshinda		2622079338					rakhshinda.almas@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	11/13/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Plan Directory Contact for Public Website			Hotline	Provider		8669372783					claimsinquiries@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	02/17/2010	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Plan to Plan Reconciliation Contact	Accounting Specialist - Medicare	Ms	Instefjord	Lori		2622079374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Processor Contact	Client Support Supervisor	Ms.	Vang	Jane		7158522064					jvang@pharmastar.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	03/02/2021	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Quality Contact	Director of Quality		Baker	Theresa		2622079308					theresa.baker@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Reconciliation Contact	Accounting Specialist - Medicare	Ms.	Instefjord	Lori		2622079374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Reconciliation Contact (Secondary)	Mbr. Accounting Mgr.	Ms.	Burgess	Valerie		2622079376					valerie.burgess@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	02/20/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Recovery Audit Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycarinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	SNP Application Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/21/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	SNP State Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/21/2024	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Surveillance Contact	Chief Compliance and Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	11/13/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	System Contact	Chief Information Officer		Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet Street		Milwaukee	WI	53208	05/25/2011	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Third Party Administrator (TPA) Liaison	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	User Access Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Utilization Management Contact	Medical Director	Dr.	Almas	Rakhshinda		2622079338					rakhshinda.almas@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2020	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2034	Utilization Review Contact	Medical Director	Dr.	Almas	Rakhshinda		2622079338					rakhshinda.almas@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	01/24/2014	2026	COMMUNITY CARE HEALTH PLAN, INC.	Local CCP	Community Care	HMO/HMOPOS		Community Care, Inc.	62	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2035	Agent/Broker Compensation Data Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	05/28/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Automated TrOOP Balance Transfer Contact	Business Systems Analyst		Murray	Karla		2672985899					kdmurray@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Backup User Access Contact	Director, Compliance & Special Investigations		Smythe	Stephen		5103735721					ssmythe@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Best Available Evidence Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Bid Audit Contact	CFO	Mr.	Riojas	Gil		5103735696					griojas@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/24/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Bid Audit Site Contact	Executive Director, Medicare Programs		Meyers	Tome		5107476239					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Bid Primary Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	CAP Report Contact for Public Website	Director, Compliance & Special Investigations		Smythe	Stephen		5103735721					ssmythe@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	CEO - CMS Administrator Contact	CEO	Mr.	Woodruff	Matt		5107476180					mwoodruff@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	CEO - Senior Official for Contracting	CEO	Mr.	Woodruff	Matt		5107476180					mwoodruff@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Chief Financial Officer	CFO	Mr.	Riojas	Gil		5103735696					griojas@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Chief Operating Officer	COO	Ms.	Watson	Ruth		5103735681					rwatson@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Chief Information Officer	CIO	Mr.	Karaiyan	Sasikumar		5103735630					skaraiyan@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Chief Information Security Officer	CIO	Mr.	Karaiyan	Sasikumar		5103735630					skaraiyan@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	CMS Casework Communication Contact	Senior Director, Health Care Services		Lam	Allison		5109951010					alam@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Complaints Tracking Contact	Director, Quality Assurance		Karmelich	Jennifer		5103735648					jkarmelich@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Contact for Fraud Investigations	Director, Compliance & Special Investigations		Smythe	Stephen		5103735721					ssmythe@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Coordination of Benefits Contact	Executive Director, Operations		Lewis	Tami		5107476181					tlewis@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Corporate Mailing						5107476178					mvalles@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Customer Service Operations Contact	Sr. Director, Member Service		DeGrano	Gia		5107476139					gdegrano@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	DIR Contact	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	DIR Contact (Secondary)	Pharmacy Supervisor		Negash	Rahel		5107476108					rnegash@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Discount Program Payment Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Emergency Part D Contact	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Emergency Part D Contact (Secondary)	Pharmacy Supervisor		Negash	Rahel		5107476108					rnegash@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Encounter Data & Risk Adjustment Operations Contact	Director, Stars Strategy and Program Management		Goradia	Jaini		5109954717					jgoradia@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Enrollment Contact	Senior Lead Business Analyst		Gordon	Kathy		5107476264					kgordon@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	EOB Transfer Contact			Lewis	Tami		5107476168				5107474181	tlewis@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Financial Audit Contact	CFO	Mr.	Riojas	Gil		5103735696					griojas@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Financial Reporting Contact	Director, Financial Planning & Analysis		Ly	Linda		5107476218					lly@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Formulary Contact	Director of Formulary Management		Megargell	Lauren		2159374135					lmegargell@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	General Contact	Associate Director Regulatory Affairs		Broadnax	Marie		5107476269					mbroadnax@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	11/20/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Government Relations Contact	Senior Manager, Public Affairs and Media Relations		Rivera	Karina		5103735730					krivera@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	HIPAA Privacy Officer	CCO/CPO		Golfin III	Richard		5107476245					rgolfin@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	HIPAA Security Officer	CCO/CPO		Golfin III	Richard		5107476245					rgolfin@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Hospice Contact	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Interoperability Contact	Director, Data Exchange and Interoperability		Gustas	Samuel		5103735769					sgustas@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	MA Appeals/Grievances Contact	Director, Quality Assurance		Karmelich	Jennifer		5103735648					jkarmelich@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	MA Claims Processing Contact for Public Website	Executive Director, Operations		Lewis	Tami		5107476181					tlewis@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Marketing Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Medical Director	CMO	Dr.	Carey	Donna		5103735738					dcarey@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/29/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Medicare Compliance Officer	CCO/CPO	Mr.	Golfin III	Richard		5107476245					rgolfin@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/29/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Medicare Coordinator	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Medicare Part D Opioid Overutilization Contact	Director, Clinical Outcomes and Therapeutic Opt.		McMahon, PharmD	Courtney		2159378563					cmcmahon@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Medication Therapy Management Contact	Director, Clinical Outcomes and Therapeutic Opt.		McMahon, PharmD	Courtney		2159378563					cmcmahon@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part C Application Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part C Reporting Contact	CAO	Ms.	Cheang	Tiffany		5107476088					tcheang@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/29/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Appeals	Director of Pharmacy Utilization Management		Bonko	Gerald						2158635100	gbonko@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Appeals Contact (Secondary)	Clinical Pharmacist, Manager of Pharmacy PA		McHale	Shawn						2158635100	smchale@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Application Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Benefits Contact	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Claims Submission Contact	Director of Clinical Operations		Ortiz	Noel		2159375325					nortiz@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	09/02/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Exceptions Contact	Director of Pharmacy Utilization Management		Bonko	Gerald						2158635100	gbonko@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Exceptions Contact (Secondary)	Clinical Pharmacist, Manager of Pharmacy PA		McHale	Shawn						2158635100	smchale@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Price File Contact (Back-up)	Medicare Part D Program Analyst		Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	009094830	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Price File Contact (Optional)	Medicare Part D Program Analyst		Weihe	Heather		4127156363					Heather.Weihe@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	009094830	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Price File Contact (Primary)	Medicare Part D Program Analyst		West	Ariel		3133781225					Ariel.West@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	009094830	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Quality Assurance Contact	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Part D Reporting Contact	CAO	Ms.	Cheang	Tiffany		5107476088					tcheang@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/29/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Patient Safety Contact	Director, Clinical Outcomes and Therapeutic Opt.		McMahon, PharmD	Courtney		2159378563					cmcmahon@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Payment Contact	CFO	Mr.	Riojas	Gil		5103735696					griojas@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/24/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Pharmacy Director	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Pharmacy Network Management Contact	Vice President Network Strategy		Sullivan	Tim		6303303638					tssullivan@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Pharmacy Network Management Contact (Secondary)	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Pharmacy Technical Help Desk Contact	Vice President Network Strategy		Sullivan	Tim							tssullivan@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active	6303303638				HMO - Health Maintenance Organization		C	Dallas
H2035	Pharmacy Technical Help Desk Contact (Secondary)	Manager Pharmacy Network		Patel	Disha							dpatel5@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active	8565061974				HMO - Health Maintenance Organization		C	Dallas
H2035	Physician Incentive Contact	CAO	Ms.	Cheang	Tiffany		5107476088					tcheang@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/29/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Plan Directory Contact for Public Website	Sr. Manager, Provider Services		Gomez	Cecilia		5107476114					cgomez@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Plan to Plan Reconciliation Contact	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Processor Contact	Director of Clinical Operations		Ortiz	Noel		2159375325					nortiz@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Quality Contact	Senior Director of Quality		Stott	Michelle		5109951209					mstott@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/30/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Reconciliation Contact	CFO	Mr.	Riojas	Gil		5103735696					griojas@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/24/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Reconciliation Contact (Secondary)	Assistant Controller		Rodriguez	Felix		5109951031					frodriguez@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Recovery Audit Contact	Executive Director, Operations	Ms.	Lewis	Tami		5107476181					tlewis@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/29/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	SNP Application Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Surveillance Contact	Executive Director, Medicare Programs		Meyers	Tome		5105415493					tmeyers@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/03/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	System Contact	CIO	Mr.	Karaiyan	Sasikumar		5103735630					skaraiyan@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Third Party Administrator (TPA) Liaison	Senior Director of Pharmacy Services		Lim	Luke		5109954781					lulim@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	06/05/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	User Access Contact	CCO/CPO	Mr.	Golfin III	Richard		5107476245					rgolfin@alamedaalliance.org	1240 S. Loop Rd		Alameda	CA	94502	01/29/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Utilization Management Contact	Director of Pharmacy Utilization Management		Bonko	Gerald		2158636483				2158635100	gbonko@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2035	Utilization Review Contact	Director of  Pharmacy Utilization Management		Bonko	Gerald		2158636483				2158635100	gbonko@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	06/04/2025	2026	ALAMEDA ALLIANCE FOR HEALTH	Local CCP	Alameda Alliance for Health	HMO/HMOPOS		Alameda Alliance for Health	314	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2041	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Boston
H2041	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	Boston
H2041	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Boston
H2041	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Boston
H2041	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H2041	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Boston
H2041	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	Boston
H2041	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2041	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF MISSOURI INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2056	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/30/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H2056	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/06/2018	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2056	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2064	Automated TrOOP Balance Transfer Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Backup User Access Contact	Director Quality and Regulatory  Operations	Ms.	Coolbaugh	Brenna		5708850074				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-56	Danville	PA	178226065	04/17/2025	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Best Available Evidence Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Bid Primary Contact	Director, Financial Reporting	Ms.	Pusti	Jessica		5705825447					jmpusti1@geisinger.edu	100 North Academy Avenue	MC 30-69	Danville	PA	178223069	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	CAP Report Contact for Public Website	Director, Quality and Regulatory Operations	Ms.	Coolbaugh	Brenna		5708462911				5708088949	bcoolbaugh1@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	CEO - CMS Administrator Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr.	Van Leeuwe	Matthew		5702716712					mvanleeuwe1@geisinger.edu	44 Woodbine Lane	MC 01-41	Danville	PA	178220141	11/28/2023	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Chief Financial Officer	Director, Financial Reporting	Ms.	Pusti	Jessica		5705825447					jmpusti1@geisinger.edu	100 North Academy Avenue	MC 30-69	Danville	PA	178223069	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Chief Operating Officer	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Chief Information Officer	Associate Vice President, Director, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Chief Information Security Officer	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	CMS Casework Communication Contact	Director, Quality and Regulatory Operations	Ms.	Coolbaugh	Brenna		5708462911				5708088949	bcoolbaugh1@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Complaints Tracking Contact	Director, Quality and Regulatory Operations	Ms.	Coolbaugh	Brenna		5708462911				5708088949	bcoolbaugh1@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Contact for Fraud Investigations	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Coordination of Benefits Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena	A	5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Corporate Mailing						5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Ave	MC 78-01	Danville	PA	178227801	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Customer Service Operations Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	DIR Contact	Director, Financial Reporting	Ms.	Pusti	Jessica		5705825447					jmpusti1@geisinger.edu	100 North Academy Avenue	MC 30-69	Danville	PA	178223069	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	DIR Contact (Secondary)	Accountant Intermediate	Ms.	Manning	Emily		5702715555					ekmanning1@geisinger.edu	100 North Academy Avenue		Danville	PA	17822	07/31/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Discount Program Payment Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Emergency Part D Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Emergency Part D Contact (Secondary)	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Encounter Data & Risk Adjustment Operations Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149790	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Enrollment Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	EOB Transfer Contact		Ms.	Bertollo	Krista		5702145059				5702146768	EOBP2P@thehealthplan.com	100 North Academy Avenue	MC3245	Danville	PA	17822	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Financial Audit Contact	Director, Financial Reporting	Ms.	Pusti	Jessica		5705825447					jmpusti1@geisinger.edu	100 N Academy Avenue	MC 30-69	Danville	PA	178223069	08/13/2021	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Financial Reporting Contact	Accountant Intermediate	Ms.	Manning	Emily		5702715555					ekmanning1@geisinger.edu	10 N Academy Avenue		Danville	PA	17822	07/31/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Formulary Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	General Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena	M	5702144179				5702149791	tmkubasti@geisinger.edu	1100 Spruce St Ste 100	MC 60-65	Kulpmont	PA	17834	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Government Relations Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	HIPAA Privacy Officer	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	HIPAA Security Officer	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Interoperability Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790					tmkubasti@geisinger.edu	100 North Academy Ave		Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	MA Appeals/Grievances Contact	Director, Quality and Regulatory Operations	Ms.	Coolbaugh	Brenna		5708462911				5708088949	bcoolbaugh1@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	MA Claims Processing Contact for Public Website	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Marketing Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 7801	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Medical Director	Medical Director, LIFE Geisinger	Dr.	Pacheco	Cybele		5702149790				5702149791	cpacheco@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Medicare Compliance Officer	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Medicare Coordinator	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Medicare Part D Opioid Overutilization Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Medication Therapy Management Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Online Enrollment Center Contact (Back-up)	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Online Enrollment Center Contact (Optional)	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Online Enrollment Center Contact (Primary)	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part C Application Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Appeals	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena						5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active	8003958759				PACE - Nat		C	Philadelphia
H2064	Part D Appeals Contact (Secondary)	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A					5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active	8003958759				PACE - Nat		C	Philadelphia
H2064	Part D Application Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Benefits Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Claims Submission Contact	AVP Financial Operations	Mr.	Gallagher	Scott		5705922355					segallagher@geisinger.edu	100 North Academy Avenue	MC 49-52	Danville	PA	178224952	08/13/2021	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Exceptions Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena						5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active	8003958759				PACE - Nat		C	Philadelphia
H2064	Part D Exceptions Contact (Secondary)	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A					5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active	8003958759				PACE - Nat		C	Philadelphia
H2064	Part D Price File Contact (Back-up)	AVP Financial Operations	Mr.	Gallagher	Scott		5705922355					segallagher@geisinger.edu	100 North Academy Avenue	MC 49-52	Danville	PA	178224952	08/13/2021	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Price File Contact (Optional)	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Price File Contact (Primary)	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Quality Assurance Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Part D Reporting Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Patient Safety Contact	Director, Quality and Regulatory Operations	Ms.	Coolbaugh	Brenna		5708462911				5708088949	bcoolbaugh1@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Payment Contact	Director, Financial Reporting	Ms.	Pusti	Jessica		5705825447					jmpusti1@geisinger.edu	100 North Academy Avenue	MC 30-69	Danville	PA	178223069	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Personal Health Record Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Pharmacy Director	Medical Director, LIFE Geisinger	Dr	Pacheco	Cybele		5702149790				5702149791	cpacheco@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Pharmacy Network Management Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Pharmacy Network Management Contact (Secondary)	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Pharmacy Technical Help Desk Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena						5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active	8003958759				PACE - Nat		C	Philadelphia
H2064	Pharmacy Technical Help Desk Contact (Secondary)	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A					5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active	8003958759				PACE - Nat		C	Philadelphia
H2064	Plan Directory Contact for Public Website	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Plan to Plan Reconciliation Contact	Accountant Intermediate	Ms.	Manning	Emily		5702715555					ekmanning1@geisinger.edu	100 North Academy Avenue		Danville	PA	17822	07/31/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Processor Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Quality Contact	Director, Quality and Regulatory Operations	Ms.	Coolbaugh	Brenna		5708462911				5708088949	bcoolbaugh1@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Reconciliation Contact	Director, Financial Reporting	Ms.	Pusti	Jessica		5705825447					jmpusti1@geisinger.edu	100 North Academy Avenue	MC 30-69	Danville	PA	178223069	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Reconciliation Contact (Secondary)	AVP Financial Operations	Mr.	Gallagher	Scott		5705822355					segallagher@geisinger.edu	100 North Academy Avenue	MC 49-52	Danville	PA	178224952	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Recovery Audit Contact	Coordinator Quality & Reporting - LIFE Geisinger	Ms.	Palmer	Deborah	A	5702149806				5702149791	dapalmer@geisinger.edu	100 North Academy Avenue	MC 60-65	Danville	PA	178226065	03/11/2022	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Surveillance Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	System Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Third Party Administrator (TPA) Liaison	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	User Access Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Utilization Management Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2064	Utilization Review Contact	Associate Vice President, LIFE Geisinger	Ms.	Kubasti	Teena		5702149790				5702149791	tmkubasti@geisinger.edu	100 North Academy Avenue	MC 78-01	Danville	PA	178227801	05/28/2024	2026	GEISINGER COMMUNITY HEALTH SERVICES	National PACE	LIFE Geisinger	National PACE		Risant Health, Inc.	96	Yes	Active					PACE - Nat		C	Philadelphia
H2085	Automated TrOOP Balance Transfer Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Backup User Access Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	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		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Bid Primary Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	CAP Report Contact for Public Website	Health Plan Operations Manager		Wachsmuth	Rosalie		5032156556				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	CEO - CMS Administrator Contact		Ms.	Tuller	Susan		2066048256					susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/27/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	CEO - Senior Official for Contracting	Executive Director	Ms.	Tuller	Susan		2063205325				2067606339	susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	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		5032153859					natalie.barr@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Chief Operating Officer		Ms.	Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Chief Information Officer		Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Chief Information Security Officer		Ms.	Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2026	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		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Complaints Tracking Contact	Quality, Compliance Manager		Vemuri	Susan		2063205325				2067606339	susan.vemuri@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Contact for Fraud Investigations	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/20/2021	2026	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		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Corporate Mailing						7072544169					cregalia@collabriacare.org	414 South Jefferson Street		Napa	CA	94559	12/20/2021	2026	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		2063205325					Velaa.Chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	DIR Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	DIR Contact (Secondary)			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Discount Program Payment Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Emergency Part D Contact			Schultz	Elizabeth		2066048256					elizabeth.schultz@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/27/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Encounter Data & Risk Adjustment Operations Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Enrollment Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	EOB Transfer Contact	PACEHealth Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Financial Audit Contact	Health Plan Operations Manager	Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Financial Reporting Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Formulary Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Formulary Contact (Secondary)			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Portland	OR	97213	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	General Contact			Regalia	Celine		7072544169					cregalia@collabriacare.org	414 South Jefferson Street		Napa	CA	94559	12/20/2021	2026	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		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	HIPAA Privacy Officer			Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	HIPAA Security Officer		Ms.	Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/12/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Interoperability Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Portland	OR	97213	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	MA Appeals/Grievances Contact			Chinn	Velaa		2063205325					Velaa.Chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	MA Claims Processing Contact for Public Website	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Marketing Contact			Kentta	Jenny		2063205325					Jennifer.Kentta@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Medical Director	Medical Director		Kazemi	Assad		2063205325				2067606339	Assad.Kazemi@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	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		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/21/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Medicare Coordinator			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Medicare Part D Opioid Overutilization Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Medication Therapy Management Contact	Medical Director		Kazemi	Assad		2063205325				2067606339	assadullah.kazemi@providence.org	4400 NE Halsey, Building 1, Suite 200		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part C Application Contact			Regalia	Celine		7072544169					cregalia@collabriacare.org	414 S. Jefferson Street		Napa	CA	94559	10/24/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Appeals	Health Plan Operations Manager		Wachsmuth	Rosalie						5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	5032153681				PACE - Nat		C	San Francisco
H2085	Part D Appeals Contact (Secondary)			Chinn	Velaa							Velaa.Chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	2063205325				PACE - Nat		C	San Francisco
H2085	Part D Application Contact			Regalia	Celine		7072544169					cregalia@collabriacare.org	414 S. Jefferson Street		Napa	CA	94559	10/24/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Benefits Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Claims Submission Contact			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/21/2022	2026	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	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	5032153672				PACE - Nat		C	San Francisco
H2085	Part D Exceptions Contact (Secondary)	Health Plan Operations Manager		Wachsmuth	Rosalie						5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	01/21/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	5032153681				PACE - Nat		C	San Francisco
H2085	Part D Price File Contact (Back-up)			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/21/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Price File Contact (Optional)			Chinn	Velaa		2063205325					Velaa.Chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Price File Contact (Primary)			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/21/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Quality Assurance Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	01/21/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Part D Reporting Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Patient Safety Contact	Quality, Risk, and Informatics Manager		Reed	Rebecca		5032153465					rebecca.reed@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Payment Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Personal Health Record Contact	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Pharmacy Director			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Pharmacy Network Management Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Pharmacy Network Management Contact (Secondary)			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	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	1801 Lind Ave SW, Suite W217		Re	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	4255256908				PACE - Nat		C	San Francisco
H2085	Pharmacy Technical Help Desk Contact (Secondary)			Wachsmuth	Rosalie							rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active	5032153681				PACE - Nat		C	San Francisco
H2085	Plan Directory Contact for Public Website			Bering	Rika		5032153857				2067606339	rika.bering@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Plan to Plan Reconciliation Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Processor Contact	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Quality Contact			Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Reconciliation Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Reconciliation Contact (Secondary)			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Recovery Audit Contact	Health Plan Operations Manager	Ms.	Wachsmuth	Rosalie		5032154124					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Surveillance Contact	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	System Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		R	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Third Party Administrator (TPA) Liaison			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	12/20/2021	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	User Access Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/05/2024	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Utilization Management Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2085	Utilization Review Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	COLLABRIA CARE	National PACE	Providence PACE	National PACE		St. Joseph Home Care Network	800	Yes	Active					PACE - Nat		C	San Francisco
H2100	Automated TrOOP Balance Transfer Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Backup User Access Contact			Durbin	Patrick		8446642248					pdurbin@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Best Available Evidence Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Bid Primary Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	CAP Report Contact for Public Website			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	CEO - CMS Administrator Contact		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	CEO - Senior Official for Contracting		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Chief Financial Officer		Mr.	Fuentes	Robert		8446642248					rfuentes@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Chief Operating Officer		Ms.	Funk	Jennie		8446642248					jfunk@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Chief Information Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Chief Information Security Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	CMS Casework Communication Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Complaints Tracking Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Contact for Fraud Investigations			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Coordination of Benefits Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Corporate Mailing						8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Customer Service Operations Contact			Waschevski	Susan		8446642248					swaschevski@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	DIR Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Discount Program Payment Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Emergency Part D Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Encounter Data & Risk Adjustment Operations Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Enrollment Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	EOB Transfer Contact			Siler	Sarah		8446642248				9167372990	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Financial Audit Contact	Sr. Dir, Health Plan	Mrs.	Siler	Sarah		8446642248				9167372990	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Financial Reporting Contact			Ryan	Chandler		8446642248					cryan@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Formulary Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	General Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Government Relations Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	HIPAA Privacy Officer			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	HIPAA Security Officer			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Interoperability Contact			Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	MA Appeals/Grievances Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	MA Claims Processing Contact for Public Website			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Marketing Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Medical Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Medicare Compliance Officer		Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Medicare Coordinator	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Medicare Part D Opioid Overutilization Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Medication Therapy Management Contact	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part C Application Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part D Appeals		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8446642248				PACE - Nat		C	San Francisco
H2100	Part D Application Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part D Benefits Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part D Claims Submission Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part D Exceptions Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8446642248				PACE - Nat		C	San Francisco
H2100	Part D Price File Contact (Back-up)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part D Price File Contact (Primary)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part D Quality Assurance Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Part D Reporting Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Patient Safety Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Payment Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Pharmacy Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Pharmacy Network Management Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Pharmacy Technical Help Desk Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8446642248				PACE - Nat		C	San Francisco
H2100	Plan Directory Contact for Public Website			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Plan to Plan Reconciliation Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Processor Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Quality Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Reconciliation Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Recovery Audit Contact	VP, Compliance	Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Surveillance Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	System Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Third Party Administrator (TPA) Liaison			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	User Access Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Utilization Management Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2100	Utilization Review Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH SAN LEANDRO, LLC	National PACE	Habitat Health San Leandro	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H2108	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	07/03/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H2108	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H2108	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H2108	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H2108	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H2108	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H2108	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2108	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH MID-ATLANTIC, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2109	Automated TrOOP Balance Transfer Contact	Director	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	Backup User Access Contact	Operations Director	Mr.	Rund	Jack		4105507044				4105507045	jrund1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	09/20/2018	2026	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	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	Bid Primary Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	CAP Report Contact for Public Website	Director	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	CEO - CMS Administrator Contact	President	Mr.	Sowers	Kevin	W	4109559540					ksowers4@jhmi.edu	600 N. Wolfe Street, Administration 400		Baltimore	MD	212871900	04/12/2018	2026	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	CEO - Senior Official for Contracting	President	Mr.	Sowers	Kevin	W	4109559540					ksowers4@jhmi.edu	600 N. Wolfe Street, Administration 400		Baltimore	MD	212871900	04/12/2018	2026	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	Ms.	Williams	Katina		4105025388				4109550732	kwill249@jhmi.edu	600 N. Wolfe Street, Billings Administration, Suite 414		Baltimore	MD	21287	09/03/2025	2026	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 Operating Officer	Chief Operating Officer	Dr.	Ishii	Lisa		4109554985					learnes2@jhmi.edu	733 N Broadway		Baltimore	MD	21205	08/09/2022	2026	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 Information Officer	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 Information Security Officer	Director	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Complaints Tracking Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Contact for Fraud Investigations	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Corporate Mailing						4109555000					ksowers4@jhmi.edu	600 N. Wolfe Street, Administration 400		Baltimore	MD	212871900	08/09/2022	2026	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	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	DIR Contact	Director	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	DIR Contact (Secondary)	Operations Director	Mr.	Rund	Jack		4105507044				4105507045	jrund1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	09/20/2018	2026	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	Discount Program Payment Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Emergency Part D Contact	Manager On-Call		on-call	Manager		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Emergency Part D Contact (Secondary)	Director of Operations		Rund	Jack		4436178247					jrund1@jhmi.edu	4940 Eastern Avenue	Mason Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	12/14/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Enrollment Contact	Outreach Coordinator	Ms.	Williams	Tiffani		4105507044				4105507045	twilli19@jhmi.edu	4940 Eastern Avenue, Mason F Lord Building 1st Floor		Baltimore	MD	21224	08/09/2022	2026	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	EOB Transfer Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Financial Audit Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Financial Reporting Contact	Director	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	Formulary Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	General Contact	Director	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	HIPAA Privacy Officer	Senior Counsel	Mr.	Bradfield	Donald	L	4105507044				4105507045	dbradfi4@jhmi.edu	5801 Smith Avenue, McAuley Hall, Suite 310		Baltimore	MD	21209	01/13/2012	2026	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	HIPAA Security Officer	Senior Counsel	Mr.	Bradfield	Donald	L	4105507044				4105507045	dbradfi4@jhmi.edu	5801 Smith Avenue, McAuley Hall, Suite 310		Baltimore	MD	21209	01/13/2012	2026	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	Interoperability Contact	Director	Mrs.	Hampton	Tonoah		4105507124					thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	MA Appeals/Grievances Contact	Director	Mr.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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	MA Claims Processing Contact for Public Website	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Marketing Contact	Outreach Coordinator	Ms.	Williams	Tiffani		4105507044				4105507045	twilli19@jhmi.edu	4940 Eastern Avenue, Mason F Lord Building 1st Floor		Baltimore	MD	21224	08/09/2022	2026	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	Medical Director	Medical Director	Dr.	McNabney	Matthew	K	4105507044				4105507045	mmcnabn1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	01/13/2012	2026	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	Mrs.	Hampton	Tonoah	H	4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	08/11/2023	2026	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 Coordinator	Director	Ms.	Hampton	Tonoah		4105507044				4105507045	thampto4@jh.edu	4940 Eastern Avenue,	Mason F Lord Bldg., East Tower, First Floor	Baltimore	MD	21224	03/03/2023	2026	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 Part D Opioid Overutilization Contact	Pharmacy Coordinator	Mr.	Green	Robert		4102886000				4105507045	rgreen59@jhmi.edu	5901 Holabird Ave Ste A-2		Baltimore	MD	21224	08/11/2023	2026	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	Medication Therapy Management Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 C Application Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 Appeals	Director	Mrs.	Hampton	Tonoah						4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active	4105507124				PACE - Nat		C	Philadelphia
H2109	Part D Appeals Contact (Secondary)	Director of Operations	Mr.	Rund	Jack						4105507045	jrund@jhmi.edu	494 Eastern Avenue	Mason F. Lord Building - East First Floor	Baltimore	MD	21224	08/11/2023	2026	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active	4105501006				PACE - Nat		C	Philadelphia
H2109	Part D Application Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 Benefits Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 Claims Submission Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Mrs.	Hampton	Tonoah						4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active	4105507124				PACE - Nat		C	Philadelphia
H2109	Part D Price File Contact (Back-up)	Pharmacy Coordinator	Mr.	Green	Robert		4102886000				4105507045	rgreen59@jhmi.edu	5901 Holabird Ave Ste A-2		Baltimore	MD	21224	08/11/2023	2026	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 Price File Contact (Primary)	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 Quality Assurance Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 Reporting Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Patient Safety Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Payment Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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 Director	Pharmacy Coordinator	Mr.	Green	Robert		4102886000				4105507045	rgreen59@jhmi.edu	5901 Holabird Ave Ste A-2		Baltimore	MD	21224	08/11/2023	2026	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 Network Management Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Mrs.	Hampton	Tonoah						4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION	National PACE	Hopkins ElderPlus	National PACE		The Johns Hopkins Health System Corporation	137	Yes	Active	4105507124				PACE - Nat		C	Philadelphia
H2109	Plan Directory Contact for Public Website	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Plan to Plan Reconciliation Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Processor Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Quality Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Reconciliation Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Reconciliation Contact (Secondary)	Operations Director	Mr.	Rund	Jack		4105507044				4105507045	jrund1@jhmi.edu	4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor		Baltimore	MD	21224	09/20/2018	2026	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	Recovery Audit Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Surveillance Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	System Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Third Party Administrator (TPA) Liaison	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	User Access Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Utilization Management Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Utilization Review Contact	Director	Mrs.	Hampton	Tonoah		4105507124				4105507045	thampto4@jh.edu	4940 Eastern Ave		Baltimore	MD	21224	08/11/2023	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H2117	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H2117	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H2117	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H2117	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H2117	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H2117	PHR Beneficiary Contact																	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H2117	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/16/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2117	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2126	Agent/Broker Compensation Data Contact	Director of Marketing, Sales and Outreach	Ms.	Carcieri	Lisa		4014596008					lcarcieri@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Backup User Access Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Best Available Evidence Contact	Director of Business Services	Ms.	Sullivan	Kari		4014596612					ksullivan2@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Bid Audit Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Bid Audit Site Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Bid Primary Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	CAP Report Contact for Public Website	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Marino	Peter		4014596141					pmarino@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Marino	Peter		4014596141					pmarino@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Chief Financial Officer	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Chief Operating Officer	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Chief Information Officer	Chief Information Officer-Vice President	Mr.	Dibiasio	Steven		4014278825					sdibiasio@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Chief Information Security Officer	Enterprise Risk and Information Security Officer	Mr.	Francis Jr	Robert		4014435989					rfrancis@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	CMS Casework Communication Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Complaints Tracking Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Contact for Fraud Investigations	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Coordination of Benefits Contact	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Corporate Mailing						4018893145	0				lgoncalves@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Customer Service Operations Contact	Manager of Member Services	Mr.	Barnett	Ronald		4014596110					rbarnett@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	DIR Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	DIR Contact (Secondary)	Director of Financial Reporting	Ms.	Miha	Mihaela		4014435931					mmiha@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Discount Program Payment Contact	Lead Accounting Systems Analyst	Mr.	Capece	Corey	W	4015244361					ccapece@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Emergency Part D Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Emergency Part D Contact (Secondary)	Manager of Regulatory  Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Enrollment Contact	Director of Business Services	Ms.	Sullivan	Kari		4014596612					ksullivan2@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	EOB Transfer Contact	Chief Operating Officer	Ms.	Carlson	Karen		4014596633				4014596021	kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Financial Audit Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014279164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Financial Reporting Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014279164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Formulary Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Formulary Contact (Secondary)	Manager of Regulatory Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	General Contact	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Government Relations Contact	Chief Growth Officer	Mr.	Burnett	David		4014596161					dburnett@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	HIPAA Privacy Officer	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	HIPAA Security Officer	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Hospice Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Interoperability Contact	Chief Information Officer-Vice President	Mr.	Dibiasio	Steven		4014278825					sdibiasio@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	MA Appeals/Grievances Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	MA Claims Processing Contact for Public Website	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Marketing Contact	Director of Marketing, Sales and Outreach	Ms.	Carcieri	Lisa		4014596008					lcarceri@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Medical Director	Medical Director	Dr.	Ottiano	Chris		4014596168					cottiano@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Medicare Compliance Officer	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Medicare Coordinator	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Medicare Part D Opioid Overutilization Contact	Manager of Regulatory  Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Medication Therapy Management Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part C Application Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4014278875					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part C Reporting Contact	Operations Oversight Manager	Ms.	Lopez	Alicia	M	4017237761					alopez@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Appeals	Supervisor, Operations	Ms.	Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Boston
H2126	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Boston
H2126	Part D Application Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Benefits Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Claims Submission Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Exceptions Contact	Vice President of Pharmacy	Mr.	Lorson	Mark							mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	4014596640				HMO - Health Maintenance Organization		C	Boston
H2126	Part D Exceptions Contact (Secondary)	Manager of Regulatory  Pharmacy and Oversight	Mr.	Broccoli	David							dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	4014276785				HMO - Health Maintenance Organization		C	Boston
H2126	Part D Price File Contact (Back-up)		Ms.	Scott	Sarah		4804798023					sarah.scott@cvshealth.com	CVS Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Price File Contact (Optional)		Ms.	Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	CVS Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Price File Contact (Primary)			Loveland	Chet		4806064865					chet.loveland@cvshealth.com	CVS Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Quality Assurance Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Part D Reporting Contact	Operations Oversight Manager	Ms.	Lopez	Alicia		4017237761					alopez@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Patient Safety Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Payment Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Pharmacy Director	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Pharmacy Network Management Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Pharmacy Network Management Contact (Secondary)	Manager of Regulatory Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Pharmacy Technical Help Desk Contact	AVP Customer Care	Mr.	Jackson	Scott							scott.jackson@cvshealth.com	CVS Caremark Pharmacy Help Desk	445 Great Circle Blvd.	Nashville	TN	37228	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H2126	Pharmacy Technical Help Desk Contact (Secondary)	Vice President of Pharmacy	Mr.	Lorson	Mark							mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	4014596640				HMO - Health Maintenance Organization		C	Boston
H2126	Plan Directory Contact for Public Website	Director of Marketing, Sales and Outreach	Ms.	Carcieri	Lisa		4014596008					lcarceri@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Plan to Plan Reconciliation Contact	Senior Manager of Financial Analysis	Mr.	Milton	Bryan		4014276726					bmilton@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Processor Contact	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Quality Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Reconciliation Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Reconciliation Contact (Secondary)	Senior Manager of Financial Analysis	Mr.	Milton	Bryan		4014276726					bmilton@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Recovery Audit Contact	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	SNP Application Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Surveillance Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	System Contact	System Administrator	Mrs.	Phouthavong	Maria		4014596119					mphouthavong@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Third Party Administrator (TPA) Liaison	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	User Access Contact	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Utilization Management Contact	Medical Director	Dr.	Ottiano	Chris		4014596168					cottiano@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2126	Utilization Review Contact	Medical Director	Dr.	Ottiano	Chris		4014596168					cottiano@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2162	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H2162	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H2162	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H2162	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H2162	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H2162	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H2162	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H2162	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2162	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE OF NEW HAMPSHIRE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2168	Agent/Broker Compensation Data Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa	E	9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/06/2025	2026	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	Automated TrOOP Balance Transfer Contact		Mr.	Esp	Bryan		8587906445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2016	2026	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	Backup User Access Contact	Chief Information Security Officer		Grijalva	Alexander		2124509779					Alexander@villagecare.org	154 Christopher Street		New York	NY	10014	09/24/2024	2026	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		2123375678					VanessaF@villagecare.org	120 Broadway		New York	NY	10271	02/01/2018	2026	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	Bid Audit Contact	Director of Medicare Products	Miss	Rodriguez	Alexandra		9295855582					alexandra.rodriguez@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	07/03/2023	2026	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	Bid Audit Site Contact	Director of Medicare Products	Miss	Rodriguez	Alexandra		9295855582					alexandra.rodriguez@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	07/03/2023	2026	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	Bid Primary Contact	Director of Medicare Products	Miss	Rodriguez	Alexandra		9295855582					alexandra.rodriguez@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	07/03/2023	2026	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	CAP Report Contact for Public Website	AVP of Managed Care Compliance	Miss	T	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	01/07/2025	2026	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active	2123375656				HMO - Health Maintenance Organization		C	New York
H2168	CEO - CMS Administrator Contact	President & Chief Executive Officer	Mrs	DeVito	Emma		8004696292					EmmaD@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	03/09/2020	2026	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	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms.	DeVito	Emma		2123375801					EmmaD@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	01/13/2021	2026	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		2123375710					DebraT@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	12/28/2022	2026	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 Operating Officer	Chief Operating Officer	Mr.	Ruskin	Shaun		2123375828					shaun.ruskin@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	07/24/2024	2026	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 Information Officer	Chief Information Officer	Mr	Myer	Stuart		2123379251					stuartm@villagecare.org	154 Christopher Street  3rd Floor		New York	NY	10014	02/16/2016	2026	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 Information Security Officer	Chief Information Security Officer	Mr	Grijalva	Alexander		2124509779					Alexander@villagecare.org	154 Christopher Street		New York	NY	10014	09/24/2024	2026	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 Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	01/07/2025	2026	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	Complaints Tracking Contact	Assistant Director of Grievance & Appeals	Ms.	Hernandez	Liukysha		7185172739					LiukyshaH@villagecare.org	112 Charles Street		New York	NY	10014	01/13/2021	2026	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	Contact for Fraud Investigations	AVP of Managed Care Compliance	Miss	Turner	Vanessa	E	9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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 Managed Care Compliance	Miss	Turner	Vanessa	E	9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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	Corporate Mailing						2123375600	5750				info@villagecare.org	112 Charles Street		New York	NY	10014	02/03/2016	2026	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		2123375678					vanessaf@villagecare.org	112 Charles Street		New York	NY	10014	11/15/2017	2026	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	DIR Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway		New York	NY	10271	01/07/2025	2026	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	DIR Contact (Secondary)	Pharmacy Specialist		Eng-Liu	Eileen		2123375600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	03/09/2020	2026	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	Discount Program Payment Contact	Treasury Account Manager	Miss	Eydlin	Angela		9296687392					Angela.Eydlin@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	06/02/2025	2026	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	Emergency Part D Contact	Chief Operating Officer	Mr.	Ruskin	Shaun		2123375828					shaun.ruskin@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	07/24/2024	2026	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	Emergency Part D Contact (Secondary)	AVP of Managed Care Compliance	Miss	Turner	Vanessa	E	9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP of Business Intelligence		Kessler	Bruce		2123375780					brucek@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	09/23/2022	2026	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	Enrollment Contact	VP, Member Experience and Support Services		Fernandez	Vanessa		2123375678					VanessaF@villagecare.org	120 Broadway		New York	NY	10271	01/13/2021	2026	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	EOB Transfer Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875				2123375711	Vanessa.Turner@villagecare.org	120 Broadway		New York	NY	10271	01/07/2025	2026	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	Financial Audit Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway		New York	NY	10271	01/07/2025	2026	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	Financial Reporting Contact	Chief Financial Officer	Ms.	Tirado	Debra		2123375710					DebraT@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	12/28/2022	2026	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	Formulary Contact	AVP, Government Affairs	Ms.	Momita	Paul		8587906350					FMT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2016	2026	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	Formulary Contact (Secondary)	AVP of Managed Care Compliance	Miss	Turner	Vanessa	E	9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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	General Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa	E	9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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 Managed Care Compliance	Miss	Turner	Vanessa	E	9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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	HIPAA Privacy Officer	Chief Compliance Officer	Mrs,	Quinn-Bermack	Dara		2123375760					DaraQ@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	12/28/2022	2026	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	HIPAA Security Officer	Chief Information Security Officer		Grijalva	Alexander		2124509779					alexanderg2@villagecare.org	154 Christopher Street		New York	NY	10014	09/24/2024	2026	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		2123375600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	01/13/2021	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Myer	Stuart		2123379251					StuartM@villagecare.org	154 Christopher Street		New York	NY	10014	10/26/2021	2026	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	MA Appeals/Grievances Contact	Assistant Director of Grievance & Appeals	Ms.	Hernandez	Liukysha		7185172739					LiukyshaH@villagecare.org	112 Charles Street		New York	NY	10014	01/13/2021	2026	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	MA Claims Processing Contact for Public Website			Services	Provider		8557692500					villagecaremaxinfo@villagecare.org	PO Box 5536		Hauppauge	NY	11788	02/03/2016	2026	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	Marketing Contact	SVP Business Development and Health Plan Ops	Ms.	Fernandez	Vanessa		2123375678					vanessaf@villagecare.org	112 Charles Street		New York	NY	10014	08/07/2023	2026	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	Medical Director	Sr. Medical Director	Dr	Byrne	Michael		9145029584					michael.byrne@villagecare.org	120 Broadway	27th Floor	New York	NY	10271	11/20/2023	2026	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 Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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 Coordinator	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	01/07/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacist Specialist		Eng Liu	Eileen		2123375600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	07/06/2021	2026	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	Medication Therapy Management Contact			Dykstra	Sarah		8587906354					MTMP@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/04/2025	2026	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	Online Enrollment Center Contact (Optional)	AVP of Managed Care Compliance		Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway		New York	NY	10271	01/07/2025	2026	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	Online Enrollment Center Contact (Primary)	Sr. Director Eligibility and Retention	Miss	Wu-Malloy	Amie		2123375643					Mengying@villagecare.org	112 Charles Street		New York	NY	10014	10/26/2021	2026	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 C Application Contact	Director of Medicare Products	Miss	Rodriguez	Alexandra		9295855582					alexandra.rodriguez@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	08/07/2023	2026	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 C Reporting Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	01/07/2025	2026	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 Appeals	AVP of Managed Care Compliance	Miss	Turner	Vanessa							Vanessa.Turner@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	01/07/2025	2026	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active	2123375656				HMO - Health Maintenance Organization		C	New York
H2168	Part D Appeals Contact (Secondary)			Redd Guinto	Karen						8587906060	karen.reddguinto@medimpact.com	10181 Scripps Gateway Court	Appeals and Grievance	San Diego	CA	92131	01/08/2021	2026	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active	8587906584				HMO - Health Maintenance Organization		C	New York
H2168	Part D Application Contact	Director of Medicare Products	Miss	Rodriguez	Alexandra		9295855582					alexandra.rodriguez@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	08/07/2023	2026	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 Benefits Contact	Director of Medicare Products	Miss	Rodriguez	Alexandra		9295855582					alexandra.rodriguez@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	08/07/2023	2026	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 Claims Submission Contact	Pharmacy Specialist		Eng-Liu	Eileen		2123375600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	01/13/2021	2026	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	AVP of Managed Care Compliance	Ms.	Turner	Vanessa							Vanessa.Turner@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	01/07/2025	2026	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active	2123375656				HMO - Health Maintenance Organization		C	New York
H2168	Part D Price File Contact (Back-up)	Medicare Part D Program Manager	Mr.	Larkin	Rory		8587905849					planfindercommunications@medImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/15/2016	2026	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 Price File Contact (Optional)	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	01/07/2025	2026	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 Price File Contact (Primary)	Pharmacy Specialist		Eng-Liu	Eileen		2123375600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	01/13/2021	2026	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 Quality Assurance Contact	Pharmacy Specialist		Eng-Liu	Eileen		2123375600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	01/13/2021	2026	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 Reporting Contact			MacLochlainn	Tine		8587907031					MedicarePartDProjectManagers@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2016	2026	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	Patient Safety Contact	Chief Operating Officer		Ruskin	Shaun		2123375828					shaun.ruskin@villagecare.org	120 Broadway	27th Floor	New York	NY	10271	07/24/2024	2026	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	Payment Contact	Chief Financial Officer	Ms.	Tirado	Debra		2123375710					DebraT@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	12/28/2022	2026	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 Director			Scharaga	Ellen		8004696292					EllenS@villagecare.org	120 Broadway		New York	NY	10271	02/01/2018	2026	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 Network Management Contact			Maldonado	Cheryl		8587906397					cheryl.maldonado@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/03/2016	2026	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	2026	VILLAGE SENIOR SERVICES CORPORATION	Local CCP	VillageCareMAX	HMO/HMOPOS		Village Care of New York, Inc.	547	Yes	Active	8888076806				HMO - Health Maintenance Organization		C	New York
H2168	Plan Directory Contact for Public Website			Services	Provider		8557692500					villagecaremaxinfo@villagecare.org	PO Box 5536		Hauppauge	NY	11788	02/03/2016	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Tirado	Debra		2123375710					DebraT@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	06/02/2025	2026	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	Processor Contact	Senior Vice President	Mr.	Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/03/2025	2026	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	Quality Contact	AVP of Quality		Rooney	Cynthia		2123375706					CynthiaR3@villagecare.org	120 Broadway	27th Floor	New York	NY	10271	02/17/2021	2026	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	Reconciliation Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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	Reconciliation Contact (Secondary)	Pharmacy Specialist		Eng-Liu	Eileen		2123375600	5964				EileenE@villagecare.org	120 Broadway		New York	NY	10271	01/13/2021	2026	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	Recovery Audit Contact	Chief Financial Officer	Ms.	Tirado	Debra		2123375710					DebraT@villagecare.org	120 Broadway	Suite 2840	New York	NY	10271	12/28/2022	2026	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	SNP Application Contact	AVP of Medicaid Regulatory Affairs	Miss	Bello	Christina		2123379292					Christina.Bello@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	12/22/2023	2026	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	SNP State Contact	AVP of Medicaid Regulatory Affairs	Miss	Bello	Christina		2123379292					Christina.Bello@villagecare.org	120 Broadway, Suite 2740		New York	NY	10271	11/20/2023	2026	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	Surveillance Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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	System Contact	CIO		Myer	Stuart		2123379251					stuartm@villagecare.org	154 Christopher Street		New York	NY	10014	02/03/2016	2026	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	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Miss	Tirado	Deb		3475412822					DebraT@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	06/02/2025	2026	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	User Access Contact	AVP of Managed Care Compliance	Miss	Turner	Vanessa		9299960875					Vanessa.Turner@villagecare.org	120 Broadway	Suite 2740	New York	NY	10271	01/07/2025	2026	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	Utilization Management Contact	Chief Operating Officer		Ruskin	Shaun		2123375828					shaun.ruskin@villagecare.org	120 Broadway	27th Floor	New York	NY	10271	07/24/2024	2026	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	Utilization Review Contact	Chief Operating Officer		Ruskin	Shaun		2123375828					shaun.ruskin@villagecare.org	120 Broadway	27th Floor	New York	NY	10271	07/24/2024	2026	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
H2172	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Flr		Oakland	CA	94612	10/25/2017	2026	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	Dallas
H2172	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2026	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	Dallas
H2172	Backup User Access Contact	Senior Medicare Products Consultant		Hershkovitz	Lena		4103618543					lena.b.hershkovitz@kp.org	111 S. Calvert St.		Baltimore	MD	21202	11/06/2019	2026	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	Dallas
H2172	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	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	Dallas
H2172	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	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	Dallas
H2172	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H2172	Bid Primary Contact	Actuary		Boakye	Osei-Yaw		3018166847					KPMedicareBids@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	09/17/2024	2026	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	Dallas
H2172	CAP Report Contact for Public Website	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	11/13/2025	2026	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	Dallas
H2172	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	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	Dallas
H2172	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	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	Dallas
H2172	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	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	Dallas
H2172	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	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	Dallas
H2172	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	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	Dallas
H2172	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	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	Dallas
H2172	CMS Casework Communication Contact	Medicare Compliance Lead		Walden	Chandra		9714047562					chandra.walden@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	11/13/2025	2026	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	Dallas
H2172	Complaints Tracking Contact	Medicare Compliance Lead		Walden	Chandra		9714047562					chandra.walden@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	11/13/2025	2026	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	Dallas
H2172	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	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	Dallas
H2172	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2026	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	Dallas
H2172	Corporate Mailing						2403308451					pamela.l.mclean@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	09/13/2024	2026	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	Dallas
H2172	Customer Service Operations Contact	Executive Director		Osborne	Susan	A	5034576663				4049495001	susan.a.osborne@kp.org	Nine Piedmont Center	3495 Piedmont Road, NE	Atlanta	GA	30305	12/12/2023	2026	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	Dallas
H2172	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	03/09/2020	2026	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	Dallas
H2172	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	07/17/2018	2026	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	Dallas
H2172	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/06/2023	2026	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	Dallas
H2172	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	07/02/2018	2026	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	Dallas
H2172	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/04/2022	2026	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	Dallas
H2172	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	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	Dallas
H2172	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/20/2017	2026	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	Dallas
H2172	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/12/2017	2026	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	Dallas
H2172	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H2172	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H2172	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/20/2023	2026	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	Dallas
H2172	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	06/01/2023	2026	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	Dallas
H2172	General Contact	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	11/13/2025	2026	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	Dallas
H2172	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	01/12/2017	2026	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	Dallas
H2172	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	11/06/2020	2026	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	Dallas
H2172	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/25/2020	2026	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	Dallas
H2172	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	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	Dallas
H2172	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					cathy.p.plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	11/03/2021	2026	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	Dallas
H2172	MA Appeals/Grievances Contact	Executive Director, Member Relations	Ms	Osborne	Susan		5038133924					susan.a.osborne@kp.org	500 NE Multnomah Street	Suite 100	Portland	OR	97232	08/02/2022	2026	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	Dallas
H2172	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	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	Dallas
H2172	Marketing Contact	Medicare Sales Manager		Dibuccio	Anthony		3015256895					KP-MedicareFilings@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	09/13/2024	2026	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	Dallas
H2172	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	11/16/2020	2026	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	Dallas
H2172	Medicare Compliance Officer	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road	Nine Piedmont Center	Atlanta	GA	303051736	11/13/2025	2026	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	Dallas
H2172	Medicare Coordinator	Executive Director, Medicare		Robinson	Tanya		3013950877					tanya.m.robinson@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	09/13/2024	2026	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	Dallas
H2172	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	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	Dallas
H2172	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	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	Dallas
H2172	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street		Rancho Cucamonga	CA	91730	08/26/2020	2026	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	Dallas
H2172	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/20/2017	2026	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	Dallas
H2172	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	10/25/2017	2026	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	Dallas
H2172	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/20/2017	2026	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	Dallas
H2172	Part C Application Contact	Senior Medicare Products Consultant		Hershkovitz	Lena		4103618543					lena.b.hershkovitz@kp.org	111 S. Calvert St.		Baltimore	MD	21202	03/01/2017	2026	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	Dallas
H2172	Part C Reporting Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road N.E.	Nine Piedmont Center	Atlanta	GA	30305	05/28/2025	2026	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	Dallas
H2172	Part D Appeals	Executive Director		Osborne	Susan	A					4043644743	susan.a.osborne@kp.org	3495 Piedmont Center	Ten Piedmont Center	Atlanta	GA	30305	12/12/2023	2026	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5034576663				HMO - Health Maintenance Organization		C	Dallas
H2172	Part D Application Contact	Senior Medicare Products Consultant		Hershkovitz	Lena		4103618543					lena.b.hershkovitz@kp.org	111 S. Calvert St.		Baltimore	MD	21202	03/01/2017	2026	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	Dallas
H2172	Part D Benefits Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	11/08/2019	2026	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	Dallas
H2172	Part D Claims Submission Contact	PO PS, National Rx Programs & Servics		Bonvie	Claudette		5623199392					Claudette.R.Bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90042	11/08/2019	2026	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	Dallas
H2172	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H2172	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	11/08/2019	2026	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	Dallas
H2172	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	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	Dallas
H2172	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/26/2023	2026	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	Dallas
H2172	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	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	Dallas
H2172	Part D Reporting Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road N.E.	Nine Piedmont Center	Atlanta	GA	30305	05/28/2025	2026	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	Dallas
H2172	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	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	Dallas
H2172	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H2172	Pharmacy Director	Executive Dir, Pharmacy		Kim	Kun		7035873657				7034664802	kun.kim@kp.org	22370 Davis Drive		Sterling	VA	20164	01/08/2024	2026	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	Dallas
H2172	Pharmacy Network Management Contact	Pharmacy Benefits Manager		Zebert	Jordan		7039273513				7034664802	jordan.m.zebert@kp.org	22370 Davis Drive	Suite 190	Sterling	VA	20164	12/02/2024	2026	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	Dallas
H2172	Pharmacy Network Management Contact (Secondary)	Program Manager III		Summers	Zarinah		7034664999					zarinah.r.summers@kp.org	22370 Davis Drive	Suite 190	Sterling	VA	20164	01/08/2024	2026	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	Dallas
H2172	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	01/12/2017	2026	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8887917229				HMO - Health Maintenance Organization		C	Dallas
H2172	Plan Directory Contact for Public Website	Manager, Provider Experience		Anderson	Allison		3018166481				8666409826	allison.x.anderson@kp.org	2101 East Jefferson Street		Rockville	MD	20852	10/25/2017	2026	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	Dallas
H2172	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/20/2023	2026	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	Dallas
H2172	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	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	Dallas
H2172	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	05/25/2022	2026	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	Dallas
H2172	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H2172	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	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	Dallas
H2172	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/03/2022	2026	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	Dallas
H2172	SNP Application Contact	Medicare Strategy Consultant		Kraft	Jessica	A	4436154973					jessica.a.kraft@kp.org	4000 Garden City Driv		Hyattsville	MD	20785	02/11/2025	2026	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	Dallas
H2172	Surveillance Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	05/28/2025	2026	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	Dallas
H2172	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/20/2017	2026	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	Dallas
H2172	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	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	Dallas
H2172	User Access Contact	Medicare Compliance Lead		Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	30305	05/28/2025	2026	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	Dallas
H2172	Utilization Management Contact	UM Compliance Manager		Ambridge-Kawczynski	Nancy		2403567079					nancy.a.ambridge-kawczynski@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	09/13/2024	2026	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	Dallas
H2172	Utilization Review Contact	UM Compliance Manager		Ambridge-Kawczynski	Nancy		2403567079					nancy.a.ambridge-kawczynski@kp.org	4000 Garden City Drive		Hyattsville	MD	20785	09/13/2024	2026	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	Dallas
H2174	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/17/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H2174	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H2174	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H2174	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H2174	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/12/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H2174	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/12/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H2174	PHR Beneficiary Contact																	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H2174	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2174	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	TRILLIUM COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2185	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Backup User Access Contact	Medicare Compliance Officer, Plan Partner Support	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Best Available Evidence Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	CEO - CMS Administrator Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	CEO - Senior Official for Contracting	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Chief Financial Officer	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Chief Operating Officer	Chief Operating Officer/General Manager	Mr.	Emami	John		7038837508					john.emami@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Chief Information Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Coordination of Benefits Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Corporate Mailing						8448546883					customerservice@lifeworksadvantage.com	PO BOX 2190		Glen Allen	VA	23058	10/21/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Discount Program Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					Mark.Hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Enrollment Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	EOB Transfer Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797				8336102390	stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Financial Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Financial Reporting Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	General Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	HIPAA Privacy Officer	Chief Compliance Officer and HIPAA Privacy Officer	Ms.	Crowe	Melanie		4049330409					melanie.crowe@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Interoperability Contact	Director of Data Operations and Architecture	Mr.	Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/17/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Marketing Contact	Marketing Director	Mrs	Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Medical Director	VP Medical Affairs		Dahlgren	Andrew		8042968288					Andrew.Dahlgren@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Medicare Coordinator	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part C Reporting Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/09/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Pharmacy Network Management Contact	VP Network Management		Santos	Christina		6088204408					christina.santos@navitus.com	361 Integrity Drive		Madison	WI	53717	06/06/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H2185	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H2185	Physician Incentive Contact	Executive Director	Mr.	Dunn	Jamie		8048140844					jamie.dunn@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Plan Directory Contact for Public Website			Sindlinger	Rocio		8558550489					rocio.sindlinger@curanahealth.com	PO BOX 4440		Glen Allen	VA	23058	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Plan to Plan Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Processor Contact	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/09/2025	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Quality Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Reconciliation Contact (Secondary)	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Recovery Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Surveillance Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					Katie.Bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	User Access Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Utilization Management Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2185	Utilization Review Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	LIFEWORKS ADVANTAGE, LLC	Local CCP	Lifeworks Advantage	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2218	Automated TrOOP Balance Transfer Contact	Part D Compliance Program Manager	Ms	Adam	Vivian		6175332430				6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Backup User Access Contact	Director of Quality & Compliance		Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Best Available Evidence Contact	Director of ESP Finance		O'Sullivan	Maureen		6175332426				6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Bid Primary Contact	Executive Director	Ms.	Reynard	Gretchen		6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	CAP Report Contact for Public Website	Executive Director	Ms.	Reynard	Gretchen		6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	CEO - CMS Administrator Contact	Executive Director PACE	Ms	Reynard	Gretchen		6175332424				6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	10/28/2024	2026	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	New York
H2218	CEO - Senior Official for Contracting	Executive Director PACE	Ms	Reynard	Gretchen		6175332424				6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2025	2026	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	New York
H2218	Chief Financial Officer	CFO	Mr.	Murphy	Todd		6175332300	2333				tmurphy@hhsi.us	1135 Morton Street		Mattapan	MA	02126	12/05/2017	2026	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	New York
H2218	Chief Operating Officer	Executive Director	Ms.	Reynard	Gretchen		6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	Chief Information Officer	Interim - CIO	Ms	Bradbury	Tracie		6175332356					tbradbury@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Chief Information Security Officer	Interim - CIO	Ms	Bradbury	Tracie		6175332356					tbradbury@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	CMS Casework Communication Contact	Executive Director	Ms.	Reynard	Gretchen		6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	Complaints Tracking Contact	Director of Quality & Compliance		Azar	Pamela		7744706740				6175332436	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Contact for Fraud Investigations	Director of Quality & Compliance	Ms.	Azar	Pamela		7744706740	2424			6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Coordination of Benefits Contact	Part D Compliance Program Manager	Ms.	Adam	Vivian		6175332430				6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Corporate Mailing						6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	Customer Service Operations Contact	Director of Quality & Compliance		Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	DIR Contact	CFO		Murphy	Todd		6175332400	2333			6175332436	tmurphy@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	DIR Contact (Secondary)	Part D Compliance Program Manager		Adam	Vivian		6175332430					viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Discount Program Payment Contact	Part D Compliance Program Manager	Ms.	Adam	Vivian		6175332430					viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Emergency Part D Contact	Part D Compliance Program Manager	Ms.	Adam	Vivian		6175332400	2430			6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	12/10/2024	2026	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	New York
H2218	Emergency Part D Contact (Secondary)	Director of Quality & Compliance		Azar	Pamela		7744706740					paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Encounter Data & Risk Adjustment Operations Contact	Director of Finance	Ms	O'Sullivan	Maureen		6172332400	328				mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Enrollment Contact	Director of Enrollment	Ms.	Pattavina	Pamela		6175332400				6175332401	ppattavina@hhsi.us	479 Torrey Street		Brockton	MA	02130	03/19/2025	2026	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	New York
H2218	EOB Transfer Contact	Director of Finance	Ms.	O'Sullivan	Maureen		6175332400	3428			6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Financial Audit Contact	Director of Finance	Ms.	O'Sullivan	Maureen		6175332400				6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Financial Reporting Contact	Director of Finance	Ms.	O'Sullivan	Maureen		6175332400				6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Formulary Contact	Medical Director	Dr.	Kopits, MD	Ilona		6175332400				6175332401	ikopits@hhsi.us	1135 Morton Street		Mattapan	MA	02126	10/28/2024	2026	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	New York
H2218	General Contact	Director of Quality & Compliance	Ms.	Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Government Relations Contact	Executive Director	Ms.	Reynard	Gretchen		6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	HIPAA Privacy Officer	Privacy Officer		Talbot	Felicia		6175332371				6175332401	ftalbot@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2025	2026	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	New York
H2218	HIPAA Security Officer	Privacy Officer		Talbot	Felicia		6175332371				6175332401	ftalbot@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2025	2026	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	New York
H2218	Interoperability Contact	Interim - CIO		Bradbury	Tracie		6175332356					tbradbury@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	MA Appeals/Grievances Contact	Director of Quality and Compliance		Azar	Pamela		7744706700	6740			6175332484	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	09/30/2020	2026	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	New York
H2218	MA Claims Processing Contact for Public Website	Director of Finance	Ms.	O'Sullivan	Maureen		6175332400	3428			6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Marketing Contact	Director of Marketing and Enrollment	Ms.	Pattavina	Pamela		7744706700				6175332401	ppattavina@hhsi.us	479 Torrey Street		Brockton	MA	02130	09/23/2025	2026	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	New York
H2218	Medical Director	Medical Director	Dr.	Kopits, MD	Ilona		6175332400				6175332401	ikopits@hhsi.us	1135 Morton Street		Mattapan	MA	02126	10/28/2024	2026	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	New York
H2218	Medicare Compliance Officer	Director of Quality and Compliance	Ms.	Azar	Pamela		7744706700	6740			6175332484	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	09/30/2020	2026	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	New York
H2218	Medicare Coordinator	Senior Vice President, ESP	Ms.	Reynard	Gretchen		6175332424				6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Medicare Part D Opioid Overutilization Contact	Director of Quality & Compliance		Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Medication Therapy Management Contact	Medical Director	Dr.	Kopits, MD	Ilona		6175332400				6175332401	ikopits@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2025	2026	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	New York
H2218	Part C Application Contact	Executive Director	Ms.	Reynard	Gretchen		6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	Part D Appeals	Director of Quality and Compliance	Ms.	Azar	Pamela						6175332401	paazar@hhsi.us	1135 Morton Street	1135 Morton Street	Mattapan	MA	02126	11/06/2025	2026	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	7744706740				PACE - Nat		C	New York
H2218	Part D Appeals Contact (Secondary)	Part D Compliance Program Manager	Ms.	Adam	Vivian						6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	6175332430				PACE - Nat		C	New York
H2218	Part D Application Contact	Part D Compliance Program Manager	Ms.	Adam	Vivian		6175332430				6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Part D Benefits Contact	Ms		Adam	Vivian		6175332430				6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Part D Claims Submission Contact	Part D Compliance Program Manager	Ms.	Adam	Vivian		6175332430				6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Part D Exceptions Contact	Part D Compliance Program Manager		Adam	Vivian						6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	6175332430				PACE - Nat		C	New York
H2218	Part D Exceptions Contact (Secondary)			Bouwmeester	Carla							cbouwmeester@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	6175333530				PACE - Nat		C	New York
H2218	Part D Price File Contact (Back-up)	Part D Compliance Program Manager		Adam	Vivian		6175332430				6175332401	viadam@hhsi.us	1135 Morton Street	1135 Morton Street	Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Part D Price File Contact (Primary)	ESP Director of Finance	Ms.	O'Sullivan	Maureen		6175332426	2424			6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Part D Quality Assurance Contact	Director of Quality & Compliance	Ms.	Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/04/2020	2026	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	New York
H2218	Part D Reporting Contact	Part D Compliance Program Manager	Ms.	Adam	Vivian		6175332430				6175332401	viadam@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Patient Safety Contact	Director of Quality & Compliance	Ms.	Azar	Pamela		7744706740	2424			6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Payment Contact	Director of Finance	Ms.	O'Sullivan	Maureen		6175332400	3428			6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Personal Health Record Contact	Medical Director	Dr.	Kopits, MD	Ilona		6175332400					ikopits@hhsi.us	1135 Morton Street		Mattapan	MA	02126	10/28/2024	2026	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	New York
H2218	Pharmacy Director	Medical Director		Kopits, MD	Ilona		6175332400				6175332401	ikopits@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2025	2026	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	New York
H2218	Pharmacy Network Management Contact	Medical Director	Ms.	Kopits, MD	Ilona		7744706740	2424			6175332401	ikopits@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2025	2026	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	New York
H2218	Pharmacy Network Management Contact (Secondary)	Executive Director	Ms.	Reynard	Gretchen		6175332424	2424			6175332401	greynard@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/19/2020	2026	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	New York
H2218	Pharmacy Technical Help Desk Contact	Pharmacist		Bouwmeester	Carla						6175332401	cbouwmeester@hhsi.us	1135 Morton Street		Mattapan	MA	02126	04/23/2010	2026	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	8667141277				PACE - Nat		C	New York
H2218	Pharmacy Technical Help Desk Contact (Secondary)	Medical Director	Dr.	Kopits, MD	Ilona						6175332401	ikopits@hhsi.us	1135 Morton Street		Mattapan	MA	02126	10/28/2024	2026	HARBOR HEALTH SERVICES, INC.	National PACE	Elder Service Plan of Harbor Health Services, Inc	National PACE		Harbor Health Services, Inc.	104	Yes	Active	6175332400				PACE - Nat		C	New York
H2218	Plan Directory Contact for Public Website	Director of Marketing and Enrollment	Ms.	Pattavina	Pamela		7744706700				6175332401	ppattavina@hhsi.us	479 Torrey Street Brockton, MA 02130		Brockton	MA	02130	09/23/2025	2026	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	New York
H2218	Plan to Plan Reconciliation Contact	Director of Finance		O'Sullivan	Maureen		6175332400				6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Processor Contact	ESP Director of Finance	Ms.	O'Sullivan	Maureen		6175332426	2424			6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Quality Contact	Director of Quality & Compliance	Ms.	Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street		Mattapan	MA	02126	11/04/2020	2026	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	New York
H2218	Reconciliation Contact	CFO		Murphy	Todd		6175332400	3426			6175332401	tmurphy@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Reconciliation Contact (Secondary)	ESP Director of Finance		O'Sullivan	Maureen		6175332426					mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Recovery Audit Contact	CFO	Mr	Murphy	Todd		6175332424	2424			6175332401	tmurphy@hhsi.us	1135 Morton Street		Mattapan	MA	02126	03/07/2023	2026	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	New York
H2218	Surveillance Contact	Director of Marketing & Enrollment	Ms.	Pattavina	Pamela		7744706700				6175332401	ppattavina@hhsi.us	479 Torrey Street Brockton, MA 02130		Brockton	MA	02130	09/23/2025	2026	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	New York
H2218	System Contact	Director of Finance	Ms.	O'Sullivan	Maureen		6175332400	3428			6175332401	mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	O'Sullivan	Maureen		6175332400					mosullivan@hhsi.us	1135 Morton Street		Mattapan	MA	02126	02/22/2022	2026	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	New York
H2218	User Access Contact	Director of Information Technology		Fudge	Kenneth		6175332300					kfudge@hhsi.us	1135 Morton Street		Mattapan	MA	02126	04/23/2010	2026	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	New York
H2218	Utilization Management Contact	Director of Quality and Compliance	Ms.	Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street	1135 Morton Street	Mattapan	MA	02126	11/06/2025	2026	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	New York
H2218	Utilization Review Contact	Director of Quality and Compliance	Ms.	Azar	Pamela		7744706740				6175332401	paazar@hhsi.us	1135 Morton Street	1135 Morton Street	Mattapan	MA	02126	11/06/2025	2026	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	New York
H2219	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Backup User Access Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689722					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Best Available Evidence Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Bid Primary Contact	Actuary	Mr.	Nganga	Francis		5087992100	79339				Francis.Nganga@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	CAP Report Contact for Public Website	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	CEO - CMS Administrator Contact	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	CEO - Senior Official for Contracting	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Chief Financial Officer	Interim Chief Financial Officer	Mr.	Consolmagno	Anthony		5083689473					Anthony.Consolmagno@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	07/15/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Chief Operating Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Chief Information Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Chief Information Security Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	CMS Casework Communication Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Complaints Tracking Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Contact for Fraud Investigations	Director Internal Audit	Ms.	Brown	Velinda		5083689016				5083689111	Velinda.Brown@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Coordination of Benefits Contact	Senior Director, Claims Administration	Ms.	Straitiff	Kirsten		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Corporate Mailing						5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Customer Service Operations Contact	Director, Customer Service	Mr.	Fregeau	Andrew		5083689958					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/10/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	DIR Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	DIR Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Discount Program Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Emergency Part D Contact	Manager, Customer Service	Mr.	Fregeau	Andrew		9784347996					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Emergency Part D Contact (Secondary)	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Encounter Data & Risk Adjustment Operations Contact	Manager, Business Service Delivery	Ms.	Ernst	Alicia		5083689369					Alicia.Ernst@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Enrollment Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	EOB Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089			5088311136	Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Financial Audit Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Financial Reporting Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Formulary Contact	Manager of Pharmacy Ops	Ms.	Doran	Kate		5087992100	79169				Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Formulary Contact (Secondary)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	General Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Government Relations Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	HIPAA Privacy Officer	Privacy Officer	Ms.	Sanford	Katrin		5083689838					Katrin.Sanford@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	HIPAA Security Officer	VP IT Operations	Mr.	Petisce	Tony		5083689300					Tony.Petisce@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Interoperability Contact	VP, Enterprise Technology Officer	Mr.	Budaj	John		5083689362					john.budaj@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	MA Appeals/Grievances Contact	Director, Care Services Support	Ms.	Ryan	Patricia		5083689771					Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	MA Claims Processing Contact for Public Website			Service	Customer		5087992100	69988				CustomerService@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Marketing Contact	Manager, Medicare Programs	Ms.	Kudron	Julie		5083689591					Julie.Kudron@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Medical Director	VP and Medical Director	Dr.	Jaoude	Jean		5083689604					Jean.Jaoude@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Medicare Compliance Officer	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Medicare Coordinator	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Medicare Part D Opioid Overutilization Contact	Supervisor, Formulary Coordinators & Technicians	Ms.	Kendall	Kate		8003332535	79169				Kate.Kendall@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Medication Therapy Management Contact	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	OffShore Subcontractor Contact	Manager, Medicare Compliance & Regulatory Affairs	Ms.	DeForge	Dena		5083689294					dena.deforge@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part C Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part D Appeals	Director, Care Services Support	Ms.	Ryan	Patricia							Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689771				PACE - Nat		C	New York
H2219	Part D Appeals Contact (Secondary)	Manager, Member Appeals and Grievances	Ms.	Foulkes	Christina							Christina.Foulkes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689447				PACE - Nat		C	New York
H2219	Part D Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part D Benefits Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part D Claims Submission Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part D Exceptions Contact	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689790				PACE - Nat		C	New York
H2219	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Ops	Ms.	Doran	Kate							Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5087992100	79169			PACE - Nat		C	New York
H2219	Part D Price File Contact (Back-up)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part D Price File Contact (Primary)	Govt Programs and Quality Clinical Pharmacist	Mr.	Huynh	Jayce		5087992100	69212				Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part D Quality Assurance Contact	Sr. Director, Pharmacy Therapeutics	Mr.	Huynh	Jayce		5083689212					Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Part D Reporting Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Patient Safety Contact	VP and Medical Director	Dr.	Jaoude	Jean		5083689604					Jean.Jaoude@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Pharmacy Director	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Pharmacy Network Management Contact	VP, Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Pharmacy Technical Help Desk Contact			Help Desk	OptumRx								1600 McConnor Parkway		Schaumburg	IL	60173	12/29/2021	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	8443688734				PACE - Nat		C	New York
H2219	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager (OptumRx)		Villanueva	Juan							Juan.Villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/13/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	8007887871				PACE - Nat		C	New York
H2219	Plan Directory Contact for Public Website	Senior Vice President, PACE Programs	Ms.	Bostek	Kristine		5083689923					Kristine.Bostek@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Plan to Plan Reconciliation Contact	Director, Medical Accounting	Mr.	Beaulieu	Michael		5083689020					Michael.Beaulieu@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Processor Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Quality Contact	Senior Director, PACE Nursing and Quality	Ms.	Malkoski	Michelle		8003332535	49979				Michelle.Malkoski@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Reconciliation Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Reconciliation Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Recovery Audit Contact	Senior Director, Claims Administration	Ms.	Straitiff	Kirsten		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Surveillance Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	System Contact	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Third Party Administrator (TPA) Liaison	Revenue Senior Accountant I	Ms.	Peloquin	Kristin		5083689297					Kristin.Peloquin@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	12/04/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	User Access Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Utilization Management Contact	VP and Medical Director	Dr.	Jaoude	Jean		5083689604					Jean.Jaoude@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2219	Utilization Review Contact	VP and Medical Director	Dr.	Jaoude	Jean		5083689604					Jean.Jaoude@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	National PACE	Fallon Health	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H2220	Automated TrOOP Balance Transfer Contact	Insurance Coordinator		Wong	Kwok		6172880970				6174740757	kwwong@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	05/30/2023	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Backup User Access Contact	Chief PACE Program Officer	Ms.	Roach	Nancy	J	6172880970				6172828625	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Best Available Evidence Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Bid Primary Contact	CFO		Cherry	Kevin		6172878000	8711				Kecherry@uphams.org	500 Columbia Road		Dorchester	MA	02125	05/19/2021	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	CAP Report Contact for Public Website	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	CEO - CMS Administrator Contact	CEO	Mr.	Trivedi	Jagdeep		6177408131				6172828625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	12/09/2015	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	CEO - Senior Official for Contracting	CEO	Mr.	Trivedi	Jagdeep		6177408131				6172828625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	12/09/2015	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Chief Financial Officer	CFO	Mr.	Cherry	Kevin		6172878000	8711				Kecherry@uphams.org	500 Columbia Road		Dorchester	MA	02125	05/19/2021	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Chief Operating Officer	Chief PACE Program Officer	Ms.	Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Chief Information Officer	IT Operations Director	Mr.	Hraybi	Samir		6172878000	8190				shraybi@uphams.org	415 Columbia Road		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Chief Information Security Officer	CEO	Mr.	Trivedi	Jagdeep		6177408131				6172828625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	02/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	CMS Casework Communication Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Complaints Tracking Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8030			6172828625	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/24/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Contact for Fraud Investigations	Compliance Officer		Mitza	Kerry		6172878000	8030			6172828625	kmitza@uphams.org	415 Columbia Road		Dorchester	MA	02125	04/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Coordination of Benefits Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Corporate Mailing						6172880970	8803			6174740757	nroach@uphams.org	500 Columbia Rd.	Mail Stop 1140-08	Dorchester	MA	02125	04/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Customer Service Operations Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/24/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	DIR Contact	CFO		Cherry	Kevin		6172878000	8711				Kecherry@uphams.org	500 Columbia Road		Dorchester	MA	02125	05/19/2021	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	DIR Contact (Secondary)	Chief PACE Program Director		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Discount Program Payment Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/24/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Emergency Part D Contact	Chief PACE Program Director		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Emergency Part D Contact (Secondary)	CEO	Mr.	Trivedi	Jagdeep		6177408131				6172828625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	04/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Encounter Data & Risk Adjustment Operations Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803				nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Enrollment Contact	Insurance Coordinator		Wong	Kwok		6172880970				6174740757	kwwong@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	01/06/2025	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	EOB Transfer Contact	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Financial Audit Contact	Chief PACE Program Officer	Ms.	Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Financial Reporting Contact	CFO	Mr.	Cherry	Kevin		6172878000				6172828625	Kcherry@uphams.org	500 Columbia Road, Dorchester, MA 02125		Dorchester	MA	02125	03/17/2023	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Formulary Contact	Medical Director		Burrows	Adam		6174401615	8901			6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Formulary Contact (Secondary)	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	General Contact	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Government Relations Contact	CEO	Mr.	Trivedi	Jagdeep		6177408131				6172828625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	12/09/2015	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	HIPAA Privacy Officer	CEO	Mr.	Trivedi	Jagdeep		6177408131				6172828625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	04/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	HIPAA Security Officer	Compliance Officer		Mitza	Kerry		6172878000	8030			6172828625	kmitza@uphams.org	415 Columbia Road		Dorchester	MA	02125	04/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Interoperability Contact			Hraybi	Samir		6177408190					shraybi@uphams.org	1140 Dorchester Ave, Dorchester, MA 02125		Dorchester, MA 02125	MA	02125	06/01/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	MA Appeals/Grievances Contact	Chief PACE Program Officer	Ms.	Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	MA Claims Processing Contact for Public Website	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Marketing Contact	Director of Growth	MS	Burris	Michelle		6172880970	8852			6172828625	MiBurris@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	03/17/2023	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Medical Director	Medical Director		Burrows	Adam		6174401615	8901			6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Medicare Compliance Officer	Compliance Officer	Mrs.	Mitza	Kerry		6172878000	8030			6172828625	kmitza@uphams.org	415 Columbia Road		Dorchester	MA	02125	09/12/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Medicare Coordinator	Compliance Officer	Mrs.	Mitza	Kerry		6172878000	8030			6172828625	kmitza@uphams.org	415 Columbia Road		Dorchester	MA	02125	04/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Medicare Part D Opioid Overutilization Contact	Chief PACE Program Officer	Ms.	Roach	Nancy	J	6172880970	8803				nroach@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Medication Therapy Management Contact	Medical Director		Burrows	Adam		6174401615	8901			6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Online Enrollment Center Contact (Back-up)	Compliance Officer		Mitza	Kerry		6172878000	8030			6172828625	kmitza@uphams.org	415 Columbia Road		Dorchester	MA	02125	04/22/2016	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Online Enrollment Center Contact (Optional)	Insurance Coordinator		Wong	Kwok		6172880970				6174740757	kwwong@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	05/24/2024	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Online Enrollment Center Contact (Primary)	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part C Application Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part D Appeals	Chief PACE Program Officer		Roach	Nancy						6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	05/30/2023	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active	6172880970				PACE - Nat		C	New York
H2220	Part D Appeals Contact (Secondary)	Medical Director		Burrows	Adam						6174740757	aburrows@uphams.org	36 Dearborn Street		Roxbury	MA	02119	05/24/2024	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active	6172880970				PACE - Nat		C	New York
H2220	Part D Application Contact	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part D Benefits Contact	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part D Claims Submission Contact	Chief PACE Program Officer		Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part D Exceptions Contact	Chief PACE Program Officer		Roach	Nancy						6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active	6172880970				PACE - Nat		C	New York
H2220	Part D Exceptions Contact (Secondary)	Medical Director		Burrows	Adam						6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	07/17/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active	6172880970				PACE - Nat		C	New York
H2220	Part D Price File Contact (Back-up)	Chief PACE Program Officer	Ms.	Roach	Nancy		6172880970					nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part D Price File Contact (Primary)	CEO	Mr.	Trivedi	Jagdeep		6177408127					jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	02/02/2021	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part D Quality Assurance Contact	Quality Assurance		Mitza	Kerry		6172878000	8030			6174740757	kmitza@uphams.org	415 Columbia Road		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Part D Reporting Contact	Chief PACE Program Officer		Roach	Nancy		6172880970				6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Patient Safety Contact	Chief PACE Program Officer	Ms.	Roach	Nancy	J	6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Payment Contact	CFO		Cherry	Kevin		6172878000	8711				Kecherry@uphams.org	500 Columbia Road		Dorchester	MA	02125	05/19/2021	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Pharmacy Director	Medical Director		Burrows	Adam		6174401615	8901			6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Pharmacy Network Management Contact	Medical Director		Burrows	Adam		6174401615	8901			6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Pharmacy Technical Help Desk Contact	Chief PACE Program Officer		Roach	Nancy						6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/24/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active	6172880970				PACE - Nat		C	New York
H2220	Plan Directory Contact for Public Website	Chief PACE Program Officer		Roach	Nancy		6172880970				6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Plan to Plan Reconciliation Contact	Insurance Coordinator		Wong	Kwok		6172880970				6174740757	kwwong@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	05/30/2023	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Processor Contact	Chief PACE Program Officer		Roach	Nancy		6172880970				6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Quality Contact	Quality Manager		Fresco	Sarah	J	6172880970	8837				sfresco@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/24/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Reconciliation Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970				6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Recovery Audit Contact	Chief PACE Program Officer	Ms.	Roach	Nancy		6172880970	8803			6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	08/09/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Surveillance Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970				6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	System Contact	Chief PACE Program Officer		Roach	Nancy	J	6172880970				6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Third Party Administrator (TPA) Liaison	Chief PACE Program Officer		Roach	Nancy	J	6172880970				6174740757	nroach@uphams.org	1140 Dorchester Ave		Dorchester	MA	02125	02/17/2022	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	User Access Contact	CEO	Mr.	Trivedi	Jagdeep		6177408131				6172828625	jtrivedi@uphams.org	415 Columbia Road		Dorchester	MA	02125	12/09/2015	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Utilization Management Contact	Medical Director		Burrows	Adam		6174401615	8901			6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2220	Utilization Review Contact	Medical Director		Burrows	Adam		6174401615	8901			6174422589	aburrows@uphams.org	1140 Dorchester Ave.		Dorchester	MA	02125	11/30/2013	2026	UPHAMS CORNER HEALTH COMMITTEE, INC.	National PACE	Upham's PACE	National PACE		Uphams Corner Health Committee, Inc.	250	Yes	Active					PACE - Nat		C	New York
H2221	Automated TrOOP Balance Transfer Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Backup User Access Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Best Available Evidence Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Bid Primary Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	CAP Report Contact for Public Website			Quality	Director		6175755850					pace_compliance@challiance.org	163 Gore St		Cambridge	MA	02141	10/10/2024	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	CEO - CMS Administrator Contact	Executive Director	Mr	Geyerhahn	Jed		6175755850				6176653110	jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	03/08/2016	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	CEO - Senior Official for Contracting	Executive Director	Mr	Geyerhahn	Jed		6175755850					jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	04/27/2017	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Chief Financial Officer	Director, Health Plan Operations	M	Tylander	Kathryn		6175755850				6176653110	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Chief Operating Officer	Director of Operations	M	Donnelly	Susan		6175755850					sdonnelly@challiance.org	163 Gore St		Cambridge	MA	02141	05/25/2023	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Chief Information Officer	Director, Health Plan Operations	M	Tylander	Kathryn		6175755850				6176653110	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Chief Information Security Officer	Executive Director	Mr	Geyerhahn	Jed		6175755850				6176653110	jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	08/22/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	CMS Casework Communication Contact	Operations Director	M	Donnelly	Sue		6175755850					sdonnelly@challiance.org	163 Gore St		Cambridge	MA	02141	08/25/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Complaints Tracking Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Contact for Fraud Investigations	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Coordination of Benefits Contact	Director, Health Plan Operations	M	Tylander	Kathryn		6175755850				6176653110	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Corporate Mailing						6175755850				6174998360	pace_compliance@challiance.org	163 Gore Street		Cambridge	MA	02141	08/22/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Customer Service Operations Contact	Operations Director	M	Donnelly	Sue		6175755850					sdonnelly@challiance.org	163 Gore St		Cambridge	MA	02141	08/25/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	DIR Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	DIR Contact (Secondary)	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Discount Program Payment Contact	Accountant II		Nathan	Martina		6035534894				6174998360	Manathan@challiance.org	163 Gore Street		Cambridge	MA	02141	10/22/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Emergency Part D Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Emergency Part D Contact (Secondary)	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Encounter Data & Risk Adjustment Operations Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Enrollment Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	EOB Transfer Contact	Director, Health Plan Operations	M	Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Financial Audit Contact	Exec. Dir.	M	Geyerhahn	Jed		6175755850				6174998360	jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Financial Reporting Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Formulary Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Formulary Contact (Secondary)	Executive Director	Mr	Geyerhahn	Jed		6175755850				6176653110	jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	11/12/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	General Contact			Geyerhahn	Jed		6174998333					pace_compliance@challiance.org	163 Gore St		Cambridge	MA	02141	02/26/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Government Relations Contact	Executive Director	Mr	Geyerhahn	Jed		6175755850					jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	04/27/2017	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	HIPAA Privacy Officer	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	HIPAA Security Officer	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Interoperability Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	MA Appeals/Grievances Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	MA Claims Processing Contact for Public Website			Health Plan Ops.	Director		6175755850				6174998360	chapace.billing@challiance.org	163 Gore Street		Cambridge	MA	02141	10/10/2024	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Marketing Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Medical Director	Medical Director	Dr.	Burns	Jonathan		6175755850					jburns@challiance.org	163 Gore St		Cambridge	MA	02141	04/27/2017	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Medicare Compliance Officer	Director, Health Plan Operations	M	Tylander	Kathryn		6175755850				6176653110	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Medicare Coordinator	Director, Health Plan Operations	M	Tylander	Kathryn		6175755850				6176653110	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Medicare Part D Opioid Overutilization Contact	Pharmacist	Ms.	Emma	D'Alleva		6175755850					edalleva@challiance.org	163 Gore St		Cambridge	MA	02141	11/06/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Medication Therapy Management Contact	Pharmacist	Ms.	Emma	D'Alleva		6175755850					edalleva@challiance.org	163 Gore St		Cambridge	MA	02141	11/06/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part C Application Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Appeals	Director, Health Plan Operations	M	Tylander	Kathryn							ktylander@challiance.org	163 Gore St		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	6175755850				PACE - Nat		C	New York
H2221	Part D Appeals Contact (Secondary)	Director of Quality		Fillas	Hannah							hfillas@challiance.org	163 Gore St		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	6175755850				PACE - Nat		C	New York
H2221	Part D Application Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Benefits Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Claims Submission Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Exceptions Contact	Director, Health Plan Operations		Tylander	Kathryn							ktylander@challiance.org	163 Gore St		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	6175755850				PACE - Nat		C	New York
H2221	Part D Exceptions Contact (Secondary)	Accountant	Ms.	Nathan	Martina							mnathan@challiance.org	163 Gore St		Cambridge	MA	02141	11/12/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	6175755850				PACE - Nat		C	New York
H2221	Part D Price File Contact (Back-up)	Exec. Dir.	M	Geyerhahn	Jed	R	6175755850				6174998360	jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	08/29/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Price File Contact (Optional)	Accountant	Ms.	Nathan	Martina		6175755850					mnathan@challiance.org	163 Gore St		Cambridge	MA	02141	11/12/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Price File Contact (Primary)	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Quality Assurance Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Part D Reporting Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Patient Safety Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Payment Contact	Director, Health Plan Operations		Tylander	Ty		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	08/29/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Pharmacy Director	Pharmacist	Ms.	Emma	D'Alleva		6175755850					edalleva@challiance.org	163 Gore St		Cambridge	MA	02141	11/06/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Pharmacy Network Management Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Pharmacy Network Management Contact (Secondary)	Executive Director	Mr	Geyerhahn	Jed		6175755850				6176653110	jgeyerhahn@challiance.org	163 Gore Street		Cambridge	MA	02141	11/12/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Pharmacy Technical Help Desk Contact	Pharmacist		Emma	D'Alleva							edalleva@challiance.org	163 Gore St		Cambridge	MA	02141	11/06/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	6175755850				PACE - Nat		C	New York
H2221	Pharmacy Technical Help Desk Contact (Secondary)	Director, Health Plan Operations	M	Tylander	Kathryn							ktylander@challiance.org	163 Gore St		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active	6175755850				PACE - Nat		C	New York
H2221	Plan Directory Contact for Public Website			Manager	PACE		6175755850					pace_compliance@challiance.org	163 Gore St		Cambridge	MA	02141	10/10/2024	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Plan to Plan Reconciliation Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Processor Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Quality Contact	Director, Health Plan Operations		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Reconciliation Contact	Director, Health Plan Operations		Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Reconciliation Contact (Secondary)	Accountant		Nathan	Martina		6175755850				6174998360	mnathan@challiance.org	163 Gore Street		Cambridge	MA	02141	11/12/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Recovery Audit Contact	Director, Health Plan Operations	M	Tylander	Kathryn		6175755850				6174998360	ktylander@challiance.org	163 Gore Street		Cambridge	MA	02141	09/24/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Surveillance Contact	Dir. of Quality/Patient Safety		Fillas	Hannah		6175755850				6174998360	hfillas@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	System Contact	Operations Director		Donnelly	Sue		6175755850					sdonnelly@challiance.org	163 Gore St		Cambridge	MA	02141	08/25/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Third Party Administrator (TPA) Liaison	Accountant II		Nathan	Martina		6035534894				6174998360	manathan@challiance.org	163 Gore Street		Cambridge	MA	02141	10/22/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	User Access Contact	Operations Director		Donnelly	Sue		6175755850					sdonnelly@challiance.org	163 Gore St		Cambridge	MA	02141	08/25/2020	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Utilization Management Contact	Dir. of Operations		Donnelly	Susan		6175755850				6174998360	sdonnelly@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2221	Utilization Review Contact	Dir. of Operations		Donnelly	Susan		6175755850				6174998360	sdonnelly@challiance.org	163 Gore Street		Cambridge	MA	02141	11/05/2025	2026	CAMBRIDGE PUBLIC HEALTH COMMISSION	National PACE	CHA PACE	National PACE		Cambridge Health Alliance	40	Yes	Active					PACE - Nat		C	New York
H2222	Automated TrOOP Balance Transfer Contact	Pharmacy Operations		Dennison	Martha		7817156640				7817156698	mdennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/23/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Backup User Access Contact	Director of Health Plan Operations		Febles	Jacklyn		7817156645					jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Best Available Evidence Contact	Director of Health Plan Operations		Febles	Jacklyn		7817156645					jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Bid Primary Contact	CFO	Mr.	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	CAP Report Contact for Public Website	COO		Ip	Calay		7817152395					Calayi@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	CEO - CMS Administrator Contact	CEO	Mr	Thompson	Douglas		7817156610				7817156699	douglast@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/24/2024	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	CEO - Senior Official for Contracting	CEO	Mr	Thompson	Douglas		7817156610				7817156699	douglast@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/24/2024	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Chief Financial Officer	CFO	Mr.	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Chief Operating Officer	COO	Ms	Ip	Calay		7817152395					Calayi@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Chief Information Officer	CIO	Mr	Coolong	John		7817156608	6689			7817156699	jcoolong@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Chief Information Security Officer	CIO	Mr	Coolong	John		7817156608	6689			7817156699	jcoolong@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	CMS Casework Communication Contact	CFO	Mr.	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Complaints Tracking Contact	Project Manager, Participant Services		Recinos Guzman	Carla		7817156612				7817156699	crecinos@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Contact for Fraud Investigations	Director Compliance	Ms	Schneid	Jennifer		6309953776				7817156699	jschneid@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Coordination of Benefits Contact	CFO	Mr.	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Corporate Mailing						7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Customer Service Operations Contact	Project Manager, Participant Services		Recinos Guzman	Carla		7817156612				7817156699	crecinos@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	DIR Contact	Pharmacy Operations		Dennison	Martha		7817156698					MDennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	DIR Contact (Secondary)	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Discount Program Payment Contact	Pharmacy Operations		Dennison	Martha		7819342936				7812685070	mdennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	06/27/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Emergency Part D Contact	CFO	Mr.	Zamansky	ANdrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Emergency Part D Contact (Secondary)	Part D Program Manager	Ms	Dennison	Martha		7819342936					MDennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Encounter Data & Risk Adjustment Operations Contact	Director of Health Plan Operations		Febles	Jacklyn		7817156645					jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Enrollment Contact	Marketing and Enrollment		Doherty	Caitlin		7817156608				7817156699	cdoherty@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/18/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	EOB Transfer Contact	Director of Health Plan Operations		Febles	Jacklyn		7817156645				7812685070	jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Financial Audit Contact	CFO	Mr	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Financial Reporting Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Formulary Contact	Part D Program Manager	Ms	Dennison	Martha		7819342936				7817156699	MDennison@elementcare.org	235 Woodland North 2nd Floor		Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Formulary Contact (Secondary)	CFO	Mr.	Zamansky	ANdrew		7817152394					AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	General Contact	CFO	Mr.	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Government Relations Contact	COO	Ms	Ip	Calay		7817152395					Calayi@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	HIPAA Privacy Officer	CIO		Coolong	John		7817156608				7817156699	jcoolong@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	HIPAA Security Officer	CIO		Coolong	John		7817156608				7817156699	jcoolong@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Interoperability Contact	CIO		Coolong	John		7817156608					jcoolong@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	MA Appeals/Grievances Contact	Project Manager, Participant Servic		Recinos Guzman	Carla		7817156612				7817156699	crecinos@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	MA Claims Processing Contact for Public Website	Director of Health Plan Operations		Febles	Jacklyn		7817156645					jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Marketing Contact	Manager Marketing		Martinson	Katie		7817156650				7817156699	kmartinson@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Medical Director	CMO		Zizza	Anthony		7817156602					anthonyz@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Medicare Compliance Officer	Director Compliance	Ms	Schneid	Jennifer		6302009658				7817156699	jschneid@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Medicare Coordinator	Director of Health Plan Operations		Febles	Jacklyn		7817156645					jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Medicare Part D Opioid Overutilization Contact	Director, Quality Improvement/Risk Management		Turnquist	Karen		7817156661					kturnquist@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Medication Therapy Management Contact	Part D Program Manager	Ms	Dennison	Martha		7819342936				7817156699	MDennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Online Enrollment Center Contact (Optional)	CFO	Mr	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Online Enrollment Center Contact (Primary)	Director of Health Plan Operations		Febles	Jacklyn		7817156645					jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part C Application Contact	CFO	Mr.	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Appeals	CFO	Mr.	Zamansky	Andrew						7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	7817152394				PACE - Nat		C	New York
H2222	Part D Appeals Contact (Secondary)	Part D Program Manager	Ms	Dennison	Martha							MDennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	7819342936				PACE - Nat		C	New York
H2222	Part D Application Contact	CFO		Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Benefits Contact	CFO		Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Claims Submission Contact	Pharmacy Operations		Dennison	Martha		7817156640				7817156699	mdennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/23/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Exceptions Contact	CFO		Zamansky	Andrew						7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	7817152394				PACE - Nat		C	New York
H2222	Part D Exceptions Contact (Secondary)	Consultant Pharmacy Network		Dennison	Martha							mdennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	7817156608				PACE - Nat		C	New York
H2222	Part D Price File Contact (Back-up)	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Price File Contact (Optional)	CFO	Mr.	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Price File Contact (Primary)	Pharmacy Operations		Dennison	Martha		7817156608					MDennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Quality Assurance Contact	CFO		Zamansky	ANdrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Part D Reporting Contact	Pharmacy Operations		Dennison	Martha		7817156640				7817156698	mdennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/23/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Patient Safety Contact	Pharmacist		Wolonsavich	Brian		7817156608				7817156699	bwolonsavich@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/18/2024	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Payment Contact	CFO		Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Pharmacy Director	Part D Program Manager		Dennison	Martha		7819342936				7817156699	MDennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Pharmacy Network Management Contact	Consultant Pharmacy Network		Dennison	Martha		7819342936					mdennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Pharmacy Network Management Contact (Secondary)	Pharmacist		Wolonsavich	Brian		7817156608				7817156699	bwolonsavich@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/18/2024	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Pharmacy Technical Help Desk Contact	Consultant Pharmacy Network		Dennison	Martha							mdennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	7817156608				PACE - Nat		C	New York
H2222	Pharmacy Technical Help Desk Contact (Secondary)	Part D Program Manager		Dennison	Martha							MDennison@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active	7819342936				PACE - Nat		C	New York
H2222	Plan Directory Contact for Public Website	Director Marketing		Gibeley	Jodi		7817152937				7817156699	jgibeley@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Plan to Plan Reconciliation Contact	CFO		Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Processor Contact	IT		Lynch	John	H	5084298506				5084298237	lynch@eatonapothecary.com	13 Water Street		Holliston	MA	01746	01/05/2006	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Quality Contact	Director, Quality Improvement/Risk Management		Turnquist	Karen		7817156661				7817156699	kturnquist@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/09/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Reconciliation Contact	Director of Health Plan Operations		Febles	Jacklyn		7817156645					jacklynf@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	09/09/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Reconciliation Contact (Secondary)	CFO		Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Recovery Audit Contact	CFO	MS	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Surveillance Contact	Director Compliance	Ms	Schneid	Jennifer		6309953776				7817156699	jschneid@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	System Contact	IT		Vidal	Pedro		7817156634				7817156698	support@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Third Party Administrator (TPA) Liaison	CFO	Mr	Zamansky	Andrew		7817152394				7817156699	AndrewZ@Elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	12/16/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	User Access Contact	IT		Vidal	Pedro		7817156634				7817156698	support@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	11/06/2023	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Utilization Management Contact	Quality Improvement Manager		McAllister	Amanda		7814172126				7817156699	amcallister@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/18/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2222	Utilization Review Contact	Quality Improvement Manager		McAllister	Amanda		7814172126				7817156699	amcallister@elementcare.org	235 Woodland North	2nd Floor	Lynn	MA	01904	04/18/2025	2026	ELEMENT CARE, INC.	National PACE	Element Care, Inc	National PACE		Element Care, Inc.	83	Yes	Active					PACE - Nat		C	New York
H2223	Automated TrOOP Balance Transfer Contact	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	12/05/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Backup User Access Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6175684732					dearauje@neighborhealth.com	10 Gove Street		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Best Available Evidence Contact	Medical Director	Dr.	Pedulla	James		6175696800				6175687259	pedullaj@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Bid Primary Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6175684567					dearauje@neighborhealth.com	10 Gove Street	Attn: Office of the CEO	East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	CAP Report Contact for Public Website	Communications Marketing Director		Martin	Emily		6175695800					martine@Neighborhealth.com	10 Gove St		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	CEO - CMS Administrator Contact	CEO/President	Mr.	Hazard	James		6175687244					hazardj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	05/20/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	CEO - Senior Official for Contracting	CEO/President	Mr.	Hazard	James		6175687244					hazardj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	05/20/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Chief Financial Officer	CFO	Mr.	Hazard	James		6175695800					hazardj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Chief Operating Officer	COO	Mr.	Boxill	Ryan		6175684570					boxillr@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Chief Information Officer	CIO	Ms	Rogers	Laura		6175684570					rogersl@NeighborHealth.com	EBNHC 10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Chief Information Security Officer	VP/CTO	Mr	Hill	Jim		6175684570					hillj@NeighborHealth.com	EBNHC 10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	CMS Casework Communication Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6175684567					dearauje@neighborhealth.com	10 Gove St		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Complaints Tracking Contact	PACE Regulatory Manager		Firth	Madelyn		6175686335					firthm@NeighborHealth.com	East Boston Neighborhood Health Center	10 Gove Street	East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Contact for Fraud Investigations	Deputy General Counsel, AVP		McGee	Amanda		6175695800					mcgeea@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Coordination of Benefits Contact	Health Plan Analyst		Moustafa	Saphia		6175686127					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Corporate Mailing						6175695800					martine@Neighborhealth.com	10 Gove St		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Customer Service Operations Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6175684714					dearauje@neighborhealth.com	10 Gove St		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	DIR Contact	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove St.		East Boston	MA	02128	01/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	DIR Contact (Secondary)	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove St		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Discount Program Payment Contact	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove St.		East Boston	MA	02128	01/02/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Emergency Part D Contact	Medical Director	Dr.	Pedulla	James		6175685800					pedullaj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Emergency Part D Contact (Secondary)	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove St		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Encounter Data & Risk Adjustment Operations Contact	PACE Regulatory Manager		Firth	Madelyn		6175686335					firthm@NeighborHealth.com	10 Gove St.		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Enrollment Contact	Health Plan Analyst		Moustafa	Saphia		6175686127					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	EOB Transfer Contact	Health Plan Analyst		Moustafa	Saphia		6175686127				6175686419	Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Financial Audit Contact	Chief Financial Officer	Mr.	Hazard	James		6175687244					hazardj@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Financial Reporting Contact	PACE Regulatory Manager		Firth	Madelyn		6175686335					firthm@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Formulary Contact	Medical Director	Dr.	Pedulla	James		6175684570					pedullaj@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Formulary Contact (Secondary)	Clinical Pharmacist		Souza	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove St.		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	General Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6175684714					dearauje@neighborhealth.com	10 Gove St		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Government Relations Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6175684714					dearauje@neighborhealth.com	10 Gove St		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	HIPAA Privacy Officer	Privacy Officer		Desisto	Elizabeth		6175695800					desistoe@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	HIPAA Security Officer	Privacy Officer		Desisto	Elizabeth		6175695800					desistoe@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Interoperability Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6176342064					dearauje@neighborhealth.com	10 Gove Street		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	MA Appeals/Grievances Contact	Director PACE Clinical		Smith	Tina		6175686460					smitht@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	MA Claims Processing Contact for Public Website	PACE Regulatory Manager		Firth	Madelyn		6175686335					firthm@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Marketing Contact	Director of Communications		Martin	Emily		6175684741					martine@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Medical Director	Medical Director	Dr.	Pedulla	James		6175684570					pedullaj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Medicare Compliance Officer	Deputy General Counsel, AVP	Mrs.	McGee	Amanda		6175685800					mcgeea@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Medicare Coordinator	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Medicare Part D Opioid Overutilization Contact	Pharmacy Manager		Souza	Ashley		6175684610					caseya@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Medication Therapy Management Contact	Pharmacy Manager		Souza	Ashley		6175684610					caseya@NeighborHealth.com	10 Gove St		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	OffShore Subcontractor Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6176342064					dearauje@neighborhealth.com	10 Gove St.		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Online Enrollment Center Contact (Primary)	Health Plan Analyst		Moustafa	Saphia		6175695800					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	09/05/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part C Application Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6175684714					dearauje@neighborhealth.com	10 Gove St		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Appeals	Clinical Pharmacist		Casey	Ashley							caseya@NeighborHealth.com	10 Gove St		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active	6175695800				PACE - Nat		C	New York
H2223	Part D Appeals Contact (Secondary)	PACE Regulatory Manager		Firth	Madelyn							firthm@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active	6175686335				PACE - Nat		C	New York
H2223	Part D Application Contact	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Benefits Contact	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove St		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Claims Submission Contact	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Exceptions Contact	Medical Director	Dr.	Pedulla	James							pedullaj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active	6175684570				PACE - Nat		C	New York
H2223	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Casey	Ashley							caseya@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active	6175695800				PACE - Nat		C	New York
H2223	Part D Price File Contact (Back-up)	PACE Regulatory Manager		Firth	Madelyn		6175686335					firthm@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Price File Contact (Optional)	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove St		East Boston	MA	02128	09/05/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Price File Contact (Primary)	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Quality Assurance Contact	Medical Director	Dr.	Pedulla	James		6175684570					pedullaj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Part D Reporting Contact	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Patient Safety Contact	Medical Director	Dr.	Pedulla	James		6175684570					pedullaj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Payment Contact	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Pharmacy Director	Clinical Pharmacist		Casey	Ashley		6175684610					caseya@NeighborHealth.com	10 Gove St		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Pharmacy Network Management Contact	Clinical Pharmacist		Casey	Ashley		6175695800					caseya@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist		Casey	Ashley		6178747545					caseya@NeighborHealth.com	10 Gove St.		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Pharmacy Technical Help Desk Contact	Clinical Pharmacist		Casey	Ashley							caseya@NeighborHealth.com	10 Gove St		East Boston	MA	02128	10/30/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active	8004390183				PACE - Nat		C	New York
H2223	PHR Beneficiary Contact																	05/20/2022	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE	East Boston Neighborhood Health Center Corporation - Neighborhood PACE	NEIGHBORHEALTH CORPORATION	861	Yes	Active	6175684732				PACE - Nat		C	New York
H2223	Plan Directory Contact for Public Website	Communications Marketing Director		Martin	Emily		6175695800					martine@Neighborhealth.com	10 Gove St		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Plan to Plan Reconciliation Contact	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	07/14/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Processor Contact	Pharmacy Strategy & Projects Director		Leung	Gerry		6175695800					leungg@neighborhealth.com	10 Gove Street		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Quality Contact	Regulatory PACE Manager		Firth	Madelyn		6175695800					firthm@Neighborhealth.com	10 Gove St		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Reconciliation Contact	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Reconciliation Contact (Secondary)	Health Plan Analyst		Moustafa	Saphia		6175695800					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	09/05/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Recovery Audit Contact	VP & Chief Administrative Officer	Mr.	DeAraujo	Ernani		6176342064					dearauje@neighborhealth.com	10 Gove St		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Surveillance Contact	VP & Chief Administrative Officer		DeAraujo	Ernani		6176342064					dearauje@neighborhealth.com	10 Gove St		East Boston	MA	02128	04/17/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	System Contact	PACE Regulatory Manager		Firth	Madelyn		6175686335					firthm@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Third Party Administrator (TPA) Liaison	Health Plan Analyst		Moustafa	Saphia		6175686124					Moustasa@NeighborHealth.com	10 Gove Street		East Boston	MA	02128	01/02/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	User Access Contact	VP & General Counsel Legal and Government Affairs		McGee	Amanda		6175695800					mcgeea@Neighborhealth.com	10 Gove St		East Boston	MA	02128	09/10/2025	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Utilization Management Contact	Medical Director	Dr.	Pedulla	James		6175684570					pedullaj@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2223	Utilization Review Contact	Health Plan Analyst		Moustafa	Saphia		6175686127					Moustasa@NeighborHealth.com	10 Gove St		East Boston	MA	02128	06/25/2024	2026	NEIGHBORHEALTH CORPORATION	National PACE	Neighborhood PACE	National PACE		NEIGHBORHEALTH CORPORATION	861	Yes	Active					PACE - Nat		C	New York
H2224	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/29/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/31/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	01/23/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	01/23/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	04/30/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/31/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	11/21/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	01/23/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/31/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H2224	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H2224	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H2224	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H2224	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H2224	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H2224	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	02/28/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	04/16/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	01/23/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	10/24/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	11/21/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2224	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	11/21/2024	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2225	Agent/Broker Compensation Data Contact	Manager, Sales Operations	Mr.	Demos	John		6174260600					jdemos@commonwealthcare.org	30 Winter Street		Boston	MA	02108	04/22/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Automated TrOOP Balance Transfer Contact	Sr. Analyst Account Management		Diaz	Yamilca		4016513856					Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02895	01/02/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Backup User Access Contact	Director, Health Plan Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/25/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Best Available Evidence Contact	Director Enrollment		Millette	Maria		4012453047					mmillette@commonwealthcare.org	30 Winter St		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Bid Audit Contact	Vice President, Actuarial Services		Jesik	David		6174260600	51808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Bid Audit Site Contact	Vice President, Actuarial Services	Mr.	Jesik	David		6174260600	51808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Bid Primary Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	CAP Report Contact for Public Website	General Manager, Market Lead - Massachusetts		Waggoner	Mark		6174260600	51606				mwaggoner@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/23/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	CEO - CMS Administrator Contact	President	Mr	Koehn	John		7328098761					jkoehn@commonwealthcare.org	30 Winter St		Boston	MA	02108	06/30/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	CEO - Senior Official for Contracting	President	Mr	Koehn	John		7328098761					jkoehn@commonwealthcare.org	30 Winter St		Boston	MA	02108	06/30/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Chief Financial Officer	Interim Chief Financial Officer	Mr.	Peary	Matthew		8605029592					mpeary@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/25/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Chief Operating Officer	Chief Operating Officer	Ms.	Cassel Kraft	Amanda		3143045870					acasselkraft@commonwealthcare.org	30 Winter Street		Boston	MA	02108	03/01/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Chief Information Officer	SVP & Chief Information Officer	Ms.	O'Rorke	Beth		6174260600	2485				bororke@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/21/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Chief Information Security Officer	VP, IT Governance and Cyber Security	Mr.	Jacobs	Tim		6174260600	52258				tjacobs@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/30/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	CMMI Model Point of Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/25/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	CMS Casework Communication Contact	Director, Appeals& Grievances		Schenk	Tyrone		8573273320				8574534517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Complaints Tracking Contact	Director, Appeals& Grievances		Schenk	Tyrone		8573273320					tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Contact for Fraud Investigations	Director, FWA Program and SIU		Vasconcelos	Nadia		6174260600	52733				nvasconcelos@commonwealthcare.org	2 Lafayette	5th Floor	Boston	MA	02111	08/08/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Coordination of Benefits Contact	Sr Director Claims Ops		Sottilotta	Lori		6174260600	1194				lsottilotta@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/27/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Corporate Mailing						6174260600	1991				elgray@commonwealthcare.org	30 Winter Street		Boston	MA	02108	02/24/2016	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Customer Service Operations Contact	Director Contact Center		Cuevas	Sabrina		6174260600	51004				scuevas@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/20/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	DIR Contact	Vice President, Actuarial Services		Jesik	David		6174260600	51808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	DIR Contact (Secondary)	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Discount Program Payment Contact	Sr. Director Treasury Operations		Jabre	Joe		6175642953					jjabre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/11/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Electronic Health Record Contact	Director, Clinical Informatics		Phan	Phuong		6174260600	52247				pphan@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	11/04/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Emergency Part D Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations		Lee	Annie		7819158014					alee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/16/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Encounter Data & Risk Adjustment Operations Contact	Director Revenue Cycle Management		Soones	Michael		6174260600	54925				msoones@commonwealthcare.org	30 Winter St		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Enrollment Contact	Director Enrollment		Millette	Maria		4012453047					mmillette@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	EOB Transfer Contact	Director, Claims Operations		Sottilotta	Lori		6174260600	1194			6174260600	lsottilotta@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/16/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Financial Audit Contact	Director, Regulatory Audit	Ms	Patterson	Kathryn		6174260600	51404				kpatterson@commonwealthcare.org	2 Avenue de Lafayette	5th Floor	Boston	MA	02111	09/24/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Financial Reporting Contact	VP & Controller	Mr.	Heath	Alan		8572602839					aheath@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/04/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Formulary Contact	Director of Pharmacy Services	Ms.	Perry	Michele		8018363750					michele.perry@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	01/02/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Formulary Contact (Secondary)	Sr. Director, Pharmacy		Berman	Tova		6174260600	51289				tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/28/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	General Contact	General Manager, Market Lead - Massachusetts		Waggoner	Mark		6174260600	51606				mwaggoner@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/23/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Government Relations Contact	Federal Policy Medicare Director		Waickman	Nicole		6174260600	51412				nwaickman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/20/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	HIPAA Privacy Officer	Sr Director Regulatory Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	07/12/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	HIPAA Security Officer	Sr Director Regulatory Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	07/12/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Hospice Contact	VP Utilization Management		Dardompre	Donna		6175079344					ddardompre@commonwealthcare.org	Lafayette City Center		Boston	MA	02111	01/31/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Interoperability Contact	SVP & Chief Information Officer		O'Rorke	Beth		6174260600	52444				bororke@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/20/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	MA Appeals/Grievances Contact	Director, Appeals& Grievances		Schenk	Tyrone		8573273320				8574534517	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	MA Claims Processing Contact for Public Website			Services	Provider		8664209332	1194				providerservices@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/03/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Marketing Contact	SVP, Marketing		Kubilus	Melissa		6174260600	52448			6174263019	mkubilus@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/03/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Medical Director	Medical Director		Lewin	Roxanne		6175812434					rlewin@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Medicare Compliance Officer	VP, Medicare Compliance Officer	Ms.	Charron	Katherine		4013785409					KCharron@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/10/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Medicare Coordinator	GM Massachusetts		Waggoner	Mark		6174260600	51606				mwaggoner@commonwealthcare.org	30 Winter Street		Boston	MA	02108	03/05/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	07/02/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Medication Therapy Management Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	OffShore Subcontractor Contact	Sr Director Regulatory Compliance		Dwinnells	Mark		6174260600	1239				mdwinnells@commonwealthcare.org	30 Winter Street		Boston	MA	02108	07/12/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Online Enrollment Center Contact (Back-up)	Sr Manager		Millette	Maria		4012563047					mmillette@commonwealthcare.org	30 Winter Street		Boston	MA	02108	03/25/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Online Enrollment Center Contact (Primary)	Director Enrollment		Millette	Maria		4012453047					mjmillette@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part C Application Contact	Sr. Director, Product		Martel	Annemarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/23/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part C Reporting Contact	Medicare Compliance Officer		Charron	Katherine		4013785409					kcharron@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/13/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Appeals	Director, Appeals & Grievances		Schenk	Tyrone						8573273320	tschenck@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/12/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active	8666102273				HMO - Health Maintenance Organization		C	Boston
H2225	Part D Appeals Contact (Secondary)	Manager, Clinical Appeals and Grievances		Mancuso	Jeremiah							jmancuso@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/11/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active	6174260600	51222			HMO - Health Maintenance Organization		C	Boston
H2225	Part D Application Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/23/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Benefits Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Claims Submission Contact	Sr. Analyst		Diaz	Yamilca		4016513856					Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02895	01/02/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Exceptions Contact	Sr. Analyst Account Management		Diaz	Yamilca							Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02895	01/02/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active	4016513856				HMO - Health Maintenance Organization		C	Boston
H2225	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Operations		Lee	Annie						6174263109	alee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/16/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active	7819158014				HMO - Health Maintenance Organization		C	Boston
H2225	Part D Price File Contact (Back-up)	Manager, Pharmacy Operations		Lee	Annie		7819158014					alee@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/16/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Price File Contact (Optional)	Manager Financial Ops		Loveland	Chet		8018363750					chet.loveland@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	01/03/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Price File Contact (Primary)	Sr Analyst Finance Ops		Scott	Sarah		4803109219					sarah.scott@cvshealth.com	9501 E. Shea Blvd.	MC 080	Scottsdale	AZ	85260	01/03/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Quality Assurance Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Part D Reporting Contact	Medicare Compliance Officer		Charron	Katherine		4013785409					kcharron@commonwealthcare.org	30 Winter Street		Boston	MA	02108	08/13/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Patient Safety Contact	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Payment Contact	VP & Controller		Heath	Alan		8572602839					aheath@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/04/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Personal Health Record Contact	Director, Health Information Management		Tandoh	Shirley		2679792990					standoh@commonwealthcare.org	30 Winter Street		Boston	MA	02108	03/25/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Pharmacy Director	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	01/02/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services	Ms.	Berman	Tova		6176554768					tberman@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/31/2022	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Pharmacy Technical Help Desk Contact	Account Manager		Diaz	Yamilca						8332519739	Yamilca.Diaz@cvshealth.com	1 CVS Dr.		Woonsocket	RI	02895	01/02/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active	8662703877				HMO - Health Maintenance Organization		C	Boston
H2225	PHR Beneficiary Contact																	03/25/2021	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS	Commonwealth Care Alliance	CareSource	321	Yes	Active	8666102273				HMO - Health Maintenance Organization		C	Boston
H2225	Physician Incentive Contact	Director Provider Network Strategy	Mr.	Driscoll	Terence		6174260600	56886				tdriscoll@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/10/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Plan Directory Contact for Public Website			Services	Member		8664209332					memberservices@commonwealthcare.org	30 Winter Street		Boston	MA	02108	01/16/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Plan to Plan Reconciliation Contact	Manager, Accounts Payable		Reeves	Jennifer		6174260600	51632				jreeves@commonwealthcare.org	30 Winter St		Boston	MA	02108	05/08/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Processor Contact	Director, Claims and Provider Network Operations		Sottilotta	Lori		6174260600	51194				lsottilotta@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/16/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Quality Contact	Sr Director Quality		Wagner	Michael		6174260600	58803				ahelwig@commonwealthcare.org	30 Winter Street		Boston	MA	02108	10/20/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Reconciliation Contact	Vice President, Actuarial Service		Jesik	David		6174260600	1808				djesik@commonwealthcare.org	30 Winter Street		Boston	MA	02108	06/26/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Reconciliation Contact (Secondary)	Director Revenue Cycle		Soones	Michael		6174260600	54925				msoones@commonwealthcare.org	30 Winter Street		Boston	MA	02108	12/05/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Recovery Audit Contact	Director, Regulatory Audit	Ms.	Patterson	Kathryn		6174260600	51404				kpatterson@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/11/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	SNP Application Contact	Sr. Director, Product		Martel	AnneMarie		6174260600	56999				amartel@commonwealthcare.org	30 Winter Street		Boston	MA	02108	05/23/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	SNP State Contact	SCO and One Care Contract Director		Friedmann	Heather		6175716907					hfriedmann@commonwealthcare.org	30 Winter Street		Boston	MA	02108	03/05/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Surveillance Contact	Director, National Sales		Joyce	Joe		6174260600	52179				jjoyce@commonwealthcare.org	30 Winter Street		Boston	MA	02108	11/20/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	System Contact	Secure File Movement Sr. Administrator		Lou	Brian		6174260600	51997				blou@commonwealthcare.org	30 Winter Street		Boston	MA	02108	03/25/2024	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Third Party Administrator (TPA) Liaison	Sr. Director Treasury Operations		Jabre	Joe		6175642953					jjabre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/11/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	User Access Contact	Director Medicare Compliance Officer		Charron	Katherine		4013785409					KCharron@commonwealthcare.org	190 White Ave		Warwick	MA	02108	08/13/2025	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Utilization Management Contact	VP UM and A&G		Dardompre	Donna		6175079344					ddardompre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/11/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2225	Utilization Review Contact	VP UM and A&G		Dardompre	Donna		6175079344					ddardompre@commonwealthcare.org	30 Winter Street		Boston	MA	02108	09/11/2023	2026	COMMONWEALTH CARE ALLIANCE, INC.	Local CCP	Commonwealth Care Alliance Massachusetts	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	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	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	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	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	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	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H2226	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2226	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	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	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2226	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H2226	Plan Directory Contact for Public Website			Customer Service	UHC		8888675511					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2226	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2230	Agent/Broker Compensation Data Contact	Director, Broker and Sales Commissions		Newcomb	Stephen		6172469980					Stephen.Newcomb@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	12/07/2018	2026	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	Automated TrOOP Balance Transfer Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/04/2021	2026	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	Backup User Access Contact	Sr. Manager, Medicare Compliance		Donovan	Gerard		6172468466					Gerard.Donovan@bcbsma.com	25 Technology Place		Hingham	MA	020434359	05/20/2024	2026	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	Enrollment Supervisor		Peterson	Colin		6172469729				6172468506	colin.peterson@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2025	2026	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	Bid Audit Contact	Sr. Manager, Actuary		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Bid Audit Site Contact	Sr. Manager, Actuary		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Bid Primary Contact	Sr. Manager, Actuary		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	CAP Report Contact for Public Website	Director, Medicare Compliance		Sullivan	Christina		7816038012					MAPDCompliance@bcbsma.com	25 Technology Place		Hingham	MA	020434359	05/17/2024	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Iselin	Sarah		6172463805					sarah.iselin@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	12/21/2022	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Iselin	Sarah		6172463805					sarah.iselin@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	12/21/2022	2026	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.	Kam	Ruby		6172463000					Ruby.Kam@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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 Operating Officer	Executive Vice President, Chief Operating Officer	Mr	Lynch	Richard		6172465000					Richard.Lynch@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Somasundaram	Prem		6172462859					prem.somasundaram@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	07/18/2024	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Di Bassinga	Nsiona		6172463988					nsiona.dibassinga@bcbsma.com	101 Huntington Avenue, Suite 1300		Boston	MA	021997611	09/24/2025	2026	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	Manager, Appeals and Grievance		Ronaghan	Danielle		6172464663				6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mailstop 03-04	Hingham	MA	020434359	05/20/2024	2026	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	Complaints Tracking Contact	Manager, Appeals and Grievance		Ronaghan	Danielle		6172464663				6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/20/2024	2026	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	Contact for Fraud Investigations	Sr Associate General Counsel		Wood	Geoffrey		6172463896					geoffrey.wood2@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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		6172469587					Janet.Seesholtz@bcbsma.com	25 Technology Place		Hingham	MA	02043	10/02/2025	2026	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	Corporate Mailing						8002004255					placeholder@cms.hhs.gov	P. O. Box 55007		Boston	MA	022055007	06/10/2010	2026	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	Director, Member Service		Hanstein	deMarigny		6172468941					deMarigny.Hanstein@bcbsma.com	25 Technology Place		HInghan	MA	02043	10/02/2025	2026	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	DIR Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@bcbsma.com	25 Technology Place		Hingham	MA	02043	08/04/2021	2026	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	DIR Contact (Secondary)	Director, Corporate Accounting and Reporting	Mr	Thurber	Steven		6172466523				6172467806	Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Discount Program Payment Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523					Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	12/04/2017	2026	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	Emergency Part D Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place	Mailstop 03-03	Hingham	MA	020434359	12/27/2022	2026	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	Employer Waiver Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Sr. Analyst		Ferbert	Laura		6172464656					Laur.Ferbert@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/06/2025	2026	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	Enrollment Contact	Sr. Manager, Medicare Enrollment		Bailey	Elizabeth		6172468678				6172468506	Elizabeth.Bailey@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/17/2024	2026	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	EOB Transfer Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@bcbsma.com	25 Technology Place	Mail Stop: 03-04	Hingham	MA	020434359	08/04/2021	2026	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	Financial Audit Contact	Audit and Risk Management	Mr.	Bulman	Tim		6172468038					Timothy.Bulman@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	11/18/2019	2026	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	Financial Reporting Contact	Financial Reporting Manager		Goveia	Ross		6172465000					Ross.Goveia@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Formulary Contact	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	Formulary Contact (Secondary)	Clinical Pharmacist		Schraut	David		6172465762					David.Schraut@BCBSMA.COM	25 Technology Place		Hingham	MA	02043	09/18/2025	2026	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	General Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place		Hingham	MA	02043	12/27/2022	2026	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, Government and Regulatory Affairs	Ms.	Wilkinson	Erika		6172467987					Erika.Wilkinson@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Abdel-Samed	Jennifer		4042424614					Jennifer.Abdel-Samed@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer	Ms.	Chang	Ann		6172463266					Ann.Chang@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	Interoperability Contact	Senior Director, Emerging Technologies		Narasimhan	Sri Ram		6172468640					Sri.Narasimhan@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	10/02/2025	2026	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	MA Appeals/Grievances Contact	Manager, Appeals and Grievance		Ronaghan	Danielle		6172464663				6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mail Stop 03/04	Hingham	MA	02043	05/17/2024	2026	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	MA Claims Processing Contact for Public Website	Sr. Manager, Claims and Appeals & Grievances		Moore	Teresa	J	6172469478					Teresa.Moore@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2020	2026	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	Marketing Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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	Medical Director	Sr. Medical Director		Dondapati	Satya		6172463821					Satya.Dondapati@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	01/30/2024	2026	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		7816038012					MAPDCompliance@bcbsma.com	25 Technology Place	Mail stop 03/03	Hingham	MA	020434359	04/28/2022	2026	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 Coordinator	VP, Government Programs		Bentley	Melanie		6172468403					Melanie.Bentley@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/17/2024	2026	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 Part D Opioid Overutilization Contact	Clinical Manager, Pharmacy Operations		Wong	Timothy		6172466927					timothy.wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	04/10/2023	2026	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	Medication Therapy Management Contact	Clinical Manager		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	05/30/2024	2026	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	Online Enrollment Center Contact (Back-up)	Manager, Medicare Enrollment		Cougler	Kevin		6172468530					kevin.cougler@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2025	2026	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	Online Enrollment Center Contact (Primary)	Sr. Manager, Medicare Enrollment		Bailey	Elizabeth		6172468678				6172468506	Elizabeth.Bailey@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/17/2024	2026	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 C Application Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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 C Reporting Contact	Program Manager		MacDougall	Erin		6172469714				6172468506	erin.macdougall@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	01/25/2021	2026	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 Appeals	Manager, Appeals and Grievance		Ronaghan	Danielle						8664637700	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place		Hingham	MA	020434359	05/17/2024	2026	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	8005836289				PPO - BBA		C	Boston
H2230	Part D Appeals Contact (Secondary)	Supervisor, Appeals and Grievance		Armstrong	Justine						6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	8005836289				PPO - BBA		C	Boston
H2230	Part D Application Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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 Benefits Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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 Claims Submission Contact	Sr. Manager, Financial Operations		Okrie	Courtney		4803181864					courtney.okrie@cvshealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	05/17/2024	2026	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						8664637700	Melinda.Nelhuebel@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/29/2018	2026	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	8003667778				PPO - BBA		C	Boston
H2230	Part D Exceptions Contact (Secondary)	Clinical Manager, Pharmacy Operations		Wong	Timothy						8664637700	Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	04/10/2023	2026	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	8003667778				PPO - BBA		C	Boston
H2230	Part D Price File Contact (Back-up)	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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 Price File Contact (Optional)	Clinical Pharmacist		Schraut	David		6172465762					David.Schraut@bcbsma.com	25 Technology Place		Hingham	MA	02043	04/22/2025	2026	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 Price File Contact (Primary)	Sr. Manager, Financial Operations		Okrie	Courtney		4803181864					courtney.okrie@cvshealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	05/17/2024	2026	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 Quality Assurance Contact	Clinical Pharmacy Manager		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	03/29/2022	2026	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 Reporting Contact	Program Manager		MacDougall	Erin		6172469714				6172468506	erin.macdougall@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	01/25/2021	2026	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	Patient Safety Contact	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	Payment Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523					Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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 Director	Director, Pharmacy Operations		Nelhuebel	Melinda		6172464407					Melinda.Nelhuebel@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/29/2018	2026	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 Network Management Contact	Lead Director, Network Management		Smith	Shawn		4803914844					Shawn.Smith@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	12/27/2022	2026	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 Network Management Contact (Secondary)	VP, Chief Pharmacy Officer		Erwin	Mary Beth		6172463276					MaryBeth.Erwin@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	10/02/2025	2026	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	2026	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	8666934620				PPO - BBA		C	Boston
H2230	Physician Incentive Contact	VP, Network Contracting		Katinas	Stephan		6172466518					Stephan.Katinas@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8002004255					MMService@bcbsma.com	25 Technology Place	Mailstop 03-02	Hingham	MA	020434359	11/18/2019	2026	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	Plan to Plan Reconciliation Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523				6172467806	Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Processor Contact	Lead Director, Networks		Graham	Heather		2145370421					Heather.Graham@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	12/27/2022	2026	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	Quality Contact	Director, Clinical Quality		Jean	Kristin		6172464727					Kristin.Jean@bcbsma.com	25 Technology Place		Hingham	MA	02043	10/02/2025	2026	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	Reconciliation Contact	Director, Corporate Accounting and Reporting	Mr	Thurber	Steven		6172466523				6172467806	steven.thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Reconciliation Contact (Secondary)	Associate Director, Accounting		Setzer	Bryan		6172466261					Bryan.Setzer@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Recovery Audit Contact	Reporting Sr. Analyst	Ms.	Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@BCBSMA.com	25 Technology Place		Hingham	MA	02043	08/04/2021	2026	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	Surveillance Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place	Mailstop 03-03	Hingham	MA	020434359	01/30/2024	2026	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	System Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	robin.kovalski@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2020	2026	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	Third Party Administrator (TPA) Liaison	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523					Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	12/04/2017	2026	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	User Access Contact	Director, Medicare Compliance		Sullivan	Christina		6172462507					Christina.Sullivan@bcbsma.com	25 Technology Place		Hingham	MA	020434359	01/30/2024	2026	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	Utilization Management Contact	Sr. Medical Director		Dondapati	Satya		6172463821					Satya.Dondapati@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	01/30/2024	2026	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	Utilization Review Contact	Sr. Medical Director		Dondapati	Satya		6172463821					Satya.Dondapati@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	01/30/2024	2026	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	Agent/Broker Compensation Data Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Automated TrOOP Balance Transfer Contact	Director, Enrollment	Mr.	Wade	Greg		3142092810					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/05/2018	2026	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	Backup User Access Contact	Compliance Analyst		Patel	Karishma		7274674873					karishma.patel@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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		3142092810					Enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	02/05/2018	2026	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	Bid Audit Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Bid Audit Site Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Bid Primary Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	CEO - CMS Administrator Contact	President	Ms.	Armstrong	Shawn		3043892792					Melisa.armstrong@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	12/14/2023	2026	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	CEO - Senior Official for Contracting	President	Ms.	Armstrong	Shawn		3043892792					Melisa.armstrong@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	12/19/2023	2026	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	Ms.	Polo	Janice		7278208021					Janice.polo@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	09/17/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Garey-Roy	Deeann		9414450519					deeann.gareyroy@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	07/20/2023	2026	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 Information Officer	Vice President, Information Technology	Mr.	Vannatta	Aaron		3147703700					avannatta@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/03/2020	2026	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 Information Security Officer	Vice President, Information Technology	Mr.	Vannatta	Aaron		3147703700					avannatta@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/19/2020	2026	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		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Complaints Tracking Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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	Corporate Mailing						7275191766					customerservice@baycarehealthplans.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	05/21/2021	2026	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		6366869682					rmeyerhoeffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2019	2026	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	DIR Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	DIR Contact (Secondary)	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Discount Program Payment Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Emergency Part D Contact	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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	Emergency Part D Contact (Secondary)	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Employer Waiver Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP, Risk Adjustment Services		Eschbach	Jason		6144397608					jeschbach@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	05/21/2021	2026	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	Enrollment Contact			Meyerhoeffer	Linda		6366869682					rmeyerhoeffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/11/2020	2026	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	EOB Transfer Contact	Director, Claims	Ms.	Walter	Dawn		3142092726				3147706096	dwalter@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2019	2026	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	Financial Audit Contact	Director, Finance	Ms.	Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Financial Reporting Contact	Director, Finance	Ms.	Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Formulary Contact		Ms	Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/05/2018	2026	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	Formulary Contact (Secondary)	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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	General Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	HIPAA Security Officer	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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	Interoperability Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	11/16/2021	2026	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	MA Appeals/Grievances Contact	Director Health Plan Operations	Mr	Hayle	Orlando	S	7273156871					Orlando.Hayle@BAYCARE.ORG	300 Park Place Blvd	Suite170	Clearwater	FL	33759	07/28/2025	2026	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	MA Claims Processing Contact for Public Website			Customer Service	Lumeris		8665095396					customerservice@baycarehealthplans.org	13900 Riverport Dr		Maryland Heights	MO	63043	12/10/2019	2026	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	Marketing Contact	Compliance Analyst	Ms.	Patel	Karishma		7274674873					karishma.patel@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	12/03/2019	2026	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	Medical Director	Medical Officer	Dr.	Repp	Cori		9417794807					Cori.Repp@baycare.org	300 Park Place Blvd., Suite 170		Clearwater	FL	33759	01/15/2025	2026	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		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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 Coordinator	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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 Part D Opioid Overutilization Contact	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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	Medication Therapy Management Contact	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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	OffShore Subcontractor Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Online Enrollment Center Contact (Back-up)	Manager, Compliance	Mr.	Ruiz	Lee		6366869602					lruiz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/11/2021	2026	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	Online Enrollment Center Contact (Optional)	Director, Member Experience & Aquisition	Ms.	Croom Tucker	Kristy		7275191909					kristy.croomtucker@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	11/11/2021	2026	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	Online Enrollment Center Contact (Primary)	Engagement Delivery Director	Ms.	Riswadkar	Nicola		3146001998					nriswadkar@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/11/2021	2026	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 C Application Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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 C Reporting Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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 Appeals	Director, Appeals and Grievances	Ms.	Meyer	Jenell							jameyer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/03/2020	2026	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active	3147703733				HMO - Health Maintenance Organization		C	Atlanta
H2235	Part D Appeals Contact (Secondary)	Manager, Appeals	Mr.	Lara	Junior							jlara@lumeris.com	13900 Riverport Drive		St. Louis	MO	63043	05/21/2021	2026	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active	3147705642				HMO - Health Maintenance Organization		C	Atlanta
H2235	Part D Application Contact	Director, CMS Applications and PBP	Mr.	Moser	Phil		3142092725					Joanna.Tofani@baycare.org	13900 Riverport Drive		Maryland Heights	MO	63043	05/21/2021	2026	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 Benefits Contact	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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 Claims Submission Contact	Sup Medicare PDE Operations	Mr.	Blansfield	John		8582915304					PDE@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/05/2018	2026	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	2026	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active	8587906682				HMO - Health Maintenance Organization		C	Atlanta
H2235	Part D Price File Contact (Back-up)	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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 Price File Contact (Primary)	Medicare Part D Project Manager	Ms.	Niemi	Kirstin		8587906455					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/05/2018	2026	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 Quality Assurance Contact	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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 Reporting Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Patient Safety Contact	Manager, Pharmacy	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	05/21/2021	2026	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	Payment Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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 Director	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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 Network Management Contact	Manager, PNS & Claims Operations	Ms.	Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/05/2018	2026	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 Network Management Contact (Secondary)	Pharmacist		McDowell	John		7576475020					john.mcdowell@baycare.org	300 Park Place Blvd	Suite170	Clearwater	FL	33759	01/15/2025	2026	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	2026	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active	8887415002				HMO - Health Maintenance Organization		C	Atlanta
H2235	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy	Ms.	Burgess	Sandra							sburgess@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2019	2026	BAYCARE SELECT HEALTH PLANS, INC.	Local CCP	BayCare Health Plans	HMO/HMOPOS		BayCare Health System, Inc.	688	Yes	Active	3142092886				HMO - Health Maintenance Organization		C	Atlanta
H2235	Physician Incentive Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Plan Directory Contact for Public Website			CustomerService	Lumeris		8665095396					customerservice@baycarehealthplans.org	13900 Riverport Dr		Maryland Heights	MO	63043	12/10/2019	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Blas	Melissa		7275191972					melissa.blas@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	03/28/2024	2026	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	Processor Contact	SVP, Government Programs and Services		Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/02/2025	2026	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	Quality Contact	Manager, Quality Stars and Accreditation		Covington	Elizabeth		6513877784					Elizabeth.covington@baycare.org	300 Park Place Blvd., Suite 170		Clearwater	FL	33759	01/15/2025	2026	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	Reconciliation Contact	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	Reconciliation Contact (Secondary)	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Recovery Audit Contact	Director, Finance	Ms.	Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	SNP Application Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	SNP State Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Surveillance Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	System Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Third Party Administrator (TPA) Liaison	Director, Finance		Blas	Melissa	A	8133852084					Melissa.Blas@BAYCARE.ORG	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	04/09/2024	2026	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	User Access Contact	Chief Compliance Officer	Ms.	Tofani	Joanna		7275191974					Joanna.Tofani@baycare.org	300 Park Place Blvd.	Suite 170	Clearwater	FL	33759	02/25/2020	2026	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	Utilization Management Contact	Dir PA Clinical Programs	Mr.	McGurran	Shawn		8587906682					Shawn.McGurran@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/05/2018	2026	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	Utilization Review Contact	Dir PA Clinical Programs	Mr.	McGurran	Shawn		8587906682					Shawn.McGurran@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/08/2019	2026	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	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	07/17/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	12/18/2024	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Mollica	Tony		6128179193					amollica@icarehealthplan.org	1555 N. RiverCenter Dr., Ste 206		Milwaukee	WI	53212	06/04/2021	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Mollica	Tony		6128179193					amollica@icarehealthplan.org	1555 N. RiverCenter Dr., Ste 206		Milwaukee	WI	53212	06/04/2021	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Chief Information Officer	Chief Information Officer	Mr.	Pandey	Vinay		4142725602				4142311052	vpandey@icarehealthplan.org	1555 N. RiverCenter Dr., Ste 206		Milwaukee	WI	53212	06/04/2021	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Chief Information Security Officer	Chief Information Officer	Mr.	Pandey	Vinay		4142725602				4142311052	vpandey@icarehealthplan.org	1555 N. RiverCenter Dr., Ste 206		Milwaukee	WI	53212	06/08/2021	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	11/19/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	12/18/2024	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Corporate Mailing						4142254764					wjensen@icarehealthplan.org	1555 N. RiverCenter Dr., Ste 206		Milwaukee	WI	53212	06/04/2021	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Encounter Data & Risk Adjustment Operations Contact	Director Financial Data Analytics		Harcus	Amanda		4142254708				4142311092	aharcus@icarehealthplan.org	1555 N RiverCenter Dr, Ste 206		Milwaukee	WI	53212	06/04/2021	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Enrollment Contact	Director, Enrollment		Burrows	Matthew		5025800594					mburrows@humana.com	101 East Main Street		Louisville	KY	40202	05/27/2021	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	EOB Transfer Contact	Sr. Compliance Professional		Rafel	Mary		4144141944				4149187598	mrafel@humana.com	1555 N Rivercenter Drive	Suite 206	Milwaukee	WI	53212	07/25/2023	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Financial Audit Contact	Associate Director	Mrs	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	07/02/2024	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street	Floor 22	Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/27/2021	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	05/27/2021	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	05/27/2021	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	07/02/2024	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	04/04/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Medical Director	Regional Vice President	Dr	Park	Kevin		5023023070					kpark2@humana.com	1555 N. Rivercenter Drive	Suite 206	Milwaukee	WI	53212	11/19/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	07/17/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	12/18/2024	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	04/04/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	04/04/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Patient Safety Contact	Sr. Compliance Professional		Rafel	Mary		4144141944				4149187598	mrafel@humana.com	1555 N. RiverCenter Dr., Ste 206		Milwaukee	WI	53212	07/25/2023	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Pharmacy Director	Regional Vice President	Dr	Park	Kevin		5023023070					kpark2@humana.com	1555 N. Rivercenter Drive	Suite 206	Milwaukee	WI	53212	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	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			Pharmacy Solutions	DST							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H2237	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H2237	Physician Incentive Contact	Value Based Purchasing Program Administrator		Hayden	Leigh		4142995497				4142725618	lhayden@icarehealthplan.org	1555 N Rivercenter Drive	Suite 206	Milwaukee	WI	53212	03/01/2021	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	07/17/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	07/31/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/01/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	11/19/2025	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2237	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	12/18/2024	2026	INDEPENDENT CARE HEALTH PLAN	Local CCP	iCare	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2247	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H2247	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2247	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2247	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H2247	Plan Directory Contact for Public Website			Customer Service	UHC		8443686885					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2247	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Agent/Broker Compensation Data Contact	Manager, Sales Operations		Chowdhury	Nahar		6179729400	60926				Nahar.Chowdury@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Automated TrOOP Balance Transfer Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Backup User Access Contact	Lead Govt Prgms Compliance Manager		Foster	Amber		7816128333					Amber.Foster@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	3152780				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Bid Audit Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Bid Audit Site Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Bid Primary Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	CAP Report Contact for Public Website	Director, Government Programs Compliance Officer		Geroski	Tami		7816121000	86892				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	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	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	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 Operating Officer	Chief Operating Officer	Ms.	Catlender	Kathryn		7816126840	84588				Katie.Catlender@point32health.org	1 Wellness Way		Canton	MA	02021	07/14/2025	2026	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 Information Officer	SVP and Chief Information Officer	Ms.	Ferhatbegovic	Selma		7816121000	84633				Selma.Ferhatbegovic@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Information Security Officer	VP Chief Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Complaints Tracking Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				Sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Contact for Fraud Investigations	VP,  Privacy, Fraud Prevention & Recovery		Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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			COB Inquiries	Medicare		7816121000					Medicare_COB_Inquiries@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Corporate Mailing						7816121000					R.Scott.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Villatoro	Yesly		7816121000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	DIR Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	DIR Contact (Secondary)	Pharmacy Analyst Senior		Santino	Cristina		7816121000	82560				cristina.santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Discount Program Payment Contact	Sr. Manager, Accounting		Parikh	Roshni		7816121000	84512				roshni.parikh@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Electronic Health Record Contact	Director, Core Administration System Application		Pavao	Joseph		7816121000	83289				Joseph.Pavao@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Emergency Part D Contact	Director, Pharmacy Operations		Bonica	Joseph		7816123342					joseph.bonica@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Emergency Part D Contact (Secondary)	Senior Manager, Pharmacy Operations		MacAuley	Jacqueline		6176123059					jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/04/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Employer Waiver Contact	Manager, Client Services		Bartkiewicz	Mary		7816121000	83937				Mary.Bartkiewicz@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment Data & Reporting		Quinlan	Judith		7816121000	83377				judith.quinlan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Enrollment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	EOB Transfer Contact	Manager, Business Implementation		Nesmith	Tanisha		7816124861				6176730286	tanisha.nesmith@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Financial Audit Contact	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	12/10/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Financial Reporting Contact	Assistant Corporate Controller		Jaiswal	Ruchi		6179729400	84518				Ruchi.Jaiswal@point32health.org	1 Wellness Way		Canton	MA	02021	08/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Formulary Contact	Clinical Pharmacist Senior		Kowalski	Alec		7816121000	82045				alec.kowalski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	General Contact	Medicare Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Lewis	Kristin		7816121000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	HIPAA Privacy Officer	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	10/06/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	HIPAA Security Officer	VP Chief  Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		MacAuley	Jacqueline		7816121000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Interoperability Contact	VP, Information Security Officer		Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Gonzalez	Michelle		6179729400	83114				michelle.gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	MA Claims Processing Contact for Public Website	Director, Claims		Patel	Monal		7816121000	88187				Monal.Patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Marketing Contact	Director, Marketing		Walsh	Tim		7816121000	87541				Tim.Walsh@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Medical Director	Medical Director	Dr.	Courtemanche	Abbie		7816121000	67024				Abbie.Courtemanche@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	10/21/2025	2026	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 Coordinator	Vice President, Medicare		Walker	Eddie		7816121000	84471				Edward.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr.	Dohan	David		7816121000	82615				David.Dohan@point32health.org	1 Wellness Way		Canton	MA	02021	12/10/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Medication Therapy Management Contact	Sr Pharmacy Program Manager		Burns	Ashlyn		7816122239					ashlyn.burns@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Ben-Ezra	Daniel		7816121000	54054				Daniel.Ben-Ezra@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Online Enrollment Center Contact (Optional)	Supervisor, Enrollment		Maloney	Kimberly		7816121000	83576				Kimberly.Maloney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Online Enrollment Center Contact (Primary)	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 C Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 C Reporting Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Appeals	Director, Appeals & Grievances		Gonzalez	Michelle							Michelle.Gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	83114			HMO - Health Maintenance Organization		C	Boston
H2256	Part D Appeals Contact (Secondary)	Sr. Program Manager, Appeals & Grievances		Mello	Sheri							sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	84862			HMO - Health Maintenance Organization		C	Boston
H2256	Part D Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Benefits Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Claims Submission Contact	Senior Manager, Pharmacy Operations		Alves	Heather		7816121000	82988				heather.alves@point32health.org	1 Wellness Way		Canton	MA	02021	10/09/2025	2026	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		Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	82370			HMO - Health Maintenance Organization		C	Boston
H2256	Part D Exceptions Contact (Secondary)	Supervisor, Pharmacy Utilization Management		Bannan	Philip							Philip.Bannan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	60178			HMO - Health Maintenance Organization		C	Boston
H2256	Part D Price File Contact (Back-up)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					Tim.Sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Price File Contact (Optional)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					tim.sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Price File Contact (Primary)	Sr Business Analyst		Moore-Elliott	Shalandria		7637974305					shalandria.moore-elliott@optum.com	1600 McConnor Pwy.		Schaumburg	IL	60173	04/03/2025	2026	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 Quality Assurance Contact	Vice President, Pharmacy		Fenton	Karen		7186121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Reporting Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Patient Safety Contact	Sr Pharmacy Implementation Specialist		von Fritzinger	Lisa		7816123778					lisa.vonfritzinger@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Payment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Director	Vice President, Pharmacy		Fenton	Karen		7816121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Network Management Contact	Manager, Retail Network Operations		Hagan	Kyle		3039895828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	04/03/2025	2026	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 Network Management Contact (Secondary)	Manager, Retail Network Operations		Ashby	JoLynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	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	Sr. Manager		Villaneuva	Juan							Juan.Villanueva@optum.com	3515 S Harbor Blvd.		Costa Mesa	CA	92626	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H2256	Pharmacy Technical Help Desk Contact (Secondary)	Associate Director, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H2256	Plan Directory Contact for Public Website	Marketing Materials Production Manager		Kayser	Kenneth		7816121000	83518				kenneth.kayser@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Plan to Plan Reconciliation Contact	Manager, Finance Operations Compliance		Schumaker	Tyler		6179729400	87394				Tyler.Schumaker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Processor Contact	Director, Claims		Patel	Monal		7816121000	88187				monal.patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Quality Contact	Director, HEDIS Quality Informatics		McCoy	Kelly		7816121000	83515				kelly.mccoy@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Reconciliation Contact	Senior Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Reconciliation Contact (Secondary)	Pharmacy Analyst Sr.		Santino	Cristina		7816121000	82560				Cristino.Santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Recovery Audit Contact	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Surveillance Contact	Director, Sales Operations		Tollefsen	John		7816122266					John.Tollefsen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	System Contact	Senior Manager, Business Account Management		Allen	Jeffrey		7816121000	83167			6179729008	Jeffrey.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Third Party Administrator (TPA) Liaison	Manager, Accounting		Gatzen	Kelly	A	8609896689					Kelly.gatzen@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	User Access Contact	Director- Medicare Compliance Officer		Geroski	Tami	A	5708142999	0				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	10/21/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Utilization Management Contact	Director, Utilization Management		Walker	Karen		7816121000					Karen.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2256	Utilization Review Contact	Lead Medical Director, Clinical Reviews	Dr.	Slota	Janet		6179729400	87527				Janet.Slota@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2261	Agent/Broker Compensation Data Contact	Director, Broker and Sales Commissions		Newcomb	Stephen		6172469980					Stephen.Newcomb@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Automated TrOOP Balance Transfer Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@BCBSMA.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/04/2021	2026	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	Backup User Access Contact	Sr. Manager, Medicare Compliance		Donovan	Gerard		6172468466					Gerard.Donovan@bcbsma.com	25 Technology Place		Hingham	MA	020434359	05/17/2024	2026	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	Enrollment Supervisor		Peterson	Colin		6172469729				6172468506	colin.peterson@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2025	2026	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	Bid Audit Contact	Sr. Manager, Actuary		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Bid Audit Site Contact	Sr. Manager, Actuary		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Bid Primary Contact	Sr. Manager, Actuary		West	Gregory		6172465077				6172463968	Gregory.West@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	CAP Report Contact for Public Website	Director, Medicare Compliance		Sullivan	Christina		7816038012					Medicarecompliance@bcbsma.com	25 Technology Place		Hingham	MA	020434359	01/30/2024	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Iselin	Sarah		6172463805					sarah.iselin@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	12/21/2022	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Iselin	Sarah		6172463805					sarah.iselin@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	12/21/2022	2026	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.	Kam	Ruby		6172463600					Ruby.Kam@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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 Operating Officer	Executive Vice President, Chief Operating Officer	Mr.	Lynch	Richard		6172465000					Richard.Lynch@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Somasundaram	Prem		6172462859					prem.somasundaram@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	07/18/2024	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Di Bassinga	Nsiona		6172463988					nsiona.dibassinga@bcbsma.com	101 Huntington Avenue, Suite 1300		Boston	MA	021997611	09/24/2025	2026	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	Manager, Appeals and Grievance		Ronaghan	Danielle		6172464663				6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mailstop 03-04	Hingham	MA	020434359	05/17/2024	2026	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	Complaints Tracking Contact	Manager, Appeals and Grievance		Ronaghan	Danielle		6172464663				6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/17/2024	2026	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	Contact for Fraud Investigations	Sr Associate General Counsel		Wood	Geoffrey		6172463896					geoffrey.wood2@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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		6172469587					Janet.Seesholtz@bcbsma.com	25 Technology Place		Hingham	MA	02043	10/02/2025	2026	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	Corporate Mailing						8002004255					placeholder@cms.hhs.gov	P. O. Box 55007		Boston	MA	022055007	06/10/2010	2026	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	Director, Member Service		Hanstein	deMarigny		6172468941					deMarigny.Hanstein@bcbsma.com	P. O. Box 55007		Boston	MA	022055007	05/17/2024	2026	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	DIR Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@BCBSMA.com	25 Technology Place		Hingham	MA	02043	08/04/2021	2026	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	DIR Contact (Secondary)	Director, Corporate Accounting and Reporting	Mr	Thurber	Steven		6172466523				6172467806	Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Discount Program Payment Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523					Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	12/04/2017	2026	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	Emergency Part D Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place	Mailstop 03-03	Hingham	MA	020434359	12/27/2022	2026	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	Employer Waiver Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Sr. Analyst		Ferbert	Laura		6172464656					Laura.Ferbert@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/06/2025	2026	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	Enrollment Contact	Sr. Manager, Medicare Enrollment		Bailey	Elizabeth		6172468678				6172468506	Elizabeth.Bailey@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/17/2024	2026	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	EOB Transfer Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@BCBSMA.com	25 Technology Place	Mail Stop: 03-04	Hingham	MA	020434359	08/04/2021	2026	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	Financial Audit Contact	Audit and Risk Management	Mr	Bulman	Tim		6172468038					Timothy.Bulman@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	09/20/2019	2026	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	Financial Reporting Contact	Financial Reporting Manager		Goveia	Ross		6172465000					Ross.Goveia@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Formulary Contact	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	Formulary Contact (Secondary)	Clinical Pharmacist		Schraut	David		6172465762					David.Schraut@bcbsma.com	25 Technology Place		Hingham	MA	02043	09/18/2025	2026	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	General Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place		Hingham	MA	02043	12/27/2022	2026	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, Government and Regulatory Affairs	Ms.	Wilkinson	Erika		6172467987					Erika.Wilkinson@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Abdel-Samed	Jennifer		4042424614					Jennifer.Abdel-Samed@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer	Ms.	Chang	Ann		6172463266					Ann.Chang@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	Interoperability Contact	Sr. Director, Emerging Technologies		Narasimhan	Sri Ram		6172468640					Sri.Narasimhan@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	10/02/2025	2026	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	MA Appeals/Grievances Contact	Manager, Appeals and Grievance		Ronaghan	Danielle		6172464663				6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place	Mail Stop 03/04	Hingham	MA	02043	05/17/2024	2026	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	MA Claims Processing Contact for Public Website	Sr. Manager, Medicare Advantage Claims and Appeals		Moore	Teresa	J	6172469478					Teresa.Moore@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2020	2026	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	Marketing Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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	Medical Director	Sr. Medical Director		Dondapati	Satya		6172463821					Satya.Dondapati@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	01/30/2024	2026	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		7816038012					MAPDCompliance@bcbsma.com	25 Technology Place	Mail stop 03/04	Hingham	MA	020434359	04/28/2022	2026	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 Coordinator	VP, Government Programs		Bentley	Melanie		6172468403					Melanie.Bentley@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/17/2024	2026	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 Part D Opioid Overutilization Contact	Clinical Manager, Pharmacy Operations		Wong	Timothy		6172466927					timothy.wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	04/10/2023	2026	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	Medication Therapy Management Contact	Clinical Manager		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	05/30/2024	2026	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	Online Enrollment Center Contact (Back-up)	Manager, Medicare Enrollment		Cougler	Kevin		6172468530					kevin.cougler@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2025	2026	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	Online Enrollment Center Contact (Primary)	Sr. Manager, Medicare Enrollment		Bailey	Elizabeth		6172468678				6172468506	Elizabeth.Bailey@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	05/17/2024	2026	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 C Application Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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 C Reporting Contact	Program Manager		MacDougall	Erin		6172469714				6172468506	erin.macdougall@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	01/25/2021	2026	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 Appeals	Manager, Appeals and Grievance		Ronaghan	Danielle						8664637700	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place		Hingham	MA	020434359	05/17/2024	2026	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	8005836289				HMO - Health Maintenance Organization		C	Boston
H2261	Part D Appeals Contact (Secondary)	Supervisor, Appeals and Grievance		Armstrong	Justine						6172468506	MedicareAdvantageRXAppeals@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	8005836289				HMO - Health Maintenance Organization		C	Boston
H2261	Part D Application Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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 Benefits Contact	Director, Medicare Product		Neylon	Sean		6172468553					Sean.Neylon@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	04/25/2023	2026	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 Claims Submission Contact	Sr. Manager, Financial Operations		Okrie	Courtney		4803181864					courtney.okrie@cvshealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	05/17/2024	2026	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						8664637700	Melinda.Nelhuebel@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/29/2018	2026	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	8003667778				HMO - Health Maintenance Organization		C	Boston
H2261	Part D Exceptions Contact (Secondary)	Clinical Manager		Wong	Timothy						8664637700	Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	12/04/2018	2026	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	8003667778				HMO - Health Maintenance Organization		C	Boston
H2261	Part D Price File Contact (Back-up)	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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 Price File Contact (Optional)	Clinical Pharmacist		Schraut	David		6172465762					David.Schraut@bcbsma.com	25 Technology Place		Hingham	MA	02043	04/22/2025	2026	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 Price File Contact (Primary)	Sr. Manager, Financial Operations		Okrie	Courtney		4803181864					courtney.okrie@cvshealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	05/17/2024	2026	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 Quality Assurance Contact	Clinical Pharmacy Manager		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	03/29/2022	2026	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 Reporting Contact	Program Manager		MacDougall	Erin		6172469714				6172468506	erin.macdougall@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	01/25/2021	2026	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	Patient Safety Contact	Manager, Clinical Pharmacy		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/17/2024	2026	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	Payment Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523					Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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 Director	Director, Pharmacy Operations		Nelhuebel	Melinda		6172464407					Melinda.Nelhuebel@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/29/2018	2026	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 Network Management Contact	Lead Director, Network Management		Smith	Shawn		4803914844					Shawn.Smith@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	12/27/2022	2026	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 Network Management Contact (Secondary)	VP, Chief Pharmacy Officer		Erwin	Mary Beth		6172463276					MaryBeth.Erwin@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	10/02/2025	2026	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	2026	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	8666934620				HMO - Health Maintenance Organization		C	Boston
H2261	Physician Incentive Contact	Vice President, Network Contracting		Katinas	Stephan		6172466518					Stephan.Katinas@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8002004255					MMService@bcbsma.com	25 Technology Place	Mailstop 03-02	Hingham	MA	020434359	11/18/2019	2026	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	Plan to Plan Reconciliation Contact	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523				6172467806	Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Processor Contact	Lead Director, Networks		Graham	Heather		2145370421					Heather.Graham@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	12/27/2022	2026	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	Quality Contact	Director of Clinical Quality		Jean	Kristin		6172464727					Kristin.Jean@bcbsma.com	25 Technology Place		Hingham	MA	02043	10/02/2025	2026	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	Reconciliation Contact	Director, Corporate Accounting and Reporting	Mr	Thurber	Steven		6172466523				6172467806	steven.thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	10/02/2025	2026	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	Reconciliation Contact (Secondary)	Associate Director, Accounting		Setzer	Bryan		6172466261					Bryan.Setzer@bcbsma.com	101 Huntington Avenue Suite 1300		Boston	MA	021997611	04/25/2023	2026	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	Recovery Audit Contact	Reporting Sr. Analyst	Ms.	Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@BCBSMA.com	25 Technology Place		Hingham	MA	02043	08/04/2021	2026	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	Surveillance Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place	Mailstop 03-04	Hingham	MA	020434359	12/27/2022	2026	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	System Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	robin.kovalski@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	08/25/2020	2026	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	Third Party Administrator (TPA) Liaison	Director, Corporate Accounting and Reporting		Thurber	Steven		6172466523					Steven.Thurber@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	02199	12/04/2017	2026	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	User Access Contact	Director, Medicare Compliance		Sullivan	Christina		6172462507					Christina.Sullivan@bcbsma.com	25 Technology Place		Hingham	MA	020434359	12/27/2022	2026	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	Utilization Management Contact	Sr. Medical Director		Dondapati	Satya		6172463821					Satya.Dondapati@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	01/30/2024	2026	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	Utilization Review Contact	Sr. Medical Director		Dondapati	Satya		6172463821					Satya.Dondapati@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	01/30/2024	2026	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	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H2272	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2272	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2272	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H2272	Plan Directory Contact for Public Website			Customer Service	UHC		8887028425					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2272	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2292	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H2292	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2292	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2292	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H2292	Plan Directory Contact for Public Website			Customer Service	UHC		8668709604					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2292	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2293	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Chief Operating Officer	President and COO of Medicare	Ms.	Hennessy	Barbara		8602739559					hennessyb@aetna.com	151 Farmington Ave.		Hartford	CT	06156	04/30/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	12/27/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	12/30/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	12/27/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	12/30/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part D Appeals	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/18/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H2293	Part D Appeals Contact (Secondary)	Supervisor Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H2293	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H2293	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H2293	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H2293	PHR Beneficiary Contact																	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				PPO - BBA		C	Atlanta
H2293	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/11/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2293	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H2318	Automated TrOOP Balance Transfer Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Backup User Access Contact	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Best Available Evidence Contact	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Bid Primary Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	CAP Report Contact for Public Website	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	CEO - CMS Administrator Contact	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/17/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	CEO - Senior Official for Contracting	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Chief Financial Officer	Chief Financial Officer	Mr.	Burmeister	Jeff		2485569132				2485569150	jeff.burmeister@pacesemi.org	21700 Northwester Highway		Southfield	MI	48075	05/09/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Chief Operating Officer	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	Mary.Naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Chief Information Officer	Chief Financial Officer	Mr.	Burmeister	Jeff		2485569132				2485569150	jeff.burmeister@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	05/09/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Chief Information Security Officer	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	CMS Casework Communication Contact	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Complaints Tracking Contact	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Contact for Fraud Investigations	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Coordination of Benefits Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Corporate Mailing						8554454554					mary.naber@pacesemi.org	21700 Northwestern Highway	Suite 900	Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Customer Service Operations Contact	Senior Director of Operations	Ms.	White	Sandra		8554454554				2485569150	Sandra.White@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	DIR Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	DIR Contact (Secondary)	Chief Financial Officer	Mr.	Burmeister	Jeff		2485569132				2485569150	jeff.burmeister@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	05/09/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Discount Program Payment Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Emergency Part D Contact	Director of Pharmacy	Mrs.	Rood	Janis		2482237320				2485569150	Janis.Rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Emergency Part D Contact (Secondary)	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Encounter Data & Risk Adjustment Operations Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168					Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Enrollment Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	EOB Transfer Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Financial Audit Contact	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Financial Reporting Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Formulary Contact	Director of Pharmacy	Ms.	Rood	Janis		8554454554					Janis.Rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	General Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Government Relations Contact	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	HIPAA Privacy Officer	Medical Records Manager	Ms.	Clark	Terina		8554454554				2485569150	terina.clark@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	HIPAA Security Officer	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Interoperability Contact	Senior Director		Anderson	Roger		2485569106					roger.anderson@pacesemi.org	21700 Northwestern Highway - Suite 900		Southfield	MI	48075	12/15/2021	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	MA Appeals/Grievances Contact	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	MA Claims Processing Contact for Public Website	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Marketing Contact	Director of Business Development and Enrollment	Mrs.	Katz	Amy		8554454554				2485569150	amy.katz@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Medical Director	Medical Director	Dr.	Katzman	Steven		8554454554					Steven.Katzman@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Medicare Compliance Officer	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Medicare Coordinator	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Rood	Janis		8554454554				2485569150	janis.rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Medication Therapy Management Contact	Director of Pharmacy	Mrs.	Rood	Janis		8554454554					Janis.rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Online Enrollment Center Contact (Back-up)	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part C Application Contact	President & CEO	Ms.	Naber	Mary		8554454554				2485439150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/17/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Appeals	Pharmacy Director	Ms.	Rood	Janis						2485569150	Janis.Rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	01/04/2021	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	8554454554				PACE - Nat		C	Atlanta
H2318	Part D Appeals Contact (Secondary)	Corporate Compliance Officer	Ms.	Diroff	Tracey							Tracey.Diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	8554454554				PACE - Nat		C	Atlanta
H2318	Part D Application Contact	President & CEO	Ms.	Naber	Mary		8554454554				2485439150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/17/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Benefits Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Claims Submission Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Exceptions Contact	Director of Pharmacy	Mrs.	Rood	Janis							Janis.rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	8554454554				PACE - Nat		C	Atlanta
H2318	Part D Exceptions Contact (Secondary)	Corporate Compliance Officer	Ms.	Diroff	Tracey						2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	8554454554				PACE - Nat		C	Atlanta
H2318	Part D Price File Contact (Back-up)	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Price File Contact (Optional)	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Price File Contact (Primary)	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Quality Assurance Contact	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Part D Reporting Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Patient Safety Contact	Quality Manager	Mrs.	Wilson	Jill		2485569150					Jill.Wilson@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Payment Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/18/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Personal Health Record Contact	Medical Records Manager	Ms.	Clark	Terina		8554454554				2485569150	terina.clark@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Pharmacy Director	Director of Pharmacy	Ms.	Rood	Janis		2482237320					Janis.Rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Pharmacy Network Management Contact	Director of Pharmacy	Ms.	Rood	Janis		2482237320					Janis.Rood@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Pharmacy Network Management Contact (Secondary)	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
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	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	1855445455				PACE - Nat		C	Atlanta
H2318	Pharmacy Technical Help Desk Contact (Secondary)	Corporate Compliance Officer	Ms.	Diroff	Tracey						2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active	8554454554				PACE - Nat		C	Atlanta
H2318	PHR Beneficiary Contact																	03/03/2017	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE	PACE Southeast Michigan	Henry Ford Health System	122	Yes	Active	8554454554				PACE - Nat		C	Atlanta
H2318	Plan Directory Contact for Public Website	Director of Marketing, PR & Communications	Ms.	Petrat	Ginger		8554454554				2485569150	ginger.petrat@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Plan to Plan Reconciliation Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Processor Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Quality Contact	Quality Manager	Ms.	Wilson	Jill		8554454554				2485569150	jill.wilson@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Reconciliation Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Reconciliation Contact (Secondary)	Chief Financial Officer	Mr.	Burmeister	Jeff		2485569132				2485569150	jeff.burmeister@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	05/09/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Recovery Audit Contact	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Surveillance Contact	Corporate Compliance Officer	Ms.	Diroff	Tracey		8554454554				2485569150	tracey.diroff@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	System Contact	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Third Party Administrator (TPA) Liaison	Director of Finance	Mrs.	Dresselhouse	Amy		2485569168				2485569150	Amy.Dresselhouse@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	02/19/2022	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	User Access Contact	President & CEO	Ms.	Naber	Mary		8554454554				2485569150	mary.naber@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	08/19/2020	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Utilization Management Contact	Medical Director	Dr.	Katzman	Steven		2485569126					Steven.Katzman@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2318	Utilization Review Contact	Chief Clinical Officer	Ms.	Emch	Donna		8554454554				2485569150	donna.emch@pacesemi.org	21700 Northwestern Highway		Southfield	MI	48075	04/15/2025	2026	PACE SOUTHEAST MICHIGAN	National PACE	PACE Southeast Michigan	National PACE		Henry Ford Health System	122	Yes	Active					PACE - Nat		C	Atlanta
H2320	Agent/Broker Compensation Data Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		6164648667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	03/21/2018	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Backup User Access Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Bid Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Bid Audit Site Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Bid Primary Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	CAP Report Contact for Public Website	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	CEO - CMS Administrator Contact	President and Chief Health Plan Officer	Mr	Gates	Nick		6164648144					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	CEO - Senior Official for Contracting	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Chief Financial Officer	Senior Vice President, Finance	Mrs.	McIntyre	Celeste		6167745142					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Chief Operating Officer	SVP, Government/Consumer Markets	Mrs.	Kincaid	Carrie		6164648969					phcompliance@priorityhealth.com	1231 East Beltine NE		Grand Rapids	MI	49525	02/10/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Chief Information Officer	Chief Information Officer	Mr	Crook	Chris		6164649939					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Chief Information Security Officer	SVP, IS Technology Services	Mr	Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE	MC 843	Grand Rapids	MI	49503	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	CMMI Model Point of Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/14/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Complaints Tracking Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE	MS 1115	Grand Rapids	MI	49525	12/14/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Contact for Fraud Investigations	Manager, Special Investigations Unit		Gross	Brenda		6164648152					Brenda.Gross@PriorityHealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	08/20/2015	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Coordination of Benefits Contact	Claims Manager		Ball	Jill		6164648044					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Corporate Mailing						6169420954				6164640145	PH-DistributionSE@PriorityHealth.com	1231 East Beltline Ave, NE		Grand Rapids	MI	49525	12/05/2005	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		5033309550					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	DIR Contact	Senior Accountant		Savic	Stephanie	M	6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	DIR Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel	K	6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	01/27/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Discount Program Payment Contact	Senior Accountant		Savic	Stephanie		6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Electronic Health Record Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Emergency Part D Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Emergency Part D Contact (Secondary)	Manager, Medicare Pharmacy Operations		VanLoenen	Amanda		6164648750					Amanda.VanLoenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	04/03/2017	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Employer Waiver Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Encounter Data & Risk Adjustment Operations Contact			Florn	Cathy		7348902858					cathy.florn@priorityhealth.com	1239 E Beltline Ave Ne		Grand Rapids	MI	49525	09/27/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Enrollment Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	EOB Transfer Contact	Claims Manager		Ball	Jill		6164648044				6169750247	phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 2205	Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Financial Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Financial Reporting Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Formulary Contact	Medicare Part D Operations Manager		Van Loenen	Amanda		6164648750					PH-MedicareFormularyContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	12/24/2015	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	General Contact	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Government Relations Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	HIPAA Privacy Officer	VP, Compliance & Privacy Officer		Rollenhagen	Cindy		6164648424					phcompliance@priorityhealth.com	1231 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	HIPAA Security Officer			Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE		Grand Rapids	MI	49503	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Hospice Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Interoperability Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	MA Appeals/Grievances Contact	Manager Grievance & Appeal		Macdonald	Amanda		6164648264					phcompliance@priorityhealth.com	1231 East Beltline Ave NE	MS 1115	Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	MA Claims Processing Contact for Public Website	Claims Manager		Ball	Jill		6164648044					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 2205	Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Marketing Contact	Sr. Markets & Product Development Director		Brown	Samia		6164648002					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Medical Director	SVP, Chief Medical Officer		Oker	Elif		6164643510					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Medicare Compliance Officer	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Medicare Coordinator	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Medicare Part D Opioid Overutilization Contact	Medicare Quality Manager		Gutierrez	Salvador		6165757622					salvador.gutierrez@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	02/07/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Medication Therapy Management Contact	Director of Pharmacy Operations		Chaffee	Jacob		6168261329					jacob.chaffee@priorityhealth.com	1231 East Beltline Dr Ne		Grand Rapids	MI	49525	05/18/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	OffShore Subcontractor Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Online Enrollment Center Contact (Optional)	Government Programs Enrollment Coordinator		Rice	Lori		6164648667					lori.rice@priorityhealth.com	1231 East Beltline Ave NE	MS 1180	Grand Rapids	MI	49525	01/07/2014	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part C Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part C Reporting Contact	Sr. Compliance Analyst		Eizinger	Eric		2178400871					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Appeals	Supervisor, Medicare Part D Appeals		Anderson	Melissa							PHMedicarePartDAPPLS@spectrumhealth.org	1231 East Beltline Ave NE		Grand Rapids	MI	49525	04/02/2020	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164648547				HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Appeals Contact (Secondary)	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather							phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164643510				HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Benefits Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Claims Submission Contact	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/21/2018	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
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	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	8004666642				HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Exceptions Contact (Secondary)	Mgr, Medicare Part D Operations	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/18/2016	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164648750				HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					Medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	11/22/2021	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Price File Contact (Optional)	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	02/05/2018	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/22/2021	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Quality Assurance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Part D Reporting Contact	Sr. Compliance Analyst		Eizinger	Eric		2178400871					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Patient Safety Contact	Clinical Pharmacy Program Manager	Mr	Chaffee	Jacob		6165756149					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Payment Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Personal Health Record Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Pharmacy Director	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Pharmacy Network Management Contact (Secondary)	Manager, Medicare Pharmacy Operations		Van Loenen	Amanda		6164648750					amanda.vanloenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	04/03/2017	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
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	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	8004666642				HMO - Health Maintenance Organization		C	Seattle
H2320	Pharmacy Technical Help Desk Contact (Secondary)	Mgr, Medicare Part D Ops	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/18/2016	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164648750				HMO - Health Maintenance Organization		C	Seattle
H2320	Physician Incentive Contact	Director, Provider Strategy & Solutions		Ryan	Susan		3137010444					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Plan Directory Contact for Public Website			Service	Customer		8883896648					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Plan to Plan Reconciliation Contact	Business Systems Analyst		Robinson	Aminah		6165753716				6169758845	aminah.robinson@priorityhealth.com	1231 East Beltline Ave NE	MS 1190	Grand Rapids	MI	49525	09/11/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Processor Contact	ESI Sr Dir - Product Management Medicare		Mahon	Snezana		3146846361					SMahon@express-scripts.com	ESI	One Express Way	St. Louis	MO	63121	12/24/2015	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Quality Contact	Manager, Quality	Mr	Straayer	Ian		6165752782					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Reconciliation Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	12/06/2022	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Reconciliation Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel		6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	02/22/2021	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Recovery Audit Contact	Manager Cost Recovery	Ms	Gross	Brenda		6164648152					brenda.gross@priorityhealth.com	1231 East Beltline NE	Mail Stop 2305	Grand Rapids	MI	49525	05/15/2014	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	SNP Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					janine.bishop@priorityhealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	SNP State Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					janine.bishop@priorityhealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Surveillance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	System Contact	Data Analytics Analyst-Senior, Sr Markets		Johnson	Joshua		6165755760					PH-MedicareSystemsContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	07/18/2016	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Third Party Administrator (TPA) Liaison	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	User Access Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Utilization Management Contact	Director, Utilization Mgmt PH Pre-Service		Mahoney	Diana		8439068561					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2320	Utilization Review Contact	Director, Medicare Care Management		Scovel	Janet		6164648656					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/06/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H2322	Agent/Broker Compensation Data Contact	Director, Producer Relations		Howard	Michelle		2484438530					mhoward@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D Manager		Peterson	Jennifer		2487764123					jpeterso@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Backup User Access Contact	Compliance Specialist		Burks	Erica		2487763543					eburks@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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		2484437532					rmullins@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Bid Audit Contact	Lead Product Consultant		Simerau	Jennie		8109558244					jsimerau@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Bid Audit Site Contact	Lead Product Consultant		Simerau	Jennie		8109558244					jsimerau@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Bid Primary Contact	Associate Actuary, Actuarial & HC Analytics	Ms.	Vrantsidis	Katherine	A	2484432022					KVrants1@HAP.ORG	1414 E Maple Road		Troy	MI	48083	05/25/2022	2026	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	CAP Report Contact for Public Website	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple		Troy	MI	48083	03/03/2025	2026	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	CEO - CMS Administrator Contact	President and CEO	Ms.	Anderson	Margaret		2484431025					manders9@hap.org	1414 E Maple		Troy	MI	48083	03/03/2025	2026	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	CEO - Senior Official for Contracting	President and CEO	Ms.	Anderson	Margaret		2484431025					manders9@hap.org	1414 E Maple		Troy	MI	48083	03/03/2025	2026	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		2487763530					mhausen1@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Operating Officer	Chief Operating Officer	Mr	Treash	Mike		3136648855					mtreash@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Information Officer	CIO	Ms	Marcath	Annette		3136648166					amarcath@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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 Information Security Officer	Interim	Ms	Skolnik	Johanna		3138746635					jskolni1@hfhs.org	One Ford Place, 2A		Detroit	MI	48202	07/30/2018	2026	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		3136648495				3136645845	wabazid@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Complaints Tracking Contact	Appeals & Grievances Analyst	Ms.	Abazid	Wassan		3136648495				3136645845	wabazid@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Contact for Fraud Investigations	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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		2484438830					cpalermo@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Corporate Mailing						2487763609					jrandle4@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/17/2025	2026	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		3136648933				3136648433	vpope@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	DIR Contact	Medicare Part D Manager		peterson	Jennifer		3136648125				3136645965	jpeterso@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/17/2025	2026	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	DIR Contact (Secondary)	Coor- Pharmacy Benefits		Holmes	Renee		2487764122					rholmes@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/17/2025	2026	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	Discount Program Payment Contact	Financial Analyst	Ms.	NASSER	ZEINAT		2487764040					ZNASSER@hap.org	1414 E MAPLE RD		TROY	MI	48083	03/03/2025	2026	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	Emergency Part D Contact	VP- Amb Clinical Pharmacy Svcs		Pirkola	Natalie		5865241175					npirkol2@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	Emergency Part D Contact (Secondary)	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	Employer Waiver Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Manager, RMRA Data Management & Analytics	Mr.	Voss	James		2487763480					jvoss3@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	Enrollment Contact	Manager, Membership & Billing		Mullins	Rhonda		2484437532					rmullins@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	EOB Transfer Contact	Director, Producer Relations		Howard	Michelle		2484438530				2484438530	mhoward@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	Financial Audit Contact	Director of Financial Operations	Mr.	Vaughn	Robert		5865240966					rvaughn2@hap.org	1414 E Maple Rd		Troy	MI	48083	12/20/2024	2026	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	Financial Reporting Contact	Finance Manager	Ms.	Tran	Anh	K	2064533049					atran7@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	Formulary Contact	Pharmacy Analyst		Wade	Marsalis		2487764726					mwade@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	Formulary Contact (Secondary)	Medicare Part D Manager		Yaldo	Traci		3136648607					tyaldo@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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	General Contact	Director, Government Programs Compliance	Mr.	Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd.		Troy	MI	48083	03/03/2025	2026	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		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	HIPAA Privacy Officer	Interim	Ms	Skolnik	Johanna		3138746635					jskolni1@hfhs.org	One Ford Place, 2A		Detroit	MI	48202	07/30/2018	2026	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	HIPAA Security Officer	Deputy Information Security Officer		Fowler	John		3138749150					jfowler2@hfhs.org	One Ford Place, 2A		Detroit	MI	48202	07/30/2018	2026	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		peterson	Jennifer		3136648125					jpeterso@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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	Interoperability Contact	VP - Chief Information Officer		Hollidge	David		2487663695					dhollid2@hap.org	1414 E Maple Rd		Troy	MI	48083	12/20/2024	2026	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	MA Appeals/Grievances Contact	Director, Appeals & Grievance		Krzyske	Heather		2485572370					hkrzyske@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	MA Claims Processing Contact for Public Website	Director, Claims Admin		Boyle	Therese		2484432035					tboyle@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Marketing Contact	Dir- Digital Engagement		Donelko	Stephanie	C	2484434080					sdonelk1@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Bloom	Charles		2485576298					cbloom@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/17/2025	2026	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		5123507810					jrandle4@hap.org	1414 E Maple		Troy	MI	48083	03/03/2025	2026	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 Coordinator	Director-Product Development & Mgt.		Putnam	Angel		2484438583					aputnam3@hap.org	1414 E. Maple Rd		Troy	MI	48083	01/31/2025	2026	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 Part D Opioid Overutilization Contact	Mgr. Pharmacy Benefits		Barta	Kelly		2487763556					kbarta@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Medication Therapy Management Contact	VP , Ambulatory Clinical Pharmacy Services		Pirkola	Natalie		2487764097					npirkol2@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	OffShore Subcontractor Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Online Enrollment Center Contact (Back-up)	Dir, Commercial Enrollment		Rader	Tracie		2484431154					trader2@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Online Enrollment Center Contact (Optional)	Manager, Medicare Operations		Mullins	Rhonda		2484437532					rmullins@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Producer Relations		Howard	Michelle		2484438530					mhoward@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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 C Application Contact	Director-Product Development & Mgt.		Ems-McLaren	Angel		2484438583					amclaren@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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 C Reporting Contact	Director, Government Programs Compliance	Mr	Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Appeals	Director - Utilization Management	Ms.	Krzyske	Heather							hkrzyske@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active	2485572370				PPO - BBA		C	Chicago
H2322	Part D Appeals Contact (Secondary)	Appeals and Grievance Manager		Baringhaus	Christophe							cbaringh@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active	2485573141				PPO - BBA		C	Chicago
H2322	Part D Application Contact	Director-Product Development & Mgt.		Putnam	Angel		2484438583					aputnam3@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Benefits Contact	Director-Product Development & Mgt.		Putnam	Angel		2484438583					aputnam3@hap.org	1414 E Maple Rd		Troy	MI	48083	01/31/2025	2026	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 Claims Submission Contact	Medicare Part D Manager		Peterson	Jennifer		3136648125					jpeterso@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/17/2025	2026	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	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active	3136648607				PPO - BBA		C	Chicago
H2322	Part D Exceptions Contact (Secondary)	Mgr. Pharmacy Benefits		Barta	Kelly							kbarta@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active	2487763556				PPO - BBA		C	Chicago
H2322	Part D Price File Contact (Back-up)	Sr. Manager, Government Programs		Dolfi	Amanda		6147613606					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2018	2026	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 Price File Contact (Optional)	Coordinator, Pharmacy Benefits		Peterson	Jennifer		3136648125					jpeterso@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Price File Contact (Primary)	Director, Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	7909 S Hardy Drive Suite 106		Tempe	AZ	85284	12/31/2018	2026	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 Quality Assurance Contact	Mgr. Pharmacy Benefits		Barta	Kelly		2487763556					kbarta@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Reporting Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Patient Safety Contact	VP-Amb Clinical Pharmacy Svcs		Pirkola	Natalie		3136648501					npirkol2@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Payment Contact	VP-Financial Services		Linville	Steven		2487763910					slinvil1@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Personal Health Record Contact	Chief Information Officer		Marcath	Annette		3136648166					amarcath@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Director	VP, Pharmacy Health Plan Administration		Pirkola	Natalie		2487764097					apetitta@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2018	2026	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 Network Management Contact (Secondary)	Pharmacy Specialist		Webb	Marcia		3136648860					mwebb2@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	2026	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO		Henry Ford Health System	122	Yes	Active	8009221557				PPO - BBA		C	Chicago
H2322	PHR Beneficiary Contact																	02/04/2013	2026	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	Local CCP	HAP Senior Plus (PPO)	Local PPO	Health Alliance Plan of Michigan	Henry Ford Health System	122	Yes	Active	8008011770				PPO - BBA		C	Chicago
H2322	Physician Incentive Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/17/2025	2026	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	Plan Directory Contact for Public Website	VP-Enterprise Operations		Spencer	Heather		2487763808					hspence2@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Plan to Plan Reconciliation Contact	Finance Manager	Ms.	Tran	Anh	K	2064533049					atran7@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	Processor Contact	Medicare Part D Manager		Smith	Leah		3136648724					lsmith17@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Quality Contact	Senior Director		Germain	Carrie		8102302299					cgermain@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Reconciliation Contact	Finance Manager	Ms.	Tran	Anh	K	2064533049					atran7@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	Reconciliation Contact (Secondary)	Principal Financial Analyst	Mr.	Puscas	Gerald		2484432023				2484431163	gpuscas@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	Recovery Audit Contact	Finance Manager	Ms.	Tran	Anh	K	2064533049				2484431163	atran7@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	SNP Application Contact			Putnam	Angel		2484438583					aputnam3@hap.org	1414 E Maple Rd		Troy	MI	48083	01/31/2025	2026	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	Surveillance Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	System Contact	Chief Information Officer		Endress	Angela		2484437529					aendres@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Finance Manager	Ms.	Tran	Anh	K	2064533049					atran7@hap.org	1414 E. Maple Rd		TROY	MI	48083	03/03/2025	2026	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	User Access Contact	Compliance Contract Administrator		Akiens	Amanda		2487763902					aakiens1@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Utilization Management Contact	VP Utilization Management		Bloom, M.D.	Charles		2485576298					cbloom@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Utilization Review Contact	VP Utilization Management		Bloom, M.D.	Charles		2485576298					cbloom@hap.org	1414 E. Maple Rd		Troy	MI	48083	03/03/2025	2026	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
H2354	Agent/Broker Compensation Data Contact	Director, Producer Relations		Howard	Michelle		2484438530					mhoward@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Automated TrOOP Balance Transfer Contact	Coor- Pharmacy Benefits		Peterson	Jennifer		3136648724					jpeterso@hap.org	1414 E Maple Rd		Troy	MI	48083	03/14/2025	2026	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	Backup User Access Contact	Contract Administrator		Burks	Erica		2487763543					eburks@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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		2484437532					rmullins@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Bid Audit Contact	Lead Product Consultant		Simerau	Jennie		8109558244					jsimerau@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Bid Audit Site Contact	Lead Product Consultant		Simerau	Jennie		8109558244					jsimerau@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Bid Primary Contact	Associate Actuary, Actuarial & HC Analytics		Vrantsidis	Katherine	A	2484432022					KVrants1@HAP.ORG	1414 E Maple Road		Troy	MI	48083	03/19/2025	2026	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	CAP Report Contact for Public Website	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	CEO - CMS Administrator Contact	President and CEO	Ms	Anderson	Margaret		2484431025					manders9@hap.org	1414 E Maple		Troy	MI	48083	03/19/2025	2026	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	CEO - Senior Official for Contracting	President and CEO	Ms.	Anderson	Margaret		2484431025					manders9@hap.org	1414 E Maple		Troy	MI	48083	03/10/2025	2026	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		2487763530					mhausen1@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Operating Officer	Chief Operating Officer	Mr	Treash	Mike		3136648855					mtreash@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Information Officer	CIO	Ms	Marcath	Annette		3136648166					amarcath@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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 Information Security Officer	Interim	Ms	Skolnik	Johanna		3138746635					jskolni1@hfhs.org	One Ford Place, 2A		Detroit	MI	48202	07/30/2018	2026	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		3136648495				3136645845	wabazid@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Complaints Tracking Contact	Appeals & Grievances Analyst	Ms.	Abazid	Wassan		3136648495				3136645845	wabazid@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Contact for Fraud Investigations	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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		2484438830					cpalermo@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Corporate Mailing						5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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		3136648933				3136648433	vpope@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	DIR Contact	Medicare Part D Manager		Peterson	Jennifer		3136648125				3136645965	jpeterso@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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	DIR Contact (Secondary)	Coor - Pharmacy Benefits		Holmes	Renee		2487764122					rholmes@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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	Discount Program Payment Contact	Accountant	MS.	NASSER	ZEINAT		2487763933					ZNASSER@hap.org	1414 E MAPLE RD		TROY	MI	48083	04/17/2025	2026	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	Emergency Part D Contact	VP, Pharmacy Health Plan Administration		Pirkola	Natalie		5865241175					npirkol2@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Emergency Part D Contact (Secondary)	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Employer Waiver Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Manager, RMRA Data Management & Analytics	Mr.	Voss	James		2487763480					jvoss3@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Enrollment Contact	Manager, Membership & Billing		Mullins	Rhonda		2484437532					rmullins@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	EOB Transfer Contact	Director, Producer Relations		Howard	Michelle		2484438530				2484438530	mhoward@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Financial Audit Contact	Director Finance	Mr.	Vaughn	Robert		1248443109					Rvaughn2@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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	Financial Reporting Contact	Principal Financial Analyst	Mr.	Puscas	Gerald		2484432023				2484431163	gpuscas@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	Formulary Contact	Pharmacy benefits coordinator		Thomas	Jennifer		3136648737					jthomas9@hap.org	1414 E Maple rd		Troy	MI	48083	08/25/2023	2026	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	Formulary Contact (Secondary)	Pharmacy Manager		Getz	Stuart		8106008032					sgetz@hap.org	1414 E Maple rd		Troy	MI	48083	10/20/2023	2026	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	General Contact	Director, Government Programs Compliance	Mr.	Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	HIPAA Privacy Officer	Interim	Ms	Skolnik	Johanna		3138746635					jskolni1@hfhs.org	One Ford Place, 2A		Detroit	MI	48202	07/30/2018	2026	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	HIPAA Security Officer	Deputy Information Security Officer		Fowler	John		3138749150					jfowler2@hfhs.org	One Ford Place, 2A		Detroit	MI	48202	07/30/2018	2026	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		Peterson	Jennifer		3136648125					jpeterso@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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	Interoperability Contact	VP - Chief Information Officer		Marcath	Annette		3136648166					amarcath@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	MA Appeals/Grievances Contact	Interim Director		Krzyske	Heather		2485572370					hkrzyske@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	MA Claims Processing Contact for Public Website	Director, Claims Admin		Boyle	Therese		2484432035				3136648433	tboyle@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Marketing Contact	Dir- Digital Engagement		Donelko	Stephanie	C	2484434080					sdonelk1@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Bloom	Charles		2485576298					cbloom@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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		5123507810					jrandle4@hap.org	1414 E Maple		Troy	MI	48303	08/25/2022	2026	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 Coordinator	Director-Product Development & Mgt.		Ems-McLaren	Angel		2484438583					amclaren@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Part D Opioid Overutilization Contact	Mgr. Pharmacy Benefits		Barta	Kelly		2487763556					kbarta@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Medication Therapy Management Contact	VP, Ambulatory Clinical Pharmacy Services		Pirkola	Natalie		2487764097					npirkol2@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	OffShore Subcontractor Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Online Enrollment Center Contact (Back-up)	Dir, Commercial Enrollment		Rader	Tracie		2484431154					trader2@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Online Enrollment Center Contact (Optional)	Manager, Medicare Operations		Mullins	Rhonda		2484437532					rmullins@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Producer Relations		Howard	Michelle		2484438530					mhoward@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 C Application Contact	Director-Product Development & Mgt.		Ems-McLaren	Angel		2484438583					amclaren@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 C Reporting Contact	Director, Government Programs Compliance	Mr	Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Appeals	Director - Utilization Management	Ms.	Krzyske	Heather							hkrzyske@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	2485572370				HMO - Health Maintenance Organization		C	Chicago
H2354	Part D Appeals Contact (Secondary)	Appeals and Grievance Manager		Baringhaus	Christophe							cbaringh@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	2485573141				HMO - Health Maintenance Organization		C	Chicago
H2354	Part D Application Contact	Director-Product Development & Mgt.		Ems-McLaren	Angel		2484438583					amclaren@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Benefits Contact	Director-Product Development & Mgt.		Ems-McLaren	Angel		2484438583					amclaren@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Claims Submission Contact	Medicare Part D Manager		peterson	Jennifer		3136648125					jpeterso@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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							sgetz@hap.org	1414 E Maple rd		Troy	MI	48083	03/17/2025	2026	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	3136648607				HMO - Health Maintenance Organization		C	Chicago
H2354	Part D Exceptions Contact (Secondary)	Mgr. Pharmacy Benefits		Barta	Kelly							kbarta@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	2487763556				HMO - Health Maintenance Organization		C	Chicago
H2354	Part D Price File Contact (Back-up)	Sr. Manager, Government Programs		Dolfi	Amanda		6147613606					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/31/2018	2026	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 Price File Contact (Optional)	Coordinator, Pharmacy Benefits		Peterson	Jennifer		3136648125					jpeterso@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Price File Contact (Primary)	Director, Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	7909 S Hardy Drive Suite 106		Tempe	AZ	85284	12/31/2018	2026	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 Quality Assurance Contact	Mgr. Pharmacy Benefits		Barta	Kelly		2487763556					kbarta@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Reporting Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Patient Safety Contact	VP - Amb Clinical Pharmacy Services		Pirkola	Natalie		3136648501					npirkol2@HAP.ORG	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Payment Contact	VP-Financial Services		Ronan	Dianna		2484431093					dronan@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Personal Health Record Contact	Chief Information Officer		Marcath	Annette		3136648166					amarcath@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Director	VP, Pharmacy Health Plan Administration		Pirkola	Natalie		3136648838					npirkol2@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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 Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/31/2018	2026	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 Network Management Contact (Secondary)	Pharmacy Specialist		Webb	Marcia		3136648860					mwebb2@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	2026	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H2354	PHR Beneficiary Contact																	12/29/2016	2026	HEALTH ALLIANCE PLAN OF MICHIGAN	Local CCP	HAP Senior Plus	HMO/HMOPOS	Health Alliance Plan of Michigan	Henry Ford Health System	122	Yes	Active	8008011770				HMO - Health Maintenance Organization		C	Chicago
H2354	Physician Incentive Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/17/2025	2026	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	Plan Directory Contact for Public Website	VP-Enterprise Operations		Spencer	Heather		2487763808					hspence2@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Plan to Plan Reconciliation Contact	Financial Analyst	Ms.	NASSER	ZEINAT		2487764040					ZNASSER@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	Processor Contact	Medicare Part D Manager		Smith	Leah		3136648724					lsmith17@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Quality Contact	Senior Director		Germain	Carrie		8102302299					cgermain@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Reconciliation Contact	Finance Manager	Ms.	Tran	Anh	K	2064533049					atran7@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	Reconciliation Contact (Secondary)	Principal Financial Analyst		Puscas	Gerald		2484432023					gpuscas@hap.org	1414 E MAPLE RD		TROY	MI	48083	03/19/2025	2026	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	Recovery Audit Contact	Principal Financial Analyst	Mr.	Puscas	Gerald		2484432023				2484431163	gpuscas@hap.org	1414 E MAPLE RD		TROY	MI	48083	09/14/2023	2026	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	SNP Application Contact	Director-Product Development & Mgt.		Ems-McLaren	Angel		2484438583					amclaren@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	SNP State Contact	Director of Medicaid Programs		Davis	Nancy		8004224641					ndavis@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	Surveillance Contact	Director, Government Programs Compliance		Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple Rd		Troy	MI	48083	03/10/2025	2026	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	System Contact	Chief Information Officer		Marcath	Annette		3136648166					amarcath@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Analyst		Puscas	Gerald		2488909209					gpuscas@hap.org	1414 E Maple Rd		Troy	MI	48083	03/19/2025	2026	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	User Access Contact	Compliance Contract Administrator		Akiens	Amanda		2487763902					aakiens1@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Utilization Management Contact	VP Utilization Management		Bloom, M.D.	Charles		2485576298					cbloom@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Utilization Review Contact	VP Utilization Management		Bloom, M.D.	Charles		2485576298					cbloom@hap.org	1414 E Maple Rd		Troy	MI	48083	03/03/2025	2026	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	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739					cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie	A	7206829848				3039961600	Lteter@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	9096779517				PACE - Nat		C	Philadelphia
H2368	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Chief Operating Officer	Market President	Ms.	Hopkins	Laura		7208127180				9094249948	lhopkins@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Chief Information Security Officer	Chief Information Security Officer	Mr.	Naus	Cole		7204564635				3039961600	mnaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	12/08/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	CMS Casework Communication Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Complaints Tracking Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Coordination of Benefits Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Corporate Mailing						7207602984				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Customer Service Operations Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	DIR Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	General Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Government Relations Contact	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Interoperability Contact	SVP, Application Systems		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	MA Appeals/Grievances Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Appeals	Director of Compliance		Martin	Jeremy						3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H2368	Part D Appeals Contact (Secondary)	Director of Compliance		Martin	Jeremy						3039961600	jmartin@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H2368	Part D Application Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H2368	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Philadelphia
H2368	Part D Price File Contact (Back-up)	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Quality Assurance Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Part D Reporting Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H2368	PHR Beneficiary Contact																	07/27/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Philadelphia
H2368	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	AKizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/28/2023	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Reconciliation Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	System Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Third Party Administrator (TPA) Liaison	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	User Access Contact	Director of Compliance		Martin	Jeremy		7207896016					jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2368	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC	National PACE	InnovAge California PACE - Sacramento	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H2378	Automated TrOOP Balance Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Backup User Access Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Best Available Evidence Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	CAP Report Contact for Public Website	Executive Director		Nilsen	Eric		9529410305				9194253001	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	CEO - CMS Administrator Contact	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	CEO - Senior Official for Contracting	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Chief Financial Officer	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Chief Operating Officer	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Chief Information Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Chief Information Security Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	CMS Casework Communication Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Complaints Tracking Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Contact for Fraud Investigations	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Coordination of Benefits Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Customer Service Operations Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	DIR Contact (Secondary)	Director of Health Plan Operations		Gallagher	Tierney		9705950523				9708295842	tgallagher@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Discount Program Payment Contact	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Emergency Part D Contact (Secondary)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Enrollment Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	General Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Government Relations Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	HIPAA Privacy Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	HIPAA Security Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	MA Appeals/Grievances Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	MA Claims Processing Contact for Public Website	Claims Administrator	Ms	Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Marketing Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Medical Director	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Medicare Compliance Officer	Director of Quality	Ms	Peterson	Nora		9709643500				9705250166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Medicare Coordinator	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Medicare Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Medication Therapy Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part C Application Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part D Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending	9709643500				PACE - Nat		C	Atlanta
H2378	Part D Application Contact	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part D Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part D Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part D Exceptions Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending	9709643500				PACE - Nat		C	Atlanta
H2378	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending	9709643500				PACE - Nat		C	Atlanta
H2378	Part D Price File Contact (Back-up)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part D Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part D Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Part D Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Patient Safety Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Payment Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Personal Health Record Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Pharmacy Director	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Pharmacy Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Pharmacy Technical Help Desk Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending	9709643500				PACE - Nat		C	Atlanta
H2378	Plan Directory Contact for Public Website	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Processor Contact	Claims Administrator		Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Quality Contact	Quality Manager	Ms.	Porter	Amy		9194253020					aporter@voa.org	5400 S. Miami Blvd., Ste 150		Durham	NC	27703	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9709643500				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations		Nilsen	Eric		6124257858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Surveillance Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	System Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Third Party Administrator (TPA) Liaison	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	User Access Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Utilization Management Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2378	Utilization Review Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/05/2024	2026	SENIOR COMMUNITY CARE OF FLORIDA	National PACE	VOANS Senior CommUnity Care of Florida	National PACE		Volunteers of America National Services	367	Yes	Pending					PACE - Nat		C	Atlanta
H2379	Part C Application Contact			Sligh	Shadon		8038378791					sfields@logisticalmed.com	175 Ashewicke Drive		Columbia	SC	29229	11/10/2025	2026	LOGISTICAL MED AND BEYOND, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2379	Part D Application Contact			Sligh	Shadon		8038378791					sfields@logisticalmed.com	175 Ashewicke Drive		Columbia	SC	29229	11/10/2025	2026	LOGISTICAL MED AND BEYOND, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2384	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Backup User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/29/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	CAP Report Contact for Public Website		Ms.	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	1649 Van Ness Ave		Fresno	CA	93721	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	CEO - CMS Administrator Contact		Ms.	Butler	Nicole		5592598592					nicole.butler@welbehealth.com	1649 Van Ness Ave		Fresno	CA	93721	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	CEO - Senior Official for Contracting		Ms.	Butler	Nicole		5592598592					nicole.butler@welbehealth.com	1649 Van Ness Ave		Fresno	CA	93721	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Chief Financial Officer		Ms.	Butler	Nicole		5592598592					nicole.butler@welbehealth.com	1649 Van Ness Ave		Fresno	CA	93721	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Chief Operating Officer		Ms.	Butler	Nicole		5592598592					nicole.butler@welbehealth.com	1649 Van Ness Ave		Fresno	CA	93721	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Contact for Fraud Investigations			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Coordination of Benefits Contact			Butler	Nicole		5592598592					nicole.butler@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Customer Service Operations Contact		Ms.	Butler	Nicole		5592598592					nicole.butler@welbehealth.com	1649 Van Ness Avenue		Fresno	CA	93721	05/29/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	DIR Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	DIR Contact (Secondary)			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Emergency Part D Contact (Secondary)			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	General Contact		Ms.	Butler	Nicole		5592598592					nicole.butler@welbehealth.com	1649 Van Ness Avenue		Fresno	CA	93721	05/29/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Government Relations Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	HIPAA Privacy Officer			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	HIPAA Security Officer			Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Medical Director			Lowe	Chad		6509354898					Chad.Lowe@WelbeHealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	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		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Medicare Coordinator		Ms.	Butler	Nicole		5592598592					nicole.butler@welbehealth.com	1649 Van Ness Avenue		Fresno	CA	93721	05/29/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	2192106392				PACE - Nat		C	San Francisco
H2384	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H2384	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H2384	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Quality Assurance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Patient Safety Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H2384	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Surveillance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2384	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	SEQUOIA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H2385	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H2385	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2385	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2385	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H2385	Plan Directory Contact for Public Website			Customer Service	UHC		8008324643					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2385	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2386	Automated TrOOP Balance Transfer Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Backup User Access Contact	Chief Information Officer	Mr.	Lane	Aaron		2769644915	7110			2769630130	alane@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Bid Primary Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	CAP Report Contact for Public Website	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	8006562272	7152			PACE - Nat		C	Philadelphia
H2386	CEO - CMS Administrator Contact	CEO	Mr.	Beck	Brian		2769644915	7101			2769630130	bbeck@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Beck	Brian		2769644915	7101			2769630130	bbeck@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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		2769644915	7103			2769630130	ccounts@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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 Operating Officer	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	02/22/2016	2026	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 Information Officer	Chief Information Officer	Mr.	Lane	Aaron		2769644915	7110			2769630130	alane@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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 Information Security Officer	Chief Information Officer	Mr.	Lane	Aaron		2769644915	7110			2769630130	alane@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Complaints Tracking Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	Contact for Fraud Investigations	Program Director		Collins	Dana		2769647152	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Corporate Mailing						2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	08/15/2011	2026	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		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	DIR Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O. Box 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	Discount Program Payment Contact	PACE Program Director		Collins	Dana		2769647152					dcollins@aasc.org	P.O. Box 765		Cedar Bluff	VA	24609	04/30/2024	2026	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	Emergency Part D Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Encounter Data & Risk Adjustment Operations Contact	PACE Director		Collins	Dana		2769647152				2769647157	dcollins@aasc.org	P O Box 765	216 College Ridge Road	Cedar Bluff	VA	24609	10/18/2019	2026	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	Enrollment Contact	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	EOB Transfer Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Financial Audit Contact	PACE Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/11/2020	2026	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	Financial Reporting Contact	Chief Financial Officer	Ms.	Counts	Carolyn		2769644915	7103			2769630130	ccounts@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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	Formulary Contact	Program Director		Collins	Dana		2769644915	7152			2769647157	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	General Contact	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	HIPAA Privacy Officer	Chief Information Officer		Lane	Aaron		2769644915	7110			2769630130	alane@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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	HIPAA Security Officer	Chief Information Officer		Lane	Aaron		2769644915	7110			2769630130	alane@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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	Interoperability Contact	PACE Program Director		Collins	Dana	M	2769647152					dcollins@aasc.org	PO Box 765	216 College Ridge Road	Cedar Bluff	VA	24609	04/30/2024	2026	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	MA Appeals/Grievances Contact	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	MA Claims Processing Contact for Public Website	PACE Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/11/2020	2026	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	Marketing Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Medical Director	Medical Director	Dr.	Owens	Dia	P	2769647176	7148			2769647157	dowens@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	07/29/2025	2026	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		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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 Coordinator	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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 Part D Opioid Overutilization Contact	Program Director	Ms.	Collins	Dana	M	2769647152				2769630130	dcollins@aasc.org	P.O. Box 765	216 College Ridge Road	Cedar Bluff	VA	24609	03/20/2019	2026	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	Medication Therapy Management Contact	Clinical Pharmacist		Hackney	Jacqueline		2769647176				2769647157	jhackney@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/29/2013	2026	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 C Application Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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 Appeals	Program Director		Collins	Dana						2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	8006562272	7152			PACE - Nat		C	Philadelphia
H2386	Part D Application Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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 Benefits Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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 Claims Submission Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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						2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	8006562272	7152			PACE - Nat		C	Philadelphia
H2386	Part D Price File Contact (Back-up)	Chief Financial Officer		Counts	Carolyn		2769644915	7103			2769630130	ccounts@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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 Price File Contact (Primary)	Program Director	Ms.	Collins	Dana	M	2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	02/14/2011	2026	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 Quality Assurance Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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 Reporting Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	Patient Safety Contact	Clinical Pharmacist		Hackney	Jacqueline		2769647176				2769647157	jhackney@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/29/2013	2026	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	Payment Contact	Chief Financial Officer	Ms.	Counts	Carolyn		2769644915	7103			2769630130	ccounts@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	10/12/2022	2026	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 Director	Clinical Pharmacist		Hackney	Jacqueline		2769647176				2769647157	jhackney@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/29/2013	2026	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 Network Management Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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						2769647157	jhackney@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/29/2013	2026	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	8668287723				PACE - Nat		C	Philadelphia
H2386	Plan Directory Contact for Public Website	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	Plan to Plan Reconciliation Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Processor Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Quality Contact	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Reconciliation Contact	PACE Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O. Box 765		Cedar Bluff	VA	24609	03/20/2019	2026	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	Recovery Audit Contact	Program Director	Ms.	Collins	Dana	M	2769644915	7152			2769630130	dcollins@aasc.org	P.O. Box 765	216 College Ridge Road	Cedar Bluff	VA	24609	05/08/2012	2026	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	Surveillance Contact	Program Director		Collins	Dana	M	2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/24/2011	2026	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	System Contact	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Third Party Administrator (TPA) Liaison	PACE Executive Assistant		Coleman	Kelli		2769647166					kcoleman@aasc.org	P.O. Box 765		Cedar Bluff	VA	24609	04/30/2024	2026	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	User Access Contact	Program Director	Ms.	Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Utilization Management Contact	Program Director		Collins	Dana		2769644915	7152			2769630130	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	04/14/2010	2026	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	Utilization Review Contact	PACE Director		Collins	Dana		2769647176	7152			2769647157	dcollins@aasc.org	P.O.B. 765		Cedar Bluff	VA	24609	03/11/2020	2026	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	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Chief Financial Officer	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Chief Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Chief Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Chief Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Customer Service Operations Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8003997524				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	DIR Contact	Manager, Health Plans Finance		Parkin	Frank		2038148504					fparkin@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Discount Program Payment Contact	Director, Finance	Ms.	Tilley	Stephanie		9312420499					stilley@amhealthplans.com	201 Jordan Road		Franklin	TN	37067	05/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4057066535				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Formulary Contact	Vice President, Pharmacy Services	Ms.	Roper	Lisa		4058262110					LRoper@AmHealthPlans.com	201 Jordan Road		Franklin	TN	37067	05/27/2025	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Formulary Contact (Secondary)	Formulary Team Lead	Ms.	Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@navitus.com	361 Integrity Drive		Madison	WI	53717	05/27/2025	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	MA Appeals/Grievances Contact	Director, Health Plan Administration	Mr.	Demick	Christophe		8003997524				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	12/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Christophe		8003997524				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	12/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Medicare Coordinator	Executive Director	Ms.	Kukuljan	Shiloh		3143549940				8442805360	skukuljan@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Medicare Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Medication Therapy Management Contact	Director of Clinical Programs	Mr	Poore	Richard		6036285133					rpoore@healthdialog.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	OffShore Subcontractor Contact	Manager, Compliance	Mr.	Burguieres	Fredrick		3364042458				8442805360	RBurguieres@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	12/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Ms	McCauley	Angela						3304058081	appeals@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	8448211763				HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Exceptions Contact	Appeals Supervisor Clinical Operations	Ms.	McCauley	Angela						3304864801	Appeals@Elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@Elixirsolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/17/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Christophe		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Part D Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Pharmacy Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Pharmacy Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@Elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	8335026757				HMO - Health Maintenance Organization		C	Kansas City
H2392	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn						4056015627	lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active	8334786370				HMO - Health Maintenance Organization		C	Kansas City
H2392	Plan Directory Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		8003997524				8442805360	DWard@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	12/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Plan to Plan Reconciliation Contact	Director, Finance	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road		Franklin	TN	37067	05/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	SNP State Contact	Executive Director	Mr.	Hazel	Mike		8003997524				8442805360	MHazel@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	12/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/16/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Third Party Administrator (TPA) Liaison	Director, Finance	Ms.	Tilley	Stephanie		9312420499					stilley@amhealthplans.com	201 Jordan Road		Franklin	TN	37067	05/27/2024	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2392	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	KANSAS SUPERIOR SELECT, INC.	Local CCP	Kansas Health Advantage	HMO/HMOPOS		Kansas Superior Select	680	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2397	Automated TrOOP Balance Transfer Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Backup User Access Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Best Available Evidence Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Bid Primary Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	CAP Report Contact for Public Website	Director of Quality & Compliance	Mrs	Ozores	Charly	M	5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	CEO - CMS Administrator Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	CEO - Senior Official for Contracting	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Chief Financial Officer	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Chief Operating Officer	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Chief Information Officer	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Chief Information Security Officer	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	CMS Casework Communication Contact	Director of Operations & Team Services	Mrs	Mija	Sarah		5188867223					smija@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Complaints Tracking Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Contact for Fraud Investigations	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Coordination of Benefits Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Corporate Mailing						5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Customer Service Operations Contact	Director of Operations & Team Services	Mrs	Mija	Sarah		5188867223					smija@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	DIR Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	DIR Contact (Secondary)	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Discount Program Payment Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Emergency Part D Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Emergency Part D Contact (Secondary)	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Encounter Data & Risk Adjustment Operations Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Enrollment Contact	Director of Operations & Team Services	Mrs	Mija	Sarah		5188867223					smija@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	EOB Transfer Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223				5188867232	mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Financial Audit Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Financial Reporting Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Formulary Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Formulary Contact (Secondary)	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	General Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Government Relations Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	HIPAA Privacy Officer	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	HIPAA Security Officer	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Interoperability Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	MA Appeals/Grievances Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	MA Claims Processing Contact for Public Website	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Marketing Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Medical Director	Medical Director	Mr	Miles	Michael		5187610300					mmiles@hhhn.org	38 Larose Street		Glens Falls	NY	12801	03/14/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Medicare Compliance Officer	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Medicare Coordinator	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Medicare Part D Opioid Overutilization Contact	Medical Director	Mr	Miles	Michael		5187610300					mmiles@hhhn.org	38 Larose Street		Glens Falls	NY	12801	03/14/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Medication Therapy Management Contact	Medical Director	Mr	Miles	Michael		5187610300					mmiles@hhhn.org	38 Larose Street		Glens Falls	NY	12801	03/14/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	OffShore Subcontractor Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Online Enrollment Center Contact (Back-up)	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Online Enrollment Center Contact (Optional)	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Online Enrollment Center Contact (Primary)	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part C Application Contact			Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part D Appeals			Spokane	Linda							lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active	5188867223				PACE - Nat		C	New York
H2397	Part D Appeals Contact (Secondary)	VP of Finance & Contracts	Mrs	Boxley	Michele							mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active	5188867223				PACE - Nat		C	New York
H2397	Part D Application Contact			Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part D Benefits Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part D Claims Submission Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part D Exceptions Contact			Spokane	Linda							lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active	5188867223				PACE - Nat		C	New York
H2397	Part D Exceptions Contact (Secondary)	VP of Finance & Contracts	Mrs	Boxley	Michele							mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active	5188867223				PACE - Nat		C	New York
H2397	Part D Price File Contact (Back-up)	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part D Price File Contact (Primary)	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part D Quality Assurance Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Part D Reporting Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Patient Safety Contact	Director of Operations & Team Services	Mrs	Mija	Sarah		5188867223					smija@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Payment Contact	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Personal Health Record Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Pharmacy Director	Medical Director	Mr	Miles	Michael		5187610300					mmiles@hhhn.org	38 Larose Street		Glens Falls	NY	12801	03/14/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Pharmacy Network Management Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Pharmacy Network Management Contact (Secondary)	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Pharmacy Technical Help Desk Contact			Spokane	Linda							lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active	5188867223				PACE - Nat		C	New York
H2397	Pharmacy Technical Help Desk Contact (Secondary)	VP of Finance & Contracts	Mrs	Ozores	Charly							cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active	5188867223				PACE - Nat		C	New York
H2397	PHR Beneficiary Contact																	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE	PACE at Hudson Headwaters	PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active	8334997223				PACE - Nat		C	New York
H2397	Plan Directory Contact for Public Website	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Plan to Plan Reconciliation Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Processor Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Quality Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Reconciliation Contact	President and Program Director	Mrs	Spokane	Linda		5188867223					lspokane@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Reconciliation Contact (Secondary)	VP of Finance & Contracts	Mrs	Boxley	Michele		5188867223					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Recovery Audit Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Surveillance Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	System Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Third Party Administrator (TPA) Liaison	VP Finance & Contracts	Mrs	Boxley	Michele		5188867213					mboxley@pacehh.org	38 Larose Street		Glens Falls	NY	12801	03/04/2025	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	User Access Contact	Director of Quality & Compliance	Mrs	Ozores	Charly		5188867223					cozores@pacehh.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Utilization Management Contact	Medical Director	Mr	Miles	Michael		5188867223					mmiles@hhhn.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2397	Utilization Review Contact	Medical Director	Mr	Miles	Michael		5188867223					mmiles@hhhn.org	38 Larose Street		Glens Falls	NY	12801	11/29/2023	2026	PACE AT HUDSON HEADWATERS, INC.	National PACE	PACE at Hudson Headwaters, Inc.	National PACE		PACE AT HUDSON HEADWATERS, INC.	816	Yes	Active					PACE - Nat		C	New York
H2400	Agent/Broker Compensation Data Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	05/28/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Automated TrOOP Balance Transfer Contact			Perez	Mary		2243342046					mary.perez@medimpact.com	MedImpact	10181 Scripps Gateway Ct	San Diego	CA	92131	01/21/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Backup User Access Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Best Available Evidence Contact	Director of Operations		Jackson	Samantha		6366141344					samantha.jackson@pillarrx.com	1061 Peruque Crossing Court		O'Fallon	MO	63366	08/27/2019	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Bid Audit Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Bid Audit Site Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Bid Primary Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	CAP Report Contact for Public Website	Chief Compliance Officer		Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active	5024106859				HMO - Health Maintenance Organization		C	Philadelphia
H2400	CEO - CMS Administrator Contact	CEO	Ms.	Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	CEO - Senior Official for Contracting	CEO	Ms.	Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Chief Financial Officer	CFO	Mr.	Aschenbeck	James		5023401535					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	12/13/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Chief Operating Officer	COO	Ms.	Kennedy	Heather		4232402709					heather.kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Chief Information Officer	CEO	Ms.	Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Chief Information Security Officer	CEO	Ms	Kennedy	Heather		4232402709					heather.kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	12/13/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Complaints Tracking Contact	Chief Compliance Officer		Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway	Suite 200	Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Coordination of Benefits Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Corporate Mailing						8442148633				8008803263	customerservice@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Customer Service Operations Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	DIR Contact	CFO	Mr.	Aschenbeck	James		5023401535					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	03/07/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	DIR Contact (Secondary)			Dwyer	Michele		6366141346					michele.dwyer@pillarrx.com	1061 Peruque Crossing Court		O'Fallon	MO	63366	09/10/2019	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Discount Program Payment Contact	CFO		Aschenbeck	James		5023401535					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	12/13/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Emergency Part D Contact	VP, Clinical Services		Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Encounter Data & Risk Adjustment Operations Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Enrollment Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	EOB Transfer Contact	CEO	Ms.	Kennedy	Heather		4232402709				8008803263	heather.kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Financial Audit Contact	CFO	Mr.	Aschenbeck	James		5023401535					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	12/13/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Financial Reporting Contact	CFO	Mr.	Aschenbeck	James		5023401535					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	12/13/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Formulary Contact			Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/25/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Formulary Contact (Secondary)	Pharmacy Consultant		Sandhu	Bibek		4088832205					Bibek.Sandhu@Pillarrx.com	10700 W Research Dr	Suite #3	Wauwatosa.	WI	53226	07/25/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	General Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Government Relations Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	HIPAA Security Officer	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Hospice Contact	VP, Clinical Services		Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Interoperability Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	MA Appeals/Grievances Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	MA Claims Processing Contact for Public Website	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Marketing Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Medical Director		Dr.	Ott	Monica		3175086296					monica.ott@abodecarepartners.com	Signature Advantage	805 N Whittington Parkway	Louisville	KY	40222	11/22/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Medicare Coordinator	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Medicare Part D Opioid Overutilization Contact	Compliance Audit Specialist		Caprara	Lisa		6366141344					lisa.caprara@pillarrx.com	1061 Peruque Crossing Court		O'Fallon	MO	63366	12/23/2020	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Medication Therapy Management Contact	VP Clinical Operations		Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 North Whittington Pkwy		Louisville	KY	40222	08/20/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Online Enrollment Center Contact (Primary)	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part C Application Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part C Reporting Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Appeals	VP Clinical Services		Green	Faith							faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active	8442148633				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Appeals Contact (Secondary)	Director Clinical Operations		Collins	Andrea							andrea.collins@medimpact.com	MedImpact	10181 Scripps Gateway Ct	San Diego	CA	92131	01/21/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Application Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Benefits Contact	VP, Clinical Services		Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3304103565					ethan.prunty@medimpact.com	MedImpact	10181 Scripps Gateway Ct	San Diego	CA	92131	01/21/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Exceptions Contact	Pharmacy Supervisor, Coverage Determinations		Larkins	Casey							clarkins@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	02/23/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active	3302859685				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Exceptions Contact (Secondary)	Compliance Audit Specialist		Caprara	Lisa							lisa.caprara@pillarrx.com	1061 Peruque Crossing Court		O'Fallon	MO	63366	12/23/2020	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active	8442148633				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Price File Contact (Back-up)	Director Reporting		Campbell	Tim		9547672633					tcampbell@elixirsolutions.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/17/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Price File Contact (Primary)	Manager Reporting & Analytics		Wentz	Christophe		3304864910					cwentz@elixirsolutions.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/24/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Quality Assurance Contact	VP, Clinical Services		Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Part D Reporting Contact	Chief Compliance Officer		Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Patient Safety Contact	VP, Clinical Services	Ms.	Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Payment Contact	CFO		Aschenbeck	James		5023401535					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	12/13/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Pharmacy Director	Pharmacy Consultant		Sandhu	Bibek		6366141344					bibek.sandhu@pillarrx.com	1061 Peruque Crossing Court		O'Fallon	MO	63366	12/23/2020	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092					Brian.hunt@medimpact.com	MedImpact	10181 Scripps Gateway Ct	San Diego	CA	92131	01/21/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Pharmacy Network Management Contact (Secondary)	VP, Clinical Services		Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Pharmacy Technical Help Desk Contact	Vice President Operations		Conn	Todd							Todd.Conn@medimpact.com	MedImpact	10181 Scripps Gateway Ct	San Diego	CA	92131	05/13/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active	8338034397				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Pharmacy Technical Help Desk Contact (Secondary)	VP, Clinical Services		Green	Faith							faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active	8442148633				HMO - Health Maintenance Organization		C	Philadelphia
H2400	Physician Incentive Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Plan Directory Contact for Public Website	CEO		Kennedy	Heather		8442148633	711				Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/08/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Plan to Plan Reconciliation Contact	CFO		Aschenbeck	James		5023813442					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Processor Contact			Davis-Jones	DeLona		8587906229					De'lona.Davis-Jones@medimpact.com	MedImpact	10181 Scripps Gateway Ct	San Diego	CA	92131	01/23/2025	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Quality Contact	VP, Clinical Services	Ms.	Green	Faith		5027090893					faith.green@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Reconciliation Contact	CFO		Aschenbeck	James		5023401535					james.aschenbeck@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	12/13/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Reconciliation Contact (Secondary)	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Recovery Audit Contact	CEO	Ms.	Kennedy	Heather		4232402709					heather.kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	SNP Application Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	SNP State Contact	Chief Compliance Officer	Ms	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Surveillance Contact	Chief Compliance Officer	Ms.	Ingram	Kristie		5024106859					kristie.ingram@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	System Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Third Party Administrator (TPA) Liaison	Director, Operations		Jackson	Samantha		6366141344					samantha.jackson@pillarrx.com	1061 Peruque Crossing Court		O'Fallon	MO	63366	12/24/2020	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	User Access Contact	EPOC	Mr.	Hofmann	Daniel		5025687193					daniel.hofmann@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	07/11/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Utilization Management Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2400	Utilization Review Contact	CEO		Kennedy	Heather		4232402709					Heather.Kennedy@signatureadvantageplan.com	805 N Whittington Parkway		Louisville	KY	40222	06/03/2024	2026	SIGNATURE ADVANTAGE, LLC	Local CCP	Signature Advantage (HMO SNP)	HMO/HMOPOS		BrightSpring Health Services, Inc.	879	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H2406	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H2406	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2406	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H2406	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H2406	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2406	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H2416	Agent/Broker Compensation Data Contact	Director of Member & Provider Services	Mr.	Magnuson	Matt		3203355243				3203355223	matt.magnuson@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Backup User Access Contact	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/10/2024	2026	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		3203355219				3203355223	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	04/02/2018	2026	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	Bid Audit Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Bid Audit Site Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2026	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	Bid Primary Contact	Managing Actuary	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2026	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	CAP Report Contact for Public Website	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207628750	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Przybilla	James		3204913334				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2026	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 Operating Officer	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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 Information Officer	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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 Information Security Officer	Director of IS&T/HIPAA Security Officer	Mr.	Hess	Jamie		3203355225				3207628750	jamie.hess@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	CMMI Model Point of Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/10/2024	2026	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		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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	Complaints Tracking Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				8776004912	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Contact for Fraud Investigations	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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		3203355219				3203355223	MedicareCOB@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56309	12/20/2023	2026	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	Corporate Mailing						3207634135				3207628750	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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 Member & Provider Services	Mr.	Magnuson	Matt		3203355243				3203355223	matt.magnuson@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	DIR Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	DIR Contact (Secondary)	Consulting Actuary	Ms.	Stensland	Katherine		6513894592				6512289893	katherine.stensland@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Discount Program Payment Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc	444 Cedar St, Suite 500	St Paul	MN	55101	12/08/2022	2026	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	Electronic Health Record Contact	Director of Business IT & Claims Administration	Mr.	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8885884420				HMO - Health Maintenance Organization		C	Chicago
H2416	Emergency Part D Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Manager	Ms.	Brand	Katie		3203355246				3207625945	katie.brand@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/27/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Mr	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paum	MN	55101	10/24/2019	2026	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	Enrollment Contact	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3203355223	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/27/2019	2026	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	EOB Transfer Contact	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3207628750	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/27/2019	2026	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	Financial Audit Contact	Chief Operating Officer	Mrs.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/24/2025	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Formulary Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Formulary Contact (Secondary)	Manager, Formulary Administration & Maintenance	Ms.	Nyawabila	Christina		8587906297					FMT@MedImpact.com	MedImpact HealthCare Systems, Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2026	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	General Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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		3203355250				3203355339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	HIPAA Privacy Officer	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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	HIPAA Security Officer	Director of IS&T / HIPAA Security Officer	Mr.	Hess	Jamie		3203355225				3207628750	jamie.hess@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	Interoperability Contact	Director Business IT & Claims Adminstration	Mr	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	MA Appeals/Grievances Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				8776004912	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	MA Claims Processing Contact for Public Website	Director Business IT & Claims Adminstration	Mr.	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	02/24/2022	2026	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	Marketing Contact	Marketing & Public Relations Coordinator	Ms.	Wencl	Kelly		3207594169				3207628750	kelly.wencl@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/10/2024	2026	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	Medical Director	Chief Senior Medical Director	Dr.	Hegstad	Scott		3203355286				3207628750	scott.hegstad@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/06/2022	2026	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		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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 Coordinator	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3203355319	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/24/2015	2026	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 Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Medication Therapy Management Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Online Enrollment Center Contact (Primary)	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3203355319	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/24/2015	2026	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 C Application Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3203355339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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 C Reporting Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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 Appeals	Appeals & Grievance Supervisor	Ms.	Creasman	Kachiri						8587906060	kachiri.creasman@medimpact.com	MedImact HealthCare Systems, Inc.	10181 Scripps Gateway CT	San Diego	CA	92131	12/13/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8582915164				HMO - Health Maintenance Organization		C	Chicago
H2416	Part D Appeals Contact (Secondary)	Appeals & Grievance Lead	Ms.	Lindberg	Laura						8587906060	Laura.Lindberg@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8582915528				HMO - Health Maintenance Organization		C	Chicago
H2416	Part D Application Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3203355339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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 Benefits Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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 Claims Submission Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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						3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	3207594154				HMO - Health Maintenance Organization		C	Chicago
H2416	Part D Exceptions Contact (Secondary)	Pharmacy Manager	Ms	Brand	Katie						3207625945	katie.brand@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	3203355246				HMO - Health Maintenance Organization		C	Chicago
H2416	Part D Price File Contact (Back-up)	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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 Price File Contact (Optional)	Pharmacy Manager	Ms	Brand	Katie		3203355246					katie.brand@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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 Price File Contact (Primary)	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55111	10/24/2019	2026	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 Quality Assurance Contact	Director of Pharmacy Management	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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 Reporting Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Patient Safety Contact	Director of Pharmacy Management	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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	Payment Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Personal Health Record Contact	Corporate Compliance Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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 Director	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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 Network Management Contact	Dir Pharmacy Network Administration	Mr.	Hunt	Brian		8587907092					Brian.Hunt@MedImpact.com	MedImpact HealthCare Systems Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2026	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 Network Management Contact (Secondary)	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905  Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8773919294				HMO - Health Maintenance Organization		C	Chicago
H2416	Pharmacy Technical Help Desk Contact (Secondary)	Director of Pharmacy	Ms.	Ehlert	Ann						3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	3207594154				HMO - Health Maintenance Organization		C	Chicago
H2416	PHR Beneficiary Contact																	11/10/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS	PrimeWest Health	PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8003662906				HMO - Health Maintenance Organization		C	Chicago
H2416	Physician Incentive Contact	Corporate Compliance Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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	Plan Directory Contact for Public Website			Contact Center	Provider		8664310802					providercontactcenter@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/24/2015	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/19/2024	2026	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	Processor Contact	Director Business IT & Claims Adminstration	Mr	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/27/2021	2026	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	Quality Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				3207628750	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Reconciliation Contact	Consulting Acturary	Ms.	Stensland	Katherine		6512289891				6512289893	katherine.stensland@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	03/31/2020	2026	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	Reconciliation Contact (Secondary)	Consulting Actuary	Ms.	Stensland	Katherine		6513894592				6512289893	katherine.stensland@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Recovery Audit Contact	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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	SNP Application Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	SNP State Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	Surveillance Contact	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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	System Contact	Chief Operating Officer	Mrs.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/06/2023	2026	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	Third Party Administrator (TPA) Liaison	Chief Operating Officer	Mrs.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	02/19/2025	2026	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	User Access Contact	Director of IS&T	Mr.	Hess	Jamie		3203355225				3207628750	jamie.hess@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Utilization Management Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				3207628750	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Utilization Review Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				3207628750	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Agent/Broker Compensation Data Contact	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Automated TrOOP Balance Transfer Contact	Data/Project Coordinator		Scherf	Savanna		2183276157				2183275545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	10/21/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Backup User Access Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	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		Anderson	Terasa		2183275505				2183275545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/18/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Bid Audit Contact	A.S.A.		Marotz	Jake		6512289891					jake.marotz@cirdanhealth.com	444 Cedar Street	Suite 500	St. Paul	MN	55101	05/29/2018	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Bid Primary Contact	A.S.A.		Marotz	Jake		6512289891					jake.marotz@cirdanhealth.com	444 Cedar Street	Suite 500	St. Paul	MN	55101	05/29/2018	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	CAP Report Contact for Public Website	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	CEO - CMS Administrator Contact	CEO	Ms.	Anderson	Sarah		2183983530				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	CEO - Senior Official for Contracting	CEO	Ms.	Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	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		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	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 Operating Officer	Utilization Management Director	Ms.	Rosik	Peggy		2183276199				2183275545	peggy.rosik@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/15/2021	2026	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 Information Officer	CEO	Ms.	Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	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 Information Security Officer	Contract Compliance Officer	Ms	Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	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		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Complaints Tracking Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Contact for Fraud Investigations	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2ND AVENUE		GRAND RAPIDS	MN	55744	09/28/2021	2026	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		Anderson	Terasa		2183275505				2183275545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	01/10/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Corporate Mailing						8008439536				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	557443983	12/14/2020	2026	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		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	DIR Contact	CFO		Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	DIR Contact (Secondary)	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Discount Program Payment Contact	CFO		Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Emergency Part D Contact	CEO		Anderson	Sarah		2183983530				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Emergency Part D Contact (Secondary)	Utilization Management Director		Rosik	Peggy		2182562038				2183275545	peggy.rosik@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	12/21/2022	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Encounter Data & Risk Adjustment Operations Contact	Claims Supervisor		Huffman	Kimberly		2183276118				2183275545	kimberly.huffman@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/24/2022	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Enrollment Contact	Data/Project Coordinator		Anderson	Terasa		2183275505				2183275545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	01/10/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	EOB Transfer Contact	Data/Project Coordinator		Anderson	Terasa		2183275505				2183275545	imcareenrollent@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	01/10/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Financial Audit Contact	CFO	Mr.	Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Financial Reporting Contact	CFO		Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Formulary Contact	Pharmacy Director		Pavek	Adam		2183276765				2183275545	adam.pavek@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	12/18/2015	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Formulary Contact (Secondary)	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	General Contact	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	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		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	HIPAA Privacy Officer	ICHHS Director		Villeneuve	Eric		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	HIPAA Security Officer	MIS Director		Sutherland	Jennifer		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	03/14/2024	2026	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		Anderson	Terasa		2183275505				2183275545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	11/05/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Interoperability Contact	CEO		Anderson	Sarah		2183276789					sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	05/09/2022	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	MA Appeals/Grievances Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	MA Claims Processing Contact for Public Website	Claims Supervisor		Huffman	Kimberly		2183276118				2183275545	kimberly.huffman@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/24/2022	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Marketing Contact	Health Plan Compliance Coordinator		Huso	Leah		2183276183				2183275545	leah.huso@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/24/2022	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Medical Director	Medical Director		Carlson, MD	Jeremy		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	01/10/2025	2026	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		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	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 Coordinator	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	01/03/2017	2026	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 Part D Opioid Overutilization Contact	Pharmacy Director		Pavek	Adam		2183276765				8008439536	adam.pavek@co.itasca.mn.us	1219 SE 2nd Avneue		Grand Rapids	MN	55744	10/17/2018	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Medication Therapy Management Contact	Sr Advisor, MTM		Pundik	Elina		4017708553				4012625955	elina.pundik@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	02/28/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Online Enrollment Center Contact (Back-up)	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Online Enrollment Center Contact (Primary)	Data/Project Coordinator		Anderson	Terasa		2183275505				2183275545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	01/10/2025	2026	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 C Application Contact	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	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 C Reporting Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	07/09/2014	2026	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 Appeals	Health Plan Compliance Coordinator		Huso	Leah						2183275545	leah.huso@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/24/2022	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active	8008439536	2183			HMO - Health Maintenance Organization		C	Chicago
H2417	Part D Appeals Contact (Secondary)	Contract Compliance Officer		Grover	Laura						2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	01/07/2021	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active	8008439536	2769			HMO - Health Maintenance Organization		C	Chicago
H2417	Part D Application Contact	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	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 Benefits Contact	Utilization Management Director		Rosik	Peggy		2183276199				2183275545	peggy.rosik@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/15/2021	2026	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 Claims Submission Contact	Pharmacy Director		Pavek	Adam		2183276765				2183275545	adam.pavek@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	01/03/2017	2026	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						2183275545	peggy.rosik@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/15/2021	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active	8008439536	2199			HMO - Health Maintenance Organization		C	Chicago
H2417	Part D Exceptions Contact (Secondary)	Quality Director		Larson	Danielle						2183275545	danielle.larson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/06/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active	8008439536	2199			HMO - Health Maintenance Organization		C	Chicago
H2417	Part D Price File Contact (Back-up)	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	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 Price File Contact (Optional)	Medicare Client Advisor		Wiltfong	Yvette		4803148335					yvette.wiltfong@caremark.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	04/01/2015	2026	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 Price File Contact (Primary)	Analyst Medicare Operations		Nichols	Kristy		4806147668					kristy.nichols@caremark.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	04/01/2015	2026	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 Quality Assurance Contact	Quality Director		Larson	Danielle		2183276180				2183275545	danielle.larson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/06/2025	2026	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 Reporting Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	07/09/2014	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Patient Safety Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Payment Contact	CFO		Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	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 Director	Pharmacy Director		Pavek	Adam		2183276765				2183275545	adam.pavek@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	01/03/2017	2026	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 Network Management Contact	Director Network Systems and Standard		Tressler	Damon		4803914702					damon.tressler@caremark.com	9501 E Shea Blvd.		Scottsdale	AZ	85260	12/15/2006	2026	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						2183275545		1219 SE 2ND AVENUE		GRAND RAPIDS	MN	55744	02/28/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active	8008439536				HMO - Health Maintenance Organization		C	Chicago
H2417	Physician Incentive Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	01/03/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Plan Directory Contact for Public Website	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Plan to Plan Reconciliation Contact	Data/Project Coordinator		Anderson	Terasa		2183275505				2183275545	imcareenrollment@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	01/10/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Processor Contact	Claims Supervisor		Huffman	Kimberly		2183276118				2183275545	kimberly.huffman@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/24/2022	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Quality Contact	Quality Director		Larson	Danielle		2183276180				2183275545	danielle.larson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	02/06/2025	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Reconciliation Contact	CFO		Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Reconciliation Contact (Secondary)	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Recovery Audit Contact	CFO	Mr.	Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	SNP Application Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	07/01/2021	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Surveillance Contact	Contract Compliance Officer		Grover	Laura		2183276769				2183275545	laura.grover@co.itasca.mn.us	1219 SE 2nd Avenue		Grand Rapids	MN	55744	04/20/2017	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	System Contact	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Third Party Administrator (TPA) Liaison	CFO		Alstad	Matthew		2183275517				2183275545	matthew.alstad@co.itasca.mn.us	1219 SE 2nd Ave		Grand Rapids	MN	55744	11/19/2019	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	User Access Contact	CEO		Anderson	Sarah		2183276789				2183275545	sarah.anderson@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	12/14/2020	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Utilization Management Contact	Utilization Management Director		Rosik	Peggy		2183276199				2183275545	peggy.rosik@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	11/15/2021	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2417	Utilization Review Contact	Utilization Management Director		Rosik	Peggy		2183276199				2183275545	peggy.rosik@co.itasca.mn.us	1219 SE 2nd Ave.		Grand Rapids	MN	55744	11/15/2021	2026	ITASCA MEDICAL CARE	Local CCP	Itasca Medical Care/IMCare Classic	HMO/HMOPOS		Itasca County	136	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2419	Agent/Broker Compensation Data Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Automated TrOOP Balance Transfer Contact	Business Systems Analyst		Murray	Karla		2672985899					kdmurray@performrx.com	PerformRx	200 Steven Dr.	Philadelphia	PA	19113	06/18/2025	2026	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	Backup User Access Contact	Compliance Officer		Marks	Jeff		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Bid Audit Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Bid Audit Site Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Bid Primary Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	CAP Report Contact for Public Website	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms	Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Operating Officer	Chief Executive Officer	Ms	Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Information Officer		Mr	Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Information Security Officer		Mr	Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316373				5074447774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Complaints Tracking Contact	Grievance and Appeals Manager		Miller	Suzette		5074316373				5074447774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Contact for Fraud Investigations	Compliance Officer		Marks	Jeff		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	Corporate Mailing						5074447770				5074447774	amcgregor@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	DIR Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	06/22/2022	2026	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	DIR Contact (Secondary)	Director of Operations		Lewer	Cheryl		5074316377				5074447477	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	02/18/2022	2026	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	Discount Program Payment Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	06/22/2022	2026	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	Emergency Part D Contact	Pharmacy Manager		Bailey	Sarah		5074315477				5074447774	sbailey@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Emergency Part D Contact (Secondary)	Director of Operations		Lewer	Cheryl		5074316377					clewer@mnscha.org	6380 West Frontage Road		Medford	MN	55049	01/23/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447770	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Enrollment Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	CLewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	EOB Transfer Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	Financial Audit Contact	Chief Financial Officer	Mr	Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Financial Reporting Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	Formulary Contact	Director of Clinical Services		Megargell	Lauren		2159374135					lmegargell@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	06/02/2021	2026	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	Formulary Contact (Secondary)	Manager, Formulary/DUR		DeHoratius	Patrick		2159375078					patrick.dehoratius@performrx.com	PerformRx	200 Steven Drive	Philadelphia	PA	19113	02/02/2023	2026	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	General Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	HIPAA Privacy Officer	Compliance Officer		Marks	Jeff		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	HIPAA Security Officer			Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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		5074316397				5074447774	kworrall@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	Interoperability Contact	Director of IT and Analytics		Hoenck	Matt		5074316391					mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	MA Appeals/Grievances Contact	Grievance and Appeals Manager		Miller	Suzette		5074316373				5074447774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	MA Claims Processing Contact for Public Website	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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	Marketing Contact	Director of Community Engagement		Braaten	Kelly		5074316572				5074447774	kbraaten@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Medical Director	Chief Medical Director	Dr.	Miller	Timothy		5074316388	6388			5074447774	tmiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Coordinator	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Part D Opioid Overutilization Contact	Director Clinical Outcomes & Therapeutic Optimizat		McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Steven Dr.	Philadelphia	PA	19113	02/02/2023	2026	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	Medication Therapy Management Contact	Director Clinical Outcomes & Therapeutic Opt.		McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/02/2023	2026	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	Online Enrollment Center Contact (Primary)	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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 C Application Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/25/2021	2026	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 C Reporting Contact	Compliance Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	05/27/2025	2026	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 Appeals	Director of Pharmacy Utilization Mgmt		Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H2419	Part D Appeals Contact (Secondary)	Clinical Pharmacist, Manager of Pharmacy Prior Aut		McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Chicago
H2419	Part D Application Contact	Compliance Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	05/27/2025	2026	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 Benefits Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 Claims Submission Contact	Director of Clinical Operations		Ortiz	Noel		2159375352					nortiz@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	05/26/2021	2026	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 Mgmt		Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H2419	Part D Exceptions Contact (Secondary)	Clinical Pharmacist, Manager of Pharmacy Prior Aut		McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/23/2015	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Chicago
H2419	Part D Price File Contact (Back-up)	Medicard Part D Program Analyst		Benedoctp	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00918	07/30/2024	2026	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 Price File Contact (Optional)	Medicare Part D Program Analyst		Weihe	Heather		4127156363					heather.weihe@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00918	06/18/2025	2026	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 Price File Contact (Primary)	Medicard Part D Program Analyst		West	Ariel		3133781225					Ariel.West@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	07/30/2024	2026	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 Quality Assurance Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 Reporting Contact	Compliance Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	05/27/2025	2026	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	Patient Safety Contact	Director Clinical Outcomes & Therapeutic Opt.		McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/02/2023	2026	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	Payment Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Personal Health Record Contact			Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 Director	VP Clinical Programs, Pharmacy Clinical Services		Maiorini	Andrew		2159378565					Amaiorini@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/01/2016	2026	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 Network Management Contact	Vice President Network Strategy		Sullivan	Tim		6303303638					tim.sullivan@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	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	Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/11/2025	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H2419	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/11/2025	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H2419	Plan Directory Contact for Public Website	Communications Manager		Gartner	Chris		5074313021				5074447774	cgartner@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Plan to Plan Reconciliation Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Processor Contact	Director of Clinical Operations		Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	05/26/2021	2026	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	Quality Contact	Manager of Quality		Smith	Justin		5074316387				5074447774	jsmith@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Reconciliation Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Reconciliation Contact (Secondary)	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr	Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	SNP Application Contact	Chief Executive Officer		Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	SNP State Contact	Chief Executive Officer		Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Surveillance Contact	Director of Community Engagement		Braaten	Kelly		5074316572				5074447774	kbraaten@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	System Contact			Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Third Party Administrator (TPA) Liaison	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	06/22/2022	2026	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	User Access Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Utilization Management Contact	Manager of Utilization Management		Beckel	Ashley		5074316583				5074447774	abeckel@mnscha.org	6380 West Frontage Road		Medford	MN	55049	01/23/2023	2026	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	Utilization Review Contact	Manager of Utilization Management		Beckel	Ashley		5074316583				5074447774	abeckel@mnscha.org	6380 West Frontage Road		Medford	MN	55049	01/23/2023	2026	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	Agent/Broker Compensation Data Contact	VP Government Programs		Clelland	Jennifer	J	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	11/04/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Automated TrOOP Balance Transfer Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Backup User Access Contact	Coordinator Government Programs		Yu	Chao		9528827240					chao.x.yu@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Best Available Evidence Contact	Sr. Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Bid Audit Contact	Director, Integrity and Compliance		Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	11/17/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Bid Audit Site Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS:  21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Bid Primary Contact	Vice President, Actuary		Stewart	Sara		9528835049					sara.m.stewart@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21105H	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	CAP Report Contact for Public Website	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	CEO - CMS Administrator Contact	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	CEO - Senior Official for Contracting	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/04/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Chief Financial Officer	SVP & Chief Financial Officer	Ms.	Johnson	Kathleen	A	9528836531					kathy.a.johnson1@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	554401309	03/29/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Chief Operating Officer	EVP, Health Engagement and Informatics Officer	Ms.	Knudson	Susan	M	9528883618					susan.m.knudson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110A	Minneapolis	MN	554401309	02/04/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Chief Information Officer	Senior Vice President and CTO	Mr.	Thull	Tim	D	9528837636					timothy.d.thull@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/16/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Chief Information Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	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	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Complaints Tracking Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Contact for Fraud Investigations	Senior Manager Claims		Dahlberg	Kara	A	9529675640					kara.a.dahlberg@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  25510F	Minneapolis	MN	55101	07/09/2024	2026	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	9529677335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Corporate Mailing						9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	05/21/2015	2026	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		9529677668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	554409463	01/29/2020	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	DIR Contact	Sr. Pharmacy Plan Contract Manager		Reinhardt	Sandra	L	9528836739					sandra.l.reinhardt@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	DIR Contact (Secondary)	Consultant, Data Analysis		Binsfeld	David	T	9529675950					david.t.binsfeld@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS 21108Q	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Discount Program Payment Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Emergency Part D Contact	Sr. Director Pharmacy Services		Strahl	Christine	L	9528835022				9529676667	christine.l.strahl@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Emergency Part D Contact (Secondary)	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536				9529676667	dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Employer Waiver Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Encounter Data & Risk Adjustment Operations Contact	Senior Manager Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South	MS: 21103J	Minneapolis	MN	55425	02/19/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Enrollment Contact	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	EOB Transfer Contact	Sr. Manager Claims Production		Huseby	Pam	J	9529675530				9528837666	pam.j.huseby@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	08/30/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Financial Audit Contact	Director Monitoring and Compliance	Ms.	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Financial Reporting Contact	Director Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	03/14/2019	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Formulary Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Formulary Contact (Secondary)	Formulary Administration Pharmacist		Savage	Robert		8587906426					robert.savage@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Ct.	San Diego	CA	92131	07/24/2019	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	General Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	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	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	08/27/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	HIPAA Privacy Officer	Sr. Director Integrity Compliance Privacy Officer		Wells	Prasanta	K	9528837325					prasanta.k.wells@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103K	Minneapolis	MN	554401309	07/23/2015	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	HIPAA Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Hospice Contact	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Interoperability Contact	Program Manager, IT		Geisler	Chris	J	6122479067					Chris.J.Geisler@HealthPartners.Com	8170 33rd Avenue S		Bloomington	MN	55425	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	MA Appeals/Grievances Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	MA Claims Processing Contact for Public Website	Sr. Manager Claims Production		Huseby	Pam	J	9529675530					RVSCProviderInquiry@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Marketing Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Medical Director	Health Plan Chief Medical Officer	Dr.	Kakacek	Virginia	L	9528837120					virginia.l.kakacek@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110Q	Minneapolis	MN	554401309	09/21/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Medicare Compliance Officer	Director, Integrity and Compliance	Ms.	Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	11/17/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Medicare Coordinator	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Medicare Part D Opioid Overutilization Contact	Pharmacy UM Systems and Data Analyst		Hamm	Sarah	K	9529677652					sarah.k.hamm@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Medication Therapy Management Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Online Enrollment Center Contact (Back-up)	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Online Enrollment Center Contact (Optional)	Admin Product Implementation Manager		Wessel	Sara	C	9529677623					sara.c.wessel@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/29/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Online Enrollment Center Contact (Primary)	Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/09/2018	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part C Application Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part C Reporting Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Appeals	Manager Member Rights and Benefits		Kruse	Morgan	L						Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS:  21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active	8007963806				HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Appeals Contact (Secondary)	Superviosr, Member Rights and Benefits		Dress	Samantha							Samantha.L.Dress@HealthPartners.com	8170 33rd Avenue South	MS: 21103R	Bloomington	MN	55425	12/06/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active	8007963806				HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Application Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Benefits Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Claims Submission Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	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					9528538700	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	11/30/2020	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active	8004927259				HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Price File Contact (Primary)	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Quality Assurance Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21108T	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Part D Reporting Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Patient Safety Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Payment Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	05/09/2013	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Pharmacy Director	VP Pharmacy		Busch	David	L	9529675049					david.l.busch@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	06/25/2020	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Pharmacy Network Management Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Pharmacy Network Management Contact (Secondary)	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/03/2025	2026	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					8888835434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/19/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active	8004927259				HMO - Health Maintenance Organization		C	Chicago
H2422	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Customer Service		Sahs	Dale							dale.sahs@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H2422	Plan Directory Contact for Public Website			Services	Provider		9528837699					RVSCProviderInquiry@HealthPartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	06/10/2013	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Plan to Plan Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Processor Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina		9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Quality Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Recovery Audit Contact	Director Monitoring and Compliance	Ms.	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	SNP Application Contact	Manager State Public Programs		BennettVo	Emi	M	9529677382					emi.m.bennettvo@healthpartners.com	8170 33rd Avenue South	PO Box 1309 MS:  21103C	Minneapolis	MN	55440	08/30/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	SNP State Contact	Manager State Public Programs		BennettVo	Emi	M	9529677382					emi.m.bennettvo@healthpartners.com	8170 33rd Avenue South	PO Box 1309 MS:  21103C	Minneapolis	MN	55440	08/30/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Surveillance Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	System Contact	Senior Manager Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21193J	Minneapolis	MN	554401309	02/19/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Third Party Administrator (TPA) Liaison	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/11/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	User Access Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Utilization Management Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2422	Utilization Review Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	HMO/HMOPOS		HealthPartners, Inc.	117	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Agent/Broker Compensation Data Contact	Mgr Sales Commission & Analytics		Bruggemann	Brad		6516623870					bradford.bruggemann@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/02/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Backup User Access Contact	Compliance		Nordwall	Darlene		6516628745					darlene.nordwall@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/30/2024	2026	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		6516623468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Dr		Eagan	MN	55121	02/02/2022	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Bid Audit Contact	Asst. Actuary		Zeterlu	Angela		6516620420					angela.zeterlu@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Bid Audit Site Contact	Asst. Actuary		Zeterlu	Angela		6516620420					angela.zeterlu@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Bid Primary Contact	Asst. Actuary		Zeterlu	Angela		6516620420					angela.zeterlu@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	CAP Report Contact for Public Website	Government Compliance Officer		Hogan	Carrie		6516621900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	CEO - CMS Administrator Contact	President/CEO Blue Plus	Ms.	Rewey	Amy		6516627105					amy.rewey@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/28/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	CEO - Senior Official for Contracting	Vice President - Medicare Government Markets	Mr.	Boles	Chris		9492013642					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/03/2024	2026	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		6516629501					John.Uribe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Chief Operating Officer	Chief Operating Officer	Mr.	Im	David		6516629275					david.im@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Chief Information Officer	Chief Information Officer	Ms	Flicek	Melissa		6516629995					melissa.flicek@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Chief Information Security Officer	VP Digital Platforms & Cybersecurity	Mr	Groshong	Christophe		6516628786					Christopher.Groshong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	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 Appeals & Grievances		Bazzarre	Tom		6516629643					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/14/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Complaints Tracking Contact	Manager Appeals & Grievances		Bazzarre	Tom		6516629643					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/14/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Contact for Fraud Investigations	Director Operational Risk Management Performance		Dickinson	Richard		6516623532					richard.dickinson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	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	Mgr Project & Program Management		Chesling	Beth		6127774823				6127776706	COBmedd@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Corporate Mailing						8663408654					contact@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/18/2019	2026	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, Service Delivery		Hovick	Denise		6516628864					denise.hovick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/01/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	DIR Contact	Managing Actuary-Actuarial		Santa	Tyler		6516628362					Tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	DIR Contact (Secondary)	Financial Analyst, Sr		Voves	Alex		6516623606					alex.voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Discount Program Payment Contact	Financial Analyst Sr		Voves	Alex		6516623606					Alex.Voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Electronic Health Record Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Emergency Part D Contact	Manager, Pharmacy Operations		Ibrahim	Sonya		6516627412					sonya.ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/13/2021	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Mitchell	Angela		6516623607					angela.mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/13/2021	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Employer Waiver Contact	Director Gov't Program Management for Medicare		Hower	Sara		6516624156					Sara.Hower@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/04/2019	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Encounter Data & Risk Adjustment Operations Contact	VP Medicare	Mr.	Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Enrollment Contact	Director Enrollment, Billing & Member Operations		McWaters	Alisha		6516621755					alisha.mcwaters@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	EOB Transfer Contact	Mgr Project & Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Financial Audit Contact	Manager, External Compliance & Regulatory Audits	Mr	Haile-Selassie	Moguss		6516628966					moguss.haile-selassie@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Financial Reporting Contact	VP Corporate Controller		Long	Darlene		6516621704					Darlene.Long@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Formulary Contact	Pharmacist Business Segment Director		Boreen	Donna		6516621264					donna.boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/28/2018	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	General Contact	Director, Medicaid Accounts-Seniors		Kosel	Karla		6516624166					Karla.Kosel@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	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		Nelson	Lin		6516627123					lin.nelson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	HIPAA Privacy Officer	Privacy Director		Armstrong	Rebecca		6516621865					rebecca.armstrong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/13/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	HIPAA Security Officer	VP Digital Platforms & Cybersecurity	Mr.	Groshong	Christophe		6516628786					christopher.groshong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	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		6516629644					beth.dick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/11/2019	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Interoperability Contact	Chief Information Officer		Flicek	Melissa		6516629995					melissa.flicek@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	MA Appeals/Grievances Contact	Manager Appeals & Grievances		Bazzarre	Tom		6516623532					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/13/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	MA Claims Processing Contact for Public Website	Manager, Business Services		Daniels	Cassandra		6516623468					cassandra.daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Marketing Contact	Compliance Manager- Enterprise Ethics & Compliance		Danisch	Gary		6516622072					medicaid.msho.materials@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Medical Director	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	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		6516621900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Medicare Coordinator	Manager, Business Services		Daniels	Cassandra		6516623468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/22/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Medicare Part D Opioid Overutilization Contact	Supv Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/07/2022	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Medication Therapy Management Contact	Mgr. Pharmacy Services		Aderinkomi	Anita		6516629221					anita.aderinkomi@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	OffShore Subcontractor Contact	Government Compliance Officer	Mr	Hogan	Carrie		6516621900					Carrie.hogan@bluecrossmn.com	3400 Yankee Drive	R337	Eagan	MN	55121	10/26/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Online Enrollment Center Contact (Back-up)	Manager, Business Services		Daniels	Cassandra		6516623468				6516623500	cassandra.daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Online Enrollment Center Contact (Primary)	Director Enrollment, Billing & Member Operations		McWaters	Alisha		6516621755					alisha.mcwaters@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part C Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/07/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part C Reporting Contact	Operations Business Analyst Pr		Littrell	Sue		6516622670					sue.littrell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Appeals	Regulatory Pharmacist Sr		Emerson	Kimberly						8006936651	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	8006936703				HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	8006936703				HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/07/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Benefits Contact	Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Claims Submission Contact	Health Data Analyst Sr.		Brooke	Lance		4026862603				4029702545	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/17/2025	2026	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	Regulatory Pharmacist Sr		Emerson	Kimberly						8006936651	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	8006936703				HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936651	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	8006936703				HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Price File Contact (Back-up)	Business Solution Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Price File Contact (Optional)	Price File Analyst		Tastad	Emily		6518085779					emily.tastad@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Price File Contact (Primary)	PBM Operations Analyst Pr		Aschoff	Ted		6516628777					theodore.aschoff@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Quality Assurance Contact	Director, Pharmacy Ops Support		Ibrahim	Sonya		6516627412					Sonya.Ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Part D Reporting Contact	Operations Business Analyst Pr		Littrell	Sue		6516622670					sue.littrell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Patient Safety Contact	Pharmacist Business Segment Director		Boreen	Donna		6516621264					donna.boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/13/2020	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Payment Contact	VP Corporate Controller		Long	Darlene		6516621704					Darlene.Long@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Pharmacy Director	Pharmacist Business Segment Director		Boreen	Donna		6516621264					Donna.Boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/29/2018	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Pharmacy Network Management Contact	AVP, Network Mangement		Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Pharmacy Network Management Contact (Secondary)	Sr Dir, Network Management		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/29/2020	2026	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	Sr Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	8006482778				HMO - Health Maintenance Organization		C	Chicago
H2425	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active	8006482778				HMO - Health Maintenance Organization		C	Chicago
H2425	PHR Beneficiary Contact																	10/18/2019	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS	Blue Cross and Blue Shield of Minnesota	Aware Integrated, Inc.	642	Yes	Active	8003822000				HMO - Health Maintenance Organization		C	Chicago
H2425	Physician Incentive Contact	Director, Medicaid Accounts-Seniors		Kosel	Karla		6516624166					Karla.Kosel@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Plan Directory Contact for Public Website	Digital Experience Strategist Sr		Cosgrove	Patrick		6516623727					patrick.cosgrove@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Plan to Plan Reconciliation Contact	Financial Analyst Pr		Harrelson	Michael		6516628490				6516622200	Michael.Harrelson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722				6127777606	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/21/2022	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Quality Contact	VP Medicare		Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Reconciliation Contact	Managing Actuary-Actuarial		Santa	Tyler		6516628362					Tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Reconciliation Contact (Secondary)	Healthcare Analyst Principle-Actuarial		Kieffer	Ryan		6516624405					Ryan.kieffer@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Recovery Audit Contact	Government Compliance Officer	Mr.	Hogan	Carrie		6516621900					Carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/26/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	SNP Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/07/2023	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	SNP State Contact	Director, Medicaid Accounts-Seniors		Kosel	Karla		6516624166					Karla.Kosel@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Surveillance Contact	Manager , Channel Management and Oversight		Moomey	Kristina		6516621707					kristina.moomey@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	System Contact	VP Digital Product Engineering		Young	Jeffrey		6516626767					Jeffrey.young@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/10/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Third Party Administrator (TPA) Liaison	Financial Analyst Senior		Voves	Alex		6516623606					Alex.Voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/13/2021	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	User Access Contact	Compliance Manager- Enterprise Ethics & Compliance		Danisch	Gary		6516622072					Gary.danisch@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	05/12/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Utilization Management Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2425	Utilization Review Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	HMO Minnesota	Local CCP	Blue Plus	HMO/HMOPOS		Aware Integrated, Inc.	642	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2441	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	06/27/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	OffShore Subcontractor Contact	Compliance Director		Hodge	Susan		4632692105					susan.hodge@elevancehealth.com	220 Virginia Avenue		Indianapolis	IN	46204	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	06/27/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H2441	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H2441	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H2441	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H2441	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Quality Assurance Contact	VP/Chief Clinical Officer - IngenioRx		Haines	Colleen		9373710575					colleen.haines@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Patient Safety Contact	VP/Chief Clinical Officer - IngenioRx		Haines	Colleen		9373710575					colleen.haines@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	12/23/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H2441	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amym.matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	12/23/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H2441	PHR Beneficiary Contact																	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H2441	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2441	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2445	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H2445	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2445	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2445	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H2445	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	05/13/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2445	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2450	Agent/Broker Compensation Data Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Automated TrOOP Balance Transfer Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Backup User Access Contact			Berg	Lynnsey		6126326655					lynnsey.berg@optum.com	P.O. Box 9472		Minneapolis	MN	554409472	11/30/2018	2026	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		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Bid Primary Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	CAP Report Contact for Public Website	Manager - Compliance		Herbst	Travis		6088272856					Travis Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	09/23/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	CEO - CMS Administrator Contact	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Chief Financial Officer	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Chief Operating Officer	Chief Operations Officer	Mr	Hjerpe	Adam		6123861065					COO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/11/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Chief Information Officer	VP, Chief Technology Officer	Mr	Peterson	Scott		9529922625					Scott.Peterson@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	09/05/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Chief Information Security Officer		Mr	Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/12/2020	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	CMS Casework Communication Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Complaints Tracking Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Contact for Fraud Investigations	Director, Special Investigations Unit		Kalin	Dan		9529922587					Daniel.Kalin@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/05/2025	2026	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		9529923252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Corporate Mailing						9529922900					Nichole.MeltonMitchell@medica.com	401 Carlson Parkway	P.O. Box 9310 CP320	Minnetonka	MN	55305	04/09/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Cost Report Contact			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	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		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	DIR Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	DIR Contact (Secondary)	VP & Chief Pharmacy Officer		Rogers	Nick		9529923611					Nicholas.Rogers@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Discount Program Payment Contact			Ricaurte	Angela		9529923748					angela.ricaurte@medica.com	401 Carlson Pkwy		Minnetonka	MN	55305	05/16/2023	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Emergency Part D Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/06/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Emergency Part D Contact (Secondary)			Day	Colton		9529928537					Colton.Day@deancare.com	1277 Deming Way		Madison	WI	53717	01/06/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Employer Waiver Contact			Alness	Stacy		9529923825					stacy.alness@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/19/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Encounter Data & Risk Adjustment Operations Contact	Director- Risk Adjustment Operations		Werwinski	Michelle		6088305958					Michelle.Werwinski@deancare.com	1277 Deming Way		Madison	WI	53717	07/01/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Enrollment Contact			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/26/2018	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	EOB Transfer Contact			Bourdages	Kathy		9529923653				9529923636	kathy.bourdages@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/03/2014	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Financial Reporting Contact			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Formulary Contact			Parr	Ross		9529921767					ross.parr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Formulary Contact (Secondary)			Seabright	Diane		9529922474					diane.valeo-seabright@deancare.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	General Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Government Relations Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	HIPAA Privacy Officer			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/20/2023	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	HIPAA Security Officer		Mr	Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/12/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Hospice Contact			Bourdages	Kathy		9529923653				9529923636	PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/31/2018	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Interoperability Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/14/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	MA Appeals/Grievances Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	MA Claims Processing Contact for Public Website			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Marketing Contact			Teff	Melissa		9529923972					melissa.teff@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/05/2020	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Medical Director	Chief Clinical & Provider Strategy Officer		Webster	David		9529922801					david.webster@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2026	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		9529922090					complianceofficer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/03/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Medicare Coordinator	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Medication Therapy Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	OffShore Subcontractor Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Online Enrollment Center Contact (Primary)			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/15/2014	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part C Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part C Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Appeals			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/28/2016	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	9529922353				Cost1		1	Kansas City
H2450	Part D Appeals Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	6088277576				Cost1		1	Kansas City
H2450	Part D Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Benefits Contact			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/09/2020	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Claims Submission Contact			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/02/2021	2026	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	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	9529922353				Cost1		1	Kansas City
H2450	Part D Exceptions Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	6088277576				Cost1		1	Kansas City
H2450	Part D Price File Contact (Back-up)			Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Farifield	OH	45014	11/17/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Price File Contact (Optional)			Bourdages	Kathy		9529923653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/26/2018	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Price File Contact (Primary)			Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/17/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Quality Assurance Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Part D Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Patient Safety Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Payment Contact			Faig	Sara		9529928358					sara.faig@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/22/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Pharmacy Director	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Pharmacy Network Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Pharmacy Network Management Contact (Secondary)			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/03/2014	2026	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	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	8009221557				Cost1		1	Kansas City
H2450	Pharmacy Technical Help Desk Contact (Secondary)			Bourdages	Kathy							PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/09/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active	8009221557				Cost1		1	Kansas City
H2450	Plan Directory Contact for Public Website			Service	Customer		8002348755					AskGovtPrograms@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Plan to Plan Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Processor Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Quality Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Reconciliation Contact (Secondary)			Schenten	Paul		9529928875					Paul.Schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	07/07/2017	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Surveillance Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	System Contact			Schwartz	Pamela		9529922584					pamela.schwartz@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Third Party Administrator (TPA) Liaison			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	User Access Contact			Harrington	Dana		6122129075					dana.harrington@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Utilization Management Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2450	Utilization Review Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA INSURANCE COMPANY	1876 Cost	Medica	1876 Cost		Medica Holding Company	439	Yes	Active					Cost1		1	Kansas City
H2458	Agent/Broker Compensation Data Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Automated TrOOP Balance Transfer Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Backup User Access Contact			Berg	Lynnsey		6126326655					lynnsey.berg@optum.com	P.O. Box 9472		Minneapolis	MN	554409472	11/30/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Best Available Evidence Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Bid Audit Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Bid Audit Site Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Bid Primary Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	CAP Report Contact for Public Website	Manager - Compliance		Herbst	Travis		6088272856					Travis Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	09/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	CEO - CMS Administrator Contact	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Chief Financial Officer	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Chief Operating Officer	Chief Operations Officer	Mr	Hjerpe	Adam		6123861065					COO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/11/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Chief Information Officer	VP, Chief Technology Officer	Mr	Peterson	Scott		9529922625					Scott.Peterson@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	09/05/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Chief Information Security Officer		Mr	Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/12/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	CMMI Model Point of Contact			Schaefer	Jennifer		9529912803					jennifer.schaefer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/15/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	CMS Casework Communication Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Complaints Tracking Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Contact for Fraud Investigations	Director, Special Investigations Unit		Kalin	Dan		9529922587					Daniel.Kalin@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/05/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Coordination of Benefits Contact			Vilendrer	Krista		9529923252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Corporate Mailing						9529922900					Nichole.MeltonMitchell@medica.com	401 Carlson Parkway	P.O. Box 9310 CP320	Minnetonka	MN	55305	04/09/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Customer Service Operations Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	DIR Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	DIR Contact (Secondary)	VP & Chief Pharmacy Officer		Rogers	Nick		9529923611					Nicholas.Rogers@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Discount Program Payment Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Emergency Part D Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/06/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Emergency Part D Contact (Secondary)			Day	Colton		9529928537					Colton.Day@deancare.com	1277 Deming Way		Madison	WI	53717	01/06/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Employer Waiver Contact			Alness	Stacy		9529923825					stacy.alness@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/19/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Encounter Data & Risk Adjustment Operations Contact	Director- Risk Adjustment Operations		Werwinski	Michelle		6088305958					Michelle.Werwinski@deancare.com	1277 Deming Way		Madison	WI	53717	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Enrollment Contact			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	EOB Transfer Contact			Bourdages	Kathy		9529923653				9529923636	kathy.bourdages@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/03/2014	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Financial Audit Contact	Sr. Director of Finance, Medicaid & Medicare	Ms	Faig	Sara		9529928358					sara.faig@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Financial Reporting Contact			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Formulary Contact			Parr	Ross		9529921767					ross.parr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Formulary Contact (Secondary)			Seabright	Diane		9529922474					diane.valeo-seabright@deancare.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	General Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Government Relations Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	HIPAA Privacy Officer			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/20/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	HIPAA Security Officer			Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/15/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Hospice Contact			Bourdages	Kathy		9529923653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Interoperability Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/14/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	MA Appeals/Grievances Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	MA Claims Processing Contact for Public Website			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Marketing Contact			Teff	Melissa		9529923972					melissa.teff@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Medical Director	Chief Clinical & Provider Strategy Officer		Webster	David		9529922801					david.webster@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Medicare Compliance Officer		Mrs	Koranteng	Milly		9529922090					complianceofficer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/03/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Medicare Coordinator	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	06/26/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Medication Therapy Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	OffShore Subcontractor Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Online Enrollment Center Contact (Primary)			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/15/2014	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part C Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part C Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Appeals			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/28/2016	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	9529922353				HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Appeals Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	6088277576				HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Benefits Contact			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/09/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Claims Submission Contact			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/02/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/28/2016	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	9529922353				HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Exceptions Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	6088277576				HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Price File Contact (Back-up)			Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Farifield	OH	45014	11/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Price File Contact (Optional)			Bourdages	Kathy		9529923653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Price File Contact (Primary)			Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Quality Assurance Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Part D Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Patient Safety Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Payment Contact			Faig	Sara		9529928358					sara.faig@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Pharmacy Director	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Pharmacy Network Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Pharmacy Network Management Contact (Secondary)			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/03/2014	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H2458	Pharmacy Technical Help Desk Contact (Secondary)			Bourdages	Kathy							PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/09/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H2458	Plan Directory Contact for Public Website			Service	Customer		8002348755					AskGovtPrograms@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Plan to Plan Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Processor Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Quality Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Reconciliation Contact (Secondary)			Schenten	Paul		9529928875					Paul.Schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	06/27/2017	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Recovery Audit Contact	Manager Claims Operations	Mr	Foley	Steve		9529924160					steven.foley@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	SNP Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	SNP State Contact			Zillhardt	John		9529922290					John.Zillhardt@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/15/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Surveillance Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	System Contact			Schwartz	Pamela		9529922584					pamela.schwartz@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Third Party Administrator (TPA) Liaison			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	User Access Contact			Harrington	Dana		6122129075					dana.harrington@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Utilization Management Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2458	Utilization Review Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2461	Agent/Broker Compensation Data Contact	Mgr Sales Commission & Analytics		Bruggemann	Brad		6516623870					bradford.bruggemann@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/02/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Backup User Access Contact	Compliance		Nordwall	Darlene		6516628745					darlene.nordwall@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/30/2024	2026	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		6516623468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Bid Primary Contact	Asst. Actuary		Zeterlu	Angela		6516620420					angela.zeterlu@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	CAP Report Contact for Public Website	Government Compliance Officer		Hogan	Carrie		6516621900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	CEO - CMS Administrator Contact	President & CEO	Ms	Erickson	Dana		6516621000					Dana.erickson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	CEO - Senior Official for Contracting	VP Medicare	Mr.	Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	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		6516629501					John.Uribe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Chief Operating Officer	Chief Operating Officer	Mr.	Im	David		6516629275					David.im@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/10/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Chief Information Officer	Chief Information Officer	Ms.	Flicek	Melissa		6516629995					melissa.flicek@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Chief Information Security Officer	VP Digital Platforms & Cybersecurity	Mr	Groshong	Chris		6516622878					Christopher.Groshong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/12/2023	2026	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 Appeals & Grievances		Bazzarre	Tom		6516629643					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/14/2023	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Complaints Tracking Contact	Manager Appeals & Grievances		Bazzarre	Tom		6516629643					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/14/2023	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Contact for Fraud Investigations	Director Operational Risk Management Performance		Dickinson	Richard		6516623532					richard.dickinson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	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		6516623468					government.program.service.request@bcbsmn.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Corporate Mailing						8663408654					contact@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/16/2017	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Cost Report Contact	Manager, Financial Reporting & Accounting		Harrelson	Michael		6516628490					Michael.Harrelson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	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		6516628864					denise.hovick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	DIR Contact	Managing Actuary-Actuarial		Santa	Tyler		6516628362					Tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	DIR Contact (Secondary)	Financial Analyst, Sr		Voves	Alex		6516623606					alex.voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Discount Program Payment Contact	Financial Analyst Sr		Voves	Alex		6516623606					Alex.Voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Emergency Part D Contact	Manager, Pharmacy Operations		Ibrahim	Sonya		6516627412					sonya.ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/13/2021	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Mitchell	Angela		6516623607					angela.mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Employer Waiver Contact	Director, Gov't Program Management for Medicare		Hower	Sara		6516624156					sara.hower@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Encounter Data & Risk Adjustment Operations Contact	VP Medicare	Mr.	Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Enrollment Contact	Mgr Business Infrastructure Services		McWaters	Alisha		6516621755					alisha.mcwaters@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	EOB Transfer Contact	Mgr Project & Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Financial Reporting Contact	Dir Sr Corporate Controller		Long	Darlene		6516621704					Darlene.Long@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Formulary Contact	Pharmacist Business Segment Director		Boreen	Donna		6516621264					donna.boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2018	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Formulary Contact (Secondary)	Supervisor, Formulary Operations		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	General Contact	VP Medicare		Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	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	Chief Lobbyist		Nelson	Lin		6516627123					lin.nelson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	HIPAA Privacy Officer	Privacy Director		Armstrong	Rebecca		6516622186					rebecca.armstrong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/13/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	HIPAA Security Officer	VP Digital Platforms & Cybersecurity		Groshong	Chris		6516622878					chris.groshong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	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		6516629644					beth.dick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/19/2019	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Interoperability Contact	Chief Information Officer		Flicek	Melissa		6516629995					Melissa.flicek@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	MA Appeals/Grievances Contact	Manager Appeals & Grievances		Bazzarre	Tom		6516623532					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	MA Claims Processing Contact for Public Website	Manager, Business Services		Daniels	Cassandra		6516623468					cassandra.daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Marketing Contact	Compliance Manager- Enterprise Ethics & Compliance		Danisch	Gary		6516622072					Medicare.materials@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/08/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Medical Director	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	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		6516621900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Medicare Coordinator	Manager, Business Services		Daniels	Cassandra		6516623468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Medicare Part D Opioid Overutilization Contact	Supv Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/07/2022	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Medication Therapy Management Contact	Mgr. Pharmacy Services		Aderinkomi	Anita		6516629221					anita.aderinkomi@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	OffShore Subcontractor Contact	Government Compliance Officer		Hogan	Carrie		6516621900					Carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/26/2023	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Online Enrollment Center Contact (Back-up)	Manager, Business Services		Daniels	Cassandra		6516623468				6516623500	cassandra.daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Online Enrollment Center Contact (Primary)	Mgr Business Infrastructure Services		McWaters	Alisha		6516621755					alisha.mcwaters@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Part C Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/07/2023	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Part C Reporting Contact	Operations Business Analyst Pr		Littrell	Sue		6516622670					sue.littrell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/05/2023	2026	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 Appeals	Regulatory Pharmacist Sr		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	8006936703				Cost1		1	Chicago
H2461	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	8006936703				Cost1		1	Chicago
H2461	Part D Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/07/2023	2026	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 Benefits Contact	Director, Benefits Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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 Claims Submission Contact	Health Data Analyst Sr.		Brooke	Lance		4026862603				4029702545	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	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	Regulatory Pharmacist Sr		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	8006936651				Cost1		1	Chicago
H2461	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	8006936651				Cost1		1	Chicago
H2461	Part D Price File Contact (Back-up)	Business Solution Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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 Price File Contact (Optional)	Price File Analyst		Tastad	Emily		6517771699					emily.tastad@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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 Price File Contact (Primary)	PBM Operations Analyst		Aschoff	Ted		6516628777					theodore.aschoff@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	04/22/2025	2026	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 Quality Assurance Contact	Director, Pharmacy Ops Support		Ibrahim	Sonya		6516627412					Sonya.Ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	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 Reporting Contact	Operations Business Analyst Pr		Littrell	Sue		6516622670					sue.littrell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	05/12/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Patient Safety Contact	Pharmacist Business Segment Director		Boreen	Donna		6516621264					donna.boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/13/2020	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Payment Contact	Dir. Sr. Corporate Controller		Long	Darlene		6516621704					Darlene.Long@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Pharmacy Director	Pharmacist Business Segment Director		Boreen	Donna		6516621264					Donna.Boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/28/2018	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Pharmacy Network Management Contact	VP Network Management		Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Pharmacy Network Management Contact (Secondary)	AVP Network Relations		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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	Sr Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	8006482778				Cost1		1	Chicago
H2461	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active	8554571209				Cost1		1	Chicago
H2461	PHR Beneficiary Contact																	07/17/2019	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost	Blue Cross and Blue Shield of Minnesota	Aware Integrated, Inc.	642	Yes	Active	8003822000				Cost1		1	Chicago
H2461	Plan Directory Contact for Public Website	Digital Content Strategist		Cosgrove	Patrick		6516623727					patrick.cosgrove@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Plan to Plan Reconciliation Contact	Manager, Financial Reporting		Harrelson	Michael		6516628490				6516622200	Michael.Harrelson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722				6127777606	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/21/2022	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Quality Contact	VP Medicare	Mr.	Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Reconciliation Contact	Managing Actuary-Actuarial		Santa	Tyler		6516628362					Tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Reconciliation Contact (Secondary)	Healthcare Analyst Principle-Actuarial		Kieffer	Ryan		6516624405					Ryan.kieffer@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Surveillance Contact	Manager , Channel Management and Oversight		Moomey	Kristina		6516627792					kristina.moomey@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	System Contact	VP Digital Product Engineering	Mr.	Young	Jeffrey		6516626767					Jeffrey.young@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/10/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Third Party Administrator (TPA) Liaison	Financial Analyst Senior		Voves	Alex		6516623606					Alex.Voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	User Access Contact	Compliance Manager- Enterprise Ethics & Compliance		Danisch	Gary		6516622072					Gary.danisch@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	05/12/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Utilization Management Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2461	Utilization Review Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	BCBSM, Inc.	1876 Cost	Blue Cross and Blue Shield of Minnesota	1876 Cost		Aware Integrated, Inc.	642	Yes	Active					Cost1		1	Chicago
H2462	Agent/Broker Compensation Data Contact	VP Government Programs		Clelland	Jennifer	J	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	11/04/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Automated TrOOP Balance Transfer Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Backup User Access Contact	Coordinator Government Programs		Yu	Chao		9528837240					Chao.X.Yu@HealthPartners.com	8170 33rd Avenue South		Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Best Available Evidence Contact	Sr. Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Bid Primary Contact	Vice President, Actuary		Stewart	Sara	M	9528835049					sara.m.stewart@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21105H	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	CAP Report Contact for Public Website	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	CEO - CMS Administrator Contact	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/06/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	CEO - Senior Official for Contracting	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/04/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Chief Financial Officer	SVP & Chief Financial Officer	Ms.	Johnson	Kathleen	A	9528836531					kathy.a.johnson1@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	554401309	03/29/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Chief Operating Officer	EVP, Health Engagement and Informatics Officer	Ms.	Knudson	Susan	M	9528836185					susan.m.knudson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110A	Minneapolis	MN	554401309	02/04/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Chief Information Officer	Senior Vice President and CTO	Mr.	Thull	Tim	D	9528837636					timothy.d.thull@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/16/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Chief Information Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	HEALTHPARTNERS, INC.	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	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Complaints Tracking Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Contact for Fraud Investigations	Senior Manager Claims		Dahlberg	Kara	A	9529675640					kara.a.dahlberg@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  25510F	Minneapolis	MN	55101	07/09/2024	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Coordination of Benefits Contact	Manager, Claims Production		Prine	Chantelle	M	9529677335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Corporate Mailing						9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	05/21/2015	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Cost Report Contact	Director Corporate Finance Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, P.O. Box 1309	MS: 21109A	Bloomington	MN	554251309	12/07/2016	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Customer Service Operations Contact	Director Member Services		Renneke	Alison		9529677668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	554409463	01/29/2020	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	DIR Contact	Sr. Pharmacy Plan Contract Manager		Reinhardt	Sandra	L	9528836739					sandra.l.reinhardt@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	DIR Contact (Secondary)	Consultant, Data Analysis		Binsfeld	David	T	9529675950					david.t.binsfeld@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS 21108Q	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Discount Program Payment Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Emergency Part D Contact	Sr. Director Pharmacy Services		Strahl	Christine	L	9528835022				9529676667	christine.l.strahl@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Emergency Part D Contact (Secondary)	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Employer Waiver Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Encounter Data & Risk Adjustment Operations Contact	Senior Manager Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South	MS: 21103J	Minneapolis	MN	55425	02/19/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Enrollment Contact	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	EOB Transfer Contact	Sr. Manager Claims Production		Huseby	Pam	J	9529675530				9528837666	pam.j.huseby@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	08/30/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Financial Reporting Contact	Director Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	05/21/2015	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Formulary Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Formulary Contact (Secondary)	Formulary Administration Pharmacist		Savage	Robert		8587906426					robert.savage@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Ct.	San Diego	CA	92131	07/24/2019	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	General Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Government Relations Contact	VP Government Programs		Clelland	Jennifer	J	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	08/30/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	HIPAA Privacy Officer	Sr. Director Integrity Compliance Privacy Officer		Wells	Prasanta	K	9528837325					prasanta.k.wells@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103K	Minneapolis	MN	554401309	05/27/2015	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	HIPAA Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Hospice Contact	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Interoperability Contact	Program Manager, IT		Geisler	Chris	J	6122479067					Chris.J.Geisler@HealthPartners.Com	8170 33rd Avenue S		Bloomington	MN	55425	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	MA Appeals/Grievances Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	MA Claims Processing Contact for Public Website	Sr. Manager Claims Production		Huseby	Pam	J	9529675530					RVSCProviderInquiry@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Marketing Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Medical Director	Health Plan Chief Medical Officer	Dr.	Kakacek	Virginia	L	9528837120					virginia.l.kakacek@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110Q	Minneapolis	MN	554401309	09/21/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Medicare Compliance Officer	Director, Integrity and Compliance	Ms.	Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	11/17/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Medicare Coordinator	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Medicare Part D Opioid Overutilization Contact	Pharmacy UM System and Data Analyst		Hamm	Sarah	K	9529677652					sarah.k.hamm@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Medication Therapy Management Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Online Enrollment Center Contact (Back-up)	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Online Enrollment Center Contact (Optional)	Admin Product Implementation Manager		Wessel	Sara	C	9529677623					sara.c.wessel@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/29/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Online Enrollment Center Contact (Primary)	Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/09/2018	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part C Application Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part C Reporting Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Appeals	Manager Member Rights and Benefits		Kruse	Morgan	L						Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS:  21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active	8007963806				Cost1		1	Chicago
H2462	Part D Appeals Contact (Secondary)	Supervisor, Member Rights and Benefits		Dress	Samantha							Samantha.L.Dress@HealthPartners.com	8170 33rd Avenue South	MS: 21103R	Bloomington	MN	55425	12/06/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active	8007963806				Cost1		1	Chicago
H2462	Part D Application Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Benefits Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Claims Submission Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Exceptions Contact	Supervisor, Clinical Review		Whelan	Hillary	A					8888835434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	11/23/2020	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active	8004927259				Cost1		1	Chicago
H2462	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Price File Contact (Primary)	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Quality Assurance Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21108T	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Part D Reporting Contact	Director Medicare and Government Program		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Patient Safety Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Payment Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	05/09/2013	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Pharmacy Director	VP Pharmacy		Busch	David	L	9529675049					david.l.busch@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	06/25/2020	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Pharmacy Network Management Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Pharmacy Network Management Contact (Secondary)	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	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					8888835434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/19/2022	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active	8004927259				Cost1		1	Chicago
H2462	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Customer Service		Sahs	Dale							dale.sahs@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active	8009221557				Cost1		1	Chicago
H2462	Plan Directory Contact for Public Website			Services	Provider		9528837699					RVSCProviderInquiry@HealthPartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	06/10/2013	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Plan to Plan Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Processor Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina		9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Quality Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Surveillance Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	System Contact	Senior Manager Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21193J	Minneapolis	MN	554401309	02/19/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Third Party Administrator (TPA) Liaison	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/11/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	User Access Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Utilization Management Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2462	Utilization Review Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	1876 Cost	HealthPartners	1876 Cost		HealthPartners, Inc.	117	Yes	Active					Cost1		1	Chicago
H2463	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2463	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H2463	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2463	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H2463	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H2463	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H2463	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2463	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN OF TEXAS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2478	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H2478	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H2478	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H2478	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H2478	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H2478	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF NEVADA INC	Local CCP	Molina Healthcare of Nevada	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H2478	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2486	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H2486	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2486	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H2486	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H2486	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H2486	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2486	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF UTAH, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2491	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H2491	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H2491	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H2491	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H2491	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/11/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H2491	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H2491	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H2491	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2491	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2509	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H2509	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2509	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2509	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H2509	Plan Directory Contact for Public Website			Customer Service	UHC		8668424968					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2509	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF FLORIDA, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2526	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H2526	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H2526	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H2526	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H2526	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H2526	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H2526	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H2526	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2526	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2541	Automated TrOOP Balance Transfer Contact	Operations Manager	Ms	Mourgos	Diane		7076154437				7076156955	dmourgos@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Backup User Access Contact	Executive Assistant	Ms	Mourgos	Diane		7076154437				7076156955	dmourgos@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Best Available Evidence Contact	Executive Director	Ms.	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Bid Primary Contact	Executive Director	Ms.	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	CAP Report Contact for Public Website	Executive Director		Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	CEO - CMS Administrator Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	CEO - Senior Official for Contracting	Executive	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Chief Financial Officer	Finance Director	Ms	Mok	Jane		7076154437					jmok@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	09/14/2023	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Chief Operating Officer	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	12/10/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Chief Information Officer	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Chief Information Security Officer	Executive Director	Mr	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	CMS Casework Communication Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Complaints Tracking Contact	QI Director		Godinez	Juan		7076154437					Jgodinez@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/18/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Contact for Fraud Investigations	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Coordination of Benefits Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Corporate Mailing						7076154437					cfalley@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	05/06/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Customer Service Operations Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	DIR Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	12/31/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	DIR Contact (Secondary)	Health Plan Specialist	Ms	Galisanao	Sharon		7076154437					sgalisanao@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	09/18/2023	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Discount Program Payment Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	12/31/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Emergency Part D Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Emergency Part D Contact (Secondary)	Medical Director	Ms	Yukiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Encounter Data & Risk Adjustment Operations Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Enrollment Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	EOB Transfer Contact	Operations Manager	Ms	Mourgos	Diane		7076154437				7076156955	dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Financial Audit Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Financial Reporting Contact	Operations Manager	Ms	Mourgos	Diane		7076154437				7076156955	dmourgos@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Formulary Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Formulary Contact (Secondary)	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	General Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Government Relations Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	HIPAA Privacy Officer	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	HIPAA Security Officer	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Interoperability Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	MA Appeals/Grievances Contact	Executive  Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	MA Claims Processing Contact for Public Website	Executive  Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Marketing Contact	Assistant	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Medical Director	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	09/18/2023	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Medicare Compliance Officer	Executive Director	Ms	Stambaugh	Kathryn		7076154437					kstambaugh@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Medicare Coordinator	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Medicare Part D Opioid Overutilization Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Medication Therapy Management Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	OffShore Subcontractor Contact	Executive Director		Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Online Enrollment Center Contact (Back-up)	Executive Director		Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part C Application Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Appeals	Medical Director	Ms	Yurkiewicz	Shara							syurkiewicz@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active	7076154437				PACE - Nat		C	San Francisco
H2541	Part D Appeals Contact (Secondary)	Operations Manager	Ms	Mourgos	Diane							dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active	7076154437				PACE - Nat		C	San Francisco
H2541	Part D Application Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Benefits Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Claims Submission Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Exceptions Contact	Medical Director	Ms	Yurkiewicz	Shara							syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active	7076154437				PACE - Nat		C	San Francisco
H2541	Part D Exceptions Contact (Secondary)	Operations Manager	Ms	Mourgos	Diane							dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active	7076154437				PACE - Nat		C	San Francisco
H2541	Part D Price File Contact (Back-up)	Health Plan Specialist	Ms	Galisanao	Sharon		7076154437					sgalisanao@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	09/18/2023	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Price File Contact (Optional)	Operations Manager		Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr.		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Price File Contact (Primary)	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Quality Assurance Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Part D Reporting Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Patient Safety Contact	Medical Director	Dr.	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/10/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Payment Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Personal Health Record Contact	Executive Director	Ms.	Stambaugh	Kathryn		7076154437					kstambaugh@agewell.org	5789 State Farm Dr.	Suite 110	Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Pharmacy Director	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Pharmacy Network Management Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Pharmacy Network Management Contact (Secondary)	Health Plan Specialist	Ms	Galisanao	Sharon		7076154437					sgalisanao@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	09/18/2023	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Pharmacy Technical Help Desk Contact	Operations Manager	Ms	Mourgos	Diane							dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active	7076154437				PACE - Nat		C	San Francisco
H2541	Plan Directory Contact for Public Website	Assistant	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Plan to Plan Reconciliation Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Processor Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Quality Contact	Director of Quality and Compliance	Mr	Godinez	Juan		7076154437					jgodinez@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	03/09/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Reconciliation Contact	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	12/31/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Reconciliation Contact (Secondary)	Executive Director		Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Recovery Audit Contact	Executive Director	Ms.	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr Ste 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Surveillance Contact	Executive Director	Ms	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	System Contact	Executive Director	Mr	Stambaugh	Kathryn		7076154437				7076156955	kstambaugh@agewell.org	5789 State Farm Dr. Suite 110		Rohnert Park	CA	94928	04/22/2025	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Third Party Administrator (TPA) Liaison	Operations Manager	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	12/31/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	User Access Contact	Assistant	Ms	Mourgos	Diane		7076154437					dmourgos@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Utilization Management Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2541	Utilization Review Contact	Medical Director	Ms	Yurkiewicz	Shara		7076154437					syurkiewicz@agewell.org	5789 State Farm Dr Suite 110		Rohnert Park	CA	94928	07/09/2024	2026	AGEWELL PACE	National PACE	AgeWell PACE	National PACE		AgeWell PACE	810	Yes	Active					PACE - Nat		C	San Francisco
H2563	Agent/Broker Compensation Data Contact	Sr. Director, Consumer Products & Sales		McVey	Kathy		7574181231					kemcvey@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Benefits		Strickland	Brandi		7572528193				7579625575	RxBenefits@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Backup User Access Contact	Compliance Consultant		Harvey	Kimberly		8046134890	20178				kdharvey@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Best Available Evidence Contact	Director Enrollment & Disenrollment		Brown	Sheila		7572528015				7576925575	sxbrown29@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Bid Audit Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Bid Audit Site Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Bid Primary Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	CAP Report Contact for Public Website	Medicare Contract Administrator		MEDICARE	SENTARA		7576876160				7575527116	jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	03/04/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8009276048				HMO - Health Maintenance Organization		C	Dallas
H2563	CEO - CMS Administrator Contact	VP, Government Programs	Mr	Whitehead	Steve		7579832538					srwhiteh@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	CEO - Senior Official for Contracting	VP, Government Programs	Mr	Whitehead	Steve		7579832538					srwhiteh@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Chief Financial Officer	SVP & CFO	Ms.	Campbell	Sharilyn		2068980702					sxcamp11@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Chief Operating Officer	VP, Government Programs	Mr	Whitehead	Steve		7579832538					srwhiteh@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/27/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Chief Information Officer	VP Information Systems	Mr	Schrecengost	Jeff		7575803501					JRSCHREC@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Siddiqui	Zishan		7572520015				7579638689	zasiddiq@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	CMS Casework Communication Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Complaints Tracking Contact	Manager, Regulatory Compliance		Jones	Uyvonka		8043398376					UXJONES@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	03/04/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Contact for Fraud Investigations	Director , Program Integrity/SIU		Abenante	Carrie		7576876405					clabenan@sentara.com	1330 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Coordination of Benefits Contact	Sr. Compliance Consultant	Ms	Godette	Maricelis		8048195151					mxcintro@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Corporate Mailing						5704920915				7575527116	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Customer Service Operations Contact	Sr. Director, Customer Services		Bain	Shenna		8133348871				7575527116	sxlucasb@sentara.com	10800 Nuckols Road		Glen Allen	VA	23060	02/11/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	DIR Contact	Director Pharmacy Performance		Hartzell	Lindsay		8048195179				7579625575	lxhartze@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	DIR Contact (Secondary)	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Discount Program Payment Contact	Director Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Emergency Part D Contact	Clinical Pharmacist		Rasnick	Dorothy		7579834243				7579625575	dxrasnic@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Emergency Part D Contact (Secondary)	Manager Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Employer Waiver Contact	Director Government Programs - Medicare		Hoffman	Daniel		7579832540				7575527396	dehoffma@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Encounter Data & Risk Adjustment Operations Contact	Director, Actuary		Ratzlaff	Dean		7576876018					daratzla@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	08/04/2023	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Enrollment Contact	Director, Enrollment		Brown	Sheila		7572528015					sxbrown29@sentara.com	4456 Corporation Lane		Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	EOB Transfer Contact	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625576	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Financial Audit Contact	Director, Medicare Compliance	Ms.	Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Financial Reporting Contact	VP & Controller		Snyder	Jeff		7572528023				7572528030	jcsnyder@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Formulary Contact	Clinical Pharmacist		Rasnick	Dorothy		7579834243				7579625575	dxrasnic@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Formulary Contact (Secondary)	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	General Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Government Relations Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	HIPAA Privacy Officer	Director, Compliance	Ms.	Dajon	Sharon	M	7575527485				7575527116	smdajon@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Siddiqui	Zishan		7572520015				7579638689	zasiddiq@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Hospice Contact	Director Pharmacy Ops & Compliance		May	Crystal		8666037514				7579625575	ccmay2@sentara.com	10800 Nuckols		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Interoperability Contact	VP, Information Systems		Brown	Marty		3056710216					Marty.brown@avmed.org	3470 NW 82nd St.		Doral	FL	33122	03/04/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	MA Appeals/Grievances Contact	Director Appeals & Grievance		Byrd	Natasha		8048195151				7576876232	nxbyrd@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	08/04/2023	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	MA Claims Processing Contact for Public Website	Director Ops Support		Rodriguez	Joseph		7579834333				7572528030	jxrodr10@sentara.com	10800 Nuckols Rd		Glen Allen	VA	23060	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Marketing Contact	Medicare Director of Marketing and Communications		Matteson	Erin		5135430355					elmattes@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Medical Director	CMO Health Plan	Dr.	Greifer	Kristyn		6782748402				7572267944	KXGREIFE@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Medicare Coordinator	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Papcun	Richard		8043013903				7579625575	RFPAPCU1@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Medication Therapy Management Contact	Clinical Pharmacist		Rasnick	Dorothy		8043013903				7579625575	DXRASNIC@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	06/19/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Erie	James		8048195151					jxerie@sentara.com	4456 Corporate Lane		Virginia Beach	VA	23462	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Online Enrollment Center Contact (Optional)	Sr. Business Analyst, Medicare		Ashar	Satish		8048195151	302				sdashar@sentara.com	4456 Corporate Lane		Virginia Beach	VA	23462	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Online Enrollment Center Contact (Primary)	Director, Enrollment		Brown	Sheila		7572528015					sxbrown29@sentara.com	4456 Corporation Lane		Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part C Application Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	12/08/2023	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part C Reporting Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	12/08/2023	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Appeals	Clinical Pharmacist		Rasnick	Dorothy						7579625576	dxrasnic@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	7579834243				HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Appeals Contact (Secondary)	Manager Pharmacy Compliance		Allen	Emily						7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8048144500				HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Application Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Benefits Contact	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Claims Submission Contact	Manager, Pharmacy Benefits		Strickland	Brandi		7572528193				7579625575	RxBenefits@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Exceptions Contact	Clinical Pharmacist		Rasnick	Dorothy						7579625576	dxrasnic@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	7579834243				HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Exceptions Contact (Secondary)	Manager Pharmacy Compliance		Allen	Emily						7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8048144500				HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Price File Contact (Back-up)	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Price File Contact (Optional)	Director Pharmacy Performance		Hartzell	Lindsay		8048195179				7579625575	lxhartze@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Price File Contact (Primary)	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Quality Assurance Contact	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Part D Reporting Contact	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7576925576	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Patient Safety Contact	Clinical Pharmacist		Rasnick	Dorothy		7579834243				7579625575	dxrasnic@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Payment Contact	Director, Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Pharmacy Director	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Pharmacy Network Management Contact	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	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	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H2563	Physician Incentive Contact	VP Network Management & Value Based Care		Krebbs	Robert		8045728832				7575527576	rlkrebbs@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	07/19/2024	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Plan Directory Contact for Public Website	Member Services		MEMBER SERVICES	OPTIMA		8009276048					members@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/11/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Plan to Plan Reconciliation Contact	Director Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Processor Contact	Director Ops Support		Rodriguez	Joseph		7579834333				7572528030	jxrodr10@sentara.com	10800 Nuckols Rd		Glen Allen	VA	23060	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Quality Contact	Director Quality Improvement		Taylor	Tonya		8046136524					tptaylor@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Reconciliation Contact	Director, Accounting Operations	Ms.	Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Reconciliation Contact (Secondary)	Manager Actuarial Support		Wimalendran	Shane		7575528944					uxwimale@sentara.com	1330 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Recovery Audit Contact	Director, Accounting Operations	Ms.	Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	SNP Application Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	12/08/2023	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	SNP State Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	12/08/2023	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Surveillance Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	System Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Third Party Administrator (TPA) Liaison	Director Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	User Access Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Utilization Management Contact	Director Utilization Management		Barber-Euresti	Jessica		8045862351				7575527108	jxbarber@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	11/03/2024	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2563	Utilization Review Contact	Director Utilization Management		Barber-Euresti	Jessica		8045862351					jxbarber@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	12/08/2023	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2564	Agent/Broker Compensation Data Contact	National Director Retail Sales	Mr.	Javor	Chris		2159378396					cjavor@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Automated TrOOP Balance Transfer Contact	Business Systems Analyst	Ms.	Murray	Karla		2672985899					kdmurray@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Backup User Access Contact	Medicare Compliance Sr Operations Analyst	Ms	Morris	Gail		2158635141					gpmorris@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Bid Audit Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Bid Audit Site Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Bid Primary Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	05/07/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	CEO - CMS Administrator Contact	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	CEO - Senior Official for Contracting	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Chief Operating Officer	President, Medicare Markets	Mr.	McDade	Chris		5704179770					cmcdad@amerihealthcaritas.com	AmeriHealth Caritas Families of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Chief Information Officer	Exec. Vice President, Chief Information Officer	Mr.	Dickson	Fred		2158636570					fdickson@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	CMS Casework Communication Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Complaints Tracking Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Contact for Fraud Investigations	Director, SIU	Mr.	McCall	Trevor		4844971241					tmccall2@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Coordination of Benefits Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Corporate Mailing						2159378725					KGrimmett@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive, 1st Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		2672981794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	DIR Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/07/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	DIR Contact (Secondary)	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2824045991					AKindred@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Discount Program Payment Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Electronic Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Emergency Part D Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Emergency Part D Contact (Secondary)	VP, Corporate Pharmacy		Cherian	Sheena		2158635768					scherian@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	2002 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare ACA and Risk Adjustment	Mr.	Greer	Kevin		2159378761					kgreer@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Enrollment Contact	Manager, Enrollment Operations	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	EOB Transfer Contact	VP, Medicare Claims	Mr.	Boyer	Joseph		2158636668				2159375321	jboyer@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Financial Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					ak16850@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Financial Reporting Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Formulary Contact	Director of Clinical Services, Formulary/DUR	Ms.	Megargell	Lauren		2159374135					Lauren.megargell@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	General Contact	VP, Medicare Strategy & Execution	Mr.	Sukhu	Chistopher		4844233175					csukhu@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	06/27/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Government Relations Contact	VP, Public Policy	Mr.	Cozzo	Steven		2159378236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	HIPAA Privacy Officer	Director Privacy	Ms.	Desipio	Nicole		4844971132					ndesipio@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Hospice Contact	Dir.  Medicare Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Interoperability Contact	Director, Medicare Performance Management		Kindred	Amanda		2484045991					akindred@amerihealthcaritas.com	4000 Town Center	Suite 1300	Southfield	MI	48075	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	MA Appeals/Grievances Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	MA Claims Processing Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Marketing Contact	Medicare Compliance Sr Operations Analyst	Ms.	Morris	Gail	P	2158635141					gpmorris@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Medical Director	Chief Medical Officer, Population Health	Dr.	Wright	Julia		2159378000					jwright6@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		2035068413					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Medicare Coordinator	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Medication Therapy Management Contact	Director, Clinical Outcomes & Therapeutic Optimiz	Ms.	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	OffShore Subcontractor Contact	Esquire	Ms.	Sitner	Roni		8602149125					rsitner@ameriheathcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Online Enrollment Center Contact (Primary)	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part C Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part C Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Appeals	Director,  Medicare Appeals and Grievances	Ms.	Lopez	Yismell							yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158635677				HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Appeals Contact (Secondary)	Manager, Medicare Appeals & Grievance	Ms.	Smith-Cooks	Tiarra							tsmithcooks@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2151112917				HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Benefits Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Claims Submission Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Prior Authorization	Mr.	McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Price File Contact (Back-up)	Medicare Part D program Analyst	Ms.	Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Price File Contact (Optional)	Medicare Part D Program Analyst	Ms	Wiehe	Heather		4127156363					heather.weihe@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Price File Contact (Primary)	Medicare Part D Program Anaylst	Ms.	West	Ariel		3133781225					Ariel.West@abarcahealth.com	PerformRx	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Part D Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Patient Safety Contact	Director,Clinical Outcomes &Therap Optimization	Ms	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Payment Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Personal Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Pharmacy Director	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Pharmacy Network Management Contact	President, Network Strategy	Mr	Sullivan	Tim		6303303638					tssullivan@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Pharmacy Network Management Contact (Secondary)	Network Operations Analyst	Mr.	Kramerov	Allen		2159374120					akramerov@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Pharmacy Technical Help Desk Contact	Manager, Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H2564	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H2564	PHR Beneficiary Contact																	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS	AmeriHealth Caritas	Independence Health Group, Inc.	609	Yes	Active	2672985710				HMO - Health Maintenance Organization		C	Chicago
H2564	Physician Incentive Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Plan Directory Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Plan to Plan Reconciliation Contact	Director, Finance	Ms	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	P.O. 7137	London	KY	40742	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Processor Contact	Director of Clincal Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerFormrx	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Quality Contact	Director, Quality Management	Ms.	Popiolek	Rose		6107234450					rpopiolek@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Reconciliation Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Reconciliation Contact (Secondary)	Manager, Medicare Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Recovery Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	SNP Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	SNP State Contact	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Surveillance Contact	Director, Retail Sales Operations	Ms.	Bech	Mary		4146875533					mbech@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	System Contact	Manager, Medicare IS	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Third Party Administrator (TPA) Liaison	Manager, MCR Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/06/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	User Access Contact	Medicare Compliance Officer	Ms	Dupre	Colleen		2035068413					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Utilization Management Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2564	Utilization Review Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS LOUISIANA, INC.	Local CCP	AmeriHealth Caritas VIP Care (HMO-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Electronic Health Record Contact	Dir I Technology	Mr.	Vellala	Nagaraju		7574732737	34790				Nagaraju.Vellala@amerigroup.com	5800 Northhampton Blvd		Norfolk	VA	23502	01/05/2017	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/10/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H2593	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H2593	PHR Beneficiary Contact																	02/07/2019	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H2593	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Reconciliation Contact (Secondary)			Li	Zhiru		5622073707					Zhiru.Li@caremore.com	12900 Park Plaza Drive	Suite 150	Cerritos	CA	90703	03/09/2016	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2593	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT TEXAS, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2610	Agent/Broker Compensation Data Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/09/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Automated TrOOP Balance Transfer Contact	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/04/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Backup User Access Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Best Available Evidence Contact	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63131	08/04/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Bid Audit Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Bid Audit Site Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Bid Primary Contact	LEAD ACTUARY		Wolfe	Brandon		8158215190					brwolfe@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	CAP Report Contact for Public Website	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	CEO - CMS Administrator Contact	COO	Ms.	Slattery	Lisa		3147705644					lslattery@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/08/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	CEO - Senior Official for Contracting	President Essence HealthCare	Mr.	Reigel	Jordan		7202528130					jreigel@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/30/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Chief Financial Officer	Chief Financial Officer	Ms.	Venable	Erin		3143243689					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	05/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Chief Operating Officer	Chief Operating Officer	Ms.	Slattery	Lisa		3147705644					lslattery@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Chief Information Officer	Chief Technology Officer	Mr.	Saghabini	JeanClaude		6173124659					jsaghbini@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/15/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Chief Information Security Officer	Chief Information Security Officer	Mr.	Vannatta	Aaron		3147703700					avannatta@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2021	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	CMMI Model Point of Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	CMS Casework Communication Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Complaints Tracking Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Contact for Fraud Investigations	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Coordination of Benefits Contact			Inquiries	COB		8665979560					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Corporate Mailing						8665979560					customerservice@essencehealthcare.com	CUSTOMER SERIVCE	P O BOX 5907	TROY	MI	48007	12/06/2022	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Customer Service Operations Contact	Vice President, Health Plan Operations	Ms.	Meyerhoffer	Linda		6366869682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	DIR Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	DIR Contact (Secondary)	Sr. Manager, Compliance Monitoring & Reporting	Ms.	Young	Polly		3142092795					pyoung@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	06/23/2022	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Discount Program Payment Contact	Sr Manager, Accounting		Almond	Barry		3142093068					balmond@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	06/20/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Emergency Part D Contact	VP, Health Plan Pharmacy		Wirick	Jennifer		7038585477					jwirick@lumeris.com	13900 Riverport Dr		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment Services	Mr.	Eschbach	Jason		6144397608					jeschbach@lumeris.com	13900 Riverport Drive		St. Louis	MO	63043	12/08/2022	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Enrollment Contact	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63131	08/04/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	EOB Transfer Contact	Sr. Director Payment Strategy & Operations		Price	Alex		3142092800				8884802577	alprice@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/22/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Financial Audit Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Financial Reporting Contact	VP, Health Plan Finance		McGinnis	Lisa		3142092780					lmcginnis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Formulary Contact	VP, Health Plan Phamacy	Ms.	Wirick	Jennifer		7028585477					jwirick@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	06/20/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Formulary Contact (Secondary)	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	General Contact	President Essence HealthCare	Mr.	Reigel	Jordan		7202528130					jreigel@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/30/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		3142092717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/17/2019	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Davis	Amy		3142093945					adavis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2021	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	HIPAA Security Officer	CISO	Mr.	Vannatta	Aaron		3147703700					avannatta@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/26/2020	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Hospice Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Interoperability Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	MA Appeals/Grievances Contact	Sr. Director, Appeals & Grievances	Ms.	Darnell	Erika		3162145746					edarnell@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/18/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	MA Claims Processing Contact for Public Website			Service	Customer		8665979560				8884802577	customerservice@essencehealthcare.com	P O BOX 5907		TROY	MI	48007	12/06/2022	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Marketing Contact	Director, Compliance Marketing	Mr.	Ruiz	Lee		6366869602					lruiz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/10/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Medical Director	Chief Medical Officer EHI		Saccocio	Saria		3142092800					ssaccocio@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/06/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Medicare Compliance Officer	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Medicare Coordinator	Chief Operating Officer	Ms.	Slattery	Lisa		3147705644					lslattery@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Medication Therapy Management Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	OffShore Subcontractor Contact	VP Compliance, Medicare CO		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Online Enrollment Center Contact (Back-up)	Director, Compliance	Mr.	Ruiz	Lee		6366869602					lruiz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/10/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Online Enrollment Center Contact (Optional)	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Online Enrollment Center Contact (Primary)	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63131	08/04/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part C Application Contact	Sr. Director CMS Applications & PBP submissions	Mr.	Moser	Phil		3142092725					pmoser@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2021	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part C Reporting Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Appeals	Sr. Director, Appeals & Grievances	Ms.	Darnell	Erika							edarnell@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/15/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	3162145746				HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Appeals Contact (Secondary)	Director, Compliance	Ms.	Burgess	Sandra							sburgess@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/10/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	3142092886				HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Application Contact	Sr. Director, CMS Applications & PBP Submissions	Mr.	Moser	Phil		3142092725					pmoser@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/10/2021	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Benefits Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_Dovico@express-scripts.com	One Express Way,		St Louis	MO	63121	11/26/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Exceptions Contact	Sr. Manager Pharmacy Prior Authorization		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way,	Mail Stop S13NB	St Louis	MO	63121	01/02/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	9013817109				HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Price File Contact (Back-up)	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Price File Contact (Optional)	Director, Compliance		Burgess	Sandy		3142092886					sburgess@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolphi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way,	Building 1	St Louis	MO	63121	10/21/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Part D Reporting Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Patient Safety Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Payment Contact	Vice President, Health Plan Finance	Ms.	McGinnis	Lisa		3142092780					lmcginnis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/17/2019	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Pharmacy Director	VP, Health Plan Pharmacy		Wirick	Jennifer		7038585477					jwirick@lumeris.com	13900 Riverport Dr		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Pharmacy Network Management Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Pharmacy Network Management Contact (Secondary)	Network Acct. Director, Retail Strategy & Contract		Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way,		St Louis	MO	63121	11/26/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	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	11/26/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H2610	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Operations		Summerfield	Kelly							ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active	3147703788				HMO - Health Maintenance Organization		C	Dallas
H2610	Physician Incentive Contact	Sr. Manager, Health Plan Finance	Mr.	Privott	David		3147703732					dprivott@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/21/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Plan Directory Contact for Public Website			Service	Customer		8665979560					customerservice@essencehealthcare.com	1P O BOX 5907		TROY	MI	48007	12/06/2022	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Plan to Plan Reconciliation Contact	Director, Health Plan Finance	Ms.	Meyer	Jenell		3147703733					jameyer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/09/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Processor Contact	Director, Government Programs Medicare		Steffen	Jeffrey		6363351729					jhsteffen@express-scripts.com	One Express Way,		St Louis	MO	63121	11/26/2024	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Quality Contact	Snr. Director, Quality Improvement		Pattison	Lisa		5082728692					lpattison@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/06/2021	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Reconciliation Contact	Vice President, Health Plan Finance	Ms.	McGinnis	Lisa		3142092780					lmcginnis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/17/2019	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Reconciliation Contact (Secondary)	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Recovery Audit Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Surveillance Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	System Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Third Party Administrator (TPA) Liaison	Sr. Manager, Accounting		Almond	Barry		3142093086					balmond@lumeris.com	13900 Riverport Dr		Maryland Heights	MO	63043	06/20/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	User Access Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Utilization Management Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2610	Utilization Review Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE, INC.	Local CCP	Essence Healthcare	HMO/HMOPOS		Lumeris Group Holdings Corporation	86	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Agent/Broker Compensation Data Contact	Director, Sales & Marketing		Dunn	John		3363651395					jdunn@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Automated TrOOP Balance Transfer Contact	Manager, Business Systems & Data		rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Backup User Access Contact	Chief Operations Officer	Dr	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Best Available Evidence Contact	Business Analyst		Bhupatiraju	Adarsh		5088047430					Adarsh.Bhupatiraju@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	01/11/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Bid Audit Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Bid Primary Contact	Chief Financial Officer		Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	CAP Report Contact for Public Website	President & CEO		Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	CEO - CMS Administrator Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	CEO - Senior Official for Contracting	President & CEO	Mr.	Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Chief Financial Officer	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Chief Operating Officer	Chief Operations Officer	Dr.	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Ave	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Chief Information Officer	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Chief Information Security Officer	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	CMS Casework Communication Contact	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Complaints Tracking Contact	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Contact for Fraud Investigations	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Coordination of Benefits Contact	Manager, Business Systems & Data		Rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	01/11/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Corporate Mailing						8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Customer Service Operations Contact	Director of Operations	Ms.	Cotten	Ashley		8889651965					acotten@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	10/16/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	DIR Contact	Chief Administrative Officer		Wickremeratne	Aruna		5088046923					aruna.w@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	DIR Contact (Secondary)	Manager, Pharmacy Network Analytics		Chaudhary	Sudhakar		5085973931					sudhakar.chaudhary@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Discount Program Payment Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Emergency Part D Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Emergency Part D Contact (Secondary)	Pharmacy Manager	Dr.	Ruedinger	Kevin		3366602249					kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Encounter Data & Risk Adjustment Operations Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Enrollment Contact	Manager, Business Systems & Data		Rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	01/11/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	EOB Transfer Contact	Operations Analyst		Durden	Dillion		8133998273	7142			8133998273	dillon.durden@nirvanahealth.com	600 North Westshore Boulevard suite	suite 900	Tampa	FL	33607	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Financial Audit Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Financial Reporting Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Formulary Contact	Chief Operations Officer	Dr.	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Avenue	STE 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Formulary Contact (Secondary)	Director, PBM Clinical Operations		Adorno	Zelys		5085326745					zelys.Adorno@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	05/23/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	General Contact	President & CEO		Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Government Relations Contact	President & CEO		Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	HIPAA Privacy Officer	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	HIPAA Security Officer	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Hospice Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Interoperability Contact	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	MA Appeals/Grievances Contact	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	MA Claims Processing Contact for Public Website	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Marketing Contact	Medicare Marketing & Communications Manager		Pritchett	Lee		3362688676					lpritchett@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	02/02/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Medical Director	Medical Director	Dr.	Evans	Stephen		3369006094					sevans@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Medicare Compliance Officer	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Medicare Coordinator	Director Strategic Growth & Product Development		McCloy	Tracey		3369005953					tmccloy@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	02/02/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Medicare Part D Opioid Overutilization Contact	Pharmacy Manager	Dr.	Ruedinger	Kevin		3366602249					kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	02/08/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Medication Therapy Management Contact	Chief Operations Officer	Dr.	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Avenue	STE 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	OffShore Subcontractor Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Online Enrollment Center Contact (Back-up)	Director, IT Operations		Inavilli	Ram		5088046864				5088046864	ram.inavilli@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Online Enrollment Center Contact (Primary)	Manager, Business Systems & Data		R	Chanukya		5088046892	7260			5088046892	chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part C Application Contact	Manager of Product Development		McCloy	Tracey		3367904525					tmccloy@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part C Reporting Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Appeals	Pharmacy Manager	Dr.	Ruedinger	Kevin							kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	3366602249				HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Appeals Contact (Secondary)	Chief Operations Officer	Dr	Homer	Deanna							dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	3367904385				HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Application Contact	Manager of Product Development		McCloy	Tracey		3367904525					tmccloy@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Benefits Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Claims Submission Contact	Manager, Business Systems & Data		Rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Exceptions Contact	Clinical Advisor		Morgan	Madeline						5082827171	madeline.morgan@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	8002371992				HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Exceptions Contact (Secondary)	Pharmacy Manager		Ruedinger	Kevin							kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	3366602249				HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Price File Contact (Back-up)	Manager, Business Systems & Data		Chaudhary	Sudhakar		5085973931					sudhakar.chaudhary@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Price File Contact (Optional)	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Price File Contact (Primary)	Technical Business Analyst		Parmar	Vihan		5085973999					vihan.parmar@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Quality Assurance Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Part D Reporting Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Patient Safety Contact	Pharmacy Manager		Ruedinger	Kevin		3366602249					kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Payment Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Pharmacy Director	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Pharmacy Network Management Contact	Chief Administrative Officer		Wickremeratne	Aruna		5088046923				3304058094	aruna.w@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Pharmacy Network Management Contact (Secondary)	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Pharmacy Technical Help Desk Contact	Consumer Services Operations Manager		Carrera	Heylen						5083106372	heylen.carrera@nirvanahealth.com	600 North Westshore Boulevard	suite 900	Tampa	FL	33607	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	8004590984				HMO - Health Maintenance Organization		C	Dallas
H2624	Pharmacy Technical Help Desk Contact (Secondary)	Chief Operations Officer	Dr.	Homer	Deanna							dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	3367904385				HMO - Health Maintenance Organization		C	Dallas
H2624	Plan Directory Contact for Public Website			Service	Customer		8889651965					conciergehta@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Processor Contact	Account Manager		Pradeep	Sneha		5088047369				5088047369	sneha.pradeep@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Quality Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Reconciliation Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Recovery Audit Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	SNP Application Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Surveillance Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	System Contact	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	User Access Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	08/05/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Utilization Management Contact	Medical Director	Dr.	Evans	Steve		3366606094					sevans@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2624	Utilization Review Contact	Medical Director	Dr.	Evans	Steve		3366606094					sevans@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2628	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	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
H2628	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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
H2628	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/05/2025	2026	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
H2628	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	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
H2628	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	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
H2628	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	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
H2628	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/05/2025	2026	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
H2628	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	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
H2628	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	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
H2628	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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
H2628	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	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
H2628	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	02/05/2025	2026	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
H2628	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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
H2628	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	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
H2628	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	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
H2628	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/05/2025	2026	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
H2628	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	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
H2628	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	02/05/2025	2026	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
H2628	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	02/05/2025	2026	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
H2628	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/29/2025	2026	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
H2628	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	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
H2628	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	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
H2628	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	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
H2628	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	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
H2628	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	02/05/2025	2026	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
H2628	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/05/2025	2026	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
H2628	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	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
H2628	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/05/2025	2026	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
H2628	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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
H2628	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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
H2628	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	02/05/2025	2026	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
H2628	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/05/2025	2026	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
H2628	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/05/2025	2026	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
H2628	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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
H2628	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	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
H2628	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/05/2025	2026	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
H2628	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	02/05/2025	2026	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
H2628	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	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
H2628	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/29/2025	2026	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
H2628	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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
H2628	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	08/28/2025	2026	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
H2628	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	05/29/2025	2026	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
H2628	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	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
H2628	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	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
H2628	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	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
H2628	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	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
H2628	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H2628	Part D Appeals Contact (Secondary)	Director, PharmD Medicare Part D CAG		Zanolli	Mindy						8884581406	mindy.zanolli@elevancehealth.com	4361 Irwin Simpson Rd.	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8144498744				HMO - Health Maintenance Organization		C	Chicago
H2628	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	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
H2628	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	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
H2628	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	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
H2628	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H2628	Part D Exceptions Contact (Secondary)	Medicare Product Innovation Director		Floyd	Cari							cari.floyd@anthem.com	1226 Sigler Street		Nashville	TN	37203	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5407984087				HMO - Health Maintenance Organization		C	Chicago
H2628	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	02/05/2025	2026	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
H2628	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	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
H2628	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/05/2025	2026	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
H2628	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	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
H2628	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	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
H2628	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	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
H2628	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/05/2025	2026	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
H2628	Pharmacy Director	Clinical Pharmacy Program Director	Ms.	Gibson	Cathy		5132550202					cathy.j.gibson@carelon.com	4592 Whispering Oak Trail		Cincinnati	OH	45247	02/05/2025	2026	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
H2628	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	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
H2628	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/05/2025	2026	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
H2628	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H2628	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H2628	PHR Beneficiary Contact																	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H2628	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/29/2025	2026	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
H2628	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	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
H2628	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/05/2025	2026	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
H2628	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	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
H2628	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	02/05/2025	2026	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
H2628	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	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
H2628	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/29/2025	2026	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
H2628	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	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
H2628	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	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
H2628	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	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
H2628	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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
H2628	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	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
H2628	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	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
H2628	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	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
H2628	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	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
H2630	Agent/Broker Compensation Data Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Automated TrOOP Balance Transfer Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Backup User Access Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Best Available Evidence Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Bid Audit Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Bid Primary Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	CAP Report Contact for Public Website	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	CEO - CMS Administrator Contact	President/CEO	Mr.	Vo	Frank		6572864323					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	CEO - Senior Official for Contracting	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Chief Financial Officer	Vice President of Finance	Mr.	Rout	Pranab		7144622389					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Chief Operating Officer	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Chief Information Officer	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Chief Information Security Officer	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	CMS Casework Communication Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Complaints Tracking Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Contact for Fraud Investigations	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Coordination of Benefits Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Corporate Mailing						8882565123					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Customer Service Operations Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	DIR Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Discount Program Payment Contact	Vice President of Finance	Mr.	Rout	Pranab		7144622389					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Emergency Part D Contact	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Emergency Part D Contact (Secondary)	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Encounter Data & Risk Adjustment Operations Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Enrollment Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	EOB Transfer Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204				8773613788	carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Financial Audit Contact	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Financial Reporting Contact	Vice President of Finance	Mr.	Rout	Pranab		7144622389					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Formulary Contact	Manager, Formulary Admin	Ms.	Nyawablia	Christina		8587906297					fmt@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Formulary Contact (Secondary)	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	General Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Government Relations Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	HIPAA Privacy Officer	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	HIPAA Security Officer	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Hospice Contact	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Interoperability Contact	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	MA Appeals/Grievances Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	MA Claims Processing Contact for Public Website	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Marketing Contact	Chief Growth Officer	Mr.	Bond	Christophe		6574526244					christopherb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Medical Director	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Medicare Compliance Officer	Chief Risk Officer	Mr.	Brown	Tariq		2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Medicare Coordinator	Chief Risk Officer	Mr.	Brown	Tariq		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Medication Therapy Management Contact	Clinical Solutions Manager III	Ms.	Nguyen	Linh		8587906627					mtmp@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Online Enrollment Center Contact (Back-up)	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Online Enrollment Center Contact (Primary)	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue		Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part C Application Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part C Reporting Contact	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Appeals			Martin	Dawn							Dawn.Martin@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8587907118				HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Appeals Contact (Secondary)	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn						7148459841	carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8882565123				HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Application Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Benefits Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Claims Submission Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Exceptions Contact	Chief Medical Officer	Mr.	Tong	Tri							trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8882565123				HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Exceptions Contact (Secondary)	Director, PA & UM Programs	Ms.	Emoto	Julianne							Julianne.emoto@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8587907104				HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Price File Contact (Back-up)	Medicare Part D Program Manager	Ms.	Keller	Shanon		8587907104					shanon.keller@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/12/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Price File Contact (Primary)	Medicare Part D Program Manager	Ms.	Keller	Shanon		8587907104					shanon.keller@medimpact.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Quality Assurance Contact	Chief Risk Officer	Mr.	Brown	Tariq		2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Part D Reporting Contact	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Patient Safety Contact	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Payment Contact	Vice President of Finance	Mr.	Rout	Pranab		7144622389					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Pharmacy Director	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Pharmacy Network Management Contact	Director, Pharmacy Network Adminstration	Mr.	Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							CustomerService@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8667054182				HMO - Health Maintenance Organization		C	San Francisco
H2630	Plan Directory Contact for Public Website	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Plan to Plan Reconciliation Contact	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Processor Contact	SVP Government Programs and Services	Mr.	Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/04/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Quality Contact	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Reconciliation Contact	Vice President of Finance	Mr.	Rout	Pranab		7144622389					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Reconciliation Contact (Secondary)	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Recovery Audit Contact	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	SNP Application Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Surveillance Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	System Contact	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Third Party Administrator (TPA) Liaison	Vice President of Finance	Mr.	Rout	Pranab		7144622389					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/09/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	User Access Contact	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Utilization Management Contact	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2630	Utilization Review Contact	Chief Medical Officer	Mr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/11/2025	2026	VERDA HEALTH PLAN OF ARIZONA, INC.	Local CCP	Verda Health Plan of Arizona	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	San Francisco
H2663	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H2663	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	02/05/2025	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2663	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF MISSOURI, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H2686	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H2686	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H2686	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H2686	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H2686	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H2686	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H2686	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H2686	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H2687	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/29/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@ingenio-rx.com	4 Varesa		Irvine	CA	92620	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/29/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	08/28/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Appeals Contact (Secondary)	Director, PharmD Medicare Part D CAG		Zanolli	Mindy						8884581406	mindy.zanolli@elevancehealth.com	4361 Irwin Simpson Rd.	Mailstop OH0205-A537	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8144498744				HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Exceptions Contact (Secondary)	Medicare Product Innovation Director		Floyd	Cari							cari.floyd@anthem.com	1226 Sigler Street		Nashville	TN	37203	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5407984087				HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Pharmacy Director	Clinical Pharmacy Program Director	Ms.	Gibson	Cathy		5132550202					cathy.j.gibson@carelon.com	4592 Whispering Oak Trail		Cincinnati	OH	45247	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H2687	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H2687	PHR Beneficiary Contact																	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H2687	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/29/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/29/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/29/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2687	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/05/2025	2026	WELLPOINT SOUTH CAROLINA, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2694	Agent/Broker Compensation Data Contact	CFO		Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Automated TrOOP Balance Transfer Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Backup User Access Contact	CCO		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Best Available Evidence Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Bid Audit Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Bid Audit Site Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Bid Primary Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	CAP Report Contact for Public Website	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Ika	Pooja	V	5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Ika	Pooja	V	5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Chief Financial Officer	Chief Financial Officer	Mr.	Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Chief Operating Officer	Chief Operating Officer	Mr.	Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Chief Information Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Chief Information Security Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	CMS Casework Communication Contact	VP Clinical Operations		Dougherty	Laurene		8136015063					laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Complaints Tracking Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Contact for Fraud Investigations	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Coordination of Benefits Contact	COO		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Corporate Mailing						5088046904					pooja.sammeta@rxadvance.com	136 Turnpike Road		Southborough	MA	01772	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Customer Service Operations Contact	Chief Operating Officer		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	DIR Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	DIR Contact (Secondary)	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Discount Program Payment Contact	CFO		Lawless	Tom		6172450509					Tom.Lawless@eternalhealth.com	31 St James Ave	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Emergency Part D Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Encounter Data & Risk Adjustment Operations Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Enrollment Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	EOB Transfer Contact	Chief Operating Officer		Price	John		2158806876				8664371627	john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Financial Audit Contact	CFO	Mr.	Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Financial Reporting Contact	CFO		Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/12/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Formulary Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Formulary Contact (Secondary)	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	32 St. James Ave	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	General Contact	Chief Executive Officer		Ika	Pooja		5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Government Relations Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	HIPAA Privacy Officer	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	HIPAA Security Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Hospice Contact	VP Clinical Operations		Dougherty	Laurene		8136015063					laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Interoperability Contact	Chief Compliance Officer		Ross	Cheyenne	L	6178404477					cheyenne.ross@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	MA Appeals/Grievances Contact	Chief Operating Officer		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	08/22/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	MA Claims Processing Contact for Public Website	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Marketing Contact	Senior Director, Marketing		Cardinal	Brittany		4136524780					brittany.cardinal@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Medical Director	Medical Director	Dr.	London	Robert		3038083311					robert.london@nirvanahealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Medicare Coordinator	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Medicare Part D Opioid Overutilization Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Medication Therapy Management Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	OffShore Subcontractor Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave		Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Online Enrollment Center Contact (Back-up)	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Online Enrollment Center Contact (Primary)			Rao	Chanukya		8565031661					chanukya.rao@rxadvance.com	136 Turnpike Rd.		Southborough	MA	01772	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part C Application Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part C Reporting Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Appeals	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active	6126326838				PPO - BBA		C	Boston
H2694	Part D Appeals Contact (Secondary)	Chief Operating Officer		Price	John							john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	08/22/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active	2158806876				PPO - BBA		C	Boston
H2694	Part D Application Contact	Product Director		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Benefits Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Claims Submission Contact	Director		Pereira	Michael		9494753456					pereira.mj@optum.com	2300 Main Street		Irvine	CA	92614	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Exceptions Contact	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active	6126326838				PPO - BBA		C	Boston
H2694	Part D Price File Contact (Back-up)			Moore-Elliot	Shalandria		6514955363					mailto:MedOps-Planfinder_DL@ds.uhc.com	1600 McConnor Pkwy		Schaumburg	IL	60173	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Price File Contact (Optional)			Vargas	Danielle		4437101262					MedOps-Planfinder_DL@ds.uhc.com	1600 McConnor Pkwy		Schaumburg	IL	60173	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Price File Contact (Primary)			Rx	Optum		6514955363					medops_planfinder@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Quality Assurance Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Part D Reporting Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Patient Safety Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Payment Contact	Chief Executive Officer		Ika	Pooja		5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Pharmacy Director	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Pharmacy Network Management Contact	Director		Ashby	JoLynn		7637326364					JAshby@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Pharmacy Technical Help Desk Contact			Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	06/04/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active	8553122306				PPO - BBA		C	Boston
H2694	Physician Incentive Contact	Chief Compliance Officer		Ross	Cheyenne		6178404477					cheyenne.ross@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	09/26/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Plan Directory Contact for Public Website			Services	Provider		8006809255					providerrelations@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Plan to Plan Reconciliation Contact	COO		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950,	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Processor Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Quality Contact	QM Director		Suarez	Keyla		6176390730	339				keyla.suarez@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Reconciliation Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Recovery Audit Contact	Chief Financial Officer	Mr.	Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	SNP Application Contact	Director of Product		Cassidy	Cheryl		4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/03/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Surveillance Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	System Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	06/07/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Third Party Administrator (TPA) Liaison	Controller		Tran	Jessica		6175131910					jessica.tran@eternalHealth.com	901 St. James Ave.	Suite 950	Boston	MA	02116	12/09/2024	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	User Access Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Utilization Management Contact	VP Clinical Operations		Dougherty	Laurene		8136015063					laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2694	Utilization Review Contact	Medical Director	Dr.	London	Robert		3038083311					robert.london@nirvanahealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH, INC.	Local CCP	eternalHealth	Local PPO		Eternal Health of Delaware, Inc.	769	Yes	Active					PPO - BBA		C	Boston
H2697	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H2697	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H2697	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H2697	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H2697	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H2697	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H2697	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF OHIO, INC.	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H2697	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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
H2704	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Backup User Access Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Bid Primary Contact	Actuary		Shmelzer	Cameron		5038131826					KPMedicareBids@kp.org	2715 Naches Ave SW		Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	CAP Report Contact for Public Website	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Complaints Tracking Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Corporate Mailing						8083487832				8084325427	Kimberly.C.Piper@kp.org	711 Kapiolani Blvd.		Honolulu	HI	96813	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Customer Service Operations Contact			Services	Member		8004430815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	General Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Government Relations Contact	Senior Vice President, Government Relations	Mr.	Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					cathy.p.plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	MA Appeals/Grievances Contact	Executive Director, Member Relations	Ms	Osborne	Susan		5038133924					susan.a.osborne@kp.org	500 NE Multnomah Street	Suite 100	Portland	OR	97232	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Marketing Contact	Marketing Consultant IV		Hollett	Gretchen		2063356869					KP-MedicareFilings@kp.org	2715 Naches Ave., SW		Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Medicare Compliance Officer	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Medicare Coordinator	Medicare Business Line		Cunningham	Pamela		8082606560					Pamela.M.Cunningham@kp.org	711 Kapiolani Boulevard		Honolulu	HI	96813	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street		Rancho Cucamonga	CA	91730	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part C Application Contact	Project Manager IV		Morgan	Emily		5104072515					emily.m.morgan@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/24/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part C Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Appeals	Executive Director, Member Relations		Osborne	Susan							Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8774083496				HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Application Contact	Project Manager IV		Morgan	Emily	M	5104072515					emily.m.morgan@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/24/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Benefits Contact	Pharmacy Benefits		Goo	Jeilyn		8084325534					jeilyn.s.goo@kp.org	Kaiser Permanente - Pharmacy Services	501 Alakawa Street	Honolulu	HI	96817	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Claims Submission Contact	Pharmacy Medicare Business Line Manager	Ms	Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Exceptions Contact (Secondary)	Pharmacy Benefits		Goo	Jeilyn	S						jeilyn.s.goo@kp.org	Kaiser Permanente Pharmacy Services	501 Alakawa St., Suite 101	Honolulu	HI	96817	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8008052739				HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Part D Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Pharmacy Director	Director, Pharmacy		Takara	Ross	T	8084325547					ross.t.takara@kp.org	501 Alakawa St, Suite 101		Honolulu	HI	96817	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Pharmacy Network Management Contact	Pharmacy Benefits		Goo	Jeilyn		8084325534					jeilyn.s.goo@kp.org	Kaiser Permanente - Pharmacy Services	501 Alakawa Street	Honolulu	HI	96817	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Pharmacy Network Management Contact (Secondary)	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8882773917				HMO - Health Maintenance Organization		C	Dallas
H2704	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Benefits		Goo	Jeilyn							jeilyn.s.goo@kp.org	501 Alakawa St., Suite 101		Honolulu	HI	96817	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8882773917				HMO - Health Maintenance Organization		C	Dallas
H2704	Plan Directory Contact for Public Website			Services	Member		8004430815					mscc@kp.org	10740 Fourth St., Second Floor		Rancho Cucamonga	CA	91730	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	SNP Application Contact	Project Manager IV		Morgan	Emily		5104072515					emily.m.morgan@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/24/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	SNP State Contact	Project Manager IV   HP Mgr-Medicare/Medicaid		Gibson	Cindy		8086369783				8084325667	cindy.b.gibson@kp.org	711 Kapiolani Blvd		Honolulu	HI	96813	08/13/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Surveillance Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	User Access Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Utilization Management Contact	Manger Utilization Management	Ms	Kon	Wendy		8082718148				8084325427	Wendy.Kon@kp.org	2828 Pa'a St.		Honolulu	HI	96819	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2704	Utilization Review Contact	Manger Utilization Management	Ms	Kon	Wendy		8082718148				8084325427	Wendy.Kon@kp.org	2828 Pa'a St.		Honolulu	HI	96819	01/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2715	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H2715	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H2715	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H2715	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H2715	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H2715	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H2715	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2715	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS INC	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2737	Agent/Broker Compensation Data Contact	Medicare Sales Manager	Ms.	Fernandes	Sarah		4132332222				4132332222	sfernandes@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Automated TrOOP Balance Transfer Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Backup User Access Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Best Available Evidence Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Bid Audit Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Bid Audit Site Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Bid Primary Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	CAP Report Contact for Public Website	Director of Medicare Program Development	Ms	Powers	Shannon	A	4132333055				4132333055	spowers@hne.com	1414 Main Street	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	4132333055				PPO - BBA		C	Boston
H2737	CEO - CMS Administrator Contact	President	Mr.	Treash	Kenneth		4137874000					ktreash@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/13/2025	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	CEO - Senior Official for Contracting	President	Mr.	Treash	Kenneth		4137874000					ktreash@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/13/2025	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Chief Financial Officer	Chief Financial Officer	Ms.	Cohen	Lisa		4132333024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Chief Operating Officer	Chief Financial Officer / VP of Operations	Ms.	Cohen	Lisa		4132333024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/30/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Chief Information Officer	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Chief Information Security Officer	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	CMS Casework Communication Contact	Complaints & Appeals Manager	Mr.	Farrell	James		4132333231				4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Complaints Tracking Contact	Complaints & Appeals Manager	Mr.	Farrell	James		4132333231				4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Contact for Fraud Investigations	Director of Compliance	Ms.	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Coordination of Benefits Contact	Recovery and Reinsurance Manager	Ms.	Carter	Ronda		4132333353				4132333353	rcarter@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Corporate Mailing						4137874000				4137343356	soconnor@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Customer Service Operations Contact	Member Services Supervisor	Ms.	Rivera	Aracelis		4132333209				4132333301	arivera@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	11/14/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	DIR Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	DIR Contact (Secondary)	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Discount Program Payment Contact	Director Medicare Program Development		Powers	Shannon		4132333055					spowers@hne.com	One Monarch Place	Springfield, MA 01144	Springfield	MA	01144	04/17/2025	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Emergency Part D Contact	Director of Pharmacy	Mr.	Tereso	Gary		4135311752				4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Emergency Part D Contact (Secondary)	Director of Compliance	Ms	Tulloch	Charmalee		8607090397				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Employer Waiver Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Program Manager		Morgan	Stephne		4132333431				4132333431	smorgan@hne.com	One Monarch Place	Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Enrollment Contact	Medicare Enrollment Supervisor	Ms.	Henriques	Christina		4137874000	3232				chenriques@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	EOB Transfer Contact	Claims Payment Manager	Ms.	Cifone	Tracy		4132333355				0000000000	tcifone@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	11/14/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Financial Audit Contact	Director of Accounting	Ms	Faford	Rebecca		4132333371				4132333371	rfaford@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Financial Reporting Contact	Chief Financial Officer	Ms.	Cohen	Lisa		4132333024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Formulary Contact		Ms.	Maloney	Julia		2242312718					julia.maloney@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Formulary Contact (Secondary)	Director of Pharmacy	Mr.	Tereso	Gary		4137874000	3420			4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	General Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Government Relations Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	HIPAA Privacy Officer	Director of Compliance	Ms	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	HIPAA Security Officer	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Hospice Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Interoperability Contact	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	MA Appeals/Grievances Contact	Complaints & Appeals Manager	Mr.	Farrell	James		4132333231				4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	MA Claims Processing Contact for Public Website	Claims Production Manager	Mr.	Decker	Shawn		4132333087				4132333087	sdecker@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Marketing Contact	Director of Marketing & Digital Strategy	Ms.	Cordial	Melissa		4132333180					mcordial@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Medical Director	VP & Chief Medical Officer	Dr	McIntosh	Kate		4132333052					kmcintosh@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Medicare Compliance Officer	Director of Compliance	Ms	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Medicare Coordinator	Medicare Program and Implementation Lead	Ms.	Redmond	Vernae'		4132333054					vredmond@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/31/2025	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Mr.	Tereso	Gary		4132333420				4132333420	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Medication Therapy Management Contact	Clinical Program Manager	Ms.	Russo	Nicole	B	4013441003					nbrusso@magellanhealth.com	Magellan Rx Management	88 Silva Lane, Tech 4	Middletown	RI	02842	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	OffShore Subcontractor Contact	Director of Compliance	Ms	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Online Enrollment Center Contact (Back-up)	Medicare Enrollment Supervisor		Henriques	Christina		4137874000	3232			4132333232	chenriques@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Online Enrollment Center Contact (Optional)	Director of Revenue Managemen & Recovery	Mr.	Carabine	Daniel		4132333339				4132333339	dcarabine@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Online Enrollment Center Contact (Primary)	Director of Revenue Management & Recovery	Mr.	Carabine	Daniel		4132333339				4132333339	dcarabine@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part C Application Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part C Reporting Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Appeals	Manager, Prior Authorization		Mourad	Hala							hala.mourad@optum.com	2441 Warrenville Rd	Suite 400	Lisle	IL	60532	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	6303285837				PPO - BBA		C	Boston
H2737	Part D Appeals Contact (Secondary)	Complaints & Appeals Supervisor	Mr.	Farrell	James						4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	4137874000	3231			PPO - BBA		C	Boston
H2737	Part D Application Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Benefits Contact	PharmD, Clinical Pharmacist	Mr.	Tereso	Gary		4137874000	3420			4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Claims Submission Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Exceptions Contact	Manager, Prior Authorization		Mourad	Hala							hala.mourad@optum.com	2441 Warrenville Rd	Suite 400	Lisle	IL	60532	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	6303285837				PPO - BBA		C	Boston
H2737	Part D Exceptions Contact (Secondary)	Director of Pharmacy	Mr.	Tereso	Gary						4127343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	8008424464	3420			PPO - BBA		C	Boston
H2737	Part D Price File Contact (Back-up)	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Price File Contact (Optional)	Director of Pharmacy	Mr.	Tereso	Gary		4137874000	3420			4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Price File Contact (Primary)	Sr. Business Analyst	Ms.	Moore-Elliott	Shalandria		7637974305					MedOps-planfinder_DL@ds.uhc.com	1600 McConnor Parkway		Schaumburg	IL	60173	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Quality Assurance Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Part D Reporting Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Patient Safety Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Payment Contact	Chief Financial Officer	Ms.	Cohen	Lisa		4132333024				4132333024	lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Personal Health Record Contact	Director Population Health Clinical Programs	Ms.	Perracchio	Margaret		4132333058				4132333058	mperracchio@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Pharmacy Director	Director of Pharmacy	Mr.	Tereso	Gary		4132333420				4132333420	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Pharmacy Network Management Contact			Pham	Katie		8178469722					katie.pham@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Pharmacy Network Management Contact (Secondary)	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Pharmacy Technical Help Desk Contact	Sr. Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir City		Eden Prairie	MN	55344	12/18/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	8003930395				PPO - BBA		C	Boston
H2737	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Services Specialist	Ms.	Bacaj	Blerina						4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active	8774433314	3423			PPO - BBA		C	Boston
H2737	PHR Beneficiary Contact																	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO	Health New England, Inc.	Baystate Health, Inc.	381	Yes	Active	8008424464	3439			PPO - BBA		C	Boston
H2737	Physician Incentive Contact	VP & Chief Medical Officer	Dr.	McIntosh	Kate		4132333052					kmcintosh@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Plan Directory Contact for Public Website			Services	Member		8774433314					memberservices@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Plan to Plan Reconciliation Contact	Assistant Controller	Ms.	King	Katie		4137874000	3008				kking2@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Processor Contact	Senior Manager, Benefits Administration		Cassata	Mercedes		6307809152					mercedes.cassata@optum.com	1600  McConnor Parkway		Schaumburg	IL	60173	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Quality Contact	Healthcare Quality Improvement Manager	Mr	Rogers	Benjamin		4132333360					brogers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Reconciliation Contact	Director of Pharmacy	Mr	Tereso	Gary		4132333420					gtereso@hne.com	One Monarch Place	Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Reconciliation Contact (Secondary)	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Recovery Audit Contact	Director of Revenue Managemen & Recovery	Mr.	Carabine	Daniel		4132333339				4132333339	dcarabine@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Surveillance Contact	Director of Compliance	Ms	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	System Contact	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Third Party Administrator (TPA) Liaison	Medicare Program and Implementation Lead	Ms.	Redmond	Vernae'		4132333054					vredmond@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/31/2025	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	User Access Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Utilization Management Contact	Director Population Health Clinical Programs	Ms.	Perracchio	Margaret		4132333058				4132333058	mperracchio@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2737	Utilization Review Contact	Director Population Health Clinical Programs	Ms.	Perracchio	Margaret		4132333058				4132333058	mperracchio@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	Local PPO		Baystate Health, Inc.	381	Yes	Active					PPO - BBA		C	Boston
H2752	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	07/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H2752	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H2752	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H2752	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H2752	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H2752	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H2752	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2752	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H2775	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H2775	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H2775	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H2775	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H2775	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H2775	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H2775	PHR Beneficiary Contact																	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H2775	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2775	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H2778	Part C Application Contact			Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	11/04/2025	2026	COMMUNITY CARE HEALTH PLAN, INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2778	Part D Application Contact			Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	11/04/2025	2026	COMMUNITY CARE HEALTH PLAN, INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2802	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H2802	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2802	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H2802	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H2802	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2802	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H2807	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Backup User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Best Available Evidence Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	CAP Report Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H2807	CEO - CMS Administrator Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Chief Operating Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Complaints Tracking Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Contact for Fraud Investigations	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Coordination of Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Customer Service Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	DIR Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Encounter Data & Risk Adjustment Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Enrollment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Financial Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	General Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Government Relations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	HIPAA Privacy Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	HIPAA Security Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	MA Appeals/Grievances Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Marketing Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Medical Director	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Medicare Compliance Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Medicare Coordinator	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Medicare Part D Opioid Overutilization Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part C Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part D Appeals	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H2807	Part D Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part D Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part D Claims Submission Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H2807	Part D Price File Contact (Back-up)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part D Price File Contact (Primary)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part D Quality Assurance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Part D Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H2807	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Quality Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Reconciliation Contact (Secondary)	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	System Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2807	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF SOCAL, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H2815	Automated TrOOP Balance Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Backup User Access Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Best Available Evidence Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	CAP Report Contact for Public Website	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	CEO - CMS Administrator Contact	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	CEO - Senior Official for Contracting	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Chief Financial Officer	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Chief Operating Officer	Executive Director	Ms	Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Chief Information Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Chief Information Security Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	CMS Casework Communication Contact	Quality and Compliance Manager		English	Debra		9709643500				9702520166	darterburn02@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Complaints Tracking Contact	Quality and Compliance Manager		English	Debra		9709643500				9702520166	darterburn02@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Contact for Fraud Investigations	Quality and Compliance Manager		English	Debra		9709643500				9702520166	darterburn02@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Coordination of Benefits Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	New York
H2815	Customer Service Operations Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	DIR Contact (Secondary)	Director of Health Plan Operations		Gallagher	Tierney		9705950523				9708295842	tgallagher@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/09/2024	2026	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	New York
H2815	Discount Program Payment Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	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	New York
H2815	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Emergency Part D Contact (Secondary)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Enrollment Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	New York
H2815	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	New York
H2815	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	General Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Government Relations Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	HIPAA Privacy Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	HIPAA Security Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	MA Appeals/Grievances Contact	Quality and Compliance Manager		English	Debra		9709643500				9702520166	darterburn02@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	MA Claims Processing Contact for Public Website	Claims Administrator	Ms	Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	09/21/2023	2026	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	New York
H2815	Marketing Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Medical Director	Quality and Compliance Manager		English	Debra		9709643500				9702520166	darterburn02@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Medicare Compliance Officer	Director of Quality	Ms	Peterson	Nora		9709643500				9705250166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Medicare Coordinator	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Medicare Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Medication Therapy Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Part C Application Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Part D Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	New York
H2815	Part D Application Contact	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Part D Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Part D Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Part D Exceptions Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	New York
H2815	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	New York
H2815	Part D Price File Contact (Back-up)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Part D Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Part D Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Part D Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Patient Safety Contact	Quality and Compliance Manager		English	Debra		9709643500				9702520166	darterburn02@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Payment Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Personal Health Record Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Pharmacy Director	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Pharmacy Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Pharmacy Technical Help Desk Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	VOANS SENIOR COMMUNITY CARE OF COLORADO, INC	National PACE	Senior CommUnity Care of Colorado	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	New York
H2815	Plan Directory Contact for Public Website	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Processor Contact	Claims Administrator		Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Quality Contact	Quality and Compliance Manager		English	Debra		9709643500				9702520166	DArterburn02@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9709643500				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations		Nilsen	Eric		6124257858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/22/2024	2026	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	New York
H2815	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	03/08/2023	2026	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	New York
H2815	Surveillance Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	System Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Third Party Administrator (TPA) Liaison	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	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	New York
H2815	User Access Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Utilization Management Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2815	Utilization Review Contact	Executive Director		Helmick	Cara		9709643500				9702520166	chelmick@voa.org	2377 Robins Way		Montrose	CO	81401	03/22/2024	2026	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	New York
H2816	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/14/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	8132063350				PFFS - Private Fee for Service		C	Denver
H2816	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	8132066534				PFFS - Private Fee for Service		C	Denver
H2816	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	8132067152				PFFS - Private Fee for Service		C	Denver
H2816	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	6023080218				PFFS - Private Fee for Service		C	Denver
H2816	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	PFFS Terms and Conditions of Payment Contact for Public Website	Vice President, Claims Operations		Cattani	Lisa		8132065748					Lisa.Cattani@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/15/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	8888889355				PFFS - Private Fee for Service		C	Denver
H2816	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	8337500408				PFFS - Private Fee for Service		C	Denver
H2816	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active	8337500408				PFFS - Private Fee for Service		C	Denver
H2816	PHR Beneficiary Contact																	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS	Member Services	Centene Corporation	351	Yes	Active	8334449088				PFFS - Private Fee for Service		C	Denver
H2816	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2816	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	PFFS	Wellcare	PFFS		Centene Corporation	351	Yes	Active					PFFS - Private Fee for Service		C	Denver
H2819	Agent/Broker Compensation Data Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8183316954					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		8182286374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Backup User Access Contact			Mata	Marcos	R	8183316954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Best Available Evidence Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Bid Audit Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Bid Audit Site Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Bid Primary Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	CAP Report Contact for Public Website	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	CEO - CMS Administrator Contact	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	CEO - Senior Official for Contracting	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Chief Financial Officer	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Chief Operating Officer	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Chief Information Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Chief Information Security Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Complaints Tracking Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Contact for Fraud Investigations	Senior Manager, Medicare Compliance		Mata	Marcos		8183316954					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Coordination of Benefits Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Corporate Mailing						5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Customer Service Operations Contact	Director		Mathews	Carolyn		5626135004					Carolyn.Mathews@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	DIR Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	DIR Contact (Secondary)	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Discount Program Payment Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Emergency Part D Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Emergency Part D Contact (Secondary)	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Employer Waiver Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland HIlls	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Actuary		Rodgers	John		3107442643					John.Rodgers@blueshieldca.com	100 N. Sepulveda Boulevard		El Segundo	CA	90245	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Enrollment Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	EOB Transfer Contact	Medicare Project & Program Manager		Zuehlke	Erica		2093713036				8558953519	zuehlke@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Financial Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Financial Reporting Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Formulary Contact	Director, Formulary Strategy and P&T		Nguyen	Nhi		9168410342					Nhi.Nguyen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Formulary Contact (Secondary)	Principal Pharmacist, Formulary Management		Trinh	Andy		3238276322					Andy.Trinh@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	General Contact			Mata	Marcos	R	8183316954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Government Relations Contact			Mata	Marcos	R	8183316954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	HIPAA Privacy Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	HIPAA Security Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Hospice Contact	Senior Program Manager		Fields	Torrie		4152295839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Interoperability Contact	VP Enterprise Digital Growth		Grimm	David		6196864233					david.grimm@blueshieldca.com	2275 Rio Bonito Way	Suite 250	San Diego	CA	92108	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	MA Appeals/Grievances Contact	Supervisor, Medicare Appeals and Grievances		Lopez	Celina		8182286183				9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	MA Claims Processing Contact for Public Website	Senior Manager, Medicare Operations		Halley	Derek		8182286374					Derek.Halley@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Marketing Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Medical Director	Medicare Medical Director	Dr.	Siddiq	Khaliq		5627137953					Khaliq.Siddiq@blueshieldca.com	555 Anton Boulevard	Suite 800	Costa Mesa	CA	92626	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Medicare Coordinator	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Medicare Part D Opioid Overutilization Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					OpioidDUR@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	02/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Medication Therapy Management Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					Dawn.Becker-Ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	OffShore Subcontractor Contact	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Online Enrollment Center Contact (Back-up)			Mata	Marcos	R	8183316954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Online Enrollment Center Contact (Optional)	IT Product Manager, Consultant		Skuta	Paul		9168660922					Paul.Skuta2@blueshieldca.com	601 12th Street		Oakland	CA	94607	10/02/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Online Enrollment Center Contact (Primary)	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part C Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part C Reporting Contact			Mata	Marcos	R	8183316954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Appeals	Supervisor, Medicare Appeals and Grievances		Lopez	Celina						9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Appeals Contact (Secondary)	Senior Manager, Operations		Salam	Shahid							Shahid.Salam@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Benefits Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Claims Submission Contact	Lead Medicare Rx Benefits & Claims Specialist		Campbell	Leslie		5306263838					leslie.campbell@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Exceptions Contact	Director, Pharmacy Prior Authorization		March	Nancee							nancee.march@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Exceptions Contact (Secondary)	Senior Manager, Medicare Compliance		Mata	Marcos							Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Price File Contact (Back-up)	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Price File Contact (Primary)	Business Analyst, Rx Benefit/Claims Implementation		Ng	Alvin		5106072964					Alvin.Ng@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Quality Assurance Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Part D Reporting Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8183316954					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Patient Safety Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					dawn.becker-ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Payment Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Pharmacy Director	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/20/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8003757924				HMO - Health Maintenance Organization		C	Dallas
H2819	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager		Nordby	Christina							cnordb01@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/30/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	5626135252				HMO - Health Maintenance Organization		C	Dallas
H2819	Physician Incentive Contact	Director, Provider Services - Network		Gonzalez	Maria		3238534445					Maria.Gonzalez2@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Plan Directory Contact for Public Website			Services	Member		8007764466					membersvcs@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Plan to Plan Reconciliation Contact	Supervisor Accounts Payable/Receivable		Perez	Cheryl		9167024442					BSCP2PRecon@blueshieldca.com	3021 Reynolds Ranch Parkway		Lodi	CA	95240	02/22/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Processor Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106073281					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Quality Contact	Director, Case Management		Taylor	Christy		6197194536					christy.taylor@blueshieldca.com	313 Camino Del Rio	North, Ste. 1300	San Diego	CA	92108	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Reconciliation Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Reconciliation Contact (Secondary)			Mata	Marcos	R	8183316954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Recovery Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	SNP Application Contact			Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Surveillance Contact			Mata	Marcos	R	8183316954					marcos.mata@blueshieldca.com	6300 Canoga Ave.		Woodland Hills	CA	91367	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	System Contact	Sr. Director, IT Product Management		Chambers	Shelley		1916866073					Shelley.Chambers@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Third Party Administrator (TPA) Liaison	Director, Actuary		Shah	Dimple		5109068189					dimple.shah@blueshieldca.com	50 Beale Street		Oakland	CA	94105	12/04/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	User Access Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Utilization Management Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2819	Utilization Review Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2835	Automated TrOOP Balance Transfer Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Backup User Access Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	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	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Bid Primary Contact	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	CAP Report Contact for Public Website	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	CEO - CMS Administrator Contact	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	CEO - Senior Official for Contracting	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	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		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Chief Operating Officer	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Rd		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Chief Information Officer	Director of Information Services	Mr	Gilreath	Hal		7344331000					HGilreath@mybrio.org	805 W. Middle		Chelsea	MI	48118	11/08/2023	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Chief Information Security Officer	Director of Information Services	Mr	Gilreath	Hal		7344331000					HGilreath@mybrio.org	805 W. Middle		Chelsea	MI	48118	11/08/2023	2026	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		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Complaints Tracking Contact	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Contact for Fraud Investigations	Executive Director		Abbey-Hardesty	Robyn		7347689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	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		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Corporate Mailing						5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	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		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	12/12/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	DIR Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Discount Program Payment Contact	PACE Director of Finance		Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Rd		Jackson	MI	49202	12/01/2025	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Emergency Part D Contact	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Emergency Part D Contact (Secondary)	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Encounter Data & Risk Adjustment Operations Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Enrollment Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	EOB Transfer Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Financial Audit Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Financial Reporting Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Formulary Contact	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	General Contact	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	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	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	HIPAA Privacy Officer	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	HIPAA Security Officer	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Interoperability Contact	Executive Director		Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	MA Appeals/Grievances Contact	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	12/12/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	MA Claims Processing Contact for Public Website	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Marketing Contact	Community Relations Director		Clark	Jade		5177689791					jclark@thomepace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Medical Director	Medical Director	Dr.	Foust	Michael	A	5177689791					mfoust@thomepace.org	2282 Springport Road		Jackson	MI	49202	02/17/2022	2026	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		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Medicare Coordinator	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Foust	Michael	A	5177689791					mfoust@thomepace.org	2282 Springport Road		Jackson	MI	49202	02/17/2022	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Medication Therapy Management Contact	Medical Director	Dr.	Foust	Michael	A	5177689791					mfoust@thomepace.org	2282 Springport Road		Jackson	MI	49202	02/17/2022	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Part C Application Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	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 Appeals	PACE Director of Finance	Ms	Dukes	Jaclyn						5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active	8448557223				PACE - Nat		C	Chicago
H2835	Part D Appeals Contact (Secondary)	Director of Quality	Ms	Gibbs	Sandy							sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/19/2018	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active	8448557223				PACE - Nat		C	Chicago
H2835	Part D Application Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	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 Benefits Contact	Pharmacist		Hill Jones	Miranda		5177689791					mhilljones@thomepace.org	Thome PACE	2282 Springport Rd	Jackson	MI	49202	11/08/2023	2026	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 Claims Submission Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	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	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active	8448557223				PACE - Nat		C	Chicago
H2835	Part D Price File Contact (Back-up)	Pharmacist		Hill Jones	Miranda		5177689791					mhilljones@thomepace.org	Thome PACE	2282 Springport Rd	Jackson	MI	49202	11/08/2023	2026	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 Price File Contact (Primary)	Pharmacist		Hill Jones	MIranda		5177689791					mhilljones@thomepace.org	Thome PACE	2282 Springport Rd	Jackson	MI	49202	11/08/2023	2026	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 Quality Assurance Contact	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	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 Reporting Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Patient Safety Contact	Medical Director	Dr.	Foust	Michael	A	5177689791					mfoust@thomepace.org	2282 Springport Road		Jackson	MI	49202	02/17/2022	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Payment Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Pharmacy Director	Pharmacist		Hill Jones	Miranda		5177689791					mhilljones@thomepace.org	Thome PACE	2282 Springport Rd	Jackson	MI	49202	11/08/2023	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Pharmacy Network Management Contact	Executive Director	Ms	Abbey-Hardesty	Robyn		5177689791					rabbey-hardesty@thomepace.org	2282 Springport Road		Jackson	MI	49202	01/24/2024	2026	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		Hill Jones	MIranda							mhilljones@thomepace.org	Thome PACE	2282 Springport Road	Jackson	MI	49202	11/08/2023	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active	8448557223				PACE - Nat		C	Chicago
H2835	Plan Directory Contact for Public Website	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Plan to Plan Reconciliation Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Processor Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Quality Contact	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Reconciliation Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Recovery Audit Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325				5177835223	jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	10/01/2024	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Surveillance Contact	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	System Contact	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Third Party Administrator (TPA) Liaison	PACE Director of Finance	Ms	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2282 Springport Road		Jackson	MI	49202	12/09/2020	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	User Access Contact	Executive Director	Ms	Decker	Susan		5177689791					sdecker@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Utilization Management Contact	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2835	Utilization Review Contact	Director of Quality	Ms	Gibbs	Sandy		5177689791					sgibbs@thomepace.org	2282 Springport Road		Jackson	MI	49202	03/07/2016	2026	THE CASCADE PACE, INC.	National PACE	Thome PACE	National PACE		United Methodist Retirement Communities, Inc.	630	Yes	Active					PACE - Nat		C	Chicago
H2836	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H2836	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H2836	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H2836	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H2836	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H2836	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H2836	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H2836	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H2845	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H2845	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Atlanta
H2845	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H2845	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H2845	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Atlanta
H2845	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H2845	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Atlanta
H2845	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2845	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H2853	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Medical Director	Medical Director	Mr	Haake	Karl		9132951245					karl.haake@sunflowerhealthplan.com	77 West Wacker Drive, 14th Floor		Chicago	IL	60601	03/30/2021	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H2853	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H2853	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H2853	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H2853	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H2853	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H2853	PHR Beneficiary Contact																	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H2853	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2853	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2875	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Best Available Evidence Contact	Manager, Enrollment		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Chief Financial Officer	Chief Financial Officer	Ms.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Government Relations Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H2875	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H2875	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2875	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2882	Automated TrOOP Balance Transfer Contact	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Backup User Access Contact	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/10/2019	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Best Available Evidence Contact	Quality Manager	Ms	Reeves	Brenda		9899535810					bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	11/03/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Bid Primary Contact	Executive Director	Ms	Minns	Lisa		9899535800				9899535801	lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	CAP Report Contact for Public Website	Executive Director	Ms	Minns	Lisa		9899535800				9899535801	lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	CEO - CMS Administrator Contact	Chief Operating Officer	Ms	Whitmore	Robin		9894663835					rawhitmore@masonicpathways.com	1200 Wright Avenue		Alma	MI	48801	04/27/2022	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	CEO - Senior Official for Contracting	Executive Director	Ms	Minns	Lisa		9899535800				9899535801	lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Chief Financial Officer	Chief Financial Officer	Mr	Hanson	Scott		9894663824					sthanson@masonicpathways.com	1200 Wright Ave		Alma	MI	48858	09/30/2025	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Chief Operating Officer	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Chief Information Officer	Director of Information Systems	Mr	Miller	Donovan		9894663814				9899682616	dmiller@masonicpathways.com	1200 Wright Avenue		Alma	MI	48801	10/03/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Chief Information Security Officer	Director of Information Systems	Mr	Miller	Donovan		9894663814				9899682616	dmiller@masonicpathways.com	1200 Wright Avenue		Alma	MI	48801	10/03/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	CMS Casework Communication Contact	Quality Manager	Ms	Reeves	Brenda		9899535810				9899535801	bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/16/2021	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Complaints Tracking Contact	Quality Manager	Mr	Reeves	Brenda		9899535810					bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	11/03/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Contact for Fraud Investigations	Quality Manager	Ms	Reeves	Brenda		9899535810				9899535802	bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/22/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Coordination of Benefits Contact	Community Liasion		Blamer	Krista		9899535813				9899535801	kkblamer@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Corporate Mailing						9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Customer Service Operations Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	DIR Contact	Executive Director	Ms	Minns	Lisa		9899535800				9899535801	lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	DIR Contact (Secondary)	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	12/10/2019	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Discount Program Payment Contact	Business Manager	Ms	LaVigne	Ashley		9899535828				9899535802	alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Emergency Part D Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Emergency Part D Contact (Secondary)	Business Office Manager	Ms	LaVigne	Ashley		9899535828				9899535801	alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	03/09/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Enrollment Contact	Community Liasion		Blamer	Krista		9899535813				9899535801	kkblamer@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	EOB Transfer Contact	Business Office Manager	Ms	LaVigne	Ashley		9899535828				9899535802	alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/16/2021	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Financial Audit Contact	Director of Finance	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows St		Mount Pleasant	MI	48858	09/30/2025	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Financial Reporting Contact	Chief Financial Officer	Mr	Stradiot	Jim		2165231010					jim.stradiot@plantemoran.com	Plante Moran	1111 Superior Ave, Suite 1250	Cleveland	OH	44114	04/17/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Formulary Contact	Medical Director	Dr.	English	Shannon		9899535839				9899535802	senglish@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	01/05/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Formulary Contact (Secondary)	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	03/10/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	General Contact	Executive Director	Ms	Minns	Lisa		9899535800				9899535801	lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Government Relations Contact	Executive Director	Ms	Minns	Lisa		9899535800				9899535801	lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	HIPAA Privacy Officer	Quality Manager	Ms	Reeves	Brenda		9899535810					bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	10/03/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	HIPAA Security Officer	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Interoperability Contact	Executive Director		Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 E Bellows St		Mount Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	MA Appeals/Grievances Contact	Quality Manager	Ms	Reeves	Brenda		9899535810					bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	11/03/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	MA Claims Processing Contact for Public Website	Business Manager	Ms	LaVigne	Ashley		9899535828				9899535802	alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/22/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Marketing Contact	Community Liasion		Blamer	Krista		9899535813				9899535801	kkblamer@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Medical Director	Medical Director	Dr.	English	Shannon		9899535839					senglish@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	01/05/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Medicare Compliance Officer	Quality Manager	Ms	Reeves	Brenda		9899535810				9899535802	bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	01/12/2021	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Medicare Coordinator	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	English	Shannon		9899535839				9899535802	senglish@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	01/05/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Medication Therapy Management Contact	Medical Director	Dr.	English	Shannon		9899535839					senglish@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	01/05/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part C Application Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part D Appeals	Business Manager	Ms	LaVigne	Ashley						9899535802	alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active	9899535828				PACE - Nat		C	Atlanta
H2882	Part D Appeals Contact (Secondary)	Executive Director	Ms	Minns	Lisa						9899535802	lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active	9899535800				PACE - Nat		C	Atlanta
H2882	Part D Application Contact	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part D Benefits Contact	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part D Claims Submission Contact	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part D Exceptions Contact	Business Office Manager	Ms	LaVigne	Ashley							alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active	9899535828				PACE - Nat		C	Atlanta
H2882	Part D Exceptions Contact (Secondary)	Executive Director	Ms	Minns	Lisa							lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active	9899535800				PACE - Nat		C	Atlanta
H2882	Part D Price File Contact (Back-up)	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part D Price File Contact (Primary)	Executive Director	Ms	Minns	Lisa		9899535800					lmmins@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part D Quality Assurance Contact	Quality Manager	Ms	Reeves	Brenda		9899535810				9899535802	bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/22/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Part D Reporting Contact	Business Office Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 E Bellows		Mt. Pleasant	MI	48858	08/16/2021	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Patient Safety Contact	Quality Manager	Ms	Reeves	Brenda		9899535810				9899535802	bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Payment Contact	Business Office Manager	Mr	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Personal Health Record Contact	Center Manager	Ms	Young	Lindsay		9899535822				9899535802	lbyoung@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	10/03/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Pharmacy Director	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Pharmacy Network Management Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Pharmacy Network Management Contact (Secondary)	LaVigne	Ms	LaVigne	Ashley		9899535828				9899535802	alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Pharmacy Technical Help Desk Contact	Pharmacist	Mr	Le	Viet							viet@kltcpharmacy.com	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active	2695984000				PACE - Nat		C	Atlanta
H2882	Plan Directory Contact for Public Website	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Plan to Plan Reconciliation Contact	Business Office Manager	Mr	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	08/20/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Processor Contact	Business Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Quality Contact	Quality Manager	Ms	Reeves	Brenda		9899535810					bkreeves@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	10/13/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Reconciliation Contact	Business Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Reconciliation Contact (Secondary)	Executive Director	Ms	Altom	Dayna		9899535800					daltom@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	10/03/2023	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Recovery Audit Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Surveillance Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	System Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Third Party Administrator (TPA) Liaison	Business Manager	Ms	LaVigne	Ashley		9899535828					alavigne@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	12/23/2020	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	User Access Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Utilization Management Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2882	Utilization Review Contact	Executive Director	Ms	Minns	Lisa		9899535800					lmminns@pacecmi.org	1750 East Bellows Street		Mt Pleasant	MI	48858	04/16/2024	2026	PACE CENTRAL MICHIGAN, INC.	National PACE	PACE Central Michigan	National PACE		PACE Central Michigan, Inc.	711	Yes	Active					PACE - Nat		C	Atlanta
H2915	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H2915	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H2915	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H2915	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H2915	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H2915	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H2915	PHR Beneficiary Contact																	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H2915	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2915	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	PENNSYLVANIA HEALTH & WELLNESS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H2918	Automated TrOOP Balance Transfer Contact	Executive Director	Mrs	Beckenholdt	Deanna		4178481718					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Backup User Access Contact	Executive Assistant	Mrs	Bohning	Susan		4178511551					sbohning@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Best Available Evidence Contact	Executive Assistant	Mrs	Bohning	Susan		4178511551					sbohning@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Bid Primary Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	CAP Report Contact for Public Website	Executive Assistant	Mrs	Bohning	Susan		4178511551					sbohning@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active	4178511551				PACE - Nat		C	Kansas City
H2918	CEO - CMS Administrator Contact	CEO	Dr	Stinson	Matthew		4178511551					matthew.stinson@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/26/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	CEO - Senior Official for Contracting	CEO	Dr	Stinson	Matthew		4178511551					matthew.stinson@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/26/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Chief Financial Officer	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Chief Operating Officer	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Chief Information Officer	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Chief Information Security Officer	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	CMS Casework Communication Contact	Exec VP Medical Services	Mr	Stinson	Matt		4178511551					mstinson@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Complaints Tracking Contact	Executive Director		Beckenholdt	Deanna		4178511551					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/26/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Contact for Fraud Investigations	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Coordination of Benefits Contact	Executive Director		Beckenholdt	Deanna		4178511551					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/26/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Corporate Mailing						4178511551					sbohning@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Customer Service Operations Contact	Executive Assistant	Mrs	Bohning	Susan		4178511551					sbohning@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	DIR Contact	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	DIR Contact (Secondary)	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Discount Program Payment Contact	Finance	Mrs	Reiber	Melissa		4178511550					melissa.reiber@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	12/04/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Emergency Part D Contact	VP of Operations	mr	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	06/26/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Emergency Part D Contact (Secondary)	Executive Director		Beckenholdt	Deanna		4178481718					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Encounter Data & Risk Adjustment Operations Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Enrollment Contact	Intake Coordinator		Beasley	Constance		4178511551					constance.beasley@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	01/13/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	EOB Transfer Contact	Exec VP Administration	Mrs	Howe	Yadira		4178511551				4178511551	yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Financial Audit Contact	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Financial Reporting Contact	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Formulary Contact	VP of Operations	mr	Kruger	Ryan		4178511551					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/26/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Formulary Contact (Secondary)	Executive Director	mr	Beckenholdt	Deanna		4178481718					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	General Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Government Relations Contact	VP of Operations	Mr	Kruger	Ryan		4178511551					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	11/12/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	HIPAA Privacy Officer	Exec VP Medical Services	Mr	Stinson	Matt		4178511551					mstinson@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	HIPAA Security Officer	Exec VP Medical Services	Mr	Stinson	Matt		4178511551					mstinson@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Interoperability Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	MA Appeals/Grievances Contact	Quality RN	Mr	Mcintosh	Garrett		4178511551					garrett.mcintosh@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	11/12/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	MA Claims Processing Contact for Public Website	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Marketing Contact	Marketing Director	Mrs	Taylor	Kristy		4178511551					kristy.taylor@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	12/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Medical Director	Exec VP Medical Services	Mr	Stinson	Matt		4178511551					mstinson@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Medicare Compliance Officer	Director Strategic Development	Mrs	March-Hopkins	Stephanie		4178511551					stephanie.marchhopkins@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Medicare Coordinator	Director of Strategic Development		March-Hopkins	Stephanie		4178511551					stephanie.marchhopkins@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Medicare Part D Opioid Overutilization Contact	VP of Operations	Mr	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Medication Therapy Management Contact	VP of Operations	Mr	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	OffShore Subcontractor Contact	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Online Enrollment Center Contact (Back-up)	Executive Director		Beckenholdt	Deanna		4178481718					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Online Enrollment Center Contact (Optional)	Executive Director		Beckenholdt	Deanna		4178481718					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Online Enrollment Center Contact (Primary)	Intake Coordinator		Beasley	Constance		4178511551					constance.beasley@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	01/13/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part C Application Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	04/16/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part D Appeals	VP of Operations		Kruger	Ryan							ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active	4175226862				PACE - Nat		C	Kansas City
H2918	Part D Appeals Contact (Secondary)	VP of Operations		Kruger	Ryan							ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active	4175226862				PACE - Nat		C	Kansas City
H2918	Part D Application Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	04/16/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part D Benefits Contact	VP of Operations		Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part D Claims Submission Contact	VP of Operations	mr	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part D Exceptions Contact	VP of Operations		Kruger	Ryan							ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active	4175226862				PACE - Nat		C	Kansas City
H2918	Part D Price File Contact (Back-up)	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part D Price File Contact (Primary)	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part D Quality Assurance Contact	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Part D Reporting Contact	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Patient Safety Contact	Exec Director Facilities	Mr	Mcintosh	Garrett		4178511551					garrett.mcintosh@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	11/12/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Payment Contact	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Personal Health Record Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Pharmacy Director	VP of Operations	mr	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Soringfield	MO	65804	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Pharmacy Network Management Contact	VP of Operations	mr	Kruger	Ryan		4178511551					ryan.kruger@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Pharmacy Technical Help Desk Contact	VP of Operations	Mr	Kruger	Ryan							ryan.kruger@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	09/02/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active	4178511551				PACE - Nat		C	Kansas City
H2918	Pharmacy Technical Help Desk Contact (Secondary)	Director of Pharmacy	Mr	Small	Aaron							aaron.small@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active	4178511551				PACE - Nat		C	Kansas City
H2918	PHR Beneficiary Contact																	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE	Jordan Valley Health Center	Advocates for a Healthy Community, Inc.	838	Yes	Active	4178511551				PACE - Nat		C	Kansas City
H2918	Plan Directory Contact for Public Website	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Plan to Plan Reconciliation Contact	COO	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	01/30/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Processor Contact	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Quality Contact	Q	Mr.	Mcintosh	Garrett		4175226862					garrett.mcintosh@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	11/12/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Reconciliation Contact	VP of Operations	Mr.	Kruger	Ryan		4175226862					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/26/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Reconciliation Contact (Secondary)	Exec VP Administration	Mrs	Howe	Yadira		4178511551					yadira.howe@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Recovery Audit Contact	Director of Finance	Mr	Beckenholdt	Deanna		4178511551					deanna.beckenholdt@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	07/11/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Surveillance Contact	Exec Director Facilities	Mr	Seebauer	Matt		4178511551					mseebauer@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	System Contact	Exec Director Facilities	Mr	Seebauer	Matt		4178511551					mseebauer@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	06/29/2023	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Third Party Administrator (TPA) Liaison	Finance	Mrs	Reiber	Melissa		4178511550					melissa.reiber@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	12/04/2024	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	User Access Contact	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Utilization Management Contact	Director of Finance	Mrs	Reiber	Melissa		4178511551					melissa.reiber@jordanvalley.org	440 E Tampa St		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2918	Utilization Review Contact	VP of Operations	Mr	Kruger	Ryan		4178511551					ryan.kruger@jordanvalley.org	440 E. Tampa Street		Springfield	MO	65806	08/05/2025	2026	Advocates for a Healthy Community, Inc. dba Jordan	National PACE	Jordan Valley Senior Care	National PACE		Advocates for a Healthy Community, Inc.	838	Yes	Active					PACE - Nat		C	Kansas City
H2923	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H2923	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H2923	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H2923	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H2923	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H2923	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H2923	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF OREGON INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H2923	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	Director of Member & Provider Services	Mr.	Magnuson	Matt		3203355243				3203355223	matt.magnuson@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Backup User Access Contact	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/10/2024	2026	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		3203355219				3203355223	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	04/02/2018	2026	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	Bid Audit Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Bid Audit Site Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2026	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	Bid Primary Contact	Managing Actuary	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2026	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	CAP Report Contact for Public Website	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207628750	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Przybilla	James		3204913334				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500,	St. Paul	MN	55101	10/24/2019	2026	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 Operating Officer	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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 Information Officer	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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 Information Security Officer	Director of IS&T/HIPAA Security Officer	Mr.	Hess	Jamie		3203355225				3207628750	jamie.hess@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	CMMI Model Point of Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/10/2024	2026	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		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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	Complaints Tracking Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				8776004912	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Contact for Fraud Investigations	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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		3203355219				3203355223	MedicareCOB@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56309	12/20/2023	2026	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	Corporate Mailing						3207634135				3207628750	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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 Member & Provider Services	Mr.	Magnuson	Matt		3203355243				3203355223	matt.magnuson@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	DIR Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	DIR Contact (Secondary)	Consulting Actuary	Ms.	Stensland	Katherine		6513894592				6512289893	katherine.stensland@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Discount Program Payment Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc	444 Cedar St, Suite 500	St Paul	MN	55101	12/08/2022	2026	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	Electronic Health Record Contact	Director of Business IT & Claims Administration	Mr.	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8885884420				HMO - Health Maintenance Organization		C	Chicago
H2926	Emergency Part D Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Manager	Ms.	Brand	Katie		3203355246				3207625945	katie.brand@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/27/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Mr	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paum	MN	55101	10/24/2019	2026	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	Enrollment Contact	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3203355223	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/27/2019	2026	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	EOB Transfer Contact	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3207628750	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/30/2019	2026	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	Financial Audit Contact	Chief Operating Officer	Mrs.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/24/2025	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Formulary Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Formulary Contact (Secondary)	Manager, Formulary Administration & Maintenance	Ms.	Nyawabila	Christina		8587906297					FMT@MedImpact.com	MedImpact HealthCare Systems, Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2026	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	General Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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		3203355250				3203355339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	HIPAA Privacy Officer	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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	HIPAA Security Officer	Director of IS&T / HIPAA Security Officer	Mr.	Hess	Jamie		3203355225				3207628750	jamie.hess@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	Interoperability Contact	Director Business IT & Claims Adminstration	Mr	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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	MA Appeals/Grievances Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				8776004912	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	MA Claims Processing Contact for Public Website	Director Business IT & Claims Adminstration	Ms.	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/27/2021	2026	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	Marketing Contact	Marketing & Public Relations Coordinator	Ms.	Wencl	Kelly		3207594169				3207628750	kelly.wencl@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/10/2024	2026	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	Medical Director	Chief Senior Medical Director	Dr.	Hegstad	Scott		3203355286				3207628750	scott.hegstad@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/06/2022	2026	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		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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 Coordinator	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3203355319	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/24/2015	2026	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 Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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	Medication Therapy Management Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	Online Enrollment Center Contact (Primary)	Manager of Enrollment	Ms.	Jirik	Becky		3203355219				3203355319	becky.jirik@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/24/2015	2026	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 C Application Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3203355339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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 C Reporting Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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 Appeals	Appeals & Grievance Supervisor	Ms.	Creasman	Kachiri						8587906060	kachiri.creasman@medimpact.com	MedImact HealthCare Systems, Inc.	10181 Scripps Gateway CT	San Diego	CA	92131	12/13/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8582915164				HMO - Health Maintenance Organization		C	Chicago
H2926	Part D Appeals Contact (Secondary)	Appeals & Grievance Lead	Ms.	Lindberg	Laura						8587906060	Laura.Lindberg@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8582915528				HMO - Health Maintenance Organization		C	Chicago
H2926	Part D Application Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3203355339	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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 Benefits Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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 Claims Submission Contact	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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						3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	3207594154				HMO - Health Maintenance Organization		C	Chicago
H2926	Part D Exceptions Contact (Secondary)	Pharmacy Manager	Ms	Brand	Katie						3207625945	katie.brand@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	3203355246				HMO - Health Maintenance Organization		C	Chicago
H2926	Part D Price File Contact (Back-up)	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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 Price File Contact (Optional)	Pharmacy Manager	Ms	Brand	Katie		3203355246					katie.brand@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	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 Price File Contact (Primary)	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55111	10/24/2019	2026	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 Quality Assurance Contact	Director of Pharmacy Management	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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 Reporting Contact	Chief Operating Officer	Ms.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Patient Safety Contact	Director of Pharmacy Management	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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	Payment Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Personal Health Record Contact	Corporate Compliance Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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 Director	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/15/2022	2026	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 Network Management Contact	Dir Pharmacy Network Administration	Mr.	Hunt	Brian		8587907092					Brian.Hunt@MedImpact.com	MedImpact HealthCare Systems Inc.	10181 Scripps Gateway Court	San Diego	CA	92131	12/13/2022	2026	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 Network Management Contact (Secondary)	Director of Pharmacy	Ms.	Ehlert	Ann		3207594154				3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905  Dakota St	Alexandria	MN	56308	09/15/2022	2026	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	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8773919294				HMO - Health Maintenance Organization		C	Chicago
H2926	Pharmacy Technical Help Desk Contact (Secondary)	Director of Pharmacy	Ms.	Ehlert	Ann						3207625945	ann.ehlert@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/20/2023	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS		PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	3207594154				HMO - Health Maintenance Organization		C	Chicago
H2926	PHR Beneficiary Contact																	11/10/2022	2026	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	Local CCP	PrimeWest Health	HMO/HMOPOS	PrimeWest Health	PrimeWest Rural MN Health Care Access Initiative	189	Yes	Active	8776004913				HMO - Health Maintenance Organization		C	Chicago
H2926	Physician Incentive Contact	Corporate Compliance Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/07/2022	2026	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	Plan Directory Contact for Public Website			Contact Center	Provider		8664310802					providercontactcenter@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/24/2015	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Tava	Alex		6513894570				6512289893	alex.tava@cirdanhealth.com	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	12/19/2024	2026	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	Processor Contact	Director Business IT & Claims Adminstration	Mr	Harris	Jeramie		3203355241				3207628750	jeramie.harris@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/27/2021	2026	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	Quality Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				3207628750	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Reconciliation Contact	Consulting Acturary	Ms.	Stensland	Katherine		6512289891				6512289893	katherine.stensland@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	03/31/2020	2026	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	Reconciliation Contact (Secondary)	Consulting Actuary	Ms.	Stensland	Katherine		6513894592				6512289893	katherine.stensland@cirdanhealth.com	Cirdan Health Systems, Inc.	444 Cedar Street, Suite 500	St. Paul	MN	55101	10/24/2019	2026	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	Recovery Audit Contact	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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	SNP Application Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	SNP State Contact	Chief Executive Officer	Mr.	Przybilla	James		3203355250				3207622912	jim.przybilla@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/23/2015	2026	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	Surveillance Contact	Corporate Compliance/HIPAA Privacy Officer	Ms.	Adams	Sandra		3203355399				3207625937	sandra.adams@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	10/11/2022	2026	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	System Contact	Chief Operating Officer	Mrs.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	03/06/2023	2026	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	Third Party Administrator (TPA) Liaison	Chief Operating Officer	Mrs.	Krafthefer	Bethany		3203355392				3207628750	bethany.krafthefer@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	02/19/2025	2026	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	User Access Contact	Director of IS&T	Mr.	Hess	Jamie		3203355225				3207628750	jamie.hess@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Utilization Management Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				3207628750	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Utilization Review Contact	Director of Quality & UM	Ms.	Zimmerman	Robin		3203355213				3207628750	robin.zimmerman@primewest.org	PrimeWest Health	3905 Dakota St	Alexandria	MN	56308	09/30/2022	2026	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	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Backup User Access Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Best Available Evidence Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Bid Primary Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	CAP Report Contact for Public Website	Quality Improvement Manager	Ms.	Pena	Eva		2312918709				2313328600	epena@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	07/16/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	CEO - CMS Administrator Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	CEO - Senior Official for Contracting	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Chief Financial Officer	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Chief Operating Officer	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James St		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Chief Information Officer	Program Integrity Manager	Mr.	McPherson	Phil		2317690539				2313328600	pmcpherson@lifecircles-pace.org	560 Seminole Road		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Chief Information Security Officer	Program Integrity Manager	Mr.	McPherson	Phil		2317690539				2313328600	pmcpherson@lifecircles-pace.org	560 Seminole Road		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	CMS Casework Communication Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2317338683	hgras@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Complaints Tracking Contact	Quality Improvement Manager	Ms.	Pena	Eva		2312918709				2313328600	epena@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	07/16/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Contact for Fraud Investigations	Program Integrity Manager	Mr.	McPherson	Phil		2317690539				2313328600	pmcpherson@lifecircles-pace.org	560 Seminole Road		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Coordination of Benefits Contact	Eligibility and Benefits Specialist	Ms.	Griswold	Jamie		2317338686	8227			2313328600	jgriwswold@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	03/11/2025	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Corporate Mailing						6165823111				6165823149	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	01/08/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Customer Service Operations Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	DIR Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Discount Program Payment Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Emergency Part D Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Encounter Data & Risk Adjustment Operations Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Road		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Enrollment Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	EOB Transfer Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Financial Audit Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Financial Reporting Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Formulary Contact	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	General Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Government Relations Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	HIPAA Privacy Officer	Quality Improvement Manager	Ms.	Pena	Eva		2312918709				2313328600	epena@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	07/16/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	HIPAA Security Officer	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Interoperability Contact	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	560 Seminole Road		Muskegon	MI	49444	04/15/2022	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	MA Appeals/Grievances Contact	Quality Improvement Manager	Ms.	Pena	Eva		2312918709				2313328600	epena@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	07/16/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	MA Claims Processing Contact for Public Website	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Marketing Contact	Marketing & Enrollment Manager	Ms.	Milanowski	Sarah		6165823114					smilanowski@lifecircles-pace.org	12330 James St.		Holland	MI	49424	07/16/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Medical Director	Medical Director	Dr.	Boettcher	Iris		2317338682				2313328600	iboettcher@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	04/25/2016	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Medicare Compliance Officer	Program Integrity Manager	Mr.	McPherson	Phil		2317690539				2313328600	pmcpherson@lifecircles-pace.org	560 Seminole Road		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Medicare Coordinator	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Medicare Part D Opioid Overutilization Contact	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Medication Therapy Management Contact	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part C Application Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part D Appeals	Program Integrity Manager	Mr.	McPherson	Phil						2313328600	pmcpherson@lifecircles-pace.org	560 Seminole Road		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active	2317690539				PACE - Nat		C	Atlanta
H2936	Part D Application Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part D Benefits Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part D Claims Submission Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part D Exceptions Contact	Accounting Manager	Ms.	Murar	Ann						6169497886	amurar@mybrio.org	560 Seminole Rd		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active	6163786469				PACE - Nat		C	Atlanta
H2936	Part D Price File Contact (Back-up)	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@lmybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part D Price File Contact (Primary)			Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part D Quality Assurance Contact			Gras	Heidi		6165823111					hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Part D Reporting Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.otg	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Patient Safety Contact	Executive Director	Ms.	Gras	Heidi		6165823111					hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Payment Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Pharmacy Director	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Pharmacy Network Management Contact			Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Pharmacy Technical Help Desk Contact			Gras	Heidi						6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active	6165823111				PACE - Nat		C	Atlanta
H2936	Plan Directory Contact for Public Website			Gras	Heidi		6165823111					hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	01/08/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Plan to Plan Reconciliation Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Processor Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Quality Contact	Quality Improvement Manager	Ms.	Pena	Eva		2312918709				2313328600	epena@lifecircles-pace.org	560 Seminole Rd		Muskegon	MI	49444	07/16/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Reconciliation Contact	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Recovery Audit Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Surveillance Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	System Contact	Executive Director	Ms.	Gras	Heidi		6165823111				2313328600	hgras@lifecircles-pace.org	560 Seminole Rd.		Muskegon	MI	49444	12/28/2021	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Third Party Administrator (TPA) Liaison	Accounting Manager	Ms.	Murar	Ann		6163786469				6169497886	amurar@mybrio.org	560 Seminole Rd.		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	User Access Contact	EHR Administrator	Mr.	Moran	Dan		2317338686				2313328600	dmoran@lifecircles-pace.org	560 Seminole Road		Muskegon	MI	49444	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Utilization Management Contact	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2936	Utilization Review Contact	Executive Director	Ms.	Gras	Heidi		6165823111				6165823149	hgras@lifecircles-pace.org	12330 James Street		Holland	MI	49424	03/06/2024	2026	LIFECIRCLES	National PACE	LIFECIRCLES	National PACE		LifeCircles	373	Yes	Active					PACE - Nat		C	Atlanta
H2937	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Backup User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Bid Primary Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	CAP Report Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	CEO - Senior Official for Contracting	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Chief Operating Officer	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Chief Information Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Chief Information Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Complaints Tracking Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Contact for Fraud Investigations	Executive Director		Noon	Jodi		7248388300	28060				SLGDirectors@seniorlifegreensburg.com	123 Triangle Drive		Greensburg	PA	15601	04/21/2025	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Corporate Mailing						8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	DIR Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Discount Program Payment Contact	CFO		Dodson	David	M	8145356000	22102				Ddodson@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/14/2025	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Emergency Part D Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Encounter Data & Risk Adjustment Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	10/18/2019	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Enrollment Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	EOB Transfer Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Financial Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Formulary Contact			N/A	N/A		1234567890	123				N/A@n/a.com	N/A		N/A	PA	15906	01/22/2013	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	General Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	HIPAA Privacy Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	HIPAA Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Interoperability Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	MIrwin@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	02/16/2022	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	MA Appeals/Grievances Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Marketing Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Medical Director	Medical Director		Abalos	Joseph		7248388300					Jabalos@physiciansolutionsgrp.com	123 Triangle Drive		Greensburg	PA	15601	04/18/2023	2026	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	Noon	Jodi		7248388300	28060				Jnoon@seniorlifegreensburg.com	123 Triangle Drive		Greensburg	PA	15601	04/21/2025	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Medicare Coordinator	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Medicare Part D Opioid Overutilization Contact	Medical Director		Abalos	Joseph		7248388300					Jabalos@physiciansolutionsgrp.com	123 Triangle Drive		Greensburg	PA	15601	04/18/2023	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Medication Therapy Management Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/13/2019	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Part C Application Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Appeals	Chief Financial Officer	Mr	Dodson	David						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H2937	Part D Appeals Contact (Secondary)	Chief Executive Officer	Mr.	Irwin	Mark						8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	12/29/2020	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active	8145356000	22101			PACE - Nat		C	Philadelphia
H2937	Part D Application Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Benefits Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Claims Submission Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H2937	Part D Price File Contact (Back-up)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Price File Contact (Primary)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Quality Assurance Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Patient Safety Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Payment Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Pharmacy Director			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Pharmacy Network Management Contact			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active	7242751203	219			PACE - Nat		C	Philadelphia
H2937	Plan Directory Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Processor Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	11/13/2025	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Quality Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Reconciliation Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Recovery Audit Contact	CFO	Mr	Dodson	David	M	8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Surveillance Contact			Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	System Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Third Party Administrator (TPA) Liaison	VP Grane PBM		Baker	John		3306968345					jebaker@granepbm.com	209 Sigma Drive		Pittsburgh	PA	15238	03/14/2025	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Utilization Management Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIOR LIFE GREENSBURG, INC.	National PACE	Senior LIFE Greensburg	National PACE		Senior LIFE Greensburg, Inc.	543	Yes	Active					PACE - Nat		C	Philadelphia
H2937	Utilization Review Contact	ChieExecutive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Backup User Access Contact	Regional Director		Barnes	Kelley		7573922650					kdbarnes@sentara.com	5788 Churchland Blvd		Portsmouth	VA	23703	04/09/2025	2026	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	Executive Director		Wendell	Andrea		7572527800					albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Bid Primary Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	CAP Report Contact for Public Website	Executive Director	Mrs.	Wendell	Andrea		7572527800				7573904375	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	CEO - CMS Administrator Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573904375	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	CEO - Senior Official for Contracting	VP, CMO Complex Care	Dr.	Dickinson	Daniel		7572523143				7573904375	djdickin@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	10/01/2024	2026	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 Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Chief Operating Officer	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Chief Information Officer	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800					kjtinsl@sentara.com	5900 E Virginia Beach Blvd	Suite 100	Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Chief Information Security Officer	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd		Norfolk	VA	23502	04/09/2025	2026	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	Executive Director		Wendell	Andrea		7572527800					albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Complaints Tracking Contact	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd	Suite 100	Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Contact for Fraud Investigations	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	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		7573922650				7579665471	atpace@sentara.com	5788 Churchland Blvd		Portsmouth	VA	23703	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Corporate Mailing						7572527805				7573904375	tsbethu1@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/15/2024	2026	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.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	DIR Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	DIR Contact (Secondary)	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Discount Program Payment Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Emergency Part D Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Emergency Part D Contact (Secondary)	Patient Accounts manager		Cardin	Amy	R	5405647374					arcardin@sentara.com	1515 Country Club Drive		Harrisonburg	VA	22802	04/03/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Encounter Data & Risk Adjustment Operations Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Enrollment Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	EOB Transfer Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Financial Audit Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Financial Reporting Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Formulary Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	General Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	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.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	HIPAA Privacy Officer	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd		Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	HIPAA Security Officer	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd		Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Interoperability Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	MA Appeals/Grievances Contact	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd	Suite 100	Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	MA Claims Processing Contact for Public Website	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Marketing Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Medical Director	Medical Director		Gonzalez	Cynthia		7572527800				7573824957	clmirand@sentara.com	5900 East Virginia Beach Blvd		Norfolk	VA	23502	04/09/2025	2026	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.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Medicare Coordinator	Medicaid/Medicare Specialist		Rather	Shay		7573922650				7579665471	sxrather@sentara.com	5788 Churchland Blvd		Portsmouth	VA	23703	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Medicare Part D Opioid Overutilization Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Medication Therapy Management Contact	Medical Director		Gonzalez	Cynthia		7572527800					clmirand@sentara.com	5900 East Virginia Beach Blvd		Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Part C Application Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	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 Appeals	Finance Director	Mrs.	Carr	Rachel						7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active	8049160286				PACE - Nat		C	Philadelphia
H2941	Part D Appeals Contact (Secondary)	Patient Accounts manager		Cardin	Amy	R						arcardin@sentara.com	1515 Country Club Drive		Harrisonburg	VA	22802	04/03/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active	5405647374				PACE - Nat		C	Philadelphia
H2941	Part D Application Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	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 Benefits Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	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 Claims Submission Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	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 Director	Mrs.	Carr	Rachel						7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active	8049160286				PACE - Nat		C	Philadelphia
H2941	Part D Exceptions Contact (Secondary)	Patient Accounts manager		Cardin	Amy	R						arcardin@sentara.com	1515 Country Club Drive		Harrisonburg	VA	22802	04/03/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active	5405647374				PACE - Nat		C	Philadelphia
H2941	Part D Price File Contact (Back-up)	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	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 Price File Contact (Optional)	Patient Accounts manager		Cardin	Amy	R	5405647374					arcardin@sentara.com	1515 Country Club Drive		Harrisonburg	VA	22802	04/03/2024	2026	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 Price File Contact (Primary)	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park	Suite 100	Virginia Beach	VA	23464	05/29/2024	2026	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 Quality Assurance Contact	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd		Norfolk	VA	23502	04/09/2025	2026	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 Reporting Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Patient Safety Contact	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd	Suite 100	Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Payment Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Pharmacy Director	Manager, Pharmacy		Lee	Doug		7573880347				7573884018	dhlee@sentara.com	600 Gresham Drive		Norfolk	VA	23507	05/26/2021	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Pharmacy Network Management Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Pharmacy Network Management Contact (Secondary)	Patient Accounts manager		Cardin	Amy	R	5405647374					arcardin@sentara.com	1515 Country Club Drive		Harrisonburg	VA	22802	04/03/2024	2026	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						7573884018	dhlee@sentara.com	600 Gresham Drive		Norfolk	VA	23507	05/26/2021	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active	7573880347				PACE - Nat		C	Philadelphia
H2941	Plan Directory Contact for Public Website	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Plan to Plan Reconciliation Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Processor Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Quality Contact	Quality Assurance Coordinator	Ms.	Tinsley	Kianna		7572527800				7573824957	kjtinsl@sentara.com	5900 E Virginia Beach Blvd		Norfolk	VA	23502	04/09/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Reconciliation Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Reconciliation Contact (Secondary)	Patient Accounts manager		Cardin	Amy	R	5405647374					arcardin@sentara.com	1515 Country Club Drive		Harrisonburg	VA	22802	04/03/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Recovery Audit Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Surveillance Contact	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	System Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Third Party Administrator (TPA) Liaison	Finance Director	Mrs.	Carr	Rachel		8049160286				7573904375	rxcarr1@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	05/29/2024	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	User Access Contact	Program Director	Mrs.	Wendell	Andrea		7572527800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Utilization Management Contact	Program Director	Mrs.	Wendell	Andrea		7572529800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2941	Utilization Review Contact	Program Director	Mrs.	Wendell	Andrea		7572529800				7573824957	albaesen@sentara.com	5900 East Virginia Beach Blvd	Ste 260	Norfolk	VA	23502	02/03/2025	2026	SENTARA LIFE CARE CORPORATION, INC	National PACE	Sentara PACE	National PACE		Sentara Health Care (SHC)	345	Yes	Active					PACE - Nat		C	Philadelphia
H2942	Agent/Broker Compensation Data Contact	VP of Sales		Stead	Bart		4172692843				4172692949	bstead@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Automated TrOOP Balance Transfer Contact	VP of Health Services		O'Connell	Daniel		4172692966				4172692919	doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Backup User Access Contact	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	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		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Bid Audit Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Bid Primary Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	CAP Report Contact for Public Website	Director of Govt Programs		Hammond	Kaitlyn		4172692827				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	CEO - CMS Administrator Contact	CEO/President	Mr.	Aug	Matthew		4172692936					maug@coxhealthplans.com	PO Box 5750		Sprinfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	CEO - Senior Official for Contracting	CEO/President	Mr.	Aug	Matthew		4172692936					maug@coxhealthplans.com	PO Box 5750		Sprinfield	MO	65801	01/20/2022	2026	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	Ms.	Henderson	Jennifer		4172692885					jhenderson@coxhealthplans.com	PO Box 5750		Sprinfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Chief Operating Officer	CEO/President	Mr.	Aug	Matthew		4172692936					maug@coxhealthplans.com	PO Box 5750		Sprinfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Chief Information Officer	CIO	Ms.	Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Chief Information Security Officer	CIO	Ms.	Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	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		4172692905				4172692949	emathis@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	12/15/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Complaints Tracking Contact	Grievance and Subrogation Coordinator		Mathis	Earlisha		4172692905				4172692949	emathis@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	12/15/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Contact for Fraud Investigations	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	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	Director of Member and Provider Services		Hopkins	Sandy		4172692920				4172692949	shopkins@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Corporate Mailing						4172692827					khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	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	Director of Member and Provider Services		Hopkins	Sandy		4172692920					shopkins@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	DIR Contact	VP of Health Services		O'Connell	Daniel		4172692966				4172692919	doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	12/19/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	DIR Contact (Secondary)	Director Reporting & Analytics		Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	12/19/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Discount Program Payment Contact	Risk Adjustment Manager	Ms.	Thompson	Jo	A	4172694969					jthompson@coxhealthplans.com	PO Box 5750		Springfield	MO	658015750	11/17/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Emergency Part D Contact	VP of Health Services		O'Connell	Daniel		4172692966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Emergency Part D Contact (Secondary)	Pharmacy Technician		Faungo	Bianca		4173706191					bfaugno@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Manager	Ms.	Thompson	Jo	A	4172694969					jthompson@coxhealthplans.com	PO Box 5750		Springfield	MO	658015750	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Enrollment Contact	Director of Member and Provider Services		Hopkins	Sandy		4172692920				4172692949	shopkins@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	EOB Transfer Contact	CIO		Butts	Susan		4172692968				4172692949	sbutts@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Financial Audit Contact	CFO	Ms.	Henderson	Jennifer		4172692885					jhenderson@coxhealthplans.com	3200 S National Ave	Building B	Springfield	MO	65801	09/25/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Financial Reporting Contact	CFO	Ms.	Henderson	Jennifer		4172692885					jhenderson@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Formulary Contact	Formulary Operations Clinical Pharmacist		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/26/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	General Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	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		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	HIPAA Privacy Officer	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	HIPAA Security Officer	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	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		4172692966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Interoperability Contact	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	MA Appeals/Grievances Contact	Grievance and Subrogation Coordinator		Mathis	Earlisha		4172692905				4172692949	emathis@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	06/12/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	MA Claims Processing Contact for Public Website	Director of Member and Provider Services		Hopkins	Sandy		4172692920				4172692949	shopkins@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Marketing Contact	VP of Sales		Stead	Bart		4172692843				4172692949	bstead@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Medical Director	Medical Director	Dr.	Flax	Julia		4172691362					Julia.Flax@coxhealth.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	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		4172692827					khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Medicare Coordinator	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Medicare Part D Opioid Overutilization Contact	VP of Health Services		O'Connell	Daniel		4172692966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	02/10/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Medication Therapy Management Contact	Manager Medication Management		Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Online Enrollment Center Contact (Primary)	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Part C Application Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Part C Reporting Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	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 Appeals	Grievance and Subrogation Coordinator		Mathis	Earlisha							emathis@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	05/23/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active	8557523796				HMO - Health Maintenance Organization		C	Kansas City
H2942	Part D Appeals Contact (Secondary)	Director Clinical Operations		Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Kansas City
H2942	Part D Application Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	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 Benefits Contact	VP of Health Services		O'Connell	Daniel		4172692966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	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 Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2024	2026	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	Director Clinical Operations		Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Kansas City
H2942	Part D Price File Contact (Back-up)	Government Programs Finance Analyst		Wentz	Chris		9547672633					cwentz@elixirsolutions.com	7835 Freedom Ave NW		North Canton	OH	44720	05/23/2023	2026	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 Price File Contact (Optional)	Director Reporting & Analytics		Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2024	2026	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 Price File Contact (Primary)	Sr Financial Manager Reporting & Analytics		Campbell	Tim		9547672633					tcampbell@elixirsolutions.com	7835 Freedom Ave NW		North Canton	OH	44720	05/23/2023	2026	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 Quality Assurance Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	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 Reporting Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Patient Safety Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Payment Contact	Risk Adjustment Manager	Ms.	Thompson	Jo Anne		4172694969					jthompson@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	06/12/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Pharmacy Director	VP of Health Services		O'Connell	Daniel		4172692966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092					Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2024	2026	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	VP Operations		Conn	Todd							Todd.Conn@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/09/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active	8554765985				HMO - Health Maintenance Organization		C	Kansas City
H2942	Plan Directory Contact for Public Website	Director of Member and Provider Services		Hopkins	Sandy		4172692920					shopkins@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Plan to Plan Reconciliation Contact	Risk Adjustment Manager	Ms.	Thompson	Jo Anne		4172694969					jthompson@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	06/12/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Processor Contact	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Quality Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Reconciliation Contact	Risk Adjustment Manager	Ms.	Thompson	Jo Anne		4172694969					jthompson@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	06/12/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Reconciliation Contact (Secondary)	CFO		Henderson	Jennifer		4172692885				4172692919	jhenderson@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Recovery Audit Contact	CFO	Ms.	Henderson	Jennifer		4172692885					jhenderson@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Surveillance Contact	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	System Contact	CIO		Sanchez	Susan		4172692968				4172692949	ssanchez@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	10/05/2023	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Third Party Administrator (TPA) Liaison	CFO		Henderson	Jennifer		4172692885				4172692919	jhenderson@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	04/04/2024	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	User Access Contact	Director of Govt Programs		Hammond	Kaitlyn		4172692728				4172692919	khammond@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Utilization Management Contact	VP of Health Services		O'Connell	Daniel		4172692966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2942	Utilization Review Contact	VP of Health Services		O'Connell	Daniel		4172692966					doconnell@coxhealthplans.com	PO Box 5750		Springfield	MO	65801	01/20/2022	2026	COX HEALTH SYSTEMS HMO INC	Local CCP	Cox HealthPlans	HMO/HMOPOS		CoxHealth	793	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H2960	Agent/Broker Compensation Data Contact	VP of Growth and Retention	Mr	Bawden	CJ		7759823218				7759823743	CJ.Bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Automated TrOOP Balance Transfer Contact	Manager		Diaz	Mario		7143172628					mario.diaz@optum.com	Optum Rx	1600 McConnor Parkway	Schaumburg	IL	60173	02/13/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Backup User Access Contact	Compliance Analyst	Ms	Breckner	Michelle		7759823123					michelle.breckner@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	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		7759823186					Tammi.Foote@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Bid Audit Contact	VP of Growth and Retention	Mr	Bawden	CJ		7759823218				7759823743	CJ.Bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Bid Audit Site Contact	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Bid Primary Contact	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	CAP Report Contact for Public Website	Senior Director of Government Programs	Mr	Bawden	CJ		7759823218				7759823743	cj.bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Sexton	Bethany	J	7759824640					Bethany.Sexton@renown.org	10315 Professional Circle		Reno	NV	89521	01/03/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Sexton	Bethany	J	7759824640					Bethany.Sexton@renown.org	10315 Professional Circle		Reno	NV	89521	10/04/2022	2026	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_Homtown Health	Ms.	Winter	Rebekah		7759825309					Rebekah.Winter@renown.org	10315 Professional Circle		Reno	NV	89521	02/21/2023	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Chief Operating Officer	Chief Executive Officer	Ms.	Sexton	Bethany		7759824640					Bethany.Sexton@renown.org	10315 Professional Circle		Reno	NV	89521	09/13/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Chief Information Officer	Chief Information Officer	Mr.	Podesta	Chuck		7759824328					chuck.podesta@renown.org	50 Liberty Street		Reno	NV	89501	01/05/2023	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Chief Information Security Officer	Chief Information Security Officer, IT General	Mr.	Ramirez	Steven		7759825000					Steven.Ramirez@renown.org	1000 Ryland St	Ste 204	Reno	NV	89502	11/30/2022	2026	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	Manager of Appeals and Grievance	Ms	Eastman	Devany		7759823115					Devany.Eastman@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Complaints Tracking Contact	Manager of Appeals and Grievance	Ms	Eastman	Devany		7759823115					Devany.Eastman@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Contact for Fraud Investigations	Special Investigations Unit Investigator	Ms	Janish	Courtney		7759824849					Courtney.Janish@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	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	Manager of Claims	Ms	Meister	Pam		7759826933					pam.meister@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/06/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Corporate Mailing						7759823223				7759823743	CJ.Bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	03/05/2020	2026	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 Customer Engagement		McKeon	Kelly		7759825212					kelly.mckeon@renown.org	10315 Professional Circle		Reno	NV	89502	10/27/2023	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	DIR Contact	Senior Financial Analyst	Mr	Wingfield	Joseph		7759823190					joseph.wingfield@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	10/27/2023	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	DIR Contact (Secondary)	Director of Finance - Hometown Health	Ms	Desrochers	Alexsis		7759823232					Alexis.Desrochers@hometownhealth.com	10315 Professional Cir		Reno	NV	89521	07/03/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Discount Program Payment Contact	Senior Accountant-HTH	Mr	Goodloe	Ricky		7759826052					Ricky.Goodloe@renown.org	1000 Ryland	Ste 301	Reno	NV	89502	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Emergency Part D Contact	Director of Pharmacy	Ms	Gouchenour	Christie		7752335750				7759823745	christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/27/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Emergency Part D Contact (Secondary)	Senior Director of Government Programs	Mr	Bawden	CJ		7756901700				7759823743	CJ.Bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/27/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Employer Waiver Contact	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Encounter Data & Risk Adjustment Operations Contact	Manager of Risk Adjustment	Ms	Paquette	Erika		7759824402					Erika.Paquette@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Enrollment Contact	Manager of Revenue_Enrollment Services	Ms	Foote	Tammi		7759823186					Tammi.Foote@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	EOB Transfer Contact	Director of Pharmacy	Ms	Gouchenour	Christie		7759823085				7759823745	christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Financial Audit Contact	Compliance Analyst	Ms	Breckner	Michelle		7759823123					Michelle.Breckner@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Financial Reporting Contact	Director of Finance - Hometown Health	Ms	Desrochers	Alexsis		7759823232					Alexis.Desrochers@hometownhealth.com	10315 Professional Cir		Reno	NV	89521	07/03/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Formulary Contact	Director of Pharmacy	Ms	Gouchenour	Christie		7759823085				7759823745	christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/03/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Formulary Contact (Secondary)	Analyst		Maloney	Julia		2242312718					Julia.Maloney@Optum.com	Optum Rx	1600 McConnor Parkway	Schaumburg	IL	60173	02/13/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	General Contact	Senior Director of Government Programs	Mr	Bawden	CJ		7759823218					CJ.bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	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		7759823218				7759823743	CJ.bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	HIPAA Privacy Officer	Director of Compliance	Mr	Colonna	Brian		7759826487					Brian.Colonna@renown.org	1000 Ryland		Reno	NV	89502	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	HIPAA Security Officer	Director of Compliance	Mr	Colonna	Brian		7759826487					Brian.Colonna@renown.org	1000 Ryland		Reno	NV	89502	11/30/2022	2026	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		7759823085					christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Interoperability Contact	Director of Reimbursement Services	Mr	Hutchcraft	Christian		7759823112					customer_service@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/06/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	MA Appeals/Grievances Contact	Manager of Appeals and Grievance	Ms	Eastman	Devany		7759823115					Devany.Eastman@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	MA Claims Processing Contact for Public Website	Director of Reimbursement Services	Mr	Hutchcraft	Christian		7759823145					Christian.Hutchcraft@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Marketing Contact	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Medical Director	Chief Medical Officer	Dr.	Beenfeldt	Derek		7759826280					Derek.Beenfeldt@renown.org	10315 Professional Circle		Reno	NV	89521	01/27/2021	2026	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		7759823025					Lenee.Linzey@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	09/24/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Medicare Coordinator	Compliance Analyst	Ms	Breckner	Michelle	A	7759823123					Michelle.Breckner@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms	Gouchenour	Christie		7759823085				7759823745	Christie.Gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Medication Therapy Management Contact	Director of Pharmacy	Ms	Gouchenour	Christie		7759823085				7759823745	christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	OffShore Subcontractor Contact	Delegation Oversight Coordinator	Ms	Boehne	Crystal		7759826395					Crystal.Boehne2@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Online Enrollment Center Contact (Back-up)	Supervisor of Revenue and Enrollment Revenue	Ms	Ravindran	Daya		7759823174					Daya.Ravindran@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/06/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Online Enrollment Center Contact (Optional)	Enrollment Analyst	Ms	Krager	Annette		7759823162					Annette.Krager@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	10/27/2023	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Online Enrollment Center Contact (Primary)	Manager of Revenue-Enrollment Svcs	Ms	Foote	Tammi		7759823186					tammi.foote@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/06/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Part C Application Contact	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Part C Reporting Contact	Compliance Analyst	Ms	Breckner	Michelle		7759823123					michelle.breckner@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	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 Appeals	Manager, Prior Authorization Appeals	Ms	le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/26/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Dallas
H2960	Part D Appeals Contact (Secondary)	Pharmacy Tech Lead - Prior Auth	Ms	Jackson	Shannon	D					8772394565	shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/26/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active	7633615070				HMO - Health Maintenance Organization		C	Dallas
H2960	Part D Application Contact	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	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 Benefits Contact	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	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 Claims Submission Contact	VP General Management		Olson	Paul		7639237912					paul_olson@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	03/03/2025	2026	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	Manager, Prior Authorization Appeals	Ms	Le	Christina						8772394565	christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/26/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Dallas
H2960	Part D Exceptions Contact (Secondary)	Pharmacy Tech Lead - Prior Authorization Appeals	Ms	Jackson	Shannon	D					8772394565	shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/26/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active	7633615070				HMO - Health Maintenance Organization		C	Dallas
H2960	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms	Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/26/2024	2026	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 Price File Contact (Optional)	Product Development Coordinator	Ms	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	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 Price File Contact (Primary)	Director		Molberg	Brandi		6514955369					brandi.molberg@optum.com	OptumRx	1600 McConnor Parkway	Schaumburg	IL	60173	02/22/2024	2026	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 Quality Assurance Contact	Director of Pharmacy	Ms	Gouchenour	Christie		7759823085				7759823745	christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	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 Reporting Contact	Compliance Analyst	Ms	Breckner	Michelle		7759823123					michelle.breckner@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Patient Safety Contact	Director of Pharmacy	Ms	Gouchenour	Christie		7759823085				7759823745	christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Payment Contact	Director of Finance - Hometown Health	Ms	Desrochers	Alexsis		7759823232					Alexis.Desrochers@hometownhealth.com	10315 Professional Cir		Reno	NV	89521	07/03/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Pharmacy Director	Director of Pharmacy	Ms	Gouchenour	Christie		7759823085				7759823745	christie.gouchenour@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Pharmacy Network Management Contact	Manager, Retail Network Operations		Perez	Felix		3033313044					Felix.perez@optum.com	OptumRx	11000 Optum Cir	Eden Prairie	MN	55344	02/22/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Pharmacy Network Management Contact (Secondary)	Director, Retail Network Operations		Ashby	JoLynn Ash		4696470504					Jashby@optum.com	OptumRx	11000 Optum Cir	Eden Prairie	MN	55344	02/22/2024	2026	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	Sr.		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/13/2023	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active	8443683139				HMO - Health Maintenance Organization		C	Dallas
H2960	PHR Beneficiary Contact																	04/10/2018	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS	Hometown Health (Senior Care Plus)	Renown Health	256	Yes	Active	8887757003				HMO - Health Maintenance Organization		C	Dallas
H2960	Physician Incentive Contact	Director of Quality	Ms	Gonsalves	Savannah		7759823056					Savannah.Gonsalves@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Plan Directory Contact for Public Website	Senior Director of Government Programs	Mr.	Bawden	CJ		7759823218				7759823743	cj.bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Plan to Plan Reconciliation Contact	Senior Financial Analyst	Mr	Wingfield	Joseph		7759823190					Joseph.Wingfield@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Processor Contact	VP Government programs and Services		Olson	Paul		7639237912					paul_olson@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	03/03/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Quality Contact	Director of Quality	Ms	Gonsalves	Savannah		7759823056					Savannah.Gonsalves@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Reconciliation Contact	Senior Financial Analyst	Mr	Wingfield	Joseph		7759823190					joseph.wingfield@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	05/20/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Reconciliation Contact (Secondary)	Director of Finance - Hometown Health	Ms	Desrochers	Alexsis		7759823232					Alexis.Desrochers@hometownhealth.com	10315 Professional Cir		Reno	NV	89521	07/03/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Recovery Audit Contact	Compliance Analyst	Ms	Breckner	Michelle		7759823123					Michelle.Breckner@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	07/02/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	SNP Application Contact	Product Development Coordinator	Ms.	Eddy	Tabatha		7759823721				7759823743	tabatha.eddy@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	SNP State Contact	Senior Director of Government Programs	Mr.	Bawden	CJ		7759823218				7759823743	cj.bawden@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	11/30/2022	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Surveillance Contact	Manager of Customer Engagement	Ms	McKeon	Kelly		7759825212					kelly.mckeon@renown.org	10315 Professional Circle		Reno	NV	89502	07/03/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	System Contact	Director of IT Applications IT Hospital	Ms	Judd	Amy		7759823152					Amy.Judd@hometownhealth.com	10315 Professional Cir		Reno	NV	89521	12/06/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Third Party Administrator (TPA) Liaison	Supervisor of Accounts Payable	Ms.	Phillips	Sarah		7759826052					Sarah.Phillips@renown.org	10315 Professional Cir		Reno	NV	89512	04/29/2025	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	User Access Contact	Compliance Manager	Ms	Linzey	Lenee		7759823025					lenee.linzey@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/17/2021	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Utilization Management Contact	Manager of Healthcare Utilization Mgr	Ms	Spooner-Mccraven	Sarah		7759824573					sarah.spoonermccraven@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/06/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2960	Utilization Review Contact	Supervisor of Clinical Utilization Mgmt   HUM	Ms	Holland	Lisa		7759825837					lisa.holland@hometownhealth.com	10315 Professional Circle		Reno	NV	89521	12/06/2024	2026	HOMETOWN HEALTH PLAN, INC.	Local CCP	Senior Care Plus	HMO/HMOPOS		Renown Health	256	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H2962	Agent/Broker Compensation Data Contact	Director Sales & Marketing	Mr.	Sessa	Wayne		3525155940				3528357169	wsessa@ulthp.com	2713 Forest Rd		Spring Hill	FL	346063377	05/19/2020	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Automated TrOOP Balance Transfer Contact	Chief Operating Officer	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	12/30/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Backup User Access Contact	Chief Information Officer	Mr.	VanWyk	Johan		8554428401				3528357169	jvanwyk@mirrahealthcare.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/26/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Best Available Evidence Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Bid Audit Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Bid Audit Site Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Bid Primary Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	CAP Report Contact for Public Website	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	4124786689				HMO - Health Maintenance Organization		C	Chicago
H2962	CEO - CMS Administrator Contact	CEO	Mr.	Romeo	Enrico		3523409008				3528357169	mromeo@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	07/02/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	CEO - Senior Official for Contracting	CEO	Mr.	Romeo	Enrico		3523409008				3528357169	mromeo@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	07/02/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Chief Financial Officer	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Chief Operating Officer	COO	Mrs.	Debi	Darilu		3525155936				3528357169	ddebi@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Chief Information Officer	Director of Information Services	Mr.	Manzano	Angel		8886574170				3528357169	anmanzano@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	07/11/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Chief Information Security Officer	Director of Information Services	Mr.	Manzano	Angel		8886574170				3528357169	anmanzano@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	07/11/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	CMS Casework Communication Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Complaints Tracking Contact	COO	Mrs.	Debi	Darilu		3525155912					ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Coordination of Benefits Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Corporate Mailing						3528357151				3528357169	cgephart@ulthp.com	1244  Mariner Blvd.		Spring Hill	FL	34609	01/29/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Customer Service Operations Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	DIR Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	DIR Contact (Secondary)	Chief Executive Officer	Mr.	Romeo	Enrique		3523409008				3528357169	mromeo@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	01/13/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Discount Program Payment Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Electronic Health Record Contact	Chief Information Officer	Mr.	VanWyk	Johan		8554428401	4428401			3528357169	jvanwyk@mirrahealthcare.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/26/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	8557307925	4428401			HMO - Health Maintenance Organization		C	Chicago
H2962	Emergency Part D Contact	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Emergency Part D Contact (Secondary)	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	12/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Encounter Data & Risk Adjustment Operations Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Enrollment Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	EOB Transfer Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Financial Audit Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Financial Reporting Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Formulary Contact	Manager, Clinical Pharmacy		Mehta	Anand		6124747424					Anand.mehta@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/11/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Formulary Contact (Secondary)	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	General Contact	CCO	Mrs.	Debi	Darilu		3525155937				3528357169	ddebi@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/19/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Government Relations Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	HIPAA Privacy Officer	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	HIPAA Security Officer		Mr.	VanWyk	Johan		8554428401	4428401			3528357169	jvanwyk@mirrahealthcare.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/26/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Hospice Contact	Chief Medical Officer	Dr.	Shah	Pragnesh		3525155954				3528357169	pshah@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Interoperability Contact	Chief Information Officer		VanWyk	Johan		3528357151					jvanwyk@mirrahealthcare.com	1244 Mariner Blvd		Springhill	FL	34609	02/16/2022	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	MA Appeals/Grievances Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	MA Claims Processing Contact for Public Website	VP, Provider Operations & Network Contracting	Mrs.	Flores	Yvonne		3528357151				3528357169	yflores@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/01/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Marketing Contact	Director Sales & Marketing	Mr.	Sessa	Wayne		3525155940				3528357169	wsessa@ulthp.com	2713 Forest Rd		Spring Hill	FL	346063377	05/18/2020	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Medical Director	Chief Medical Officer	Dr.	Shah	Pragnesh		3525155954				3528357169	pshah@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Medicare Coordinator	Sr. Compliance Specialist	Ms.	Briones	Lymari		3525155926				3528357169	lbriones@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	01/29/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Medicare Part D Opioid Overutilization Contact	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Medication Therapy Management Contact	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Online Enrollment Center Contact (Back-up)	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Online Enrollment Center Contact (Optional)	Director Sales & Marketing	Mr.	Sessa	Wayne		3525155940				3528357169	wsessa@ulthp.com	2713 Forest Rd		Spring Hill	FL	346063377	11/02/2016	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Online Enrollment Center Contact (Primary)	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part C Application Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		3525155930				3528357169	npatel@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	01/29/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part C Reporting Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Appeals	Manager, Prior Authorization		Bricker	Bryce							bryce.m.bricker@optum.com	9040 S. Rita Rd		Tucson	AZ	85747	01/11/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	6126326838				HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Appeals Contact (Secondary)	Part D Pharmacy Compliance Manager		Walker	Shante							swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	6159740575				HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Application Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		1352515593				3528357169	npatel@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/01/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Benefits Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Claims Submission Contact	PharmD		Davelis	Mia		4022101214					Mia.davelis@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/11/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	6126326838				HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Exceptions Contact (Secondary)	Part D Pharmacy Compliance Manager		Walker	Shante							swalker@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	6159740575				HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Price File Contact (Back-up)	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Price File Contact (Primary)			Vargas	Danielle		4437101262					MedOps-Planfinder_DL@ds.uhc.com	1600 McConnor Parkway		Schaumburg	IL	60173	11/08/2022	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Quality Assurance Contact	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Part D Reporting Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Patient Safety Contact	Chief Medical Director	Dr.	Shah	Pragnesh		3525155954				3528357169	pshah@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	11/12/2020	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Payment Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Pharmacy Director	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575				3528357169	swalker@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/11/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Hagan	Kyle		3039895828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	01/05/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Pharmacy Network Management Contact (Secondary)	Part D Pharmacy Compliance Manager		Walker	Shante		6159740575					swalker@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/10/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Pharmacy Technical Help Desk Contact	Sr. Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	1000 Optum Circle		Eden Prairie	MN	55344	12/07/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active	8003117517				HMO - Health Maintenance Organization		C	Chicago
H2962	PHR Beneficiary Contact																	09/06/2012	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS	Ultimate Health Plans, Inc.	Ultimate Healthcare Holdings, LLC	489	Yes	Active	8886574171				HMO - Health Maintenance Organization		C	Chicago
H2962	Physician Incentive Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Plan Directory Contact for Public Website			Service	Customer		8886574170					communications@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	04/05/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Plan to Plan Reconciliation Contact	Vice President, Finance	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/24/2025	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Processor Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Quality Contact	COO	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	06/13/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Reconciliation Contact	Director, Financial Planning and Analysis	Mr.	Uhlig	Joshua		4124786689				3528357169	juhlig@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/19/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Reconciliation Contact (Secondary)	Chief Operating Officer	Mrs.	Debi	Darilu		3525155912				3528357169	ddebi@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	09/19/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Recovery Audit Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	SNP Application Contact	Chief Compliance Officer	Mrs.	Patel	Niral		3528357151	5912			3528357169	npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	01/02/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	SNP State Contact	Chief Compliance Officer	Mrs.	Patel	Niral		3528357151				3528357169	npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	01/02/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Surveillance Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	System Contact		Mr.	VanWyk	Johan		8554428401	4428401			3528357169	jvanwyk@mirrahealthcare.com	1244 Mariner Blvd.		Spring Hill	FL	34609	02/26/2021	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Third Party Administrator (TPA) Liaison	CEO	Mr.	Romeo	Enrico		3523409008				3528357169	mromeo@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	07/02/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	User Access Contact	Chief Compliance Officer	Mrs.	Patel	Nirali		7276862938					npatel@ulthp.com	1244 Mariner Blvd.		Spring Hill	FL	34609	03/08/2023	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Utilization Management Contact	Chief Medical Officer	Dr.	Shah	Pragnesh		3525155954				3528357169	pshah@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/01/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2962	Utilization Review Contact	Chief Medical Officer	Dr.	Shah	Pragnesh		3525155954				3528357169	pshah@ulthp.com	1244 Mariner Blvd		Spring Hill	FL	34609	02/01/2024	2026	ULTIMATE HEALTH PLANS, INC.	Local CCP	Ultimate Health Plans	HMO/HMOPOS		Ultimate Healthcare Holdings, LLC	489	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H2992	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Backup User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Bid Primary Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	CAP Report Contact for Public Website	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	CEO - CMS Administrator Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	CEO - Senior Official for Contracting	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Chief Operating Officer	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Chief Information Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Chief Information Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Complaints Tracking Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Contact for Fraud Investigations	Executive Director	Ms	Detwiler	Megan		7242225433	21318				SLWDirectors@seniorlifewashington.com	2114 North Franklin Drive		Washington	PA	15301	08/26/2024	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Corporate Mailing						8145356000	22101			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	DIR Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Discount Program Payment Contact	CFO		Dodson	David	M	8145356000	22102				Ddodson@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/14/2025	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Emergency Part D Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Encounter Data & Risk Adjustment Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	10/18/2019	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Enrollment Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	EOB Transfer Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Financial Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Formulary Contact			N/A	N/A		1234567890	123				N/A@n/a.com	N/A		N/A	PA	15906	01/22/2013	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	General Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	HIPAA Privacy Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	HIPAA Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Interoperability Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	MIrwin@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	02/16/2022	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	MA Appeals/Grievances Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Marketing Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Medical Director	Medical Director		Anderson	Sheila		7242225433					SMAnderson@physiciansolutionsgrp.com	2114 North Franklin Drive		Washington	PA	15301	10/05/2018	2026	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		7242225433	21318				SLWDirectors@seniorlifewashington.com	2114 North Franklin Drive		Washington	PA	15301	08/26/2024	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Medicare Coordinator	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Medicare Part D Opioid Overutilization Contact	Medical Director		Anderson	Sheila		7242225433					SMAnderson@physiciansolutionsgrp.com	2114 North Franklin Drive		Washington	PA	15301	11/27/2018	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Medication Therapy Management Contact	Cheif Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/13/2019	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Part C Application Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Appeals	Chief Financial Officer	Mr	Dodson	David						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H2992	Part D Appeals Contact (Secondary)	Chief Executive Officer	Mr.	I	Mark						8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	12/29/2020	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active	8145356000	22101			PACE - Nat		C	Philadelphia
H2992	Part D Application Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Benefits Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Claims Submission Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H2992	Part D Price File Contact (Back-up)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Price File Contact (Primary)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Quality Assurance Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Patient Safety Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Payment Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Pharmacy Director			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Pharmacy Network Management Contact			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active	7242751203	219			PACE - Nat		C	Philadelphia
H2992	Plan Directory Contact for Public Website	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Processor Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	11/13/2025	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Quality Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Reconciliation Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Recovery Audit Contact	CFO	Mr	Dodson	David	M	8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Surveillance Contact			Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	System Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Third Party Administrator (TPA) Liaison	VP Grane PBM		Baker	John		3306968345					jebaker@granepbm.com	209 Sigma Drive		Pittsburgh	PA	15238	03/14/2025	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Utilization Management Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H2992	Utilization Review Contact	Cheif Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	SENIORLIFE WASHINGTON, INC.	National PACE	Senior LIFE Washington / Uniontown / Greene	National PACE		SeniorLife Washington, Inc.	409	Yes	Active					PACE - Nat		C	Philadelphia
H3038	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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
H3038	Best Available Evidence Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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
H3038	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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
H3038	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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
H3038	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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
H3038	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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
H3038	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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
H3038	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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
H3038	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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
H3038	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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
H3038	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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
H3038	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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
H3038	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H3038	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H3038	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H3038	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H3038	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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
H3038	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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
H3038	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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
H3038	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H3038	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H3038	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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
H3038	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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
H3038	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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
H3038	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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
H3038	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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
H3041	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H3041	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H3041	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H3041	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H3041	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H3041	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H3041	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H3041	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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
H3048	Agent/Broker Compensation Data Contact	Director of Compliance		Pinilla	Isis	P	8133575380					Pinillai@securhealthplan.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Automated TrOOP Balance Transfer Contact	Operations Manager, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Backup User Access Contact	IT Director		Kamsler	Daniel		8133575361					kamsled@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Best Available Evidence Contact			Englehart	Ernie		3526911016					eenglehart@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Bid Audit Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Bid Primary Contact	Chief Financial Officer		Wang	Angelica		8136195752					wangx@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	CAP Report Contact for Public Website	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	CEO - CMS Administrator Contact	Chief Financial Officer	Ms	Wang	Angelica		8136195752					wangx@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	CEO - Senior Official for Contracting	Chief Operating Officer	Ms	Winans	Kathy		7274576944					winansk@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Chief Financial Officer	Chief  Financial Officer	Ms	Wang	Angelica		8136195752					wangx@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Chief Operating Officer	Chief Operating Officer	Ms	Winans	Kathy		8133575328					winansk@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Chief Information Officer	IT Director	Mr.	Kamsler	Daniel		8133575361					kamslerd@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Chief Information Security Officer	IT Director	Mr.	Kamsler	Daniel		8133575361					kamslerd@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	CMMI Model Point of Contact	Chief Financial Officer		Wang	Angelica		8136185752					wangx@carenu.com	12470 Telecom Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	CMS Casework Communication Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Complaints Tracking Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Contact for Fraud Investigations	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Coordination of Benefits Contact			Middleton	Tom	P	8337673287					tmiddleton@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/09/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Corporate Mailing						8337673287					memberservices@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	01/24/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Customer Service Operations Contact	VP of Growth and Member Experience		Kaczmarek	Maya		2605806025					kaczmarm@carenu.com	4200 W. Cypress Boulevard		Tampa	FL	33607	12/17/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	DIR Contact	Chief  Financial Officer	Ms	Wang	Angelica	J	8136195752					wangx@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/28/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Discount Program Payment Contact	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Electronic Health Record Contact	Chief Financial Officer		Wang	Xiao		8136195752					wangx@carenu.com	4200 Cypress Street	Suite 690	tampa	FL	33607	07/07/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Emergency Part D Contact	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Emergency Part D Contact (Secondary)	Director of Compliance		Pinilla	Isis		8133575380					Pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Encounter Data & Risk Adjustment Operations Contact			Challapally	Swathi		3525498059					schallapally@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Enrollment Contact			Campbell	Katrina	P	3526316564					kacampbell@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	EOB Transfer Contact			Middleton	Tom		8444766900				3526160906	tmiddleton@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/09/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Financial Audit Contact	Chief  Financial Officer	Ms	Wang	Angelica		8138718147					wangx@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/28/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Financial Reporting Contact	Chief Financial Officer	Ms	Wang	Angelica		8138718147					wangx@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	09/09/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Formulary Contact	Sr. Analyst, Formulary Operations		Paddock	Deanna		6087291628				6087292628	deanna.paddock@navitus.com	361 Integrity Drive		Madison	WI	53717	02/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Formulary Contact (Secondary)	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	General Contact			Service	Customer		8337673287					memberservices@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	01/24/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Government Relations Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	HIPAA Privacy Officer	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	HIPAA Security Officer	IT Director		Kamsler	Daniel		8133575361					kamsled@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	01/24/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Hospice Contact	Director, Health Services		Gonzales	Courtney		8133575330	1716405				gonzalec@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	01/27/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Interoperability Contact	IT Director		Kamsler	Daniel		8133575361					kamsled@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	01/24/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	MA Appeals/Grievances Contact			Novak	Sarah		7276743480					NovakS@carenu.com	4200 W. Cypress Boulevard		Tampa	FL	33607	09/23/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	MA Claims Processing Contact for Public Website			Middleton	Tom		8337673287					tmiddleton@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/09/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Marketing Contact			Krishnamurthy	Marutheesh	P	5734189707					MarutheeshK@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/08/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Medical Director	Chief Medical Director	Dr.	Seleznick	Mitchel		8133575340					seleznim@secur.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	03/11/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Medicare Compliance Officer	Compliance Officer	Ms	Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Medicare Coordinator			Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Medicare Part D Opioid Overutilization Contact	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Medication Therapy Management Contact	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	OffShore Subcontractor Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Online Enrollment Center Contact (Primary)			Campbell	Katrina		3526316564					kacampbell@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part C Application Contact	Chief Financial Officer		Wang	Xiao	A	8136195752					wangx@carenu.com	4200 West Cypress		Tampa	FL	33607	07/07/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part C Reporting Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	361 Integrity Drive		Madison	WI	53717	10/02/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	New York
H3048	Part D Application Contact	Chief Executive Officer		Winans	Kathy		7274576944					Winansk@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	07/08/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part D Benefits Contact	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part D Claims Submission Contact	Operations, Technical Programs		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization		LeClair	Christophe						9202214676	christopher.leclair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active	9202221417				HMO - Health Maintenance Organization		C	New York
H3048	Part D Exceptions Contact (Secondary)	Pharmacy Director		Hua	James							huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active	8337673287				HMO - Health Maintenance Organization		C	New York
H3048	Part D Price File Contact (Back-up)	Provider Quality Manager		Saeger	Deborah	L	6087291578				6087292578	deb.saeger@navitus.com	361 Integrity Drive		Madison	WI	53717	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part D Price File Contact (Primary)			Plan Finder	Navitus		5122313140					plan.finder@navitus.com	361 Integrity Drive		Madison	WI	53717	02/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part D Quality Assurance Contact	Provider Quality Manager		Saeger	Deborah	L	6087291578				6087292578	deb.saeger@navitus.com	361 Integrity Drive		Madison	WI	53717	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Part D Reporting Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Patient Safety Contact	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Payment Contact	Chief  Financial Officer		Wang	Angelica		8136195752					wangx@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/28/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Pharmacy Director	Pharmacy Director		Hua	James		8135209001					huaj@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Pharmacy Network Management Contact	VP, Network Management		Santos	Christina		6088204408					christina.santos@navitus.com	361 Integrity Drive		Madison	WI	53717	02/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						8665951975	danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/02/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	New York
H3048	Plan Directory Contact for Public Website	IT Director		Kamsler	Daniel		8133575361					kamsled@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	01/24/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Plan to Plan Reconciliation Contact			Wang	Angelica		8136195752					wangx@carenu.com	12470 Telecome Drive	Ste. 301	Temple Terrace	FL	33637	11/19/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Processor Contact			Middleton	Tom		8337673287					tmiddleton@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/09/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Quality Contact			Pinilla	Isis		8133575330					Pinillai@securhealthplan.com	4200 W. Cypress Boulevard	Ste. 690	Tampa	FL	33607	08/28/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Reconciliation Contact			Campbell	Katrina		3526316564					kacampbell@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Reconciliation Contact (Secondary)			Wang	Angelica		8136195752					wangx@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/28/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Recovery Audit Contact	Compliance Officer	Ms	Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/12/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	SNP Application Contact	Chief Financial Officer		Wang	Xiao	A	8136195752					wangx@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	07/07/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	SNP State Contact	Chief Financial Officer		Wang	Xiao	A	8136195752					wangx@carenu.com	4200 Cypress Street	Suite 690	tampa	FL	33607	07/07/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Surveillance Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	System Contact			Pandey	Rohit		3526911014					rpandey@mirrahealthcare.com	10470 Spring Hill Drive		Spring Hill	FL	34608	02/13/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Third Party Administrator (TPA) Liaison	CFO		Wang	Xiao		8136195752					wangx@carenu.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	08/05/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	User Access Contact	Compliance Officer		Pinilla	Isis		8133575380					pinillai@securhealthplan.com	4200 West Cypress Street	Suite 690	Tampa	FL	33607	04/11/2024	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Utilization Management Contact	Director, Health Services		Gonzales	Courtney		8133575330	1716405				gonzalec@carenu.com	4200 W. Cypress Street	Suite 690	Tampa	FL	33607	01/27/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3048	Utilization Review Contact	Director, Health Services		Gonzales	Courtney		8133575330	1716405				gonzalec@carenu.com	4200 W. Cypress Street	Suite 690	Tampa	FL	33607	01/27/2025	2026	SECUR INC	Local CCP	SECUR Health Plan	HMO/HMOPOS		Chapters CareNu Inc	829	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3060	Automated TrOOP Balance Transfer Contact	Director Financial Management	Mr.	Hamm	David	A	7247761100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/14/2024	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Backup User Access Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Bid Primary Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	07/05/2018	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	CAP Report Contact for Public Website	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/09/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	CEO - CMS Administrator Contact	CEO	Mr	Hamm	David	A	7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/19/2023	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	CEO - Senior Official for Contracting	CEO	Mr	Hamm	David	A	7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/19/2023	2026	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		7247761100					jeffrey.carraway@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	02/02/2018	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Chief Operating Officer	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	04/19/2023	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Chief Information Officer	VP Technology and Quality	Mr	Lamb	Charles		7247209202					charles.lamb@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	09/16/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Chief Information Security Officer	VP Technology and Quality	Mr	Lamb	Charles		7247209202					charles.lamb@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	09/16/2016	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Complaints Tracking Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Contact for Fraud Investigations	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Corporate Mailing						4123561668					leslie.kisow@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	06/07/2023	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	DIR Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Discount Program Payment Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Emergency Part D Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Emergency Part D Contact (Secondary)	Accounting Manager	Ms	Cionni	Jane		3042810400					maryjane.cionni@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	01/13/2025	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Encounter Data & Risk Adjustment Operations Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Enrollment Contact	Accounting Manager	Ms.	Cionni	Jane		7247422202					maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	01/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	EOB Transfer Contact	Director of Financial Management	Mr.	Hamm	David		7247422226				7247722960	dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Financial Audit Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Financial Reporting Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Formulary Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	04/21/2017	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	General Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	HIPAA Privacy Officer	Compliance Officer	Ms.	Kaminski	Leean		7247422295					leean.kaminski@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/11/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	HIPAA Security Officer	Director MIS	Mr.	Gilson	Dennis		7246254841					dennis.gilson@lutheranseniorlife.org	500 Wittenberg Way	P. O. Box 928	Mars	PA	16046	08/09/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Interoperability Contact	Director Financial Management		Hamm	David		7247761100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	12/16/2024	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	MA Appeals/Grievances Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	MA Claims Processing Contact for Public Website	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Marketing Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Medical Director	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	04/21/2017	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Medicare Coordinator	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	10/15/2018	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Medication Therapy Management Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	04/21/2017	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part C Application Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Appeals	Director of Financial Management	Mr.	Hamm	David							dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422226				PACE - Nat		C	Philadelphia
H3060	Part D Appeals Contact (Secondary)	Accounting Manager	Ms.	Cionni	Jane							maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	01/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422202				PACE - Nat		C	Philadelphia
H3060	Part D Application Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/11/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Benefits Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Claims Submission Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	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	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422226				PACE - Nat		C	Philadelphia
H3060	Part D Exceptions Contact (Secondary)	Accounting Manager		Cionni	Jane							Maryjane.cionni@lutheranseniorlife.org	Lutheran SeniorLife	1323 Freedom Road	Cranberry Township	PA	16066	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422202				PACE - Nat		C	Philadelphia
H3060	Part D Price File Contact (Back-up)	Accounting Manager	Ms.	Cionni	Jane		7247422202					Maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	01/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Price File Contact (Optional)	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/11/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Price File Contact (Primary)	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/11/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Quality Assurance Contact	Director, Quality Assurance & Education	Ms.	Hankey	Laura		7243022017					laura.hankey@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Part D Reporting Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Patient Safety Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	04/21/2017	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Payment Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/11/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Personal Health Record Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Pharmacy Director	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	04/21/2017	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Pharmacy Network Management Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Pharmacy Network Management Contact (Secondary)	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/11/2016	2026	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	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	7242875433				PACE - Nat		C	Philadelphia
H3060	Pharmacy Technical Help Desk Contact (Secondary)	Medical Director	Dr.	Hanna	Abeer							abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	04/21/2017	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active	7242875433				PACE - Nat		C	Philadelphia
H3060	PHR Beneficiary Contact																	01/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE	Lutheran SeniorLife	Lutheran SeniorLife	352	Yes	Active	7247421100				PACE - Nat		C	Philadelphia
H3060	Plan Directory Contact for Public Website	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Plan to Plan Reconciliation Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Processor Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Quality Contact	Director, Quality Assurance & Education	Ms.	Hankey	Laura		7243022017					laura.hankey@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Reconciliation Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Recovery Audit Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Surveillance Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	System Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Third Party Administrator (TPA) Liaison	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/21/2016	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	User Access Contact	Director of Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	03/10/2020	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Utilization Management Contact	Utilization Review Coordinator	Ms.	Nemec	Dawn		4123561653					dawn.nemec@lutheranseniorlife.org	740 Blackburn Road, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE BUTLER, LLC	National PACE	LIFE Butler County	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H3060	Utilization Review Contact	Utilization Review Coordinator	Ms.	Nemec	Dawn		4123561653					dawn.nemec@lutheranseniorlife.org	740 Blackburn Road, Suite 300		Sewickley	PA	15143	04/08/2019	2026	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		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Backup User Access Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Best Available Evidence Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Bid Primary Contact	CPO		Hernandez	Jorge		9544737112					jfhernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	CAP Report Contact for Public Website			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending	9544737483				PACE - Nat		C	Atlanta
H3069	CEO - CMS Administrator Contact	CEO	Mr	Strum	Shane		9544737070					sstrum@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	CEO - Senior Official for Contracting	CEO	Mr	Strum	Shane		9544737070					sstrum@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Chief Financial Officer	CFO	Mr.	Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Chief Operating Officer	CFO	Mr.	Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Chief Information Officer	CIO	Mrs.	Ross	Kathy		9548474082					ksross@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Chief Information Security Officer		Mrs.	Ross	Kathy		9548474082					ksross@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	CMS Casework Communication Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Complaints Tracking Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Contact for Fraud Investigations			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Coordination of Benefits Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Corporate Mailing						9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Customer Service Operations Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	DIR Contact			Lacknauth	Dave		9544737078					dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Discount Program Payment Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Emergency Part D Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Encounter Data & Risk Adjustment Operations Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Enrollment Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	EOB Transfer Contact			Fernandez	Alexander		9544737483				9544737009	amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Financial Audit Contact	CFO	Mr.	Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Financial Reporting Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Formulary Contact			Lacknauth	Dave		9544737078					dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	General Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Government Relations Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	HIPAA Privacy Officer			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	HIPAA Security Officer			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Interoperability Contact			Ross	Kathy		9548474082					ksross@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	MA Appeals/Grievances Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	MA Claims Processing Contact for Public Website			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Marketing Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Medical Director		Dr.	Calvo	Aldo		9547611020					acalvo@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Medicare Compliance Officer	CFO	Mr.	Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Medicare Coordinator	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Medicare Part D Opioid Overutilization Contact			Lacknauth	Dave		9544737078					dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Medication Therapy Management Contact			Lacknauth	Dave		9544737078					dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part C Application Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	10/16/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part D Appeals			Fernandez	Alexander							amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending	9544737483				PACE - Nat		C	Atlanta
H3069	Part D Application Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	10/16/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part D Benefits Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part D Claims Submission Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	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	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending	9544737483				PACE - Nat		C	Atlanta
H3069	Part D Price File Contact (Back-up)			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part D Price File Contact (Primary)			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part D Quality Assurance Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Part D Reporting Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Patient Safety Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Payment Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Pharmacy Director			Lacknauth	Dave		9544737078					dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Pharmacy Network Management Contact			Lacknauth	Dave		9544737078					dlacknauth@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	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	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending	9544737078				PACE - Nat		C	Atlanta
H3069	Plan Directory Contact for Public Website	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Plan to Plan Reconciliation Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Processor Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Quality Contact	VP of Quality	Mr.	Gallison	Barry		9544737151					bgallison@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Reconciliation Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Recovery Audit Contact	CFO	Mr.	Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Surveillance Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	System Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Third Party Administrator (TPA) Liaison			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	User Access Contact			Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Utilization Management Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3069	Utilization Review Contact	CFO		Fernandez	Alexander		9544737483					amfernandez@browardhealth.org	1800 NW 49th Street		Fort Lauderdale	FL	33309	12/27/2021	2026	NORTH BROWARD HOSPITAL DISTRICT	National PACE	Broward Health	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H3071	Agent/Broker Compensation Data Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/07/2023	2026	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	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2026	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	Backup User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/03/2025	2026	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	Bid Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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	Bid Audit Site Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	04/27/2022	2026	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	Bid Primary Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	CAP Report Contact for Public Website	Compliance Director	Ms.	Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	06/03/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	01/23/2024	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	01/23/2024	2026	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.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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 Operating Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	09/04/2024	2026	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 Information Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	09/04/2024	2026	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 Information Security Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	09/04/2024	2026	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	CMMI Model Point of Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/03/2025	2026	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	Complaints Tracking Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Contact for Fraud Investigations	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Corporate Mailing						8476968500					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway		Park Ridge	IL	60068	03/16/2022	2026	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	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/03/2025	2026	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	DIR Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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	DIR Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Discount Program Payment Contact	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	Thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Emergency Part D Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	09/04/2024	2026	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	Emergency Part D Contact (Secondary)	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact		Ms	Teibowei	Gladys		2142872625					gladys.teibowei@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	09/04/2024	2026	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	Enrollment Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/03/2025	2026	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	EOB Transfer Contact			Lange	Tracie		8476968503				8008861082	tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Financial Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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	Formulary Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2026	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	Formulary Contact (Secondary)	Pharmacy Director		Lopez	Eduardo		7542085867					elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	12/07/2022	2026	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	General Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	01/23/2024	2026	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	HIPAA Privacy Officer	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2026	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	HIPAA Security Officer	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539				8555158166	Eric.Annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Interoperability Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	MA Appeals/Grievances Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/03/2025	2026	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	MA Claims Processing Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Marketing Contact	VP of Marketing	Ms.	Branco	Margaret		7187957495					margaret.branco@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/06/2023	2026	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	Medical Director	Medical Director	Dr.	Butt, MD	Tariq		3125458471					tariq.butt@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	05/18/2022	2026	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		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	06/14/2022	2026	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 Coordinator	Compliance Specialist	Ms.	Wilcox	Hailey		8476968503					Hailey.wilcox@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/07/2024	2026	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 Part D Opioid Overutilization Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2026	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	Medication Therapy Management Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3304058084	Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	OffShore Subcontractor Contact		Mrs.	Lange	Tracie		8476968503				8476923225	Tracie.Lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	09/04/2024	2026	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 C Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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 C Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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 Appeals			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	01/02/2024	2026	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H3071	Part D Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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 Benefits Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	09/04/2024	2026	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 Claims Submission Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/02/2024	2026	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			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	01/02/2024	2026	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H3071	Part D Price File Contact (Back-up)			Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/02/2024	2026	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 Price File Contact (Optional)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2026	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 Price File Contact (Primary)			Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/02/2024	2026	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 Quality Assurance Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2026	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 Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Patient Safety Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2026	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	Payment Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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 Director	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	03/16/2022	2026	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 Network Management Contact			Perez	Felix		3053313044				3053313044	Felix.perez@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	01/02/2024	2026	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 Network Management Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	12/14/2023	2026	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	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	P.O. Box 2975		Mission	KS	66201	12/14/2023	2026	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H3071	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Bretten	Brad							bradley.betten@optum.com	P.O. Box 2975		Mission	KS	66201	12/14/2023	2026	CLEAR SPRING HEALTH COMMUNITY CARE, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H3071	Physician Incentive Contact		Ms.	Wilcox-Lange	Tracie		8476968503				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	09/03/2019	2026	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	Plan Directory Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		2249855588				3124290194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Processor Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/02/2024	2026	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	Quality Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/01/2024	2026	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	SNP Application Contact		Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	09/03/2019	2026	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	SNP State Contact		Ms.	Wilcox-Lange	Tracie		8476968502				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	09/03/2019	2026	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	Surveillance Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	System Contact	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539					eric.annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Third Party Administrator (TPA) Liaison	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	03/16/2022	2026	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	Utilization Management Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Utilization Review Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H3080	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H3080	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H3080	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H3080	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H3080	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H3080	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF ALABAMA INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H3080	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Backup User Access Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Best Available Evidence Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Bid Primary Contact	Chief Financial Officer		Shahbazian	Hermes		2067883618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/19/2017	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	CAP Report Contact for Public Website	Pace and Senior Services Director		Castillo	Ken		2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Nomura	Kelli		2067883659					knomura@ichs.com	720 8th Ave South		Seattle	WA	98104	04/03/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Nomura	Kelli		2067883659					knomura@ichs.com	720 8th Ave South		Seattle	WA	98104	04/03/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Chief Financial Officer	Chief Financial Officer	Mr.	Shahbazian	Hermes		2067883618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Chief Operating Officer	Chief Operating Officer	Mr.	East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Chief Information Officer	Chief Information Officer	Ms.	Hong	Nam Phuong		2067883650					namphuongh@ichs.com	720 8th Ave South		Seattle	WA	98104	04/03/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Chief Information Security Officer	Chief Information Officer	Ms.	Hong	Nam Phuong		2067883650					namphuongh@ichs.com	720 8th Ave South		Seattle	WA	98104	04/03/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	CMS Casework Communication Contact	Pace and Senior Services Director		Castillo	Kenneth		2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Complaints Tracking Contact	Quality Assurance Administrator		Rivas	Marc		2069625871					marcosr@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Contact for Fraud Investigations	HAWP Compliance Officer	Ms.	Bansil	Ninya		2067883722					ninyab@ichs.com	PO Box 3007		Seattle	WA	98114	03/22/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Coordination of Benefits Contact	Pace and Senior Services Director		Castillo	Kenneth		2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Corporate Mailing						2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Customer Service Operations Contact	Pace and Senior Services Director		Castillo	Kenneth		2062001890					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	DIR Contact	Chief Financial Officer		Shahbazian	Hermes		2067883618					2hermes@ichs.com	PO Box 3007		Seattle	WA	98114	03/09/2021	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	DIR Contact (Secondary)	Chief Operations Officer		East	Jade		2062001890					jadee@ichs.com	720 8th Ave S Ste 100		Seattle	WA	98104	04/23/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Discount Program Payment Contact	Chief Operations Officer		East	Jade	E	2062001890					jadee@ichs.com	720 8th Ave South		Seattle	WA	98104	10/06/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Emergency Part D Contact	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	803 S. Lane St		Seattle	WA	98104	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Emergency Part D Contact (Secondary)	Chief Operations Officer		East	Jade		2062001890					jadee@ichs.com	720 8th Ave S Ste 100		Seattle	WA	98104	04/23/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Encounter Data & Risk Adjustment Operations Contact	Pace and Senior Services Director		Castillo	Kenneth		2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Enrollment Contact	Marketing Supervisor		Wong	Kayla		2067883717					chingw@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	EOB Transfer Contact	Chief Operating Officer		East	Jade		2064627116				2069623301	jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Financial Audit Contact	Chief Financial Officer	Mr.	Shahbazian	Hermes		2067883618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/19/2017	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Financial Reporting Contact	Chief Financial Officer		Shahbazian	Hermes		2067883618					2hermes@ichs.com	PO Box 3007		Seattle	WA	98114	04/04/2023	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Formulary Contact	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Formulary Contact (Secondary)	Chief Operations Officer		East	Jade		2062001890					jadee@ichs.com	720 8th Ave S Ste 100		Seattle	WA	98104	04/23/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	General Contact	Pace and Senior Services Director		Castillo	Kenneth		2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Government Relations Contact	Chief Executive Officer		Nomura	Kelli		2067883659					knomura@ichs.com	720 8th Ave South		Seattle	WA	98104	04/03/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	HIPAA Privacy Officer	HAWP Compliance Officer		Bansil	Ninya		2067883722					ninyab@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	HIPAA Security Officer	Chief Information Officer		Hong	Nam Phuong		2067883650					namphuongh@ichs.com	720 8th Ave South		Seattle	WA	98104	04/03/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Interoperability Contact	Chief Information Officer		Hong	Nam Phuong		2067883650					namphuongh@ichs.com	720 8th Ave S		Seattle	WA	98104	04/03/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	MA Appeals/Grievances Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	MA Claims Processing Contact for Public Website	Chief Financial Officer		Shahbazian	Hermes		2067883618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/19/2017	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Marketing Contact	Pace and Senior Services Director		Castillo	Kenneth		2064627189					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Medical Director	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Medicare Compliance Officer	HAWP Compliance Officer	Ms.	Bansil	Ninya		2067883722					ninyab@ichs.com	PO Box 3007		Seattle	WA	98114	03/22/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Medicare Coordinator	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Medicare Part D Opioid Overutilization Contact	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Medication Therapy Management Contact	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Online Enrollment Center Contact (Back-up)	caiz@ichs.com		Zeng	Cai		2026521413					caiz@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Online Enrollment Center Contact (Optional)	Pace and Senior Services Director		Castillo	Kenneth		2067883545					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Online Enrollment Center Contact (Primary)	Marketing Supervisor		Wong	Kayla		2067883717					chingw@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part C Application Contact	Chief Operations Officer		East	Jade		2062001890					jadeeric@outlook.com	720 8th Ave S Ste 100		Seattle	WA	98104	04/23/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part D Appeals	Chief Operating Officer		East	Jade							jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/05/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active	2064627116				PACE - Nat		C	San Francisco
H3084	Part D Application Contact	Chief Operations Officer		East	Jade		2062001890					jadee@ichs.com	720 8th Ave S Ste 100		Seattle	WA	98104	04/23/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part D Benefits Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part D Claims Submission Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part D Exceptions Contact	Chief Operating Officer		East	Jade							jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active	2064627116				PACE - Nat		C	San Francisco
H3084	Part D Price File Contact (Back-up)	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part D Price File Contact (Primary)	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part D Quality Assurance Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	P.O. Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Part D Reporting Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	P.O. Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Patient Safety Contact	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Payment Contact	Chief Operations Officer		East	Jade	E	2062001890					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	10/06/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Pharmacy Director	Pharmacy Director		Lee	JuHui		2067883756					juhuil@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Pharmacy Network Management Contact	Pace and Senior Services Director		Castillo	kenneth		2067883545					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Pharmacy Technical Help Desk Contact	Pharmacy Director		Lee	Juhui							juhuil@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active	2067883756				PACE - Nat		C	San Francisco
H3084	Pharmacy Technical Help Desk Contact (Secondary)	Chief Operations Officer		East	Jade							jadee@ichs.com	720 8th Ave S Ste 100		Seattle	WA	98104	04/23/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active	2062001890				PACE - Nat		C	San Francisco
H3084	Plan Directory Contact for Public Website	Pace and Senior Services Director		Castillo	Kenneth		2067883545					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Plan to Plan Reconciliation Contact	Chief Financial Officer		Shahbazian	Hermes		2067883618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/19/2017	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Processor Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Quality Contact	Quality Assurance Administrator		Rivas	Marc		2069625871					marcosr@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Reconciliation Contact	Chief Financial Officer		Shahbazian	Hermes		2067883618					2hermes@ichs.com	720 8th Ave South		Seattle	WA	98104	12/19/2017	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Reconciliation Contact (Secondary)	Fiscal Administrator		Woo	Kiss		2065332617					kwoo@ichs.com	720 8th Ave S Ste 100		Seattle	WA	98104	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Recovery Audit Contact	Fiscal Administrator	Ms	Woo	Kiss		2065332617					kwoo@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Surveillance Contact	Chief Operating Officer		East	Jade		2064627116					jadee@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	System Contact	Pace and Senior Services Director		Castillo	Kenneth		2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Third Party Administrator (TPA) Liaison	Fiscal Administrator		Woo	kiss		2065332617					kwoo@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	User Access Contact	Pace and Senior Services Director		Castillo	Kenneth		2064627189					kennethc@ichs.com	PO Box 3007		Seattle	WA	98114	06/16/2025	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Utilization Management Contact	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3084	Utilization Review Contact	PACE Medical Director		Walia	Mandeep		2064627185					mandeepw@ichs.com	PO Box 3007		Seattle	WA	98114	12/06/2024	2026	INTERNATIONAL COMMUNITY HEALTH SERVICES	National PACE	International Community Health Services	National PACE		International Community Health Services	718	Yes	Active					PACE - Nat		C	San Francisco
H3093	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H3093	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	Atlanta
H3093	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3093	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	MOLINA HEALTHCARE OF ILLINOIS, INC.	Local CCP	Molina Healthcare of Illinois	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3113	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H3113	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3113	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3113	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H3113	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3113	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	OXFORD HEALTH PLANS (NJ), INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3124	Agent/Broker Compensation Data Contact	Vice President, Sales		Olmstead	Jim		2158499606					jolmstead@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Automated TrOOP Balance Transfer Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	troop@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Backup User Access Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Best Available Evidence Contact	AVP, Enrollment		Johnson	Chris		2158499606				2159679267	cjohnson@hpplans.com	1101 Market Street	Suite	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Bid Audit Contact	Director, Product Development  & Growth		Fisher	Craig		2158499606					cfisher1@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Bid Audit Site Contact	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market St	STE 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Bid Primary Contact	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market St	STE 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	CAP Report Contact for Public Website	Compliance Officer		Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	CEO - CMS Administrator Contact	President and Senior Official for Contracting	Mrs.	Hoglund	Krista		2158454747					krista.hoglund@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	CEO - Senior Official for Contracting	President and Senior Official for Contracting	Mrs.	Hoglund	Krista		2158454747					krista.hoglund@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Gregory	J	2152873338					gregory.czar@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	06/10/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Chief Operating Officer	Chief Operating Officer	Mr.	McTiernan	Chris		2157797914					cmctiernan@jeffersonhealthplans.com	1101 Market Street	30th Floor	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Chief Information Officer	Vice President, Information Services & Technology	Mr.	Yetter	Mike		2155035110					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Chief Information Security Officer	Vice President, Information Security	Mr.	Odom	Mark		2155032439					Mark.Odom@jefferson.edu	833 Chestnut		Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	CMMI Model Point of Contact	Director, Product Development  & Growth		Fisher	Craig		2159914090					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	CMS Casework Communication Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2159914023					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Complaints Tracking Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2158499606					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Contact for Fraud Investigations	Director, SIU		Sondergaard	Christian		2159914046					csondergaard@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Coordination of Benefits Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	cob@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Corporate Mailing						2158499606				2155921034	jbaker@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Customer Service Operations Contact	General Manager, Health Plan Operations		Dans	Kim		2158499606					kdans@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	DIR Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					DIR@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	DIR Contact (Secondary)	Director Actuarial Services		Rudi	Brian		2159914077					brudi@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Discount Program Payment Contact	Manager, Pharmacy Regulations and Implementations		McCaffrey	Hannah		2159657142				2159679263	hlivengood@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	09/02/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Emergency Part D Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	rvangala@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Emergency Part D Contact (Secondary)	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					pharmacymedicare@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Encounter Data & Risk Adjustment Operations Contact	Director, Encounter Data Reporting		Raupp	Mike		2158499606					mraupp@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Enrollment Contact	AVP, Enrollment		Johnson	Chris		2158499606					cjohnson@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	EOB Transfer Contact	AVP, Claims		McConaghy	Sandy		2158499606				2159679261	smcconaghy@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Financial Audit Contact	Chief Financial Officer	Mr.	Czar	Gregory	J	2152873338					gregory.czar@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	10/13/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Financial Reporting Contact	Vice President, Finance	Mr.	Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Formulary Contact	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					Formulary@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Formulary Contact (Secondary)	Formulary Pharmacist		Vaisberg	Fallan		2158499606					fvaisberg@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	General Contact	AVP Compliance		Bellito	Lisa		2159914090					lbellito@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Government Relations Contact	SVP, Government Affairs		Jones	Kearline		2158499606					kdjones@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	HIPAA Privacy Officer	Manager, Privacy		Dahiya	Prerna		2158499606					pdahiya@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	HIPAA Security Officer	Manager, Privacy		Dahiya	Prerna		2158499606					pdahiya@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Hospice Contact	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					pharmacymedicare@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Interoperability Contact	Vice President, Health Plan Systems		Yetter	Michael		2152729971					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	MA Appeals/Grievances Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2158499606					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	MA Claims Processing Contact for Public Website	AVP, Claims		McConaghy	Sandy		2158499606					smcconaghy@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Marketing Contact	Director, Marketing Communications		Grzyb	Sarah		2158499606					sgrzyb@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Medical Director	Senior Medical Director		Harris-Williams	Merleen		2158499606					mhwilliams@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Medicare Compliance Officer	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Medicare Coordinator	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Medicare Part D Opioid Overutilization Contact	Clinical Programs Pharmacist		Olchowecky	Kateryna		2158499606				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Medication Therapy Management Contact	Director, Pharmacy Services		Dolores	Danielle		2158499606				2159679270	MTM@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	OffShore Subcontractor Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Support		Polkus	Megan		2159674561					mpolkus@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Online Enrollment Center Contact (Primary)	AVP, Enrollment		Johnson	Chris		2158499606				2159679267	cjohnson@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part C Application Contact			Fisher	Craig		2159914090					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part C Reporting Contact			Fisher	Craig		2159914077					cfisher1@jeffersonhealthplans.com	1101 Market Street		Philadephia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part D Appeals	Manager, Complaints, Grievances and Appeals		Watkins	Leah							Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	2159914023				PPO - BBA		C	Chicago
H3124	Part D Appeals Contact (Secondary)	Supervisor, Complaints, Grievances and Appeals		Rostovskis	Tara							trostovskis@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	2673853491				PPO - BBA		C	Chicago
H3124	Part D Application Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part D Benefits Contact			Fisher	Craig		2159914077					cfisher1@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part D Claims Submission Contact	Manager, Pharmacy Benefit Design and Audit		Chan	Kay		2159914197				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part D Exceptions Contact	Director, Pharmacy Services		Dolores	Danielle						8663713239	Exceptions@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	2159914329				PPO - BBA		C	Chicago
H3124	Part D Price File Contact (Back-up)	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2159657142					Formulary@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part D Price File Contact (Primary)	Manager, Pharmacy Benefit Design and Audit		Chan	Kay		2159914197				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part D Quality Assurance Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					rvangala@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Part D Reporting Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					DIR@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Patient Safety Contact	Director, Pharmacy Services		Dolores	Danielle		2159914329					ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Payment Contact	Vice President, Finance		Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Pharmacy Director	Director, Pharmacy Services		Dolores	Danielle		2159914328				8663713239	ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Pharmacy Network Management Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	Pharmacynetwork@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Services		Dolores	Danielle		2159914329				8663713239	ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Pharmacy Technical Help Desk Contact	Director, Pharmacy Services		Dolores	Danielle						2159679270	Formulary@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	8666934620				PPO - BBA		C	Chicago
H3124	Pharmacy Technical Help Desk Contact (Secondary)	Supervisor Pharmacy Technician		Mahler	Brandi						2159679270	bmahler@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active	8666934620				PPO - BBA		C	Chicago
H3124	Plan Directory Contact for Public Website	Director, Marketing Communications		Grzyb	Sarah		6098657999					sgrzyb@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Plan to Plan Reconciliation Contact	Pharmacy Regulatory Business Coordinator		Rutledge-Glazov	Rose	A	2159657142				2159679263	P2P@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Processor Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	rvangala@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Quality Contact	AVP Quality Improvement & Performance		Mullen	Alyssa		6095054006					amullen@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Reconciliation Contact	Vice President, Finance		Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Reconciliation Contact (Secondary)	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	DIR@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Recovery Audit Contact	SVP, Health Care Data Analytics	Mrs.	Potts	Carol		2158499606					cpotts@hpplans.com	1101 Market Street	Suite	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	SNP Application Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	SNP State Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Surveillance Contact	Vice President, Sales		Olmstead	Jim		7176093994					jolmstead@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	System Contact	Vice President, Health Plan Systems		Yetter	Michael		2152729971					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Third Party Administrator (TPA) Liaison	Manager, Pharmacy Regulations and Implementations		McCaffrey	Hannah		2159657142				2159679263	hlivengood@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	09/02/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	User Access Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Utilization Management Contact	Interim VP, Medical Management		Sinni	Jennifer		2158454757					jmsinni@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3124	Utilization Review Contact	Interim VP, Medical Management		Sinni	Jennifer		2158454757					jmsinni@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	PARTNERS INSURANCE COMPANY OF NEW JERSEY INC	Local CCP	Jefferson Health Plans	Local PPO		Thomas Jefferson University	523	Yes	Active					PPO - BBA		C	Chicago
H3127	Agent/Broker Compensation Data Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Automated TrOOP Balance Transfer Contact	Sr. Account Executive, Health Plans		Benz	Monica		4254576944					MBenz@express-scripts.com	One Express Way		St. Louis	MO	63121	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Backup User Access Contact	Director of Information Systems	Ms.	Chipelewski	Jill		9062253915					jchipelewski@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Best Available Evidence Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Bid Audit Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Bid Primary Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	CAP Report Contact for Public Website	Compliance & Risk Management Officer	Ms.	Sandstrom	Nicole		9062257784				9062258684	nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	CEO - CMS Administrator Contact	President & CEO	Ms.	Holmquist	Melissa		9063620303					mholmquist@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	CEO - Senior Official for Contracting	President & CEO	Ms.	Holmquist	Melissa		9062257157					mholmquist@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Chief Financial Officer	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Chief Operating Officer	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Chief Information Officer	Director of Information Systems	Ms.	Chipelewski	Jill		9062253915					jchipelewski@uphp.om	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Chief Information Security Officer	Director of Information Systems	Ms.	Chipelewski	Jill		9062253915					jchipelewski@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	CMS Casework Communication Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Complaints Tracking Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Contact for Fraud Investigations	Compliance & Risk Management Officer	Ms.	Sandstrom	Nicole		9062257784				9062258684	nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Coordination of Benefits Contact	Director of Claims Administration	Ms.	LaCosse	Leslie		9062257503					llacosse@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Corporate Mailing						9062257500				9062257690	mholmquist@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Customer Service Operations Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	DIR Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	DIR Contact (Secondary)	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Discount Program Payment Contact	Controller	Mr.	Adriano	Aaron		9062258790					aadriano@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/15/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Emergency Part D Contact	Pharmacy Director		Wales	Abby		9063617898				9062258792	awales@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Emergency Part D Contact (Secondary)	President & CEO		Holmquist	Melissa		9063620303					mholmquist@uphp.com	853 W. Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington St		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Enrollment Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	EOB Transfer Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Financial Audit Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Financial Reporting Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Formulary Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Formulary Contact (Secondary)	Sr. Account Executive, Health Plans		Benz	Monica		4254576944					MBenz@express-scripts.com	One Express Way		St. Louis	MO	63121	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	General Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Government Relations Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	HIPAA Privacy Officer	Compliance & Risk Management Officer	Ms.	Sandstrom	Nicole		9062257784				9062258684	nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	HIPAA Security Officer	Director of Information Systems	Ms,	Chipelewski	Jill		9062253915					jchipelewski@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Hospice Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Interoperability Contact	Director of Information Systems	Ms.	Chipelewski	Jill		9062253915					jchipelewski@uphp.om	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	MA Appeals/Grievances Contact	Clinical Services Manager - Appeals	Ms.	St. Aubin	Kylah		9062275678					kstaubin@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	MA Claims Processing Contact for Public Website	Director of Claims Adminstration	Ms.	LaCosse	Leslie		9062257503				9062258751	llacosse@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Marketing Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Medical Director	Medical Director	Dr.	Darr	Francis		9062256740					fdarr@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Medicare Compliance Officer	Compliance & Risk Management Officer	Ms.	Sandstrom	Nicole		9062257784				9062258684	nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Medicare Coordinator	Chief Operating Officer	Ms.	Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Medicare Part D Opioid Overutilization Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Medication Therapy Management Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Online Enrollment Center Contact (Back-up)	Chief Operating Officer		Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Online Enrollment Center Contact (Primary)	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part C Application Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part C Reporting Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Appeals	Pharmacy Director		Wales	Abby						9062254516	awales@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active	8773499324				HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Appeals Contact (Secondary)	Pharmacist	Mr.	Moisio	Donald						9062254516	dmoisio@uphp.com	853 W Washington Ave		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active	9062255488				HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Application Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Benefits Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Claims Submission Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Exceptions Contact	Pharmacy Director		Wales	Abby						9062254516	awales@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active	8773499324				HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Exceptions Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop: S13NB	St. Louis	MO	63121	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active	9013817109				HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way	Bldg 1	St. Louis	MO	63121	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Price File Contact (Optional)	Manager, Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Price File Contact (Primary)	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Quality Assurance Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Part D Reporting Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Patient Safety Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Payment Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Pharmacy Director	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Pharmacy Network Management Contact	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Pharmacy Network Management Contact (Secondary)	Network Account Director, Retail Strategy &Contrac		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	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	01/31/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H3127	Plan Directory Contact for Public Website	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	08/01/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Processor Contact	Director of Claims Administration		LaCosse	Leslie		9062257503					llacosse@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Quality Contact	Director of Population Health	Ms.	Joffee	Janey		9062264286					jjoffee@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Reconciliation Contact	Chief Financial Officer	Ms.	Lesher	Jennifer		9062257491					jlesher@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/04/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Reconciliation Contact (Secondary)	Pharmacy Director		Wales	Abby		9062257953				9062258792	awales@uphp.com	853 W Washington St		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Recovery Audit Contact	Compliance & Risk Management Officer	Ms.	Sandstrom	Nicole		9062257784				9062258684	nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	SNP Application Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	SNP State Contact	Chief Operating Officer	Ms.	Bicigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Surveillance Contact	Chief Operating Officer	Ms.	BIcigo	Melanie		9062257749					mlbicigo@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	System Contact	Director of Information Systems		Chipelewski	Jill		9062253915					jchipelewski@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Third Party Administrator (TPA) Liaison	Controller	Mr.	Adriano	Aaron		9062258790					aadriano@uphp.com	853 W. Washington Street		Marquette	MI	49855	12/15/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	User Access Contact	Compliance & Risk Management Officer	Ms.	Sandstrom	Nicole		9062257784				9062258684	nsandstrom@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Utilization Management Contact	Director of Population Health	Ms.	Joffee	Janey		9062264286				9062258782	jjoffee@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3127	Utilization Review Contact	Clinical Services Manager	Ms.	Tyrrell	Maureen		9062275685				9062321624	mtyrrell@uphp.com	853 W. Washington Street		Marquette	MI	49855	01/23/2025	2026	UPPER PENINSULA HEALTH PLAN, LLC	Local CCP	Upper Peninsula Health Plan (UPHP) MI Coordinated Health	HMO/HMOPOS		DLP Marquette Health Plan, LLC	877	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3138	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Backup User Access Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					Lynn.M.Cooper@kp.org	10350 E Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Bid Primary Contact	Actuary		Hedgecock	Peter		5035679087					KPMedicareBids@kp.org	500 NE Multnomah #100		Portland	OR	97232	06/27/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	CAP Report Contact for Public Website	Medicare Compliance Lead	Ms.	Cooper	Lynn		7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Complaints Tracking Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Corporate Mailing						7205279215					lynn.m.cooper@kp.org	10350 East Dakota Avenue		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Customer Service Operations Contact	Ex Director, Member Services Contact Centers, Denv		Martin	Norman	K	3039124673					NK.Martin@kp.org	7901 East Lowry Blvd, Ste 150 and 400		Denver	CO	80230	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	DIR Contact	Manager Financial Reporting & Analysis		Hsiue	Tony		5626583836				5626583866	tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Employer Waiver Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	06/01/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	General Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					Cathy.P.Plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	MA Appeals/Grievances Contact	Sr. Manager, Grievances and Appeals		McGaughy	Rachel		7206033201					Rachel.X.McGaughy@kp.org	7901 E. Lowry Blvd. Denver, CO 80230		Portland	OR	97232	12/04/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	MA Claims Processing Contact for Public Website	Dir Customer Engagement Mgmt		Galloway	Lonnie		9094772466					Lonnie.L.Galloway@kp.org	10740 4th Street		Rancho Cucamonga	CA	91730	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Marketing Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					KP-MedicareFilings@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Medicare Compliance Officer	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Medicare Coordinator	Program Director, Medicare Market/Product Strategy	Ms.	Johnston	Stacy		7203902574					stacy.johnston@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street	2nd Floor, Cubicle 023W02	Rancho Cucamonga	CA	91730	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part C Application Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part C Reporting Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Appeals	Sr. Manager, Grievances and Appeals		McGaughy	Rachel							Rachel.X.McGaughy@kp.org	7901 E. Lowry Blvd. Denver, CO 80230		Portland	OR	97232	12/04/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	7206033201				PPO - BBA		C	Dallas
H3138	Part D Appeals Contact (Secondary)	Sr. Grievance and Appeals Consultant		Elkhaddari	Claudia							claudia.elkhaddari@kp.org	2500 S. Havana Street		Aurora	CO	80014	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	3032832813				PPO - BBA		C	Dallas
H3138	Part D Application Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Benefits Contact	PO PS, National Rx Programs & Servics		Bonvie	Claudette		5623199392					Claudette.R.Bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90042	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Claims Submission Contact	PO PS, National Rx Programs & Servics		Bonvie	Claudette		5623199392					Claudette.R.Bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90042	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				PPO - BBA		C	Dallas
H3138	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Price File Contact (Primary)	Pharmacy Benefits Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Part D Reporting Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Patient Safety Contact	Medical Safety & Quality Coordinator		Rasmussen	Jon		3039903890					Jon.Rasmussen@kp.org	10350 East Dakota Ave.		Denver	CO	80247	11/21/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Pharmacy Director	Chief Pharmacist		Reed	Leah		3037393623				3037393660	leah.k.reed@kp.org	16601 E. Centretech Parkway		Aurora	CO	80011	12/04/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Pharmacy Network Management Contact	Chief Pharmacist		Reed	Leah		3037393623					leah.k.reed@kp.org	16601 E. Centretech Parkway		Aurora	CO	80011	12/04/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8887917255				PPO - BBA		C	Dallas
H3138	Plan Directory Contact for Public Website			Services	Member		8004762167					colorado.cs@kp.org	10350 East Dakota Ave.		Denver	CO	80247	11/21/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Reconciliation Contact (Secondary)	Manager Financial Reporting & Analysis		Hsiue	Tony		5626583836				5626583866	tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	SNP Application Contact	Director Accreditation, Regulatory & Licensing		Beagle	Robin	E	2063272431					robin.e.beagle@kp.org	10350 East Dakota Ave		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	SNP State Contact	Director Accreditation, Regulatory & Licensing		Beagle	Robin		2063272431				8776328502	Robin.e.beagle@kp.org	10350 East. Dakota Ave		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Surveillance Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave, Third Floor		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	User Access Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/14/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Utilization Management Contact	Director, Utilization Management		Mills	Greg		3036495229					Gregory.Mills@kp.org	10240 Park Meadows Drive		Lone Tree	CO	80124	11/21/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3138	Utilization Review Contact	Director, Utilization Management		Mills	Greg		3036495229					Gregory.Mills@kp.org	10240 Park Meadows Drive		Lone Tree	CO	80124	11/21/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	Local CCP	Kaiser Permanente	Local PPO		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					PPO - BBA		C	Dallas
H3146	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/22/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3146	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/07/2018	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3146	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	07/02/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3152	PHR Beneficiary Contact																	02/28/2007	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H3152	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3152	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (NJ)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3170	Agent/Broker Compensation Data Contact	Commission Analyst	Ms.	Westley	Tracey		4029828256					tracey.westley@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	02/01/2016	2026	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	Chicago
H3170	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/11/2025	2026	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	Chicago
H3170	Backup User Access Contact			Nysson	Jacob		4023901820					Jacob.Nysson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	06/25/2025	2026	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	Chicago
H3170	Best Available Evidence Contact	Manager Medicare Advantage Accounts Rec & Enrollme	Ms.	Vlietstra	Josh		4029826064					Josh.Vlietstra@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68108	08/07/2025	2026	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	Chicago
H3170	Bid Audit Contact	Sr Product Portfolio Manager		Wilkinson	Celia		4023901820					celia.wilkinson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H3170	Bid Audit Site Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	Bid Primary Contact	Sr. Product Portfolio Manager	Ms.	Wilkinson	Celia		4029827000					celia.wilkinson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	02/22/2023	2026	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	Chicago
H3170	CEO - CMS Administrator Contact	Chief Revenue Officer	Mr	Rowe	Ron		4029826013					ron.rowe@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	02/13/2023	2026	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	Chicago
H3170	CEO - Senior Official for Contracting	Chief Revenue Officer	Mr	Rowe	Ron		4029826013					ron.rowe@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	02/13/2023	2026	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	Chicago
H3170	Chief Financial Officer	EVP Chief Financial Officer	Mr	Werner	Chad		4026162860					chad.werner@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H3170	Chief Operating Officer	VP, Senior Market Segment Leader	Mr	Peifer	M. Keith		4029827000					Mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	08/12/2024	2026	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	Chicago
H3170	Chief Information Officer	VP Information Services, CIO	Mr.	Kolli	Rama		4029827556					Rama.Kolli@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	02/01/2016	2026	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	Chicago
H3170	Chief Information Security Officer	Director of Information Assurance and CSO	Mr.	Kremke	Kerry		4029827583					Kerry.Kremke@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	02/01/2016	2026	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	Chicago
H3170	CMS Casework Communication Contact	MCO	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Drive		nebraska	NE	68106	09/09/2024	2026	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	Chicago
H3170	Complaints Tracking Contact	MCO	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Drive		nebraska	NE	68106	12/19/2024	2026	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	Chicago
H3170	Contact for Fraud Investigations	Director Payment Integrity		Hirschbrunner	Scott		4029827000					si@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	11/17/2025	2026	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	Chicago
H3170	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/11/2025	2026	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	Chicago
H3170	Corporate Mailing						4023901820					MedicareCompliance@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H3170	Customer Service Operations Contact	Manager Customer Service		Graeve	Sheryl		4029827036					Sheryl.Graeve@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	11/17/2025	2026	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	Chicago
H3170	DIR Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	DIR Contact (Secondary)	Part D Program Manager		Westrum	Josh		4023901820					josh.westrum@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H3170	Discount Program Payment Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2026	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	Chicago
H3170	Electronic Health Record Contact	Manager Clinical Quality Improvement	Ms.	Frey	Sherri		4029828539					sherri.frey@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H3170	Emergency Part D Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	Emergency Part D Contact (Secondary)	Part D Program Manager		Westrum	Josh		4023901820					josh.westrum@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H3170	Employer Waiver Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	Encounter Data & Risk Adjustment Operations Contact	Manager Risk Adjustment	Ms.	Boardman	Laura		4029827636					laura.boardman@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	10/16/2020	2026	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	Chicago
H3170	Enrollment Contact	Manager Medicare Advantage Accounts Rec & Enrollme	Ms.	Vlietstra	Josh		4029826064					Josh.Vlietstra@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68108	08/07/2025	2026	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	Chicago
H3170	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/11/2025	2026	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	Chicago
H3170	Financial Audit Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2026	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	Chicago
H3170	Financial Reporting Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2026	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	Chicago
H3170	Formulary Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384					cindy.godfrey@primetherapeutics.com	29090 Ames Crossing Road		Eagan	MN	55121	12/16/2025	2026	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	Chicago
H3170	General Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	Government Relations Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	HIPAA Privacy Officer	Director of Information Assurance and CSO	Mr.	Kremke	Kerry		4029827583					Kerry.Kremke@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/16/2020	2026	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	Chicago
H3170	HIPAA Security Officer	Director of Information Assurance and CSO	Mr.	Kremke	Kerry		4029827583					Kerry.Kremke@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/16/2020	2026	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	Chicago
H3170	Hospice Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	Interoperability Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	MA Appeals/Grievances Contact	Medicare Advantage Specialist	Ms.	Norman	Courtney		4029828931					Courtney.Norman@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H3170	MA Claims Processing Contact for Public Website		Ms.	Vytlas	Shannon		4029827000					Shannon.Vytlas@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H3170	Marketing Contact	Marketing Specialist, Direct to Consumer	Ms.	Young	Morgan		4029827000					morgan.young@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	08/04/2023	2026	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	Chicago
H3170	Medical Director	CMO, VP Healthcare Svcs	Dr.	Gordon-Simet	Josette		4029828925					josette.gordonsimet@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/29/2022	2026	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	Chicago
H3170	Medicare Compliance Officer	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	05/19/2025	2026	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	Chicago
H3170	Medicare Coordinator		Mr	Nysson	Jacob		4023901820					jacob.nysson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H3170	Medicare Part D Opioid Overutilization Contact	Supv Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/06/2022	2026	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	Chicago
H3170	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations		Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	2900 Ames Crossing Road		EAgan	MN	55120	03/11/2025	2026	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	Chicago
H3170	Online Enrollment Center Contact (Primary)	Manager Medicare Advantage Accounts Rec & Enroll	Ms.	Vlietstra	Josh		4029826064					Josh.Vlietstra@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68108	08/07/2025	2026	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	Chicago
H3170	Part C Application Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	Part C Reporting Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/19/2024	2026	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	Chicago
H3170	Part D Appeals	Regulatory Pharmacist		Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/22/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3170	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetheraputics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/18/2024	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3170	Part D Application Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	Part D Benefits Contact	Manager, PBM Operations		Sager	Shelby		9529133984					Shelby.Sager@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/16/2025	2026	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	Chicago
H3170	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	09/18/2024	2026	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	Chicago
H3170	Part D Exceptions Contact	Regulatory Pharmacist		Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/22/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3170	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/18/2024	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3170	Part D Price File Contact (Back-up)	Price File Analyst Sr		Trudeau	Ashley		6127771338					ashley.trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/06/2022	2026	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	Chicago
H3170	Part D Price File Contact (Optional)	QA Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/06/2022	2026	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	Chicago
H3170	Part D Price File Contact (Primary)	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	Part D Quality Assurance Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	Part D Reporting Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/19/2024	2026	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	Chicago
H3170	Patient Safety Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	Payment Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2026	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	Chicago
H3170	Pharmacy Director	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	11/14/2023	2026	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	Chicago
H3170	Pharmacy Network Management Contact	AVP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	MConlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/09/2023	2026	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	Chicago
H3170	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/22/2024	2026	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	Chicago
H3170	Pharmacy Technical Help Desk Contact	Sr Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/16/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8554571351				HMO - Health Maintenance Organization		C	Chicago
H3170	Pharmacy Technical Help Desk Contact (Secondary)	AVP , Customer Experience & Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/16/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	HMO/HMOPOS		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8554571209				HMO - Health Maintenance Organization		C	Chicago
H3170	Physician Incentive Contact	CMO, VP Healthcare Svcs	Dr.	Gordon-Simet	Josette		4029828925					josette.gordonsimet@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/29/2022	2026	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	Chicago
H3170	Plan Directory Contact for Public Website	Manager, Provider Services		Trice	Ashley		4029827000					Ashley.Trice@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/23/2024	2026	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	Chicago
H3170	Plan to Plan Reconciliation Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2026	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	Chicago
H3170	Processor Contact	Director PBM Operations	Ms.	Allie	Cindy		6127776755				6127776706	MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing		Eagan	MN	55121	06/20/2023	2026	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	Chicago
H3170	Quality Contact	Manager Clinical Quality Improvement	Ms.	Frey	Sherri		4029828539					sherri.frey@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H3170	Reconciliation Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/19/2024	2026	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	Chicago
H3170	Recovery Audit Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2026	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	Chicago
H3170	Surveillance Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H3170	System Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H3170	Third Party Administrator (TPA) Liaison	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	01/17/2020	2026	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	Chicago
H3170	User Access Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	02/22/2023	2026	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	Chicago
H3170	Utilization Management Contact	Manager Government Medical Services	Ms.	Garmong	Cortny		4029826002					cortny.garmong@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H3170	Utilization Review Contact	Manager Government Medical Services	Mr.	Garmong	Cortny		4029826002					cortny.garmong@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H3186	Agent/Broker Compensation Data Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Backup User Access Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Best Available Evidence Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Bid Audit Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Bid Audit Site Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Bid Primary Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	CAP Report Contact for Public Website	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8007525863				PPO - BBA		C	Dallas
H3186	CEO - CMS Administrator Contact	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	CEO - Senior Official for Contracting	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Chief Financial Officer	Chief Financial Officer	Mr.	Custis	Stephen		6129649158					Stephen.Custis@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Chief Operating Officer	Vice President of Operations	Ms.	Foemmel	Sara		7153836634					foemmel.sara@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Chief Information Officer	Cheif Information Officer	Mr.	Reimer	Brad		6053287937					Brad.Reimer@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Chief Information Security Officer	Vice President - Information Security Officer	Ms.	Hogstad	Kimberly		6053287410					Kimberly.Hogstad@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	CMMI Model Point of Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	CMS Casework Communication Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Complaints Tracking Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Contact for Fraud Investigations	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Coordination of Benefits Contact	Director of Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Corporate Mailing						8007525863					memberservices@sanfordhealth.org	PO BOX 91110		Sioux Falls	SD	57109	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Customer Service Operations Contact	Director of Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	DIR Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/24/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	DIR Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Discount Program Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Emergency Part D Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Emergency Part D Contact (Secondary)	Senior Pharmacist	Mr.	Reuman	Reed		6053122761					Reed.Reuman@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Employer Waiver Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Encounter Data & Risk Adjustment Operations Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Enrollment Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	EOB Transfer Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		6053287182				6053286811	Aleesa.Jansick@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Financial Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	09/24/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Financial Reporting Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Formulary Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Formulary Contact (Secondary)	Principal Pharmacy Benefits Specialist		Chen	Honghua		2242312740					Christine.Chen2@optum.com	1600  McConnor Parkway	Suite 201	Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	General Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Government Relations Contact	Head of Government Affairs	Mr.	Wheeler	Dylan		6053287186					Dylan.Wheeler@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	HIPAA Privacy Officer	Lead Privacy Officer	Ms.	Sundby	Jennifer		6053625407					Jennifer.Sundby@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	HIPAA Security Officer	Information Security Compliance Officer	Mr.	Otte	Brody		6053126563					Brody.Otte@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Hospice Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Interoperability Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	MA Appeals/Grievances Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	MA Claims Processing Contact for Public Website	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Marketing Contact	Director of Marketing	Ms.	McCloskey	Diana		6053122762					Diana.Mccloskey@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Medical Director	Chief Medical Officer	Dr.	Faber	Kevin		6053287192					Kevin.Faber@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Medicare Coordinator	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Medication Therapy Management Contact	Clinical Program Manager	Ms.	Liaqat	Tazeen		6305440541					Tazeen.liaqat@optum.com	1240 South Pine Island Rd.		Plantation	FL	33324	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	OffShore Subcontractor Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Online Enrollment Center Contact (Back-up)	Manager of Inside Sales	Mr.	Arnett	Jack		6053286886					Jack.Arnett@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Online Enrollment Center Contact (Optional)	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Online Enrollment Center Contact (Primary)	Director of Medicare Programs	Mr.	Ovenden	Nathan		6053122606					Nathan.Ovenden@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part C Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part C Reporting Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Appeals	Manager, Prior Authorization Appeals	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H3186	Part D Appeals Contact (Secondary)	Pharmacy Technician, PA Appeals	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H3186	Part D Application Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Benefits Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Claims Submission Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Exceptions Contact	Manager, Prior Authorization	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H3186	Part D Exceptions Contact (Secondary)	Pharmacy Technician, PA	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H3186	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms.	Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Price File Contact (Optional)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Price File Contact (Primary)	Senior Business Analyst	Ms.	Lam	Annie		6124286588					Annie.Lam@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Quality Assurance Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Part D Reporting Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Patient Safety Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Personal Health Record Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Pharmacy Director	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Perez	Felix		7632833503					Felix.Perez@optum.com	1600 McConnor Parkway , IL 601736801		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations	Ms.	Ashby	Jolynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Pharmacy Technical Help Desk Contact	Pharmacy Technical Help Desk	Sr.	Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8446429090				PPO - BBA		C	Dallas
H3186	PHR Beneficiary Contact																	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO	Sanford Health Plan	Sanford Health	740	Yes	Active	8882786485				PPO - BBA		C	Dallas
H3186	Physician Incentive Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Plan Directory Contact for Public Website	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Processor Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Quality Contact	Director of Quality and STARS Strategy	Ms.	Kanta	Misty		6053122788					Misty.Kanta@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Reconciliation Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Recovery Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	SNP Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	SNP State Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Surveillance Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	System Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Third Party Administrator (TPA) Liaison	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	User Access Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Utilization Management Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3186	Utilization Review Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN OF MINNESOTA	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H3192	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/26/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/26/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Government Relations Contact	Executive Dir., Govt. Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	06/23/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3192	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/07/2018	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3192	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3204	Agent/Broker Compensation Data Contact	Director-INDIVIDUAL PLAN PROGRAMS & SALES OPS	Mrs	Montoya	Jessica		5059238241					jemontoya@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/16/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Automated TrOOP Balance Transfer Contact	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235530					kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/11/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Backup User Access Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	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	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Bid Audit Contact	Compliance Officer	Ms	Quintana Clyde	Alejandra		5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Bid Audit Site Contact	Compliance Officer	Ms	Quintana Clyde	Alejandra		5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Bid Primary Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	09/13/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	CAP Report Contact for Public Website	Compliance Officer	Ms	Quintana Clyde	Alejandra		5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	8663887737	8598			HMO - Health Maintenance Organization		C	Dallas
H3204	CEO - CMS Administrator Contact	President, Presbyterian Health Plan	Ms	Thiltgen	Heather		5059235408				5059238244	hthiltgen@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/21/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	CEO - Senior Official for Contracting	President, Presbyterian Health Plan	Ms	Thiltgen	Heather		5059235408				5059238244	hthiltgen@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/21/2025	2026	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	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Chief Operating Officer	Vice President and Chief Operations Officer	Mr	Johnson	John		5059235274					jjohnson12@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/15/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Chief Information Officer	Chief Technology Performance Officer	Mr	Fett	Doug		5059238644				5059238244	cfett@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/05/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Chief Information Security Officer	Chief Information Security Officer	Ms	McClung	Barbara		4082197031					bmcclung2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/05/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	CMMI Model Point of Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/05/2025	2026	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	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Complaints Tracking Contact	Medicare Manager, Appeals and Grievance	Mr	Anaya	Daniel		5059235821				5059236111	danaya@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Contact for Fraud Investigations	Director Program Integrity	Ms	Jamison	Mary Alice		5059236706					mjamison2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	02/16/2024	2026	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	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235530					kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/11/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Corporate Mailing						5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/26/2021	2026	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		5059238580				5059235124	kgarcia3@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/29/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	DIR Contact	Manager, Pharmacy Data and Rebates	Ms	Jaramillo	Monica		5059235459					mojarami@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/01/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	DIR Contact (Secondary)	Executive Director Pharmacy Services	Mr	Roland	Frank		5059235530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	03/17/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Discount Program Payment Contact	Manager, Budget and Financial Planning	Ms	Lemmons	Lisa		5059236314				5059238244	llemmons2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Emergency Part D Contact	Executive Director Pharmacy Services	Mr	Roland	Frank		5059235530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	03/17/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Emergency Part D Contact (Secondary)	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235530					kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/18/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Employer Waiver Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment	Mr	Bundy	Andrew		5059236452					abundy@phs.org	9521 San Mateo NE		Albuquerque	NM	87113	03/10/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Enrollment Contact	Vice President, Chief Financial Officer	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	EOB Transfer Contact	Vice President, Chief Financial Officer	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Financial Audit Contact	Compliance Officer	Ms	Quintana Clyde	Alejandra		5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Financial Reporting Contact	Vice President, Chief Financial Officer	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Formulary Contact	Formulary and Therapeutics Manager	Mr	Garcia	Steven		5059235533					sgarcia84@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/16/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Formulary Contact (Secondary)	VP Chief Medical Officer	Dr	White	Clinton		5059235875					cwhite13@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/01/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	General Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	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	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	HIPAA Privacy Officer	Privacy Officer	Ms	Collaros	Sophia		5059236176				5059238159	scollaros@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/26/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	HIPAA Security Officer	Chief Information Security Officer	Ms	McClung	Barbara		4082197031					bmcclung2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/05/2022	2026	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	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235530					kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/11/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Interoperability Contact	Chief Technology Performance Officer	Mr	Fett	Doug		5059238644				5059238244	cfett@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/05/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	MA Appeals/Grievances Contact	Medicare Manager, Appeals and Grievance	Mr	Anaya	Daniel		5059235821				5059236111	danaya@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	MA Claims Processing Contact for Public Website	Presbyterian Customer Service Center		Provider Care Unit	PCSC		5059236060				5059235124	info@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/28/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Marketing Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Medical Director	VP Chief Medical Officer	Dr	White	Clinton		5059235875					cwhite13@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/01/2024	2026	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		5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Medicare Coordinator	Director, Medicare Programs	Ms	Jamael	Rosie		5059238203				5059235866	rjamael@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/22/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Medicare Part D Opioid Overutilization Contact	Manager Medicare Part D, Pharmacy Services	Ms	Padilla	Melissa		5059235533					mpadilla28@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/02/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Medication Therapy Management Contact	Manager Medicare Part D, Pharmacy Services	Ms	Padilla	Melissa		5059235533					mpadilla28@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/02/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Online Enrollment Center Contact (Back-up)	Director, Enrollment Operations	Mr	Myers	Richard		5059236169				5059235385	rmyers4@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/16/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Online Enrollment Center Contact (Optional)	Vice President, Member Communications	Ms	Nevarez	Lourdes		5059235783				5059235385	lnevarez@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	01/28/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Online Enrollment Center Contact (Primary)	Manager, Enrollment Operations	Ms	Bracamonte	Susie		5059236017				5059235385	sbracamo@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/15/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Part C Application Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Part C Reporting Contact	Medicare Reporting Data Specialist	Ms	Lamers	Rhema		5059237959					rlamers@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/01/2024	2026	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 Appeals	Medicare Manager, Appeals and Grievance	Mr	Anaya	Daniel						5059236111	danaya@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	5059235821				HMO - Health Maintenance Organization		C	Dallas
H3204	Part D Appeals Contact (Secondary)	Director, Appeals and Grievance	Ms	Napoleone Salazar	Sarah						5059236111	snapoleon@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/09/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	5059238064				HMO - Health Maintenance Organization		C	Dallas
H3204	Part D Application Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	07/12/2023	2026	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 Benefits Contact	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235530					kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/11/2023	2026	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 Claims Submission Contact	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235530					kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/11/2023	2026	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	03/17/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	5059235530				HMO - Health Maintenance Organization		C	Dallas
H3204	Part D Exceptions Contact (Secondary)	Medicare Part D Manager, Pharmacy Services	Ms	Padilla	Melissa							mpadilla28@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	5059235533				HMO - Health Maintenance Organization		C	Dallas
H3204	Part D Price File Contact (Back-up)			Rx	Capital		6154231269					governmentprograms@cap-rx.com	228 Park Avenue South Suite 87234		New York	NY	10003	01/02/2024	2026	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 Price File Contact (Optional)	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235526				5059235540	kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/29/2020	2026	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 Price File Contact (Primary)	Executive Director, Pharmacy Services	Mr	Roland	Frank		5059235530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	03/17/2025	2026	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 Quality Assurance Contact	Executive Director, Pharmacy Services	Mr	Roland	Frank		5059235530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	03/17/2025	2026	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 Reporting Contact	Medicare Programs Reporting Specialist	Ms	Lamers	Rhema		5059237959					rlamers@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	10/01/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Patient Safety Contact	Manager Medicare Part D, Pharmacy Services	Ms	Padilla	Melissa		5059235533					mpadilla28@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	05/02/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Payment Contact	Vice President, Chief Financial Officer	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Pharmacy Director	Executive Director, Pharmacy Services	Mr	Roland	Frank		5059235530					froland2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	03/17/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Pharmacy Network Management Contact	Eprescribe Program Manager, Pharmacy Services	Mr	Van Klaveren	Kasey		5059235530					kvanklave@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/11/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Pharmacy Network Management Contact (Secondary)	Medicare Part D Manager, Pharmacy Services	Ms	Padilla	Melissa		5059235533					mpadilla28@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	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	03/17/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	8665285829				HMO - Health Maintenance Organization		C	Dallas
H3204	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Part D Manager, Pharmacy Services	Ms	Padilla	Melissa							mpadilla28@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active	8665285829				HMO - Health Maintenance Organization		C	Dallas
H3204	Physician Incentive Contact	Vice President, Provider Network Management	Mr	Gear	Brady		5059235805				5059235400	bgear@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/29/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Plan Directory Contact for Public Website	Presbyterian Customer Service Center		Provider Care Unit	PCSC		5059235757				5059235124	info@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	01/18/2018	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Plan to Plan Reconciliation Contact	Data Reporting Specialist, Risk Adjustment	Ms	Pham	Sindy		5059236012				5059238244	rpham@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/13/2019	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Processor Contact	Vice President, Chief Financial Officer	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Quality Contact	Vice President, Pop Health and Quality Strategy	Ms	Moore	Megan		5059238471				5058433841	mmoore17@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	01/09/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Reconciliation Contact	Vice President, Chief Financial Officer	Mr	Spalding	David		5059235719				5059238244	dspalding@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	12/12/2024	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Reconciliation Contact (Secondary)	Director, Financial Planning and Analysis	Ms	Andersen	Stacy		5059238307				5059238252	kandersen@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	06/29/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Recovery Audit Contact	Compliance Officer	Ms	Quintana Clyde	Alejandra		5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	SNP Application Contact	Vice President, Medicare Programs	Mr	Ayerza	Gabriel		2066618676					gayerza@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	09/13/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Surveillance Contact	Compliance Officer	Ms	Quintana Clyde	Alejandra		5059237496				5059238159	aquintana30@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	11/09/2021	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	System Contact	Chief Technology Performance Officer	Mr	Fett	Doug		5059238644				5059238244	cfett@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	04/05/2022	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Third Party Administrator (TPA) Liaison	Manager, Budget and Financial Planning	Ms	Lemmons	Lisa		5059236314				5059235540	llemmons2@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/04/2020	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	User Access Contact	Director, Medicare Programs	Ms	Jamael	Rosie		5059238203				5059235866	rjamael@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/22/2025	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Utilization Management Contact	VP Associate Chief Medical Officer	Dr	White	Clinton		5059235875					cwhite13@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/14/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3204	Utilization Review Contact	VP Associate Chief Medical Officer	Dr	White	Clinton		5059235875					cwhite13@phs.org	9521 San Mateo Blvd NE		Albuquerque	NM	87113	08/14/2023	2026	PRESBYTERIAN HEALTH PLAN	Local CCP	Presbyterian Health Plan	HMO/HMOPOS		Presbyterian Healthcare Services	188	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3219	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	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	Atlanta
H3219	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H3219	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	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	Atlanta
H3219	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	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	Atlanta
H3219	Bid Audit Contact	Sr.  Manager Actuarial		Castanada	Elena		9132025156					eacastanada@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/18/2025	2026	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	Atlanta
H3219	Bid Audit Site Contact	Sr.  Manager Actuarial		Castanada	Elena		9132025156					eacastanada@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/18/2025	2026	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	Atlanta
H3219	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	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	Atlanta
H3219	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	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	Atlanta
H3219	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Wieland	Robert		6128597257					WielandR@AllinaHealthAetna.com	1550 Utica Avenue South	Suite 250	St. Louis Park	MN	55416	11/12/2021	2026	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	Atlanta
H3219	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Wieland	Robert		6128597257					WielandR@AllinaHealthAetna.com	1550 Utica Avenue South	Suite 250	St. Louis Park	MN	55416	11/12/2021	2026	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	Atlanta
H3219	Chief Financial Officer	Chief Financial Officer	Mr.	Jacobsen	Jeffrey		6513507639					JacobsenJ1@AllinaHealthAetna.com	1550 Utica Ave. S	Suite 250	St. Louis Park	MN	55416	12/18/2018	2026	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	Atlanta
H3219	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/02/2025	2026	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	Atlanta
H3219	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	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	Atlanta
H3219	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	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	Atlanta
H3219	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	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	Atlanta
H3219	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	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	Atlanta
H3219	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	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	Atlanta
H3219	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	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	Atlanta
H3219	Corporate Mailing						6513507649					MolitorL@AllinaHealthAetna.com	1550 Utica Avenue South	Suite 250	St. Louis Park	MN	55416	12/18/2018	2026	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	Atlanta
H3219	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	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	Atlanta
H3219	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H3219	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H3219	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H3219	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	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	Atlanta
H3219	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	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	Atlanta
H3219	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H3219	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	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	Atlanta
H3219	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H3219	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	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	Atlanta
H3219	Financial Reporting Contact	Chief Financial Officer	Mr.	Jacobsen	Jeffrey		6513507639					JacobsenJ1@AllinaHealthAetna.com	1550 Utica Ave. S	Suite 250	St. Louis Park	MN	55416	04/02/2019	2026	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	Atlanta
H3219	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H3219	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	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	Atlanta
H3219	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	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	Atlanta
H3219	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	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	Atlanta
H3219	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H3219	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	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	Atlanta
H3219	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	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	Atlanta
H3219	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	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	Atlanta
H3219	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	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	Atlanta
H3219	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	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	Atlanta
H3219	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	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	Atlanta
H3219	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	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	Atlanta
H3219	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	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	Atlanta
H3219	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	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	Atlanta
H3219	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H3219	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	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	Atlanta
H3219	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	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	Atlanta
H3219	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	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	Atlanta
H3219	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	12/18/2024	2026	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	Atlanta
H3219	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	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	Atlanta
H3219	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H3219	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H3219	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H3219	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	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	Atlanta
H3219	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H3219	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H3219	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H3219	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H3219	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H3219	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	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	Atlanta
H3219	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	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	Atlanta
H3219	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H3219	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H3219	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H3219	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	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	Atlanta
H3219	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H3219	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	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	Atlanta
H3219	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	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	Atlanta
H3219	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	ALLINA HEALTH AND AETNA INSURANCE COMPANY	Local CCP	Allina Health Aetna Medicare	Local PPO		Allina Health and Aetna Insurance Holding Company	687	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H3219	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	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	Atlanta
H3219	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	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	Atlanta
H3219	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	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	Atlanta
H3219	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	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	Atlanta
H3219	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	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	Atlanta
H3219	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H3219	Reconciliation Contact (Secondary)	Chief Financial Officer	Mr.	Jacobsen	Jeffrey		6513507639					JacobsenJ1@AllinaHealthAetna.com	1550 Utica Ave. S	Suite 250	St. Louis Park	MN	55416	04/02/2019	2026	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	Atlanta
H3219	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H3219	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	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	Atlanta
H3219	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	02/05/2025	2026	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	Atlanta
H3219	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H3219	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	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	Atlanta
H3219	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H3219	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	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	Atlanta
H3219	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	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	Atlanta
H3219	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	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	Atlanta
H3239	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3239	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/25/2018	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3239	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH, INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3240	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/16/2022	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	William		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street		Costa Mesa	CA	92626	05/01/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Medical Director	Medicare Chief Medical Officer		Latif	Omar		8185777721					omar.latif@anthem.com	3080 Bristol Street	Suite 200 CACM00-0000	Costa Mesa	CA	92626	06/08/2022	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	10/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3240	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3240	PHR Beneficiary Contact																	02/07/2019	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H3240	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Utilization Management Contact	Health Services Director, UM Operations		Heapes	Mary		7322152000					mary.heapes@empireblue.com	17 Cornell Drive		East Brunswick	NJ	08816	01/16/2020	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3240	Utilization Review Contact	Health Services Director, UM Operations		Heapes	Mary		7322152000					mary.heapes@empireblue.com	17 Cornell Drive		East Brunswick	NJ	08816	01/17/2020	2026	WELLPOINT NEW JERSEY, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3251	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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 Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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 Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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 Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Mgr Project & Program Managemen	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Formulary Contact	Director Pharmacy Medicare	Mr	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	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	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2026	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	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	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	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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 Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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 Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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 C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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 C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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 Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Denver
H3251	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Denver
H3251	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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 Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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 Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	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 Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Denver
H3251	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Denver
H3251	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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 Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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 Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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 Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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 Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	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 Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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 Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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 Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8772777898				HMO - Health Maintenance Organization		C	Denver
H3251	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of New Mexico	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	0000000000				HMO - Health Maintenance Organization		C	Denver
H3251	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	11/06/2015	2026	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	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	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	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H3256	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H3256	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H3256	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H3256	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3256	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3259	Agent/Broker Compensation Data Contact	Manager Broker Administration	Mrs.	Logan	Lynne		4235356550				4235353178	Lynne_Logan@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/14/2016	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Automated TrOOP Balance Transfer Contact	Advisor Business CVS		Davis	Brittany		4806064613					FIRSupport@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/21/2021	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Backup User Access Contact	Medicare Compliance Officer		Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Best Available Evidence Contact	Manager Operations		Hardy	Sequita		4239911375					Sequita_Hardy@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/24/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Bid Audit Contact	Medicare Compliance Officer	Mrs	Womble	Charriet		6153479580					Charriet_Womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	374022011	07/08/2024	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Bid Primary Contact	BlueCare Plus Director of Sales		Burchette	Kevin		4236023013					Kevin_Burchette@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/06/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	CAP Report Contact for Public Website	Medicare Compliance Officer		Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	CEO - CMS Administrator Contact	President	Mr	Dungan	Casey		4235355635					Casey_Dungan@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	01/07/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	CEO - Senior Official for Contracting	President	Mr	Dungan	Casey		4235355635					Casey_Dungan@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/11/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Chief Financial Officer	VP BlueCare Tn Finance & CEO	Mr.	Gaither	Keith		4236370185					Keith_Gaither@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	01/30/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Chief Operating Officer	Chief Operating Officer	Mr	Sullivan	Patrick		4235357192					Patrick_Sullivan@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/01/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Chief Information Officer	VP Infrastructure & Operations	Ms	Weaver	Jennifer		4235355173				4235359109	Jennifer_Weaver@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/16/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Chief Information Security Officer	VP Infrastructure & Operations	Ms	Weaver	Jennifer		4235355173				4235359109	Jennifer_Weaver@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/16/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	CMS Casework Communication Contact	Clinical Management		Pugh	Donna		4235356563					Donna_Pugh@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Complaints Tracking Contact	Manager Clinical Management		Pugh	Donna		4235356563					Donna_Pugh@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Contact for Fraud Investigations	Director Special Investigations Unit	Mr.	Tidwell	Norman		6153483005				4235357024	Norman_Tidwell@bcbst.com	1 Cameron Hill Circle, Bldg 1.4		Chattanooga	TN	37402	05/02/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Coordination of Benefits Contact	Manger Revenue Reconciliation		Camp	Jan		4235353639					jan_camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/20/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Corporate Mailing						4235356914				4235357567	Jason_Lloyd@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/12/2012	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Customer Service Operations Contact	Director Service Operations		Scissom	Melissa		4235358356				4235919109	Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	DIR Contact	Pharmacy Analyst I		Bushey	Andrew		4235355402					Andrew_Bushey@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	DIR Contact (Secondary)	Pharmacy Operations Manager	Mrs	Moore	Mary-Marga		4235356116					Mary-Margaret_Moore@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Discount Program Payment Contact	Mgr Investments & Financial Mgt		Conway	Kendrick		4236819483					Kendrick_Conway@BCBST.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/10/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Emergency Part D Contact	VP of Pharmacy		Tate	Natalie		4234437868				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/20/2016	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Emergency Part D Contact (Secondary)	Advisor, Strategic Accounts		Edwards	Susan		4803821417					Susan.Edwards@CBSHealth.com	9501 E. Shea Blvd	Mail Code 121	Scottsdale	AZ	85260	12/04/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Encounter Data & Risk Adjustment Operations Contact	Director Medicare Advantage Risk Adjustment		Livingood	Eric		4235357352					Richard_Livingood@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/18/2019	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Enrollment Contact	Manager Operations		Hardy	Sequita		4239911375					Sequita_Hardy@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/24/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	EOB Transfer Contact	Director Service Operations		Scissom	Melissa		4235358356				4235919109	Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Financial Audit Contact	External Audit Coordinator	Ms	Grafe	Kimberly		4232909053					Kimberly_Grafe@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/21/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Financial Reporting Contact	Financial Coordinator		Petty	Charles		4234753854					Charles_Petty@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/04/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Formulary Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Formulary Contact (Secondary)	Clinical Advisor Med D CVS		Tolbert	Myla		4698656265					Myla.Tolbert@CVSHealth.com	750 W John Carpenter Frwy		Irving	TX	75039	12/20/2021	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	General Contact	Medicare Compliance Officer		Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Government Relations Contact	Medicare Compliance Officer		Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	HIPAA Privacy Officer	Managing Director & Chief Privacy Officer		Yernberg	Heidi		7089302891					Heidi_Yernberg@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/03/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	HIPAA Security Officer	VP & Deputy General Counsel		Oliver	Alicia		4235352922					Alicia_Oliver@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	01/11/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Hospice Contact	Director Service Operations		Scissom	Melissa		4235358356				4235919109	Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Interoperability Contact	Application Manager		Foust	Adam		4235356672					Adam_Foust@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/28/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	MA Appeals/Grievances Contact	Manager Clinical Management		Pugh	Donna		4235356563					Donna_Pugh@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	MA Claims Processing Contact for Public Website	Director Service Operations		Scissom	Melissa		4235358356				4235919109	Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Marketing Contact	Ethics & Compliance Manager		Clements	Amy		4235358225					Amy_Clements@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Medical Director	Medical Director	Dr.	Pate	Linda		4235357171					Linda_Pate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Medicare Coordinator	Director Service Operations		Farriss	Rhonda		4235354887				4235919109	Rhonda_Farriss@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/19/2018	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Medication Therapy Management Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	OffShore Subcontractor Contact	Medicare Compliance Officer		Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Online Enrollment Center Contact (Back-up)	Business Analyst		Sharp	Dana		4235354453					Dana_Sharp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/04/2013	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Online Enrollment Center Contact (Optional)	Manager Operations		Hardy	Sequita		4239911375					Sequita_Hardy@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/28/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Online Enrollment Center Contact (Primary)	Operations Supervisor II (QIP)		Bowling	Jameekah		4235356646					Jameekah_Bowling@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/15/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part C Application Contact	BlueCare Plus Director of Sales		Burchette	Kevin		4236023013					Kevin_Burchette@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/27/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part C Reporting Contact	Business Analytics Manager		Carson	Mindy		4235358476					Mindy_Carson@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Appeals	VP of Pharmacy		Tate	Natalie							Natalie_Tate@bcbst.com	1 Cameron Hill Circle	Suite 51	Chattanooga	TN	37402	12/09/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Appeals Contact (Secondary)	Coverage Review Pharmacist		Holloway	Angela							Angela_Holloway@BCBST.com	1 Cameron Hill Circle	Suite 51	Chattanooga	TN	37402	12/31/2020	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	8003325762				HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Application Contact	BlueCare Plus Director of Sales		Burchette	Kevin		4236023013					Kevin_Burchette@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/27/2023	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Benefits Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Claims Submission Contact	Sr Analyst, Account Manager CVS		Satre	Amanda		4807930968					Amanda.Satre@CVSHealth.com	9501 E. Shea Blvd	Mail Code 121	Scottsdale	AZ	85260	12/04/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Exceptions Contact	VP of Pharmacy		Tate	Natalie							Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Exceptions Contact (Secondary)	Coverage Review Pharmacist		Dillon	Celia							Celia_Dillon@BCBST.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/12/2020	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Price File Contact (Back-up)	Sr Analyst		Mitchell	Sarah		4804798023					sarah.mitchell3@CVSHealth.com	9501 E. Shea Blvd	MC034	Scottsdale	AZ	85260	06/03/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Price File Contact (Optional)	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Price File Contact (Primary)	Pharmacy Operations Manager		Moore	Mary	M	4235356116				4235357599	Mary-Margaret_Moore@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/12/2019	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Quality Assurance Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Part D Reporting Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Patient Safety Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Payment Contact	Manager Revenue Reconciliation		Camp	Jan		4235353639					Jan_Camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Pharmacy Director	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Pharmacy Network Management Contact	Advisor Network Products CVS		Lowe	David		4807449231				8773875800	David.Lowe2@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/20/2021	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Pharmacy Network Management Contact (Secondary)	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/03/2015	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Pharmacy Technical Help Desk Contact	Vendor Management		Rodriguez	Alex							Alex.rodriguez@CVSHealth.com	2401 Cherahala  Blvd		Knoxville	TN	37932	02/16/2024	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H3259	Pharmacy Technical Help Desk Contact (Secondary)	VP of Pharmacy		Tate	Natalie							Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/31/2020	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active	8003325762				HMO - Health Maintenance Organization		C	Chicago
H3259	Plan Directory Contact for Public Website			Service	Customer		8002991407					BlueCarePlus_GM@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/14/2016	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Plan to Plan Reconciliation Contact	Business Analyst Associate		Stinnett	James		4235351624					P2PAdministration_GM@bcbst.com	Attn: P2P Coordinator	1 Cameron Hill Circle Suite 0050	Chattanooga	TN	374020050	02/07/2018	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Processor Contact	Director Service Operations		Scissom	Melissa		4235358356				4235919109	Melissa_Scissom@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Quality Contact	Director Servicer Operations		Farriss	Rhonda		4235354887					Rhonda_Farriss@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/26/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Reconciliation Contact	Actuarial Assistant		Brown	Grace		4235444852					Grace_Brown@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Reconciliation Contact (Secondary)	Manager Actuarial Services Services		Fahr	Gregory		8137650612				4235353467	Gregory_Fahr@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Recovery Audit Contact	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	SNP Application Contact	Medicare Compliance Officer		Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Surveillance Contact	Medicare Compliance Officer		Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	System Contact	Mgr Applications Systems & Pro	Mrs.	Jackson	Barbara		4235357580				4236190778	Barbara_Jackson@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/14/2016	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Third Party Administrator (TPA) Liaison	Accounting Analyst		Toombs	Daniel		8658055741					Daniel_Toombs@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/17/2025	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	User Access Contact	Sr Ethics & Compliance Specialist		Underwood	Jackie		4233222094					Jackie_Underwood@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/10/2024	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Utilization Management Contact	Manager Clinical Management		Pugh	Donna		4235356563				4235919109	Donna_Pugh@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2021	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3259	Utilization Review Contact	Manager Clinical Management		Pugh	Donna		4235356563				4235919109	Donna_Pugh@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2021	2026	VOLUNTEER STATE HEALTH PLAN	Local CCP	BlueCare Plus Tennessee	HMO/HMOPOS		BlueCross BlueShield of Tennessee	34	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3260	Automated TrOOP Balance Transfer Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Backup User Access Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Best Available Evidence Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Bid Primary Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	CAP Report Contact for Public Website			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	CEO - CMS Administrator Contact		Mr.	Hollendoner	Joe		3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	CEO - Senior Official for Contracting		Mr.	Hollendoner	Joe		3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Chief Financial Officer		Ms	Goldman	Robyn		3239938948					rgoldman@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Chief Operating Officer		Mr.	Hollendoner	Joe		3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Chief Information Officer		Mr.	Hollendoner	Joe		3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Chief Information Security Officer		Mr.	Hollendoner	Joe		3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	CMS Casework Communication Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Complaints Tracking Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Contact for Fraud Investigations			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Coordination of Benefits Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Corporate Mailing						3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Customer Service Operations Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	DIR Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Discount Program Payment Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Emergency Part D Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Encounter Data & Risk Adjustment Operations Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Enrollment Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	EOB Transfer Contact			Pollock	Kiera		3238605827				3237606610	kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Financial Audit Contact	Director of Senior Care Services	Ms	Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Financial Reporting Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Formulary Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	General Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Government Relations Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	HIPAA Privacy Officer			Hollendoner	Joe		3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	HIPAA Security Officer			Hollendoner	Joe		3239937484					JHollendoner@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Interoperability Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	MA Appeals/Grievances Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	MA Claims Processing Contact for Public Website			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Marketing Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Medical Director			Duffy	Kaiyti		3238605827					kduffy@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Medicare Compliance Officer		Ms	Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Medicare Coordinator			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Medicare Part D Opioid Overutilization Contact			Duffy	Kaiyti		3238605827					kduffy@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Medication Therapy Management Contact			Duffy	Kaiyti		3238605827					kduffy@lalgbtcenter.org	1125 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part C Application Contact			Pollock	Kiera		3238605827					KPollock@lalgbtcenter.com	1625 Schrader Blvd		Los Angeles	CA	90028	06/25/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part D Appeals			Pollock	Kiera							kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending	3238605827				PACE - Nat		C	San Francisco
H3260	Part D Application Contact			Pollock	Kiera		3238605827					KPollock@lalgbtcenter.com	1625 Schrader Blvd		Los Angeles	CA	90028	06/25/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part D Benefits Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part D Claims Submission Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part D Exceptions Contact			Pollock	Kiera							kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending	3238605827				PACE - Nat		C	San Francisco
H3260	Part D Price File Contact (Back-up)			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part D Price File Contact (Primary)			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part D Quality Assurance Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Part D Reporting Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Patient Safety Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Payment Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Pharmacy Director			Thibeau	Nicole		3238605827					nthibeau@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Pharmacy Network Management Contact			Thibeau	Nicole		3238605827					nthibeau@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Pharmacy Technical Help Desk Contact			Thibeau	Nicole							nthibeau@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending	3239937484				PACE - Nat		C	San Francisco
H3260	Plan Directory Contact for Public Website			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Plan to Plan Reconciliation Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Processor Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Quality Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Reconciliation Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Recovery Audit Contact	Director of Senior Care Services	Ms	Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Surveillance Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	System Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Third Party Administrator (TPA) Liaison			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	User Access Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Utilization Management Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3260	Utilization Review Contact			Pollock	Kiera		3238605827					kpollock@lalgbtcenter.org	1118 N. McCadden Place		Los Angeles	CA	90038	06/28/2024	2026	LOS ANGELES LGBT CENTER	National PACE	Los Angeles LGBT Center	National PACE		Los Angeles LGBT Center	852	Yes	Pending					PACE - Nat		C	San Francisco
H3274	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Backup User Access Contact	Medicare Compliance Officer, Plan Partner Support	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Best Available Evidence Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	CEO - CMS Administrator Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	CEO - Senior Official for Contracting	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Chief Financial Officer	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Chief Operating Officer	Chief Operating Officer/General Manager	Mr.	Emami	John		7038837508					john.emami@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Chief Information Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Coordination of Benefits Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Corporate Mailing						8558550489					customerservice@alignseniorcare.com	PO BOX 4440		Glen Allen	VA	23058	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Discount Program Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					Mark.Hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Enrollment Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	EOB Transfer Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797				8336102390	stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Financial Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Financial Reporting Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	General Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	HIPAA Privacy Officer	Chief Compliance Officer and HIPAA Privacy Officer	Ms.	Crowe	Melanie		4049330409					melanie.crowe@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Interoperability Contact	Director of Data Operations and Architecture	Mr.	Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Marketing Contact	Marketing Director	Mrs	Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Medical Director	VP Medical Affairs		Dahlgren	Andrew		8042968288					Andrew.Dahlgren@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Medicare Coordinator	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part C Reporting Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/09/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Pharmacy Network Management Contact	VP Network Management		Santos	Christina		6088204408					christina.santos@navitus.com	361 Integrity Drive		Madison	WI	53717	06/06/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H3274	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3274	Physician Incentive Contact	Account Manager	Ms.	Dixon	Denise		7142641621					Denise.Dixon@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Plan Directory Contact for Public Website			Sindlinger	Rocio		8558550489					rocio.sindlinger@curanahealth.com	PO BOX 4440		Glen Allen	VA	23058	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Plan to Plan Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Processor Contact	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/09/2025	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Quality Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Reconciliation Contact (Secondary)	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Recovery Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Surveillance Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					Katie.Bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	User Access Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Utilization Management Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3274	Utilization Review Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE CALIFORNIA INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3276	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H3276	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H3276	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H3276	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H3276	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Price File Contact (Primary)	Sr. Manager Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	12/16/2024	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	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	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	01/12/2023	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8009221557	2			HMO - Health Maintenance Organization		C	New York
H3276	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H3276	PHR Beneficiary Contact																	05/11/2023	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS	ConnectiCare Inc	Molina Healthcare, Inc.	165	Yes	Active	8002242273				HMO - Health Maintenance Organization		C	New York
H3276	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3276	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/29/2025	2026	CONNECTICARE INSURANCE COMPANY, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3284	Automated TrOOP Balance Transfer Contact	Executive Director		Stengel	Laura		2534597270				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Backup User Access Contact	Executive Director		Stengel	Laura		2534597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	09/21/2023	2026	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		2534037614				2534726833	steve.schramm@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	07/28/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Bid Primary Contact	CFO		Schramm	Steve		2534037614				2534726833	steve.schramm@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	07/28/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	CAP Report Contact for Public Website	Executive Director		Stengel	Laura		2534597970				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active	2534597970				PACE - Nat		C	Seattle
H3284	CEO - CMS Administrator Contact	VP-Care Continuum	Ms	Siedenstrang	Lynn		2534597970				2534726833	lynn.siedenstrang@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	CEO - Senior Official for Contracting	VP-Care Continuum	Ms	Siedenstrang	Lynn		2534597970				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	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		2534037614				2534726833	steve.schramm@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	07/28/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Chief Operating Officer	Executive Director	Ms	Stengel	Laura		2534597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Chief Information Officer	Executive Director	Ms	Stengel	Laura		2534597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Chief Information Security Officer	Executive Director	Ms	Stengel	Laura	M	2534597970				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	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		6054644821				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Complaints Tracking Contact	Compliance Officer		Clay	Chelsea		6054644821				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Contact for Fraud Investigations	Compliance Officer		Clay	Chelsea		6054644821				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	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		2534037614				2534726833	steve.schramm@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	01/12/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Corporate Mailing						4153616395				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	01/14/2022	2026	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		2534597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	DIR Contact	Executive Director		Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	02/23/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Discount Program Payment Contact	CFO		Schramm	Steve		4259857716				2534726833	steve.schramm@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	07/28/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Emergency Part D Contact	Executive Director		Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	02/23/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Emergency Part D Contact (Secondary)			Stengel	Laura		2534726833					laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	02/22/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Encounter Data & Risk Adjustment Operations Contact	Executive Director		Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	02/23/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Enrollment Contact	Executive Director	Mrs	Stengel	Laura		2534597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	EOB Transfer Contact	Fomulary and Plan Benefit Coordinator		Biren	Alicia		7158522061				7158367683	abiren@pharmastarpbm.com	Pharmastar PO Box 3217		Eau Claire	WI	54702	12/23/2020	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Financial Audit Contact	Quality and Compliance DIrector	Mrs	Clay	Chelsea		2534597270				2534726833	chelsea.clay@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Financial Reporting Contact	Executive Director		Stengel	Laura		2534597270				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Formulary Contact	Executive Director		Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	02/23/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	General Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	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		2534597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	HIPAA Privacy Officer	Privacy Officer		Bhatia	Shilpa		2534597865				2534733117	shilpa.bhatia@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	01/12/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	HIPAA Security Officer	Privacy Officer		Bhatia	Shilpa		2534597865				2534733117	shilpa.bhatia@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	01/12/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Interoperability Contact	Identity and Access Manager	Ms	Weisberg	Kathy		2534597384					kathy.weisberg@multicare.org	315 Martin Luther King Jr Way		Tacoma	WA	98415	10/19/2021	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	MA Appeals/Grievances Contact	Compliance Officer		Clay	Chelsea		6054644821				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	MA Claims Processing Contact for Public Website	Executive Director		Stengel	Laura		2534597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Marketing Contact	Executive Director		Stengel	Laura		4154597270				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	09/21/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Medical Director	Medical Director	Mrs	Van Fleet-Green	Jessica		2534597270				2534726833	Jessica.VanFleet-Green@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	01/14/2022	2026	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		2533122773				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Medicare Coordinator	Compliance Officer		Clay	Chelsea		6054644821				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Medicare Part D Opioid Overutilization Contact	Compliance Officer		Clay	Chelsea		6054644821				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Medication Therapy Management Contact	Executive Director		Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	02/23/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Part C Application Contact	Compliance Officer		Clay	Chelsea		6054644821				2534726833	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	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 Appeals	Compliance Officer		Clay	Chelsea							Chelsea.Clay@multicare.org	6442 S Yakima St		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active	8662646121				PACE - Nat		C	Seattle
H3284	Part D Application Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Avenue		Tacoma	WA	98408	03/18/2022	2026	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 Benefits Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	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 Claims Submission Contact	Client Support Supervisor	Ms	Vang	Jane		7158522064				7158367683	jvang@pharmastaronline.com	2503 North Hillcrest Parkway		Altoona	WI	54720	12/23/2020	2026	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	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active	8662646121				PACE - Nat		C	Seattle
H3284	Part D Price File Contact (Back-up)	Client Support Manager	Ms	Slowiak	Andrea		7158522983					asloiak@pharmastarpbm.com	Pharmastar PO Box 3217		Eau Claire	WI	54702	12/23/2020	2026	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 Price File Contact (Primary)	Formulary and Plan Benefit Coordinator	Ms	Biren	Alicia		7158522061					abiren@pharmastarpbm.com	Pharmastar PO Box 3217		Eau Claire	WI	54702	12/23/2020	2026	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 Quality Assurance Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	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 Reporting Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Patient Safety Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Payment Contact	Finance Manager		Hagen	Jake		2538861766					jake.hagen@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	04/04/2025	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Pharmacy Director	Executive Director		Stengel	Laura		4153616395				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Pharmacy Network Management Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	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	04/24/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active	6054644821				PACE - Nat		C	Seattle
H3284	Plan Directory Contact for Public Website	Executive Director		Stengel	Laura		4153616395				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Plan to Plan Reconciliation Contact	Executive Director		Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Processor Contact	Client Support Supervisor	Ms	Vang	Jane		7158522064				7158367683	jvang@pharmastaronline.com	2503 North Hillcrest Parkway		Altoona	WI	54720	12/23/2020	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Quality Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Reconciliation Contact	Executive Director	Mrs	Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	02/23/2023	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Recovery Audit Contact	Executive Director	Ms	Stengel	Laura		2534597271				2534726833	laura.stengel@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Surveillance Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	System Contact	Executive Director		Stengel	Laura		4153616395				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Third Party Administrator (TPA) Liaison	Finance Manager		Hagen	Jake		2538861766					jake.hagen@multicare.org	6442 S. Yakima Ave.		Tacoma	WA	98408	04/04/2025	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	User Access Contact	Executive Director		Stengel	Laura		4153616395				2534726833	Laura.Stengel@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	11/12/2024	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Utilization Management Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3284	Utilization Review Contact	Compliance Officer		Clay	Chelsea		6054644821				2534733117	Chelsea.Clay@multicare.org	6442 S Yakima Ave		Tacoma	WA	98408	03/18/2022	2026	PNW PACE PARTNERS, LLC	National PACE	Pacific Northwest PACE Partners	National PACE		MultiCare Health Systems	780	Yes	Active					PACE - Nat		C	Seattle
H3288	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Medicare Coordinator	AVP, Service Operations		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H3288	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H3288	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H3288	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H3288	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H3288	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/10/2018	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3288	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH AND LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H3291	Agent/Broker Compensation Data Contact	Chief Operating Officer	Mr.	Beddingfield	Ryan		6785336300					rbeddingfield@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Best Available Evidence Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	06/09/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	CEO - CMS Administrator Contact		Mr.	Pruitt	Neil		7708066893					npruitt@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	02/04/2019	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	CEO - Senior Official for Contracting		Mr.	Pruitt	Neil		7708066893					npruitt@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	02/04/2019	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Chief Financial Officer	CFO	Mr	Small	Phil		7702796200					PhSmall@pruitthealth.com	1626 Jeurgens Ct		Norcross	GA	30093	05/05/2021	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Chief Operating Officer	Chief Operating Officer	Mr.	Beddingfield	Ryan		6785336300					rbeddingfield@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	09/08/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Chief Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens C0urt		Norcross	GA	30093	06/09/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Coordination of Benefits Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Corporate Mailing						8442243659					customerservice@pruitthealthpremier.com	P.O. Box 2190		Glen Allen	VA	230582190	01/28/2017	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Discount Program Payment Contact	VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/19/2024	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	EOB Transfer Contact			Lowry	Kristy		8448546883				8003756496	customerservice@pruitthealthpremier.com	P.O. Box 2190		Glen Allen	VA	230582190	01/15/2020	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Financial Audit Contact	CFO	Mr.	Small	Phil		7702796200					phsmall@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	12/15/2021	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Financial Reporting Contact	CFO	Mr.	Small	Phil		7702796200					phsmall@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	12/15/2021	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	General Contact			Tolbert	Angie		7068367966					atolbert@pruitthealth.com	1626 jeurgens Court		Norcross	GA	30093	09/05/2018	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	HIPAA Privacy Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens COurt		Norcross	GA	30093	06/09/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	HIPAA Security Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	06/09/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Marketing Contact	Marketing Director		Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Medical Director		Dr.	Stallings	Ravelle		6785336300					rstallings@pruitthealth.com	PruittHealth Premier	1626 Jeurgens Court	Norcross	GA	30093	12/15/2021	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	06/09/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Medicare Coordinator	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	rachel.blair@navitus.com	Navitus Health Solutions,	1025 West Navitus Drive	Appleton	WI	54913	09/30/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Price File Contact (Back-up)			Plan Finder	Navitus		5122313140				6087292584	plan.finder@navitus.com	Navitus Health Solutions, LLC	361 Integrity Drive	Madison	WI	53717	04/15/2024	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	12/31/2019	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	12/05/2023	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Pharmacy Network Management Contact	VP, Network Mgmt		Santos	Christina		6088204408					christina.santos@navitus.com	Navitus Health Solutions	361 Integrity Drive	Madison	WI	53717	09/30/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H3291	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3291	Physician Incentive Contact			Thompson	Monica		4789720407					monica.thompson@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Plan Directory Contact for Public Website			Sidlinger	Rocio		8558550489	1664				rocio.sidlinger@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Reconciliation Contact (Secondary)	VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/19/2024	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					compliance@pruitthealthpremier.com	1626 Jeurgens Court		Norcross	GA	30093	06/07/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Surveillance Contact	Chief Operating Officer	Mr.	Beddingfield	Ryan		6785336300					rbeddingfield@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Third Party Administrator (TPA) Liaison	CFO	Mr	Small	Phil		7702796200					PhSmall@pruitthealth.com	1626 Jeurgens Ct		Norcross	GA	30093	09/28/2022	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	User Access Contact	Medicare Compliance Officer	Ms.	Christopher	kelly		4046944897					kelly.christopher@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	02/06/2023	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3291	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER, INC.	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3305	Agent/Broker Compensation Data Contact	Director, Sales Administration		Sheehy	Cathryn		5189913973					csheehy@mvphealthcare.com	625 State St		Schenectady	NY	12305	04/15/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Backup User Access Contact	Compliance Coordinator		Carter	Marlo		5189913814					mcarter@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Best Available Evidence Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	RMoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Bid Audit Contact	Sr. Director, Internal Audit		Hillerman	Stephen		5189913995					shillerman@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Bid Audit Site Contact	VP, Acting Chief Actuary		Lombardo	Matt		5189913845				5183882311	mlombardo@mvphealthcare.com	625 State Street		Schenectady	NY	12305	07/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Bid Primary Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	CAP Report Contact for Public Website	Corporate Compliance Officer		Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	CEO - CMS Administrator Contact	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	CEO - Senior Official for Contracting	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Chief Financial Officer	Chief Financial Officer	Ms.	Austen	Karla		5183882357					kausten@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/26/2014	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Chief Operating Officer	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Chief Information Officer	Chief Digital & Information Officer	Mr.	Della Villa	Michael		5183882323					mdellavilla@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Chief Information Security Officer	VP, Office of the CDIO & CISO	Mr.	Swits	David		5189913694					dswits@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/11/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	CMS Casework Communication Contact	Leader, Medicare Appeals		Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Complaints Tracking Contact	Leader, Medicare Appeals		Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Contact for Fraud Investigations	Leader, Special Investigations Unit		Cordato	Rocco		5189010613					rcordato@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Coordination of Benefits Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Corporate Mailing						8006657924					memberservices@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Customer Service Operations Contact	Sr. Leader, Customer Care & Support Services		Greenberg	Melissa		5189913731					mgreenberg@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	DIR Contact	Leader, State & Federal Plan BIlling		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	DIR Contact (Secondary)	Sr. Director, Actuary		Jaiman	Rajshree		5189913834					rjaiman@mvphealthcare.com	625 State St.		Schenectady	NY	12305	02/28/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Discount Program Payment Contact	Analyst		Bates	Marcus		5853272286					mbates@mvphealthcare.com	625 State St		Schenectady	NY	12305	11/10/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Emergency Part D Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Emergency Part D Contact (Secondary)	Professional, Compliance Coordinator		Dunham	Kristina		5857208250					kdunham@mvphealthcare.com	20 South Clinton Ave		Rochester	NY	14604	04/05/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Encounter Data & Risk Adjustment Operations Contact	Director, Ops Vendor Compliance & Transaction Mgt		Shader	Michelle		5189913778					mshader@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/30/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Enrollment Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	rmoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	EOB Transfer Contact	Director, Pharmacy Management		Colin	Wendy		5858852435				8004010915	wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Financial Audit Contact	Sr. Director, Internal Audit	Mr.	Hillerman	Stephen		5189913995				5188363202	shillerman@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Financial Reporting Contact	Sr. Leader, Accounting & Assistant Controller		Cenzano	Jennifer		5189010623					jcenzano@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Formulary Contact	Professional, Pharmacy Program Management		Berube	Leah		5183951264					lberube@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/17/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Formulary Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	General Contact	Medicare Compliance Officer		Borges	Linda		5189913803					mco@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/15/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Government Relations Contact	Medicare Compliance Officer		Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	HIPAA Privacy Officer	Corporate Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	HIPAA Security Officer	Corporate Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Hospice Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					WColin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Interoperability Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	MA Appeals/Grievances Contact	Leader, Medicare Appeals		Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	MA Claims Processing Contact for Public Website	Sr. Leader, Govt Programs, Commercial & IH Claims		Santilli	RJ		5189913775					rsantilli@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Marketing Contact	Sr. Director, Medicare Marketing & Strategic Partn		Regan	Jennifer		5189010772					jregan@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/06/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Medical Director	Chief Medical Officer		Merola	Jason		5853272208					jmerola@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	12/12/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Medicare Coordinator	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Management		Colin	Wendy		5858852435				8004010915	wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Medication Therapy Management Contact	Leader, Pharmacy Clinical Operations		MacArthur	Carly		5183867483					cmacarthur@mvphealthcare.com	625 State St.		Schenectady	NY	12305	04/05/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	OffShore Subcontractor Contact	Sr. Director, Cyber Security and Cyber GRC		Rich	John		5189913674					jrich@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/11/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Online Enrollment Center Contact (Primary)	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	rmoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part C Application Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part C Reporting Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/28/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Appeals	Leader, Medicare Appeals		Allen	Amy						5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	5852588096				HMO - Health Maintenance Organization		C	Boston
H3305	Part D Appeals Contact (Secondary)	Compliance Coordinator, Medicare Appeals		Stepnowski	Ashley							astepnowski@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	5857208126				HMO - Health Maintenance Organization		C	Boston
H3305	Part D Application Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Benefits Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Claims Submission Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Exceptions Contact	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	5858852435				HMO - Health Maintenance Organization		C	Boston
H3305	Part D Exceptions Contact (Secondary)	Leader, Pharmacy Clinical Operations		MacArthur	Carly							cmacarthur@mvphealthcare.com	625 State St		Schenectady	NY	12305	04/05/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	5183867483				HMO - Health Maintenance Organization		C	Boston
H3305	Part D Price File Contact (Back-up)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/05/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Price File Contact (Optional)	Professional, Pharmacy Compliance Coordinator		Dunham	Kristina		5857208250					KDunham@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Price File Contact (Primary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Quality Assurance Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Part D Reporting Contact	Professional, Pharmacy Compliance Coordinator		Dunham	Kristina		5857208250					Kdunham@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Patient Safety Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Payment Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Pharmacy Director	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd. MC 080		Scottsdale	AZ	85260	07/18/2018	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H3305	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active	5858852435				HMO - Health Maintenance Organization		C	Boston
H3305	Physician Incentive Contact	VP, Network, Provider Relations and Vendor Mgmt		MacKinnon	Matthew		5858852485					mmackinnon@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Plan Directory Contact for Public Website	Director, Provider Data Management		Santilli	Richard		5189913775					rsantilli@mvphealthcare.com	625 State St		Schenectady	NY	12305	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Plan to Plan Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Processor Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Quality Contact	Sr. Leader, Quality Performance & Reporting		Rocklein	Lisa		5858852510					lrocklein@mvphealthcare.com	20 South Clinton Avenue		rochester	NY	14604	10/17/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					YMarcus@mvphealthcare.com	625 State St		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Reconciliation Contact (Secondary)	Sr. Director, Actuarial		Jaiman	Rajshree		5189913834					rjaiman@mvphealthcare.com	625 State St.		Schenectady	NY	12305	02/28/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/28/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	SNP Application Contact	Leader, Product Strategy		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/02/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Surveillance Contact	Medicare Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	System Contact	VP, Office of the CDIO & CISO		Swits	David		5189913694					dswits@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Third Party Administrator (TPA) Liaison	Analyst		Bates	Marcus		5853272286					mbates@mvphealthcare.com	625 State St		Schenectady	NY	12305	11/10/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	User Access Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Utilization Management Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3305	Utilization Review Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	HMO/HMOPOS		MVP Health Care, Inc.	197	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3312	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3312	PHR Beneficiary Contact																	11/15/2012	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H3312	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3312	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (NY)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3321	Automated TrOOP Balance Transfer Contact	Director of Quality Management		Barrington	Michele		3154134595				3157033599	mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2026	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	Backup User Access Contact	Executive Director		Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	05/28/2024	2026	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		3154134595				3157033599	mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2026	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	Bid Primary Contact			Kopenski	Frank		2627842250					frank.kopenski@milliman.com	15800 Bluemound Road	Suite 400	Brookfield	WI	530056069	06/18/2005	2026	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	CAP Report Contact for Public Website	Director of Quality Management		Barrington	Michele		3154134595				3157033599	mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2026	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	CEO - CMS Administrator Contact	Executive Director	Mrs.	Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/29/2022	2026	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	CEO - Senior Official for Contracting	Executive Director	Mrs.	Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/29/2022	2026	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	3154133206					jmurray@lorettosystem.org	700 E. Brighton Ave		Syracuse	NY	13205	09/26/2017	2026	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 Operating Officer	Executive Director	Mrs.	Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/29/2022	2026	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 Information Officer	Chief Information Officer	Mr	Claps	Brandon		3154133633					bclaps@lorettosystem.org	700 East Brighton Ave		Syracuse	NY	13205	09/26/2017	2026	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 Information Security Officer	Compliance Officer/ Med Rec Dir	Ms	Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/16/2017	2026	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	Complaints Tracking Contact	Director of Quality Management	Ms.	Barrington	Michele		3154134595					mbarrington@lorettosystem.org	109 Lawrence Ave		North Syracuse	NY	13212	08/29/2022	2026	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	Contact for Fraud Investigations	Compliance Officer/ Med Rec Dir		Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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		3154133126				3154694737	bnutting@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	04/07/2022	2026	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	Corporate Mailing						3154525800				3154525739	sbutton@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	08/16/2017	2026	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		3154134579				3154597113	tnatoli@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	05/03/2022	2026	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	DIR Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Discount Program Payment Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	01/23/2025	2026	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	Emergency Part D Contact	Medical Director	Dr	Heisig	David		3154133914				3154597113	dheisig@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	02/24/2022	2026	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	Emergency Part D Contact (Secondary)	Corporate Controller	Mr.	Murray	John	G	3154133206					jmurray@lorettosystem.org	700 E. Brighton Ave		Syracuse	NY	13205	09/26/2017	2026	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	Encounter Data & Risk Adjustment Operations Contact			Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	115 Creek Circle		East Syracuse	NY	13057	02/24/2022	2026	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	Enrollment Contact	Executive Director		Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/16/2017	2026	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	EOB Transfer Contact	Account Manager		Page	Heather		3154134546				3154033599	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	02/24/2022	2026	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	Financial Audit Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Financial Reporting Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Formulary Contact	Medical Director	Dr	Heisig	David		3154133914				3154597113	dheisig@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	02/24/2022	2026	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	General Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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		3154133437				3157033599	sbutton@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2026	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	HIPAA Privacy Officer	Compliance Officer/ Med Rec Dir		Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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	HIPAA Security Officer	Compliance Officer/ Med Rec Dir		Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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	Interoperability Contact	Executive Director		Button	Stephanie		3154133437					sbutton@lorettosystem.org	109 Lawrence Rd. East		North Syracuse	NY	13212	02/24/2022	2026	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	MA Appeals/Grievances Contact	Director of Quality Management	Ms.	Barrington	Michele		3154134595				3157033599	mbarrington@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/29/2022	2026	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	MA Claims Processing Contact for Public Website	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Marketing Contact	Director of Marketing		Natoli	Tammy		3154134579				3156712680	tnatoli@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	05/03/2022	2026	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	Medical Director	Medical Director	Dr	Heisig	David		3154133914				3154597113	dheisig@lorettosystem.org	177 Lawrence Rd East		North Syracuse	NY	13212	02/24/2022	2026	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		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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 Coordinator	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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 Part D Opioid Overutilization Contact	Medical Director		Heisig	David		3154525800					dheisig@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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	Medication Therapy Management Contact	Medical Director	Dr	Heisig	David		3154133914				3154597113	dheisig@lorettosystem.org	177 Lawrence Rd East		North Syracuse	NY	13212	02/24/2022	2026	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	Online Enrollment Center Contact (Back-up)	Corporate Controller	Mr.	Murray	John	G	3154133206					jmurray@lorettosystem.org	700 E. Brighton Ave		Syracuse	NY	13205	09/26/2017	2026	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	Online Enrollment Center Contact (Primary)	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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 C Application Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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 Appeals	Director of Quality Management		Barrington	Michele						3154597113	mbarrington@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/29/2022	2026	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active	8887287223	4595			PACE - Nat		C	New York
H3321	Part D Appeals Contact (Secondary)	Compliance Officer		Nutting	Barbara						3154597113	bnutting@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	01/05/2021	2026	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active	8887287223	3126			PACE - Nat		C	New York
H3321	Part D Application Contact			Kopenski	Frank		2627842250				2627844116	frank.kopenski@milliman.com	15800 Bluemound Road	Suite 400	Brookfield	WI	530056069	06/18/2005	2026	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 Benefits Contact	Medical Director	Dr	Heisig	David		3154133914				3154597113	dheisig@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	02/24/2022	2026	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 Claims Submission Contact	Director of Quality Management		Barrington	Michele		3154134595					mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2026	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	2026	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active	8887287223				PACE - Nat		C	New York
H3321	Part D Price File Contact (Back-up)	Systems Analyst	Mr	Porter	Jeff		3154134586					jporter@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	04/20/2016	2026	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 Price File Contact (Primary)	Director of Quality Management		Barrington	Michele		3154134595					mbarrington@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	08/29/2022	2026	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 Quality Assurance Contact	Director of Quality Management	Ms.	Barrington	Michele		3154134595					mbarrington@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	08/29/2022	2026	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 Reporting Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Patient Safety Contact	Executive Director		Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/16/2017	2026	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	Payment Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Personal Health Record Contact	Compliance Officer/ Med Rec Dir		Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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 Director			Heisig	David		3154133914					dheisig@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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 Network Management Contact	Director of Quality Management	Ms.	Barrington	Michele		3154134595					mbarrington@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	08/29/2022	2026	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 Network Management Contact (Secondary)	Corporate Controller	Mr.	Murray	John	G	3154133206					jmurray@lorettosystem.org	700 E. Brighton Ave		Syracuse	NY	13205	09/26/2017	2026	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	2026	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE		Loretto Rest Realty Corporation	133	Yes	Active	8887287223				PACE - Nat		C	New York
H3321	PHR Beneficiary Contact																	03/23/2015	2026	LORETTO INDEPENDENT LIVING SERVICES, INC.	National PACE	Independent Living Srvcs Of Central Ny	National PACE	Independent Living Services of Central NY	Loretto Rest Realty Corporation	133	Yes	Active	8772085284				PACE - Nat		C	New York
H3321	Plan Directory Contact for Public Website	Marketing Director	Mrs.	Natoli	Tammy		3154134579					tnatoli@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	05/03/2022	2026	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	Plan to Plan Reconciliation Contact	Director of Quality Management	Ms.	Barrington	Michele		3154134595				3157033599	mbarrington@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	08/29/2022	2026	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	Processor Contact	Systems Analyst	Mr	Porter	Jeff		3154134586					jporter@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	04/20/2016	2026	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	Quality Contact	Director of Quality Management	Ms.	Barrington	Michele		3154134595					mbarrington@lorettosystem.org	109 Lawrence Road		North Syracuse	NY	13212	08/29/2022	2026	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	Reconciliation Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Recovery Audit Contact	Executive Director	Mrs.	Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/29/2022	2026	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	Surveillance Contact	Executive Director		Button	Stephanie		3154525800				3154597113	sbutton@lorettosystem.org	109 Lawrence Rd East		North Syracuse	NY	13212	08/16/2017	2026	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	System Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Third Party Administrator (TPA) Liaison	Accounting Manager		Page	Heather		3154134546					hpage@lorettosystem.org	109 Lawrence Road		North Syracuse	NY	13212	12/11/2024	2026	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	User Access Contact	Accounting Manager	Ms.	Page	Heather		3154134546				3154597113	hpage@lorettosystem.org	109 Lawrence Road East		North Syracuse	NY	13212	09/28/2017	2026	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	Utilization Management Contact	Compliance Officer/ Med Rec Dir		Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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	Utilization Review Contact	Compliance Officer/ Med Rec Dir		Nutting	Barbara		3154133126				3154694737	bnutting@lorettosystem.org	100 Malta Lane		North Syracuse	NY	13212	02/24/2022	2026	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		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Backup User Access Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	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		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Bid Primary Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/14/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	CAP Report Contact for Public Website	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	michele.wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/14/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	CEO - CMS Administrator Contact	Executive Director	Ms.	Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	CEO - Senior Official for Contracting	Executive Director	Ms.	Mazzacco	Michelle		5183823290				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	12/19/2023	2026	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 Manager	Mrs.	Kaufmann	Lisa		5182795672				5182741829	lisa.kaufmann@sphp.com	Eddy SeniorCare	433 River Street, 3rd Floor	Troy	NY	12180	10/29/2024	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Chief Operating Officer	Executive Director	Mr.	Flaherty	Michael		5183823290				5183823398	Michael.Flaherty@sphp.com	1938 Curry Road		Schenectady	NY	12303	10/29/2024	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Chief Information Officer	Executive Director	Mr.	Flaherty	Michael		5183823290					michael.flaherty@sphp.com	1938 Curry Road		Schenecady	NY	12203	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Chief Information Security Officer	Executive Director	Mr.	Flaherty	Michael		5183823290					michael.flaherty@sphp.com	1938 Curry Road		Schenectaady	NY	12303	05/21/2025	2026	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	Mr.	Flaherty	Michael		5183823290				5183823398	Michael.Flaherty@sphp.com	1938 Curry Road		Schenectady	NY	12303	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Complaints Tracking Contact	Executive Director	Mr.	Flaherty	Michael		5183823290				5183823398	Michael.Flaherty@sphp.com	1938 Curry Road		Albany	NY	12303	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Contact for Fraud Investigations	Executive Director	Ms.	Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	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		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/14/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Corporate Mailing						5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	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	Mr.	Flaherty	Michael		5183823290				5183823398	Michael.Flaherty@sphp.com	1938 Curry Road		Schenectady	NY	12303	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	DIR Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	DIR Contact (Secondary)	Financial Analyst	Mr.	O'Brien	Paul	P	5182701733				5182741829	Paul.P.Obrien@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/14/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Discount Program Payment Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Emergency Part D Contact	Executive Director	Mr.	Flaherty	Michael		5183823290				5183823398	Michael.Flaherty@sphp.com	1938 Curry Road		Schenectady	NY	12303	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Emergency Part D Contact (Secondary)	Finance Supervisor	Mrs.	Wittman	Michele		5182701734				5182701829	michele.wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/14/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Encounter Data & Risk Adjustment Operations Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Enrollment Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/14/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	EOB Transfer Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/14/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Financial Audit Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Financial Reporting Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Formulary Contact	Executive Director	Ms.	Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	General Contact	Executive Director	Ms.	Mazzacco	Michelle		5183823290				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	02/18/2023	2026	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		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	HIPAA Privacy Officer	Executive Vice President	Mrs.	Mazzacco	Michelle		5186692694				5183823398	Michelle.mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	02/20/2024	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	HIPAA Security Officer	Executive Vice President	Mrs.	Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	02/20/2024	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Interoperability Contact	Executive Director	Mr.	Flaherty	Michael		5183823290					Michael.Flaherty@sphp.com	1938 Curry Road		Schenectady	NY	12303	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	MA Appeals/Grievances Contact	Executive Director	Mr.	Flaherty	Michael		5183823290				5183823398	Michael.Flaherty@sphp.com	1938 Curry Road		Schenectady	NY	12303	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	MA Claims Processing Contact for Public Website	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Marketing Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Medical Director	DO		Ricker	Kerry	E	5183823290				5183823398	Kerry.Ricker@sphp.com	1938 Curry Road		Schenectady	NY	12303	12/06/2022	2026	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		5183823290					Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	03/24/2022	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Medicare Coordinator	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Medicare Part D Opioid Overutilization Contact	Executive Director	Ms.	Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Medication Therapy Management Contact	Executive Director	Ms.	Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Online Enrollment Center Contact (Primary)	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part C Application Contact	Executive Director	Ms.	Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Appeals	Executive Director	Ms.	Mazzacco	Michelle						5183828001	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	Part D Appeals Contact (Secondary)	Finance Supervisor	Ms.	Wittman	Michele						5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	Part D Application Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Benefits Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Claims Submission Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	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						5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	Part D Exceptions Contact (Secondary)	Finance Analyst	Mr.	O'Brien	Paul						5182741829	Paul.P.Obrien@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	Part D Price File Contact (Back-up)	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Price File Contact (Optional)	Finance Analyst	Mr.	O'Brien	Paul		5182701733				5182741829	Paul.P.Obrien@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Price File Contact (Primary)	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Quality Assurance Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Part D Reporting Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Patient Safety Contact	Executive Director	Mr.	Mazzacco	Michael		5183823290				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	10/29/2024	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Payment Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Personal Health Record Contact	EMR Administrator	Ms	Hollner	Sarah		5183823290				5183828001	Sarah.Hollner@sphp.com	1938 Curry Road		Schenectady	NY	12303	12/01/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Pharmacy Director	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Pharmacy Network Management Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Pharmacy Network Management Contact (Secondary)	Finance Manager	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	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						5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	Pharmacy Technical Help Desk Contact (Secondary)	Finance Manager	Mrs.	Wittman	Michele						5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	PHR Beneficiary Contact																	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE	Eddy SeniorCare	Trinity Health Corporation	234	Yes	Active	8553767888				PACE - Nat		C	New York
H3322	Plan Directory Contact for Public Website	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Plan to Plan Reconciliation Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Processor Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Quality Contact	Executive Director	Mr.	Flaherty	Michael		5183823290				5183823398	Michael.Flaherty@sphp.com	1938 Curry Road		Schenectady	NY	12303	05/21/2025	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Reconciliation Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Reconciliation Contact (Secondary)	Finance Analyst	Mr.	OBrien	Paul		5182701733				5182741829	Paul.P.Obrien@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Recovery Audit Contact	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Surveillance Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	System Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Third Party Administrator (TPA) Liaison	Finance Supervisor	Ms.	Wittman	Michele		5182701734				5182741829	Michele.Wittman@sphp.com	1938 Curry Road		Schenectady	NY	12303	01/03/2021	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	User Access Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Utilization Management Contact	Executive Director		Mazzacco	Michelle		5186692694				5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	SENIOR CARE CONNECTION, INC.	National PACE	Eddy SeniorCare	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	New York
H3322	Utilization Review Contact	Executive Director		Mazzacco	Michelle		5183823290	6361			5183823398	Michelle.Mazzacco@sphp.com	1938 Curry Road		Schenectady	NY	12303	09/20/2020	2026	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		8582915269					partdcat@medimpact.com	136-65 37th Ave.		Flushing	NY	11354	01/03/2023	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Backup User Access Contact	Security Administrator	Mr.	Hsu	Lester		7185194182					lhsu@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Best Available Evidence Contact	CFO	Ms.	Tirtasaputra	Leny		3475012901					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Bid Primary Contact	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	03/24/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	CAP Report Contact for Public Website	Chief Compliance Officer		Nelson Jones	Alicia		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active	3474430157				PACE - Nat		C	New York
H3329	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		5166407669					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	03/24/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Chief Financial Officer	CFO	Ms..	Tirtasaputra	Leny		3475012901					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Chief Operating Officer	Chief Operating Officer	Mrs.	Connelly	Patricia		9297335854					pconnelly@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/22/2024	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Chief Information Officer	VP of Performance Improvement	Mr.	Walter	Justin		9295363686					jwalter@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Chief Information Security Officer	Security Administrator	Mr.	Hsu	Lester		7185194182					lhsu@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	CMS Casework Communication Contact	SVP of Quality	Ms.	St Fleur	Gilda		3473877782					gstfleur@centerlight.org	136-65 37th Ave		Flushing	NY	11354	08/21/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Complaints Tracking Contact	Director Appeals & Grievances	Ms.	Singh	Devi		9298371582					desingh@centerlight.org	555 Albany Ave		Amityville	NY	11701	12/21/2021	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Nelson Jones	Alicia		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	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		6464831796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Corporate Mailing						3476406000					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	03/24/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	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		3479206110				6172236932	etabakovic@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	DIR Contact	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	DIR Contact (Secondary)	CFO		Tirtasaputra	Leny		3475012901					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Discount Program Payment Contact	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Emergency Part D Contact	Pharmacy Director	Ms	Jing	Shu		9176977979				3157504990	Sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Encounter Data & Risk Adjustment Operations Contact	Director, Encounter and Data Analytics	Mr.	Lee	Jay		6318417316	16104				jaylee@centerlight.org	2401 White Plains Road		Bronx	NY	10467	06/13/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Enrollment Contact	SVP, Market Engagement & Growth	Mr.	Rios	Adrian		9299461210					adrian.rios@c2qhealthsolutions.com	136-65 37th Ave		Flushing	NY	11354	08/21/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	EOB Transfer Contact	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796				3157503336	tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Financial Audit Contact	CFO	Ms	Tirtasaputra	Leny		6464831796					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Financial Reporting Contact	CFO	Ms	Tirtasaputra	Leny		3475012901					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Formulary Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979				3157504990	sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	General Contact	Chief Compliance Officer		Nelson Jones	Alicia		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Government Relations Contact	Director Of Compliance	Mr.	Fairweather	Adrian		9295051346					afairweather@centerlight.org	136-65 37th Avenue		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	HIPAA Privacy Officer	Chief Compliance Officer		Nelson Jones	Alicia		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	HIPAA Security Officer	Security Administrator	Mr.	Hsu	Lester		7185194182					lhsu@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Interoperability Contact	CEO		Buonocore-Rut	Tara		6464831796					TBRUT@centerlight.org	136-65 37th Ave.		Flushing	NY	11354	05/22/2024	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	MA Appeals/Grievances Contact	Director Appeals & Grievances	Ms.	Singh	Devi		9298371582					desingh@centerlight.org	555 Albany Ave	2nd Floor	Amityville	NY	11701	12/21/2021	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	MA Claims Processing Contact for Public Website	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Marketing Contact	VP of Marketing	Ms.	Woloszczak	Ivynell		7185195251	15370				IWoloszczak@centerlight.org	136-65 37th Ave		Flushing	NY	11354	06/13/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Medical Director	Chief Medical Officer	Dr.	Farah	Ziad		9298164443					zfarah@centerlight.org	216 East 99th Street		New York	NY	10029	07/03/2023	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	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		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Medicare Coordinator	Director of Compliance	Mr.	Fairweather	Adrian		9295051346					afairweather@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Medicare Part D Opioid Overutilization Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979					Sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	01/24/2023	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Medication Therapy Management Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979					Sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Online Enrollment Center Contact (Back-up)	SVP, Market Engagement & Growth	Mr.	Rios	Adrian		9299461210				7189441243	adrian.rios@c2qhealthsolutions.com	136-65 37th Ave		Flushing	NY	11354	08/21/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Online Enrollment Center Contact (Primary)	SVP, Market Engagement & Growth	Mr.	Rios	Adrian		9299461210					adrian.rios@c2qhealthsolutions.com	136-65 37th Ave		Flushing	NY	11354	08/21/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part C Application Contact	Chief Compliance Officer	Ms.	Nelson Jones	Alicia		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Appeals	Director, Appeal&Grievances	Ms.	Singh	Devi							desingh@centerlight.org	555 Albany Ave		Amityville	NY	11701	12/21/2021	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active	8772268500	4033			PACE - Nat		C	New York
H3329	Part D Appeals Contact (Secondary)	SVP of Quality	Ms.	St Fleur	Gilda							gstfleur@centerlight.org	136-65 37th Ave		Flushing	NY	11354	08/21/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active	8772268500				PACE - Nat		C	New York
H3329	Part D Application Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979					sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Benefits Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979					sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Claims Submission Contact	Supervisor of Medicare Operations		Distel	Chris		8582915269					pde@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/13/2023	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	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	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active	8587905846				PACE - Nat		C	New York
H3329	Part D Exceptions Contact (Secondary)	Pharmacy Director	Ms.	Jing	Shu						3157504990	sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active	9176977979				PACE - Nat		C	New York
H3329	Part D Price File Contact (Back-up)	VP, Finance Operations and Provider Data Managemen	Mr.	Hormaza	Victor		9298371601					vhormaza@centerlight.org	2401 White Plains Road		Bronx	NY	10467	06/13/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Price File Contact (Optional)	Medicare Part D Project Manager		Keller	Shanon		8587907104					medicarepartdmanagers@medimpact.com	136-65 37th Ave.		Flushing	NY	11354	12/30/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Price File Contact (Primary)	VP, Finance Operations and Provider Data Managemen	Mr.	Hormaza	Victor		9298371601					vhormaza@centerlight.org	2401 White Plains Road		Bronx	NY	10467	06/13/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Quality Assurance Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979					Sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Part D Reporting Contact	Pharmacy Director	Ms.	Jing	Shu		3476406615					sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Patient Safety Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979					sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Payment Contact	CFO		Tirtasaputra	Leny		3475012901					ltirtasaputra@centerlight.org	136-65 37th Ave		FLUSHING	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Pharmacy Director	Pharmacy Director	Ms.	Jing	Shu		9176977979					sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Pharmacy Network Management Contact	Pharmacy Director	Ms.	Jing	Shu		9176977979					sjing@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Pharmacy Network Management Contact (Secondary)		Ms.	Frey	Jessica		8582915348					jessica.frey@medimpact.com	136-65 37th Ave.		Flushing	NY	11354	12/30/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/24/2023	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active	8443362681				PACE - Nat		C	New York
H3329	Plan Directory Contact for Public Website	Customer Service Team (CST)		.	.		8332522737					customerserviceteam@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Plan to Plan Reconciliation Contact	Sr. Accountant		Barsamyan	Anahit		2016555825					abarsamyan@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Processor Contact	SVP, Government Programs and Services		Helmus	Scott		8584373471					Scott.Helmus@medimpact.com	10181 Scripps Gateway C		San Diego	CA	92131	12/03/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Quality Contact	SVP of Quality	Ms.	St Fleur	Gilda		3473877782					gstfleur@centerlight.org	136-65 37th Ave		Flushing	NY	11354	08/21/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Reconciliation Contact	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796					tbrut@centerlight.org	137-65 37th Ave.		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Reconciliation Contact (Secondary)	CFO		Tirtasaputra	Leny		3475012901					ltirtasaputra@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Recovery Audit Contact	Chief Compliance Officer	Ms.	Nelson Jones	Alicia		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Surveillance Contact	Chief Compliance Officer	Ms.	Nelson Jones	Alicia		3474430157					anjones@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	System Contact	Security Administrator	Mr	Hsu	Lester		7182008377					lhsu@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Third Party Administrator (TPA) Liaison	Chief Executive Officer	Mrs.	Buonocore-Rut	Tara		6464831796					tbrut@centerlight.org	136-65 37th Ave		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	User Access Contact	Chief Compliance Officer	Ms.	Nelson-Jones	Alicia		3474430157					anjones@centlight.org	136-65 37th Ave.		Flushing	NY	11354	05/11/2022	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Utilization Management Contact	Director of PA & UM Programs	Ms.	Emoto	Julianne		8587905846					julianne.emoto@medimpact.com	136-65 37th Ave.		Flushing	NY	11354	01/03/2023	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3329	Utilization Review Contact	VP of Clinical Operations	Dr.	Ogando	Heather		6465651834					hogando@centerlight.org	555 Albany Ave		Amityville	NY	11701	08/21/2025	2026	CENTERLIGHT HEALTHCARE, INC.	National PACE	CenterLight Healthcare PACE	National PACE		CenterLight Health System, Inc.	65	Yes	Active					PACE - Nat		C	New York
H3330	Agent/Broker Compensation Data Contact	Dir. Medicare Sales		Pappalardo	Kimberly		6464477024					kpappalardo@emblemhealth.com	55 Water Street		New York	NY	10041	01/31/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	06/25/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Backup User Access Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Best Available Evidence Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	05/24/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Bid Audit Contact	Medicare Compliance Leader		Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	02/07/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Bid Audit Site Contact	Sr. Medicare Audit Spec.		Chan	Tat		6464470218					tchan@emblemhealth.com	55 Water Street		New York	NY	10041	05/28/2020	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Bid Primary Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	11/08/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	CAP Report Contact for Public Website	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	CEO - CMS Administrator Contact	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	02/11/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	CEO - Senior Official for Contracting	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	02/11/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		6464476174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	07/02/2020	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Chief Operating Officer	Chief Operating Officer	Mr.	MacMillan	Thomas		6464474401					tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	02/06/2024	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Chief Information Officer	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	07/30/2019	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Chief Information Security Officer	VP, Technology and CISO	Mr.	McDermott	Thomas	M	6464474110					tmcdermott@emblemhealth.com	55 Water Street		New York	NY	10041	05/23/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	CMMI Model Point of Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	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	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/22/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Complaints Tracking Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	07/22/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Contact for Fraud Investigations	Director, Special Investigations		Lupo	Chris		6318442453					Clupo@EmblemHealth.com	395 North Service Road		Melville	NY	11747	03/02/2017	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Coordination of Benefits Contact	AVP, Provider Claim Resolution		Maxwell	Christine		8606745751					cmaxwell@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/16/2024	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Corporate Mailing						6464475000					Cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	08/01/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Customer Service Operations Contact	VP Customer Service		Tirado	Nicole		5184466981					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	02/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	DIR Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	DIR Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/16/2024	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Discount Program Payment Contact	Financial Operations and Treasury		Czerczak	Ewelina		8606745716					egradka@emblemhealth.com	175 Scott Swamp Rd		New York	CT	06032	01/31/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Emergency Part D Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Emergency Part D Contact (Secondary)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/22/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Employer Waiver Contact	AVP, Product Dev., Admin., & Perf. Analysis		Averyanova	Nataliya		6464475044					naveryanova@emblemhealth.com	55 Water Street		New York	NY	10041	05/23/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Encounter Data & Risk Adjustment Operations Contact	Dir., Enterprise Gov't Submissions		Guenther	Anne Marie		8606745847					aconnors@connecticare.com	175 Scott Swamp Rd		Farmington	CT	06034	05/23/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Enrollment Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	05/23/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	EOB Transfer Contact	Dir., Claims Operations		Salcedo	Clifford		2126150511				2125105319	csalcedo@emblemhealth.com	55 Water Street		New York	NY	10041	01/31/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Financial Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	02/07/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Financial Reporting Contact	Dir., Financial Reporting		Nogajewski	Scott		7086461563					snogajewski@emblemhealth.com	55 Water Street		New York	NY	10041	12/16/2024	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Formulary Contact	Sr. Formulary Specialist		Sitilides Cimino	Irene		6864477926					isitilidescimino@emblemhealth.com	55 Water Street		New York	NY	10041	11/15/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Formulary Contact (Secondary)	Director, Formulary Development & UM		Sandoval	Natalie		3479132921					nasandoval@emblemhealth.com	55 Water St		New York	NY	10041	08/01/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	General Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Government Relations Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	HIPAA Privacy Officer	VP, Corporate Compliance		Lurin	Joseph		6464475203					jlurin@emblemhealth.com	55 Water Street		New York	NY	10041	07/29/2019	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	HIPAA Security Officer	AVP, IT Governance		McDermott	Thomas		6464474110					TMcDermott@emblemhealth.com	55 Water Street		New York	NY	10041	06/29/2018	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Hospice Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/22/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Interoperability Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	MA Appeals/Grievances Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	03/12/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	MA Claims Processing Contact for Public Website	VP, Claims Operations		Henderson	Linda		6464476795					lhenderson@emblemhealth.com	175 Scott Swamp Road		Farmington	CT	06032	10/23/2020	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Marketing Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Medical Director	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	02/05/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Medicare Compliance Officer	Dir., Govt. Program Regulatory/MCO	Mr.	Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Medicare Coordinator	VP, Medicare	Mr.	Walsh	Eric		6464477893					ericwalsh@emblemhealth.com	55 Water Street		New York	NY	10041	09/06/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Medicare Part D Opioid Overutilization Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	03/06/2024	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Medication Therapy Management Contact	Clinical Pharmacy Program Leader		Mhajan	Ruby		6464477632					rumhajan@emblemhealth.com	55 Water Street		New York	NY	10041	12/20/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	OffShore Subcontractor Contact	Lead Admin., Regulatory Pgm.		Kelly	Veronica		6464477494					vkelly@emblemhealth.com	55 Water Street		New York	NY	10041	11/26/2019	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Online Enrollment Center Contact (Back-up)	Knowledge Manager, Enroll. & Bill.		Gonzalez	Gabriel		6464477722					gabriel.gonzalez@emblemhealth.com	55 Water Street		New York	NY	10041	05/24/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Online Enrollment Center Contact (Optional)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com.com	55 water Street		New York	NY	10041	05/24/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Online Enrollment Center Contact (Primary)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	05/24/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part C Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	11/08/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part C Reporting Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Appeals	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A					2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	03/12/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	6464477215				HMO - Health Maintenance Organization		C	New York
H3330	Part D Appeals Contact (Secondary)	Mgr., G & A, Expedited Claims		Montana	Kim						2125108130	kgrace@emblemhealth.com	55 Water Street		New York	NY	10041	08/22/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	6464470523				HMO - Health Maintenance Organization		C	New York
H3330	Part D Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	11/08/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Benefits Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	01/31/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Claims Submission Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Exceptions Contact	Pharmacy Client Ops Director		Der Weer	J'Nisha							jderweer@emblemhealth.com	55 Water street		New York	NY	10041	10/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	6464477198				HMO - Health Maintenance Organization		C	New York
H3330	Part D Exceptions Contact (Secondary)	Pharmacy Perf. Mgmt. Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	4015251683				HMO - Health Maintenance Organization		C	New York
H3330	Part D Price File Contact (Back-up)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Price File Contact (Optional)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Price File Contact (Primary)	Sr. Manager Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	12/16/2024	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Quality Assurance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Part D Reporting Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Patient Safety Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	03/06/2024	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Payment Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	02/12/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Personal Health Record Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Pharmacy Director	VP, Chief Pharmacy Officer		Smith	Jonalan		7858407007					jsmith@emblemhealth.com	55 Water St		New York	NY	10041	08/01/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Pharmacy Network Management Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	10/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Pharmacy Network Management Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	10/10/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	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	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	01/12/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	8009221557	2			HMO - Health Maintenance Organization		C	New York
H3330	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water street		New York	NY	10041	10/10/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	4015251683				HMO - Health Maintenance Organization		C	New York
H3330	PHR Beneficiary Contact																	04/20/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS	EmblemHealth	EmblemHealth, Inc.	361	Yes	Active	8773447364				HMO - Health Maintenance Organization		C	New York
H3330	Plan Directory Contact for Public Website	VP Customer Service		Tirado	Nicole		8773447364					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	03/26/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		6464473017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	08/16/2022	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Processor Contact	AVP, Claims Operations		Gauthier	Kathleen	H	8604096435					kgauthier@connecticare.com	175 Scott Swamp Road	PO BOX 4050	Farmington	CT	06034	05/24/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Quality Contact	Data Analytics & Reporting Leader		Goldfarb	Julie		6315775110	65110				jgoldfarb@emblemhealth.com	55 Water Street		New York	NY	10041	01/10/2023	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Reconciliation Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	07/15/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Reconciliation Contact (Secondary)	Mgr., Enrollment & Billing		Roman	Erica		6464477125					eroman@emblemhealth.com	55 Water Street		New York	NY	10041	02/12/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Recovery Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	02/07/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	SNP Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	11/08/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	SNP State Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	11/08/2021	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Surveillance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	System Contact	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	05/09/2019	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Third Party Administrator (TPA) Liaison	Dir., Treasury		Pastorello	Thomas		9172248582					tpastorello@emblemhealth.com	55 Water Street		New York	NY	10041	01/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	User Access Contact	Lead Medicare Regulatory Spec.		Handy	Michelle		5184466949					mhandy@EmblemHealth.com	80 Wolf Road		Albany	NY	12205	11/14/2016	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Utilization Management Contact	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	02/05/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3330	Utilization Review Contact	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	02/05/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3331	Automated TrOOP Balance Transfer Contact	Pharmacy Administrative Coordinator	Ms.	Van den Bosch	Sarah		5859220080					Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	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	Backup User Access Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	06/17/2024	2026	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	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	08/06/2025	2026	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	Bid Primary Contact	Manager, Finance Reporting	Ms.	Franca	Kathryn		5859221038					kathryn.franca@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	05/30/2023	2026	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	CAP Report Contact for Public Website	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	08/06/2025	2026	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	CEO - CMS Administrator Contact	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	CEO - Senior Official for Contracting	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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		5859221796					Albert.Caprino@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	12/22/2022	2026	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 Operating Officer	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	09/09/2019	2026	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 Information Officer	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	09/09/2019	2026	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 Information Security Officer	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	09/09/2019	2026	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	Vice President	Mr.	VInnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	Complaints Tracking Contact	Vice President	Mr.	VInnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	Contact for Fraud Investigations	Lead Compliance Coordinator		Marciano	Sheila		5859224749					complianceE1@rochesterregional.org	100 Kings Highway South		Rochester	NY	14617	02/15/2024	2026	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	Pharmacy Administrative Coordinator	Ms.	Van den Bosch	Sarah		5859220080					Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	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	Corporate Mailing						5856714300					Denis.Vinnik@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	08/06/2025	2026	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	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	DIR Contact	CFO, Extended Acute Care Services	Mr.	Caprino	Albert		5859221796					Albert.Caprino@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	12/22/2022	2026	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	DIR Contact (Secondary)	Manager, Financial Reporting	Ms.	Franca	Kathryn		5859221038					kathryn.franca@rochesterregional.org	100 Kings Highway South		Rochester	NY	14617	03/02/2023	2026	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	Discount Program Payment Contact	Manager, Finance Reporting	Ms.	Franca	Kathryn		5859221038					kathryn.franca@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	05/30/2023	2026	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	Emergency Part D Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Administrative Coordinator	Ms.	Van den Bosch	Sarah		5859220080					Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					JeanMarie.Mangione@RochesterRegional.org	490 E. Ridge Road		Rochester	NY	14621	03/02/2023	2026	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	Enrollment Contact	Director of Business Development	Ms.	Ralston	Kathy		5859222812					katherine.ralston@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/16/2023	2026	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	EOB Transfer Contact	Pharmacy Administrative Coordinator	Ms.	Van den Bosch	Sarah		5859220080				5859222864	Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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	Financial Audit Contact	Vice President CFO, Extended Care Services	Mr.	Caprino	Albert		5859221796					Albert.Caprino@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	12/22/2022	2026	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	Financial Reporting Contact	Manager, Finance Reporting	Ms.	Franca	Kathryn		5859221038					kathryn.franca@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	05/30/2023	2026	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	Formulary Contact			formulary	not using		5859222200				5859222864	notusing@rochestergeneral.org	2066 Hudson Avenue		Rochester	NY	14617	02/23/2022	2026	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	General Contact	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	HIPAA Privacy Officer	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	HIPAA Security Officer	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	09/09/2019	2026	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	Interoperability Contact	Director of Health Plan Operations		Mangione	Jean Marie		5859222867					JeanMarie.Mangione@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	02/23/2022	2026	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	MA Appeals/Grievances Contact	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	MA Claims Processing Contact for Public Website	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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	Marketing Contact	Director of Business Development	Ms.	Ralston	Kathy		5859222812				5859222864	Katherine.Ralston@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/16/2023	2026	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	Medical Director	Medical Director	Dr.	Ryan	Stephen		5859222855				5859222864	Steve.Ryan@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	03/02/2023	2026	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	Manager, Corporate Compliance	Ms	Marciano	Sheila		5859224749					Sheila.marciano@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	02/15/2024	2026	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 Coordinator	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/16/2023	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr.	Ryan	Stephen		5859222855				5859222864	Steve.Ryan@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	03/02/2023	2026	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	Medication Therapy Management Contact	Medical Director	Dr.	Ryan	Stephen		5859222855				5859222864	Steve.Ryan@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	03/02/2023	2026	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 C Application Contact	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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 Appeals	Administrative Pharmacy Coordinator	Ms.	Van den Bosch	Sarah							Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active	5859220080				PACE - Nat		C	New York
H3331	Part D Application Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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 Benefits Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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 Claims Submission Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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	Dr.	Ryan	Stephen						5859222855	stephen.ryan@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	03/02/2023	2026	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active	8554574636				PACE - Nat		C	New York
H3331	Part D Price File Contact (Back-up)	Manager, Finance Reporting	Ms.	Franca	Kathryn		5859221038					kathryn.franca@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	03/02/2023	2026	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 Price File Contact (Primary)	CFO, Extended Acute Care Services	Mr.	Caprino	Albert		5859221796					Albert.Caprino@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	12/22/2022	2026	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 Quality Assurance Contact	Administrative Pharmacy Coordinator	Ms.	Van den Bosch	Sarah		5859220080					Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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 Reporting Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	05/30/2023	2026	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	Patient Safety Contact	Medical Director	Dr.	Ryan	Stephen		5859222855				5859222864	stephen.ryan@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	01/27/2021	2026	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	Payment Contact	Manager, Finance Reporting	Ms.	Franca	Kathryn		5859221038					kathryn.franca@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	05/30/2023	2026	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 Director	Medical Director		Ryan	Stephen		5859222855				5859222864	Stephen.Ryan@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	01/27/2021	2026	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 Network Management Contact	Provider Network Coordinator	Mr.	Mastrella	Frank		5859222828					Frank.Mastrella@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	05/30/2023	2026	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 Network Management Contact (Secondary)	Consulting Clinical Pharmacist	Ms.	Dorward	Kathryn		5856426004					Kathryn.Dorward@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	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	Administrative Pharmacy Coordinator	Ms.	Van den Bosch	Sarah							Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active	5859220080				PACE - Nat		C	New York
H3331	Pharmacy Technical Help Desk Contact (Secondary)	Consulting Clinical Pharmacist	Ms.	Dorward	Kathryn								490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	INDEPENDENT LIVING FOR SENIORS, INC.	National PACE	ElderONE an Affiliate of Rochester Regional Health	National PACE		Rochester Regional Health	132	Yes	Active	5856426004				PACE - Nat		C	New York
H3331	Plan Directory Contact for Public Website	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	Plan to Plan Reconciliation Contact	Administrative Pharmacy Coordinator	Ms.	Van den Bosch	Sarah		5859220080					Sarah.van-den-Bosch@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	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	Processor Contact	Senior Accountant	Ms.	Ingrassia	Maria		5859221037					Maria.Ingrassia@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	05/30/2023	2026	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	Quality Contact	Senior Performance Improvement Coordinator	Ms.	Tack	Ashley		3155761696				5859222864	Ashley.Tack@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	12/04/2024	2026	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	Reconciliation Contact	Senior Accountant	Ms.	Ingrassia	Maria		5859221037					Maria.Ingrassia@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	05/30/2023	2026	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	Reconciliation Contact (Secondary)	Manager, Finance Reporting	Ms.	Franca	Kathryn		5859221038					kathryn.franca@rochesterregional.org	100 Kings Highway		Rochester	NY	14617	05/30/2023	2026	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	Recovery Audit Contact	Director of Health Plan Operations	Ms.	Mangione	Jean Marie		5859222867					jeanmarie.mangione@rochesterregional.org	490 E. Ridge Rd		Rochester	NY	14621	05/30/2023	2026	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	Surveillance Contact	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	System Contact	Vice President	Mr.	Vinnik	Denik		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	Third Party Administrator (TPA) Liaison		Ms.	Murray	Sarah		6073513737					Sarah.murray@rochesterregional.org	490 East Ridge Road		Rochester	NY	14621	01/07/2025	2026	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	User Access Contact	Vice President	Mr.	Vinnik	Denis		5856714300					Denis.Vinnik@rochesterregional.org	490 East Ridge Rd		Rochester	NY	14621	08/06/2025	2026	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	Utilization Management Contact	Director, PACE Operations	Ms.	Mihaly	Crystol		5857038287				5859222864	crystol.mihaly@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	03/02/2023	2026	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	Utilization Review Contact	Director, PACE Operations	Ms.	Mihaly	Crystol		5857038287				5859222864	crystol.mihaly@rochesterregional.org	490 E. Ridge Road		Rochester	NY	14621	03/02/2023	2026	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	Agent/Broker Compensation Data Contact	Manager, Broker Administration and Operations		McBride	Kelly		5857396683					Kelly.McBride@Excellus.com	165 Court Street		Rochester	NY	14647	04/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Automated TrOOP Balance Transfer Contact	Supervisor, Medicare Operations		Matecki	Lisa		7166145722					Lisa.Matecki@excellus.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Backup User Access Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court Street		Rochester	NY	14647	11/02/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		7168574435				7168576160	medicare.reconciliation.unit@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Bid Audit Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Bid Audit Site Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Bid Primary Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	CAP Report Contact for Public Website	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	CEO - CMS Administrator Contact	Executive Vice President & Chief Financial Officer	Mr	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	CEO - Senior Official for Contracting	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	05/03/2021	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Chief Operating Officer	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	05/03/2021	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Chief Information Officer	SVP & Chief Info Data Digital Officer	Ms	Langston	Cindy		5853276529					Cindy.Langston@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Chief Information Security Officer	Vice President, Chief Information Security Officer	Mr.	Pickup	Jason		5853397620	25511				Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Complaints Tracking Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Contact for Fraud Investigations	Corporate Director of Special Investigations		Paris	Meg		5852384425				5854536346	Meg.Paris@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Coordination of Benefits Contact	Manager, Analysis and Recovery		May	Mary		3157928873					Mary.May@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Corporate Mailing						5852384505					CCiardi@excellus.com	165 Court Street		Rochester	NY	14647	02/07/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		5853996683					Alexander.Levi@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	DIR Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	02/17/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	DIR Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	02/17/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Discount Program Payment Contact	Director Financial Operations		McCullough	Shandell		5852384672					Shandell.McCullough@excellus.com	165 Court Street		Rochester	NY	14647	05/20/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Emergency Part D Contact	Executive Vice President & Chief Financial Officer		Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court St		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Rocco	Darlene		5852613857				8778125306	Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment Data Analytics		Palmer	Benjamin		3156717270					Benjamin.Palmer@excellus.com	333 Butternut Drive		Dewitt	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Enrollment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	08/24/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	EOB Transfer Contact	Strategic Pharmacy Change Manager		Ammons	Andrea		5853397986				8778125306	Andrea.Ammons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Financial Audit Contact	Director, Regulatory Auditing & Medicare Oversight	Mrs	Knappen	Heather		5857390661					heather.knappen@excellus.com	165 Court Street		Rochester	NY	14647	11/11/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Financial Reporting Contact	Manager, Medicare and SN Finance		Stalzer	Virginia		5852384428					Virginia.Stalzer@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Formulary Contact	Medicare Part D Formulary Manager		Woodruff	Eric		7167832740					Eric.Woodruff@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	06/15/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Formulary Contact (Secondary)	Medicare Part D Formulary Manager		Banaszak	Danielle		7166145704					Danielle.Banaszak@excellus.com	205 Park Club Lane		Buffalo	NY	14221	06/15/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	General Contact	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	HIPAA Privacy Officer	VP, Ethics & Privacy Officer		Hill	Timothy	J	3158771234					Timothy.Hill@excellus.com	333 Butternut Drive		Dewitt	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	HIPAA Security Officer	Vice President, Chief Information Security Officer		Pickup	Jason		5853397620					Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Hospice Contact	Director, Pharmacy Utilization Management		Khan	Joe		7168437881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Interoperability Contact	Strategic Porfolio Management		Meek	Shauna		5852384570					Shauna.Meek@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	MA Appeals/Grievances Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Rafael.Gomez@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	10/09/2017	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	MA Claims Processing Contact for Public Website	Manager, Customer Operations		Amato	Heather		7162505162					Heather.Amato@Univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	08/24/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Marketing Contact	Marketing Manager		Reardon	Elizabeth		5853276504					Elizabeth.Reardon@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Medical Director	Senior VP and Corporate Medical Director		Cohen	Stephen		5854536366					Stephen.Cohen@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Medicare Coordinator	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Medicare Part D Opioid Overutilization Contact	Quality Improvement Clinical Pharmacist		Morano	Melissa		7166145705					melissa.morano@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	06/15/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Medication Therapy Management Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	08/24/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Online Enrollment Center Contact (Back-up)	Enrollment Operation Project Manager II		Abiusi	Amy		7164408638					Amy.Abiusi@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Online Enrollment Center Contact (Optional)	Manager, EDI & Enrollment Governance		Field	Eric		3154360215					Eric.Field@excellus.com	333 Butternut Drive		Syracuse	NY	13214	10/09/2020	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Online Enrollment Center Contact (Primary)	Enrollment Operations Analyst II		Conway	Michael		7165738029					Michael.Conway@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part C Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					Kelli.McParlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	11/19/2021	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part C Reporting Contact	Medicare Compliance Program Administrator		Dewa	Renate		3155732791					Renate.Dewa@excellus.com	165 Court Street		Rochester	NY	14647	01/04/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Appeals	Compliance Program Administrator III		Gomez	Rafael							Rafael.Gomez@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	7168576226				PPO - BBA		C	Chicago
H3335	Part D Appeals Contact (Secondary)	Manager of Advocacy and Compliance Ops		Casillo	Lynda							Lynda.Casillo@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	7168576146				PPO - BBA		C	Chicago
H3335	Part D Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					Kelli.McParlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	11/19/2021	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Benefits Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Claims Submission Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Exceptions Contact	Director, Pharmacy Utiization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	7168437881				PPO - BBA		C	Chicago
H3335	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Brayer	Hayden							Hayden.Brayer@excellus.Com	165 Court Street		Rochester	NY	14647	04/01/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	5854536416				PPO - BBA		C	Chicago
H3335	Part D Price File Contact (Back-up)	Pharmacy Product Ops Specialist		DuVall	Amanda		7168576177					Amanda.DuVall@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	12/04/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Price File Contact (Optional)	Director of Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107th St.	#11202	Overland Park	KS	66207	07/23/2020	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Price File Contact (Primary)	Pharmacy Product Ops Specialist		Ciaramaglia	Shannon		5852384506					shannon.ciaramaglia@excellus.com	165 Court Street		Rocheser	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Quality Assurance Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	08/24/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Part D Reporting Contact	Medicare Compliance Program Administrator		Dewa	Renate		3155732791					Renate.Dewa@excellus.com	165 Court Street		Rochester	NY	14647	01/04/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Patient Safety Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	08/24/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Payment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	08/24/2023	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Pharmacy Director	Director, Pharmacy Operations		Rocco	Darlene		5853277544					Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		5853277530				5853396640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Pharmacy Network Management Contact (Secondary)	Network Account Directory Retail Strategy and Cont		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		ST Louis	MO	63121	02/14/2020	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
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	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				PPO - BBA		C	Chicago
H3335	Pharmacy Technical Help Desk Contact (Secondary)	SR Director Goverment Programs, Medicare		Gibson	Sharon							SGGibson@Express-scripts.Com	One Express Way		St Louis	MO	63121	12/31/2019	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				PPO - BBA		C	Chicago
H3335	Physician Incentive Contact	VBP Clinical Programs Manager		Ferris	Laura		3152435765				3156716752	Laura.Ferris@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Plan Directory Contact for Public Website	Manager, Medicare Compliance		Spitler	Tracy		5852383644					Tracy.Spitler@Excellus.com	165 Court Street		Rochester	NY	14647	08/28/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		5856492768					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Processor Contact	SR Directory Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St Louis	MO	63121	11/07/2018	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Quality Contact	Manager, HCI Governance		Alexander	Elizabeth	C	5857520776					elizabeth.alexander@excellus.com	165 Court Street		Rochester	NY	14647	10/28/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Reconciliation Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	02/17/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	02/17/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Recovery Audit Contact	Manager Financial Compliance	Mr.	Mau	Ahren		5854785535					Ahren.Mau@excellus.com	165 Court St		Rochester	NY	14647	08/26/2021	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Surveillance Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	System Contact	VP and Chief Apps Officer		Kay	Carolanne		5854142258					Carolanne.Kaye@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Third Party Administrator (TPA) Liaison	Financial Analyst		McManus	Michael		5853397789					Michael.Mcmanus@excellus.com	165 Court Street		Rochester	NY	14647	01/18/2022	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	User Access Contact	Medicare Compliance Program Administrator		Conte	Elva		7168437805					Elva.Conte@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Utilization Management Contact	Clinical Operations Accreditation & Compliance		Burnop	Elizabeth		3152721088					Elizabeth.Burnop@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3335	Utilization Review Contact	Clinical Operations Accreditation & Compliance		Burnop	Elizabeth		3152721088					Elizabeth.Burnop@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H3344	Agent/Broker Compensation Data Contact	Director Government Sales		Aquino	Cathy		7166354948				7166318857	cathy.aquino@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/29/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Automated TrOOP Balance Transfer Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Backup User Access Contact	Risk Operations Analyst		Carr	Sarah Jane		7166313001					SarahJane.Carr@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/19/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Best Available Evidence Contact	Manager - Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Bid Audit Contact	Director - Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Bid Audit Site Contact	Chief Compliance Officer		Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Bid Primary Contact	Director - Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	CAP Report Contact for Public Website	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	CEO - CMS Administrator Contact	President and CEO	Dr.	Cropp, MD	Michael		7166353995				7162507135	Michael.Cropp@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	08/18/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	CEO - Senior Official for Contracting	President and CEO	Dr.	Cropp, MD	Michael		7166353995				7162507135	Michael.Cropp@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	08/18/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Chief Financial Officer	Executive Vice President - Chief Financial Officer	Mr.	Gross	Jared		7166353516					Jared.Gross@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/11/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Chief Operating Officer	Exec Vice President and Chief Operating Officer	Mr.	Rodgers	John		7166353630					john.rodgers@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/11/2015	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Chief Information Officer	Chief Information Security Officer	Mr.	Jabrucki	Peter		7162507383					Peter.Jabrucki@Independenthealth.com	511 Farber lakes		Buffalo	NY	14221	01/14/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Chief Information Security Officer	Chief Information Security Officer	Mr.	Jabrucki	Peter		7162507383					Peter.Jabrucki@Independenthealth.com	511 Farber lakes		Buffalo	NY	14221	01/14/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	CMS Casework Communication Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Complaints Tracking Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Contact for Fraud Investigations	Director-Corporate Recoveries		Caulfield	Sheila		7166353783					Sheila.Caulfield@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/11/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Coordination of Benefits Contact	Manager - Corporate Recoveries		Abou-Said	Kelly		7166353758					Kelly.Abou-Said@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/07/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Corporate Mailing						7166313001					Dawn.Odrzywolski@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Customer Service Operations Contact	Manager - Servicing		Plotner	Jenna		7162504424					Jenna.Plotner@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/22/2021	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	DIR Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	DIR Contact (Secondary)	Supervisor-Rebates Analytics		Ketch	Jamie		7166312485					Jamie.Ketch@pbdrx.com	10 Earhart Dr.		Williamsville	NY	14221	02/20/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Discount Program Payment Contact	Manager - Treasury Services		Fisher	Dave		7166353561					Dave.Fisher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/28/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Emergency Part D Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Emergency Part D Contact (Secondary)	Manager - Pharmacy Services		Jahn	Heather		7166354890					Heather.Jahn@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Employer Waiver Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Encounter Data & Risk Adjustment Operations Contact	Manager - Government Programs Implementation		Everett	Wade		7162507367					Wade.Everett@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/03/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Enrollment Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	EOB Transfer Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885				7166319636	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Financial Audit Contact	VP-Pricing & Underwriting	Ms.	Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Financial Reporting Contact	Accountant Regulatory Reporting		Coder	Sara		7162507123					Sara.Coder@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Formulary Contact	Clinical Pharmacist		Wrobel	Mark		7166353831					Mark.Wrobel@independenthealth.com	511 Farber Lakes Dr		Buffalo	NY	14221	01/29/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Formulary Contact (Secondary)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/21/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	General Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Government Relations Contact	SVP Government Programs		Tracy	Robert		7166354904					Robert.Tracy@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	HIPAA Privacy Officer	Chief Information Security Officer		Jabrucki	Peter		7162507383				7162507115	peter.jabrucki@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	HIPAA Security Officer	Chief Information Security Officer		Jabrucki	Peter		7162507383				7162507115	peter.jabrucki@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Hospice Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Interoperability Contact	VP-IT Application Delivery		Haak	Lesley		7162504443					Lesley.Haak@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	MA Appeals/Grievances Contact	Director, Benefit Administration and Compliance		Kieser	Michelle		7166353938					Michelle.Kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/11/2015	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	MA Claims Processing Contact for Public Website			Relations Dept	Provider		7166313282				7166353890	Provider@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/06/2008	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Marketing Contact	Director Government Sales		Aquino	Cathy		7166354948				7166318857	cathy.aquino@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Medical Director	EVP - Chief Medical Officer	Dr.	Billittier, MD	Anthony		7166353635					Anthony.Billittier@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/19/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/20/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Medicare Coordinator	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Medicare Part D Opioid Overutilization Contact	Manager-MTM & Pharmacy Quality		Hathaway	Natalie		7166357877					Natalie.Hathaway@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Medication Therapy Management Contact	Manager-MTM & Pharmacy Quality		Hathaway	Natalie		7166357877					Natalie.Hathaway@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	OffShore Subcontractor Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Online Enrollment Center Contact (Back-up)	Operations and System Analyst-Mbrs Operations		Cleary	Jennifer		7166313001	2274				Jennifer.Cleary@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	08/21/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Online Enrollment Center Contact (Primary)	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part C Application Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part C Reporting Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	jeremy.laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Appeals	Director - Benefit Administration and Compliance		Kieser	Michelle							michelle.kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/11/2015	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	8006651502				PPO - BBA		C	Dallas
H3344	Part D Appeals Contact (Secondary)	Director, Benefit Administration and Compliance		Kieser	Michelle							Michelle.Kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/15/2016	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	8007365771				PPO - BBA		C	Dallas
H3344	Part D Application Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Benefits Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Claims Submission Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Exceptions Contact	Vice President - Pharmacy		Verrall	Kelly						7166310149	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			PPO - BBA		C	Dallas
H3344	Part D Exceptions Contact (Secondary)	Manager - Pharmacy Services		Jahn	Heather						7166310149	Heather.Jahn@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			PPO - BBA		C	Dallas
H3344	Part D Price File Contact (Back-up)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/21/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Price File Contact (Optional)	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Price File Contact (Primary)	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Quality Assurance Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Part D Reporting Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	jeremy.laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Patient Safety Contact	Director, Pharmacy, Quality and MTM		Verrall	Kelly		7166354885				7162507121	kelly.verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Payment Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Pharmacy Director	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Pharmacy Network Management Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Pharmacy Network Management Contact (Secondary)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Pharmacy Technical Help Desk Contact	Manager, Provider and Member Services		Dandridge	Tinika							script@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/02/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	8009939898				PPO - BBA		C	Dallas
H3344	Pharmacy Technical Help Desk Contact (Secondary)	Vice President - Pharmacy		Verrall	Kelly						7166310149	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			PPO - BBA		C	Dallas
H3344	PHR Beneficiary Contact																	07/24/2009	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO	Independent Health - Member Services	Independent Health Association, Inc.	131	Yes	Active	8006651502				PPO - BBA		C	Dallas
H3344	Physician Incentive Contact	Director-Value-Based Reimbursement		Ghil	Peter		7166353840					Peter.Ghil@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/23/2022	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Plan Directory Contact for Public Website			Services	Member		8006651502					wnyms@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/08/2008	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Plan to Plan Reconciliation Contact	Pharmacy Systems Gov. Programs Manager		Miszuk	Jane		7166357857					Jane.Miszuk@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/11/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Processor Contact	Director-Claims Operations		Taggart	David		7166357837					David.Taggart@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/11/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Quality Contact	Manager-Quality Programs		Zell	Christy		7166353852					Christy.Zell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Reconciliation Contact	VP-Pricing & Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Reconciliation Contact (Secondary)	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Recovery Audit Contact	Director - Medicare Programs	Mr.	Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	SNP Application Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Surveillance Contact	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	System Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Third Party Administrator (TPA) Liaison	Manager - Treasury Services		Fisher	Dave		7166353561					Dave.Fisher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/28/2018	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	User Access Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	Jeremy.Laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Utilization Management Contact	Director, Utilization Quality Ops Improvement Mgt		Salemi	Phil		7166353908					Philip.Salemi@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3344	Utilization Review Contact	Director, Utilization Quality Ops Improvement Mgt		Salemi	Phil		7166353908					Philip.Salemi@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	Local CCP	Independent Health	Local PPO		Independent Health Association, Inc.	131	Yes	Active					PPO - BBA		C	Dallas
H3347	Agent/Broker Compensation Data Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Automated TrOOP Balance Transfer Contact	Assistant Director Pharmacy Services		Sahani	Ankit		7189218841					asahani@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	11/30/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Backup User Access Contact			Chan	Lauren		7186302561					lchan@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	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		7186302608				7186301709	alewis@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Bid Audit Contact	Chief Financial Officer		Koschitzki	David		7184917208					dkoschit@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Bid Audit Site Contact	VP, Product Management		Johnson	Chad		7189217922					jcjohnso@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Bid Primary Contact	VP, Product Management		Johnson	Chad		7189217922					jcjohnso@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	CAP Report Contact for Public Website	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	CEO - CMS Administrator Contact	President & CEO	Mr.	Wagner	David		7184917209				7184917138	dwagner@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	10/04/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	CEO - Senior Official for Contracting	President & CEO	Mr.	Wagner	David		7184917209				7184917138	dwagner@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	10/04/2023	2026	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		7184917208					dkoschit@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	10/04/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Chief Operating Officer	President & CEO	Mr.	Wagner	David		7184917209				7184917138	dwagner@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Chief Information Officer	SVP of Information Services	Mr.	Retig	Seth		2126495260					sretig@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/21/2025	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Chief Information Security Officer	Senior VP of Health Plan Information Services	Mr.	Azoff	Craig		7189217826					cazoff@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/30/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	CMS Casework Communication Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Complaints Tracking Contact	Regulatory Compliance Specialist		Hernandez	Dawn		7186302598					dhernand@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/21/2025	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Contact for Fraud Investigations	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	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		7186302608				7186301709	alewis@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Corporate Mailing						7189218066				7189211616	jcjohnso@mjhs.org	55 Water Street	46th floor	New York	NY	10041	01/09/2024	2026	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 Member Services		Alston	Doretha		7189217830					DALSTON@MJHS.ORG	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	DIR Contact	VP, Pharmacy		Ference	Eunice		7186302691				7187652106	eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	DIR Contact (Secondary)	Chief Financial Officer		Koschitzki	David		7184917208					dkoschit@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Discount Program Payment Contact	Assistant Director Pharmacy Services		Sahani	Ankit		7189218841					asahani@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Emergency Part D Contact	VP, Pharmacy	Ms	Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Employer Waiver Contact	VP, Product Management		Johnson	Chad		7189217922					jcjohnso@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Encounter Data & Risk Adjustment Operations Contact	VP, Health Economics		O'Brien	Jaclyn		7189217717					JOBRIEN@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Enrollment Contact	Director of Member Operations		Lewis	Alison		7186302608				7186301709	alewis@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	EOB Transfer Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260				7187595262	cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Financial Audit Contact	VP of Finance	Mr.	Coleman	John		7187594482					johcolem@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	10/04/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Financial Reporting Contact	VP of Finance	Mr.	Coleman	John		7187594482					johcolem@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Formulary Contact	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Formulary Contact (Secondary)	Assistant Director Pharmacy Services		Sahani	Ankit		7189218841					asahani@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	General Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Government Relations Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	HIPAA Privacy Officer	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	HIPAA Security Officer	Senior VP of Health Plan Information Services		Azoff	Craig		7189217826					cazoff@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/30/2024	2026	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		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Interoperability Contact	SVP, Elderplan Information Services		Azoff	Craig		7189217826					cazoff@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/30/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	MA Appeals/Grievances Contact	Director of Appeals and Grievances		Arzu	Marcela		7187594054					marzu@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	MA Claims Processing Contact for Public Website	VP Claims & Call Center		Ditkowsky	Lee		7187594601					lditkows@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Marketing Contact	Chief Marketing & Communications Officer		Ashley	Diane		2123565888					dashley@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Medical Director	Executive Director of Medical Affairs	Dr.	Burgos	Gilbert		3476753297					gburgos@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Medicare Compliance Officer	VP of Compliance & Privacy	Ms.	Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	10/04/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Medicare Coordinator	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Medicare Part D Opioid Overutilization Contact	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Medication Therapy Management Contact	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	OffShore Subcontractor Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Online Enrollment Center Contact (Back-up)	Member Operations Manager		Rhatigan	William		7187594203					wrhatiga@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	02/20/2025	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Online Enrollment Center Contact (Primary)	Director of Member Operations		Lewis	Alison		7186302608				7187652473	alewis@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part C Application Contact	VP, Product Management		Johnson	Chad		7189217922					jcjohnso@mjhs.org	55 Water Street	46th Floor	Brooklyn	NY	11220	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part C Reporting Contact	Senior Director of Regulatory Compliance		Chan	Lauren		7186302561					lchan@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/21/2025	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part D Appeals	RPH Manager, Clinical Operations		Vo	Binh						7326914838	_IRE_Reconsideration@CVSHealth.com	620 Epsilon Dr		Pittsburgh	PA	15238	01/16/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active	2244764838				HMO - Health Maintenance Organization		C	New York
H3347	Part D Appeals Contact (Secondary)	Supervisor		Allen	Karyn						7326914838	IRESupportTeam@Cvshealth.com	620 Epsilon Dr		Pittsburgh	PA	15238	01/16/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active	2244768124				HMO - Health Maintenance Organization		C	New York
H3347	Part D Application Contact	VP, Product Management		Johnson	Chad		7189217922					jcjohnso@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part D Benefits Contact	VP, Product Management		Johnson	Chad		7189217922					jcjohnso@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part D Claims Submission Contact	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	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	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active	7186302691				HMO - Health Maintenance Organization		C	New York
H3347	Part D Exceptions Contact (Secondary)	Assistant Director Pharmacy Services		Sahani	Ankit							ASAHANI@MJHS.ORG	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active	7189218841				HMO - Health Maintenance Organization		C	New York
H3347	Part D Price File Contact (Back-up)	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part D Price File Contact (Primary)	Sr. Manager		Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	CVS Health	9501 E Shea Blvd, MC034	Scottsdale	AZ	85260	01/16/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part D Quality Assurance Contact	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street		New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Part D Reporting Contact	Senior Director of Regulatory Compliance		Chan	Lauren		7186302561					lchan@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/21/2025	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Patient Safety Contact	VP, Quality and Performance Improvement		Frisari	Josephine		7189217984				7182088858	jfrisari@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Payment Contact	VP of Health Economics		O'Brien	Jaclyn		7189217717				7186301709	jobrien@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Pharmacy Director	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Pharmacy Network Management Contact	VP, Pharmacy		Ference	Eunice		7186302691					eference@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Pharmacy Network Management Contact (Secondary)	Assistant Director Pharmacy Services		Sahani	Ankit		7189218841					asahani@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	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	AVP Customer Care		Jackson	Scott							scott.jackson@cvshealth.com	CVS Caremark	1 CVS Drive	Woonsocket	RI	02895	12/20/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H3347	Plan Directory Contact for Public Website			Services	Provider		7189217979					EPProviderServices@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	02/20/2025	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Plan to Plan Reconciliation Contact	AVP of Risk Adjustment		Mohanakrishnan	Meera		9293556494					mmohanak@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/21/2025	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Processor Contact	VP Claims & Call Center		Ditkowsky	Lee		7187594601					lditkows@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Quality Contact	VP of Quality & Performance Improvement		Frisari	Josephine		7189217984					JFRISARI@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/12/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Reconciliation Contact	VP of Health Economics		O'Brien	Jaclyn		7189217717					JOBRIEN@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Reconciliation Contact (Secondary)	Director of Actuarial Services		Myers	Daniel		7189863384					DMYERS@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Recovery Audit Contact	VP of Revenue Cycle	Ms.	Robeck	Marina		7186302510					MROBECK@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	SNP Application Contact	VP, Product Management		Johnson	Chad		7189217922					jcjohnso@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	SNP State Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Surveillance Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	System Contact	Director of Member Operations		Lewis	Alison		7186302608				7187652473	alewis@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Third Party Administrator (TPA) Liaison	Assistant Director Pharmacy Services		Sahani	Ankit		7189218841					asahani@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	User Access Contact	VP of Compliance & Privacy		Weatherly	Candice		7187594260					cweather@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	08/16/2023	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Utilization Management Contact	VP of Medical Management & Case Management		Bennett	Robert		7189217611				7187595105	rbennett@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3347	Utilization Review Contact	VP of Medical Management & Case Management		Bennett	Robert		7189217611				7187595105	rbennett@mjhs.org	55 Water Street	46th Floor	New York	NY	10041	01/09/2024	2026	ELDERPLAN, INC.	Local CCP	Elderplan	HMO/HMOPOS		Elderplan, Inc.	395	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3351	Agent/Broker Compensation Data Contact	Manager, Broker Administration and Operations		McBride	Kelly		5857396683					Kelly.McBride@Excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Automated TrOOP Balance Transfer Contact	Supervisor, Medicare Operations		Matecki	Lisa		7166145722					Lisa.Matecki@excellus.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Backup User Access Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		7168574435				7168576160	medicare.reconciliation.unit@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Bid Audit Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Bid Audit Site Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Bid Primary Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	CAP Report Contact for Public Website	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	CEO - CMS Administrator Contact	Executive Vice President & Chief Financial Officer	Mr	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	CEO - Senior Official for Contracting	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Chief Operating Officer	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Chief Information Officer	SVP & Chief Info Data Digital Officer	Ms	Langston	Cindy		5853276529					Cindy.Langston@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Chief Information Security Officer	Vice President, Chief Information Security Officer	Mr.	Pickup	Jason		5853397620	25511				Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Complaints Tracking Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Contact for Fraud Investigations	Corporate Director of Special Investigations		Paris	Meg		5852384425				5854536346	Meg.Paris@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Coordination of Benefits Contact	Manager, Analysis and Recovery		May	Mary		3157928873					Mary.May@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Corporate Mailing						5852384505					CCiardi@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		5853996683					Alexander.Levi@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	DIR Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	DIR Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Discount Program Payment Contact	Director Financial Operations		McCullough	Shandell		5852384672					Shandell.McCullough@excellus.com	165 Court Street		Rochester	NY	14647	05/20/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Emergency Part D Contact	Executive Vice President & Chief Financial Officer		Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court St		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Rocco	Darlene		5852613857				8778125306	Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment Data Analytics		Palmer	Benjamin		3156717270					Benjamin.Palmer@excellus.com	333 Butternut Drive		Dewitt	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Enrollment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	EOB Transfer Contact	Strategic Pharmacy Change Manager		Ammons	Andrea		5853397986				8778125306	Andrea.Ammons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Financial Audit Contact	Director, Regulatory Auditing & Medicare Oversight	Mrs	Knappen	Heather		5857390661					heather.knappen@excellus.com	165 Court Street		Rochester	NY	14647	11/11/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Financial Reporting Contact	Manager, Medicare and SN Finance		Stalzer	Virginia		5852384428					Virginia.Stalzer@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Formulary Contact	Medicare Part D Formulary Manager		Woodruff	Eric		7167832740					Eric.Woodruff@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Formulary Contact (Secondary)	Medicare Part D Formulary Manager		Banaszak	Danielle		7166145704					Danielle.Banaszak@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	General Contact	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	HIPAA Privacy Officer	VP, Ethics & Privacy Officer		Hill	Timothy	J	3158771234					Timothy.Hill@excellus.com	333 Butternut Drive		Dewitt	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	HIPAA Security Officer	Vice President, Chief Information Security Officer		Pickup	Jason		5853397620					Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Hospice Contact	Director, Pharmacy Utilization Management		Khan	Joe		7168437881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Interoperability Contact	Strategic Porfolio Management		Meek	Shauna		5852384570					Shauna.Meek@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	MA Appeals/Grievances Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Rafael.Gomez@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	MA Claims Processing Contact for Public Website	Manager, Customer Operations		Amato	Heather		7162505162					Heather.Amato@Univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Marketing Contact	Marketing Manager		Reardon	Elizabeth		5853276504					Elizabeth.Reardon@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Medical Director	Senior VP and Corporate Medical Director		Cohen	Stephen		5854536366					Stephen.Cohen@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Medicare Coordinator	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Medicare Part D Opioid Overutilization Contact	Quality Improvement Clinical Pharmacist		Morano	Melissa		7166145705					melissa.morano@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	06/20/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Medication Therapy Management Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Online Enrollment Center Contact (Back-up)	Enrollment Operation Project Manager II		Abiusi	Amy		7164408638					Amy.Abiusi@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Online Enrollment Center Contact (Optional)	Manager, EDI & Enrollment Governance		Field	Eric		3154360215					Eric.Field@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Online Enrollment Center Contact (Primary)	Enrollment Operations Analyst II		Conway	Michael		7165738029					Michael.Conway@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part C Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					Kelli.McParlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part C Reporting Contact	Medicare Compliance Program Administrator		Dewa	Renate		3155732791					Renate.Dewa@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Appeals	Compliance Program Administrator III		Gomez	Rafael							Rafael.Gomez@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	7168576226				HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Appeals Contact (Secondary)	Manager of Advocacy and Compliance Ops		Casillo	Lynda							Lynda.Casillo@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	7168576146				HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					Kelli.McParlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Benefits Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Claims Submission Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Exceptions Contact	Director, Pharmacy Utiization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	7168437881				HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Brayer	Hayden							Hayden.Brayer@excellus.Com	165 Court Street		Rochester	NY	14647	04/01/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	5854536416				HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Price File Contact (Back-up)	Pharmacy Product Ops Specialist		DuVall	Amanda		7168576177					Amanda.DuVall@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	12/04/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Price File Contact (Optional)	Director of Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107th St.	#11202	Overland Park	KS	66207	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Price File Contact (Primary)	Pharmacy Product Ops Specialist		Ciaramaglia	Shannon		5852384506					shannon.ciaramaglia@excellus.com	165 Court Street		Rocheser	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Quality Assurance Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Part D Reporting Contact	Medicare Compliance Program Administrator		Dewa	Renate		3155732791					Renate.Dewa@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Patient Safety Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Payment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Pharmacy Director	Director, Pharmacy Operations		Rocco	Darlene		5853277544					Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		5853277530				5853396640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Pharmacy Network Management Contact (Secondary)	Network Account Directory Retail Strategy and Cont		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		ST Louis	MO	63121	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H3351	Pharmacy Technical Help Desk Contact (Secondary)	SR Director Goverment Programs, Medicare		Gibson	Sharon							SGGibson@Express-scripts.Com	One Express Way		St Louis	MO	63121	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H3351	Physician Incentive Contact	VBP Clinical Programs Manager		Ferris	Laura		3152435765				3156716752	Laura.Ferris@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Plan Directory Contact for Public Website	Manager, Medicare Compliance		Spitler	Tracy		5852383644					Tracy.Spitler@Excellus.com	165 Court Street		Rochester	NY	14647	08/28/2025	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		5856492768					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Processor Contact	SR Directory Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St Louis	MO	63121	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Quality Contact	Manager, HCI Governance		Alexander	Elizabeth	C	5857520776					elizabeth.alexander@excellus.com	165 Court Street		Rochester	NY	14647	10/28/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Reconciliation Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Recovery Audit Contact	Manager Financial Compliance	Mr.	Mau	Ahren		5854785535					Ahren.Mau@excellus.com	165 Court St		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Surveillance Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	System Contact	VP and Chief Apps Officer		Kay	Carolanne		5854142258					Carolanne.Kaye@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Third Party Administrator (TPA) Liaison	Financial Analyst		McManus	Michael		5853397789					Michael.Mcmanus@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	User Access Contact	Medicare Compliance Program Administrator		Conte	Elva		7168437805					Elva.Conte@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Utilization Management Contact	Clinical Operations Accreditation & Compliance		Burnop	Elizabeth		3152721088					Elizabeth.Burnop@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3351	Utilization Review Contact	Clinical Operations Accreditation & Compliance		Burnop	Elizabeth		3152721088					Elizabeth.Burnop@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	Local CCP	Excellus Health Plan, Inc	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Agent/Broker Compensation Data Contact	VP, Associate General Counsel	Ms.	Jan	Munizeh		6467675166					mjan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Backup User Access Contact	Manager, LTC Programs	Ms.	Duker	Stephanie		3324554464					sduker@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Bid Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Bid Audit Site Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Bid Primary Contact	Director, Medicare Strategy	Ms.	Wheeler	Jillian		2073222422					jiwheeler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	CAP Report Contact for Public Website	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	CEO - CMS Administrator Contact	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	01/13/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	CEO - Senior Official for Contracting	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	01/13/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Chief Financial Officer	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	03/05/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Chief Operating Officer	SVP, Operations	Ms.	Weinseiss	Karen		6466773595					kweinseiss@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Chief Information Officer	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Chief Information Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	CMS Casework Communication Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Complaints Tracking Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Contact for Fraud Investigations	VP, Associate General Counsel	Mr.	Kianovsky	Nahum		2128013240					nkianovsky@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		9176982415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Corporate Mailing						6463138967					clogreira@healthfirst.org	Healthfirst Medicare Plan	100 Church Street, 18th Floor	New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		2128011639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	DIR Contact	Manager, Pharmacy Finance	Mr.	Sheridan	Justin		2124535509					jsheridan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	DIR Contact (Secondary)	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					Tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	10/14/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Discount Program Payment Contact	VP, Controller	Mr.	Barattin	Craig		2125191780					cbarattin@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	12/12/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Emergency Part D Contact	VP, Pharmacy	Mr.	Modi	Bhavesh		2122096442					bmodi@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	01/13/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Emergency Part D Contact (Secondary)	Director, Pharmacy Regulatory & Compliance	Ms.	Andreu	Kim		6462732839					kandreu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	01/13/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters	Mr.	Miller	Robert		2125193011					rmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Enrollment Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	EOB Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753				6463134645	jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Financial Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Financial Reporting Contact	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Formulary Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Formulary Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/25/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	General Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	HIPAA Privacy Officer	AVP, Chief Privacy Officer	Ms.	Radler	Laurie		9172863902					lradler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	HIPAA Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Hospice Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Interoperability Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	MA Appeals/Grievances Contact	VP, Appeals & Grievances	Ms.	Johnston	Meredith		6467674748					mjohnston@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	MA Claims Processing Contact for Public Website	VP Application Development	Mr.	Brexel	CJ		2128232481					cbrexel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/08/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Marketing Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Medical Director	Chief Clinical Officer	Dr.	Schechtman	Jay		2128016170					jschechtman@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		2124534495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Medicare Coordinator	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Benefits	Ms.	Baja	Melody		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/22/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Medication Therapy Management Contact	Pharmacy Manager	Ms.	Ziu	Rezarta		6463134678					rziu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Online Enrollment Center Contact (Primary)	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part C Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part C Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Appeals	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	3013464234				HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Appeals Contact (Secondary)	Sr. Manager, Pharmacy Regulatory & Compliance	Ms.	Alenkina	Karolina							kalenkina@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Benefits Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Claims Submission Contact	Manager, Pharmacy Benefits	Ms.	Grodzitsky	Janet		6467675231					jparedes@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Exceptions Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Exceptions Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie							mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/25/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Price File Contact (Back-up)	Sr. Manager, Financial Operations	Ms.	Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	CVS Health	9501 E. Shea Blvd, MC121	Scottsdale	AZ	85260	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Price File Contact (Optional)	Advisor, Med D Finance	Mr.	Pertgen	Richard		8045258502					richard.pertgen@cvshealth.com	CVS Health	9501 E Shea Blvd, MC121	Scottsdale	AZ	85260	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Price File Contact (Primary)	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Quality Assurance Contact	AVP, Pharmacy	Ms.	Kourlas	Helen		2122096456					hkourlas@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Part D Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Patient Safety Contact	Manager, Pharmacy	Ms.	Gandara Rodriguez	Alexandra		2124792775					agandararodriguez@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Payment Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Pharmacy Director	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	10/14/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Pharmacy Network Management Contact	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	10/14/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist	Ms.	An	Diana		3476911405					dan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Pharmacy Technical Help Desk Contact	AVP Customer Care	Mr.	Jackson	Scott							scott.jackson@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	12/20/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H3359	Plan Directory Contact for Public Website			Services	Provider		8888011660					hfprovsrvs@healthfirst.org	P.O. Box 5168		New York	NY	102745168	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					P2P@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Processor Contact	Executive Director	Mr.	Mangin	Marty		3124981167					martin.mangin@cvshealth.com	CVS Health	3100 Sanders Rd	Northbrook	IL	60062	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Quality Contact	VP, Clinical Quality	Ms.	Washington	Laisha		2128016186					lawashington@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Reconciliation Contact	VP, Actuarial Services	Ms.	Liang	Angela		2124535538					aliang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Recovery Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	SNP Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	SNP State Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Surveillance Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	System Contact	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Third Party Administrator (TPA) Liaison	Sr. Manager, Accounting	Ms.	Tyme	Denise		6462732814					dtyme@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	User Access Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Utilization Management Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3359	Utilization Review Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/22/2024	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3362	Agent/Broker Compensation Data Contact	Director Government Sales		Aquino	Cathy		7166354948				7166318857	cathy.aquino@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/29/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Automated TrOOP Balance Transfer Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Backup User Access Contact	Risk Operations Analyst		Carr	Sarah Jane		7166313001					SarahJane.Carr@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/19/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Best Available Evidence Contact	Manager - Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Bid Audit Contact	Director - Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Bid Audit Site Contact	Chief Compliance Officer		Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Bid Primary Contact	Director - Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	CAP Report Contact for Public Website	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	CEO - CMS Administrator Contact	President and CEO	Dr.	Cropp, MD	Michael		7166353995				7162507135	Michael.Cropp@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	08/18/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	CEO - Senior Official for Contracting	President and CEO	Dr.	Cropp, MD	Michael		7166353995				7162507135	Michael.Cropp@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	08/18/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Chief Financial Officer	Executive Vice President - Chief Financial Officer	Mr.	Gross	Jared		7166353516					Jared.Gross@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/11/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Chief Operating Officer	Exec Vice President and Chief Operating Officer	Mr.	Rodgers	John		7166353630					john.rodgers@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/17/2015	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Chief Information Officer	Chief Information Security Officer	Mr.	Jabrucki	Peter		7162507383					Peter.Jabrucki@Independenthealth.com	511 Farber lakes		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Chief Information Security Officer	Chief Information Security Officer	Mr.	Jabrucki	Peter		7162507383					Peter.Jabrucki@Independenthealth.com	511 Farber lakes		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	CMS Casework Communication Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Complaints Tracking Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Contact for Fraud Investigations	Director-Corporate Recoveries		Caulfield	Sheila		7166353783					Sheila.Caulfield@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/11/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Coordination of Benefits Contact	Manager - Corporate Recoveries		Abou-Said	Kelly		7166353758					Kelly.Abou-Said@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/07/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Corporate Mailing						7166313001					Dawn.Odrzywolski@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Customer Service Operations Contact	Manager - Servicing		Plotner	Jenna		7162504424					Jenna.Plotner@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/22/2021	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	DIR Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	DIR Contact (Secondary)	Supervisor-Rebates Analytics		Ketch	Jamie		7166312485					Jamie.Ketch@pbdrx.com	10 Earhart Dr.		Williamsville	NY	14221	02/20/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Discount Program Payment Contact	Manager - Treasury Services		Fisher	Dave		7166353561					Dave.Fisher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/28/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Emergency Part D Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Emergency Part D Contact (Secondary)	Manager - Pharmacy Services		Jahn	Heather		7166354890					Heather.Jahn@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Employer Waiver Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Encounter Data & Risk Adjustment Operations Contact	Manager - Government Programs Implementation		Everett	Wade		7162507367					Wade.Everett@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/03/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Enrollment Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	EOB Transfer Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885				7166319636	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Financial Audit Contact	VP-Pricing & Underwriting	Ms.	Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Financial Reporting Contact	Accountant Regulatory Reporting		Coder	Sara		7162507123					Sara.Coder@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Formulary Contact	Clinical Pharmacist		Wrobel	Mark		7166353831					Mark.Wrobel@independenthealth.com	511 Farber Lakes Dr		Buffalo	NY	14221	01/29/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Formulary Contact (Secondary)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/21/2019	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	General Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Government Relations Contact	SVP Government Programs		Tracy	Robert		7166354904					Robert.Tracy@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	HIPAA Privacy Officer	Chief Information Security Officer		Jabrucki	Peter		7162507383				7162507115	peter.jabrucki@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	HIPAA Security Officer	Chief Information Security Officer		Jabrucki	Peter		7162507383				7162507115	peter.jabrucki@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Hospice Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Interoperability Contact	VP-IT Application Delivery		Haak	Lesley		7162504443					Lesley.Haak@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	MA Appeals/Grievances Contact	Director, Benefit Administration and Compliance		Kieser	Michelle		7166353938					Michelle.Kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/17/2015	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	MA Claims Processing Contact for Public Website			Relations Dept	Provider		7166313282				7166353890	Provider@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/06/2008	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Marketing Contact	Director Government Sales		Aquino	Cathy		7166354948				7166318857	cathy.aquino@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/29/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Medical Director	EVP - Chief Medical Officer	Dr.	Billittier, MD	Anthony		7166353635					Anthony.Billittier@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/19/2019	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/20/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Medicare Coordinator	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Medicare Part D Opioid Overutilization Contact	Manager-MTM & Pharmacy Quality		Hathaway	Natalie		7166357877					Natalie.Hathaway@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Medication Therapy Management Contact	Manager-MTM & Pharmacy Quality		Hathaway	Natalie		7166357877					Natalie.Hathaway@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	OffShore Subcontractor Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Online Enrollment Center Contact (Back-up)	Operations and System Analyst-Mbrs Operations		Cleary	Jennifer		7166313001	2274				Jennifer.Cleary@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	08/21/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Online Enrollment Center Contact (Primary)	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part C Application Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part C Reporting Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	jeremy.laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Appeals	Director - Benefit Administration and Compliance		Kieser	Michelle							michelle.kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/11/2015	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	8006651502				HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Appeals Contact (Secondary)	Director, Benefit Administration and Compliance		Kieser	Michelle							Michelle.Kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/17/2015	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	8007365771				HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Application Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Benefits Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Claims Submission Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Exceptions Contact	Vice President - Pharmacy		Verrall	Kelly						7166310149	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Exceptions Contact (Secondary)	Manager - Pharmacy Services		Jahn	Heather						7166310149	Heather.Jahn@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Price File Contact (Back-up)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/21/2019	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Price File Contact (Optional)	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Price File Contact (Primary)	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Quality Assurance Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Part D Reporting Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	jeremy.laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Patient Safety Contact	Director, Pharmacy, Quality and MTM		Verrall	Kelly		7166354885				7162507121	kelly.verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Payment Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Pharmacy Director	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Pharmacy Network Management Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Pharmacy Network Management Contact (Secondary)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Pharmacy Technical Help Desk Contact	Manager, Provider and Member Services		Dandridge	Tinika							script@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/02/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	8009939898				HMO - Health Maintenance Organization		C	Dallas
H3362	Pharmacy Technical Help Desk Contact (Secondary)	Vice President - Pharmacy		Verrall	Kelly						7166310149	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			HMO - Health Maintenance Organization		C	Dallas
H3362	PHR Beneficiary Contact																	07/28/2009	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS	Independent Health - Member Services	Independent Health Association, Inc.	131	Yes	Active	8006651502				HMO - Health Maintenance Organization		C	Dallas
H3362	Physician Incentive Contact	Director-Value-Based Reimbursement		Ghil	Peter		7166353840					Peter.Ghil@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/23/2022	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Plan Directory Contact for Public Website			Services	Member		8006651502					wnyms@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/08/2008	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Plan to Plan Reconciliation Contact	Pharmacy Systems Gov. Programs Manager		Miszuk	Jane		7166357857					Jane.Miszuk@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/11/2019	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Processor Contact	Director-Claims Operations		Taggart	David		7166357837					David.Taggart@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/11/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Quality Contact	Manager-Quality Programs		Zell	Christy		7166353852					Christy.Zell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Reconciliation Contact	VP-Pricing & Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Reconciliation Contact (Secondary)	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Recovery Audit Contact	Director - Medicare Programs	Mr.	Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	SNP Application Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Surveillance Contact	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	System Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Third Party Administrator (TPA) Liaison	Manager - Treasury Services		Fisher	Dave		7166353561					Dave.Fisher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/28/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	User Access Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	Jeremy.Laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/17/2020	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Utilization Management Contact	Director, Utilization Quality Ops Improvement Mgt		Salemi	Phil		7166313001	3434				Philip.Salemi@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/08/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3362	Utilization Review Contact	Director, Utilization Quality Ops Improvement Mgt		Salemi	Phil		7166313001	3434				Philip.Salemi@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/08/2018	2026	INDEPENDENT HEALTH ASSOCIATION, INC.	Local CCP	Independent Health	HMO/HMOPOS		Independent Health Association, Inc.	131	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3379	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H3379	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3379	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3379	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H3379	Plan Directory Contact for Public Website			Customer Service	UHC		8668709604					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3379	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/18/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/21/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/03/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/10/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	09/25/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	09/25/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/21/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	06/03/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Corporate Mailing						4125447031					Thomas.Boettler@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/23/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5182205661				5184232294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/02/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Encounter Data & Risk Adjustment Operations Contact	Director, Actuarial Services	Mr.	DelPrince	Vincent	M	4125443939					Vincent.Delprince@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Enrollment Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					david.stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	EOB Transfer Contact	Manager, Claims	Ms.	Johannes	Karin		7168876875				7168876875	karin.johannes@highmark.com	257 West Genesee St.		Buffalo	NY	14202	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/15/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	10/06/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					Justine.Patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/03/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	11/08/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Interoperability Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	MA Appeals/Grievances Contact	Manager, Appeals & Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	MA Claims Processing Contact for Public Website	Manager, Claims	Ms.	Johannes	Karin		7168876875					Karin.Johannes@highmark.com	257 West Genesee St.		Buffalo	NY	14202	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	06/23/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Medical Director	VP, Executive Medical Director	Dr,	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing	Mr.	Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					david.stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part C Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4125444579				HMO - Health Maintenance Organization		C	Boston
H3384	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4125441596				HMO - Health Maintenance Organization		C	Boston
H3384	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	11/08/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite SPECARE	Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8006002227				HMO - Health Maintenance Organization		C	Boston
H3384	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	9013817109				HMO - Health Maintenance Organization		C	Boston
H3384	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets	Ms	Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	11/09/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Payment Contact	Vice President, Accounting & Reporting	Mr	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	03/12/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		Buffalo	NY	14203	02/14/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Pharmacy Network Management Contact	Network Account Director, Retail Strategy&Contract		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/30/2016	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	11/08/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H3384	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	5705783579				HMO - Health Maintenance Organization		C	Boston
H3384	PHR Beneficiary Contact																	10/28/2021	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS	Highmark Western and Northeastern New York Inc	Highmark Health	123	Yes	Active	8003292792				HMO - Health Maintenance Organization		C	Boston
H3384	Physician Incentive Contact	VP Prov Reimbursement & Network	Mr.	McDonald	Brendan		4125446611					brendan.mcdonald@highmarkhealth.org	120 5th Avenue Place		Pittsburgh	PA	152223099	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Plan Directory Contact for Public Website			Service	Customer		8773271395					customerservice@bcbswny.com	PO Box 13599		Albany	NY	12212	02/21/2020	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Plan to Plan Reconciliation Contact	Manager, Operational Accounting		Stehr	Brett		7173022748					P2Precon@highmark.com	Highmark, Inc. Attn: Cashier	PO Box 898820	Camp Hill	PA	17089	06/28/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Quality Contact	Director, Clinical Quality		Christian	Shari		7168878811					shari.christina@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/29/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/23/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/28/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Utilization Management Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3384	Utilization Review Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H3387	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3387	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3387	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H3387	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3387	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW YORK, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3388	Agent/Broker Compensation Data Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Automated TrOOP Balance Transfer Contact	Director Enrollment and Billing		Knickerbocker	Kaitlin		5186415168				5186414605	kaitlin.knickerbocker@cdphp.com	6 Wellness Way		Latham	NY	12110	05/02/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Backup User Access Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Best Available Evidence Contact	Manager, Enrollment & Billing		Salzer	Cheryl		5186414170					cheryl.salzer@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Bid Audit Contact	Medicare Actuary	Mr	Budhiraja	Puneet		5186415568				5186414605	Puneet.Budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Bid Audit Site Contact	Medicare Actuary	Mr	Budhiraja	Puneet		5186415568				5186414605	Puneet.Budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Bid Primary Contact	Medicare Actuary	Mr	Budhiraja	Puneet		5186415568				5186414605	Puneet.Budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	CAP Report Contact for Public Website	Medicare Compliance Officer		Dibble	Laura		5853397745					laura.dibble@lifethc.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	CEO - CMS Administrator Contact	President and CEO	Mr	OGrady	Brian		5186415110				5186415506	Brian.O'Grady@cdphp.com	6 Wellness Way		Latham	NY	12110	06/28/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	CEO - Senior Official for Contracting	President and CEO	Mr	OGrady	Brian		5186415110				5186415506	Brian.O'Grady@cdphp.com	6 Wellness Way		Latham	NY	12110	06/28/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Chief Financial Officer	EVP/Finance/CFO	Mr	Kahlon	Sikander		5186414050					paul.kahlon@cdphp.com	6 Wellness Way		Latham	NY	12110	08/25/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Chief Operating Officer	Chief Operating Officer	Mr.	Thornton	Barry		5854536456					Barry.Thornton@cdphp.com	6 Wellness Way		Latham	NY	12110	11/03/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Chief Information Officer	Chief Operating Officer	Mr.	Thornton	Barry		5854536456					Barry.Thornton@cdphp.com	6 Wellness Way		Latham	NY	12110	11/03/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Ewing	Jeff		5186415369					jeffrey.ewing@cdphp.com	6 Wellness Way		Latham	NY	12110	11/03/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	CMS Casework Communication Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Complaints Tracking Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Contact for Fraud Investigations	Director Special Investigations Unit		Williams	Todd		5186414060				5186414605	todd.williams@cdphp.com	6 Wellness Way		Latham	NY	12110	05/02/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Coordination of Benefits Contact	Medicare Reimbursement Coordinator		Moye	Nancy		5186415274				5186414605	Medicare_Compliance_Inquiries@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Corporate Mailing						5186413000				5186414605	info@cdphp.com	Capital District Physicians' Health Plan	6 Wellness Way	Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Customer Service Operations Contact	Director, Member Services		Spinner	Carmen		5186413741				5186413507	carmen.spinner@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	DIR Contact	Revenue Accounting Supervisor		Keller	Alexis		5183414012					Alexis.Keller@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	DIR Contact (Secondary)	Senior Healthcare Accounting Analyst	Ms	Anderson	Tiffany		5186414044				5186414605	Tiffany.Anderson@cdphp.com	6 Wellness Way		Latham	NY	12110	07/28/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Discount Program Payment Contact	Accounts Receivable Accountant		Ogden	Wendy		5186414057					wendy.ogden@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Emergency Part D Contact	Directory Medicare Part D Pharmacy Programs		Reed	Lisa		5186413231				5186413207	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	05/02/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Emergency Part D Contact (Secondary)	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664					luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	05/02/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Employer Waiver Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Encounter Data & Risk Adjustment Operations Contact	Mgr. Encounter Ops Compliance and Recoveries		Uline	Nicole		5186414571					nicole.uline@cdphp.com	6 Wellness Way		Latham	NY	12110	02/11/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Enrollment Contact	Director Enrollment and Billing		Knickerbocker	Kaitlin		5186415168				5186414605	kaitlin.knickerbocker@cdphp.com	6 Wellness Way		Latham	NY	12110	05/02/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	EOB Transfer Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Financial Audit Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Financial Reporting Contact	CFO	Mr	Kahlon	Paul		5186414050				5186414006	paul.kahlon@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Formulary Contact	Clinical Pharmacist		Reed	Lisa		5186413231				5186413208	Lisa.Reed@cdphp.com	6 Wellness Way		Latham	NY	12210	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Formulary Contact (Secondary)	Pharmacy Enterprise Medicare Advisor Lead		Sgambati	John		5186413313				5186413208	John.Sgambati@cdphp.com	6 Wellness Way		Latham	NY	12110	09/26/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	General Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Government Relations Contact	Medicare Compliance Officer		Dibble	Laura		5853397745					Laura.Dibble@excellus.com	6 Wellness Way		Latham	NY	12110	10/01/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	HIPAA Privacy Officer	Privacy Officer		Hinman	Todd		5186415261				5186415505	todd.hinman@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	HIPAA Security Officer	VP Information Risk and Governance (Interim CISO)		Ewing	Jeff		5186415369				5186414004	jeffrey.ewing@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Hospice Contact	Director Enrollment and Billing		Knickerbocker	Kaitlin		5186415168					kaitlin.knickerbocker@cdphp.com	6 Wellness Way		Latham	NY	12110	05/02/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Interoperability Contact	Mgr. Medicare Operations		Kozak	Stephanie		5186414661					stephanie.kozak@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	MA Appeals/Grievances Contact	Team Lead - Medicare Quality and Appeals		Lucas	June		5186413249				5186413203	june.lucas@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	MA Claims Processing Contact for Public Website	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Marketing Contact	Mgr. Medicare Operations		Kozak	Stephanie		5186414661					stephanie.kozak@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Medical Director	EVP/Chief Medicare Officer (inerim)	Dr.	Coplin	Bruce		5186413370				5186413205	bruce.coplin@cdphp.com	6 Wellness Way		Latham	NY	12110	11/20/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Medicare Compliance Officer	Compliance Program Administrator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/31/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Medicare Coordinator	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Medicare Part D Opioid Overutilization Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Medication Therapy Management Contact	Lead Managed Care Pharmacist		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	OffShore Subcontractor Contact	Medicare Compliance Officer - Interim		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	11/10/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Online Enrollment Center Contact (Primary)	Manager, Web Services		Monthony	Regina		5186415023				5186415506	regina.monthony@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part C Application Contact	Product Manager Sales Innovation		Kozak	Stephanie		5186414661					Stephanie.kozak@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part C Reporting Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Appeals	Team Lead- Medicare Quality and Appeals		Lucas	June						5186413203	june.lucas@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	5186413249				HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Application Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Benefits Contact	Lead Managed Care Pharmacist		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Claims Submission Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Exceptions Contact	Lead Managed Care Pharmacist		Reed	Lisa						5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	5186413231				HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Exceptions Contact (Secondary)	Lead Managed Care Pharmacist		Reed	Lisa						5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	5186413231				HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Price File Contact (Back-up)	Pharmacy Enterprise Medicare Advisor Lead		Sgambati	John		5186413313					John.Sgambati@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Price File Contact (Optional)	Dir. Comm Pharmacy Prgrms and Medicare		Reed	Lisa		5186413231					lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Price File Contact (Primary)	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Quality Assurance Contact	Dir. Medicare Part Pharmacy Programs		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	02/11/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Part D Reporting Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Patient Safety Contact	Senior Vice President/Chief Quality Officer		Golderman	Renee		5186413240				5186413208	renee.golderman@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Payment Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Pharmacy Director	Dir. Medicare Part D Pharmacy Programs		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	02/11/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Pharmacy Network Management Contact	Dir. Medicare Part D Pharmacy Programs		Reed	Lisa		5186413231				5186413508	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	02/11/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Pharmacy Network Management Contact (Secondary)	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186413208	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	8335991018				HMO - Health Maintenance Organization		C	Chicago
H3388	Physician Incentive Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Plan Directory Contact for Public Website	Medicare Compliance Coordinator		Noonan	Michelle		8009267526				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Plan to Plan Reconciliation Contact	VP Financial Analytics and Risk Adjustment		Burby	Casidhe		5186414074				5186414102	P2PADMIN@cdphp.com	Attn Risk Management - P2P	6 Wellness Way	Latham	NY	12110	02/11/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Processor Contact	Manager, Membership and Billing		Salzer	Cheryl		5186414170				5186414008	cheryl.salzer@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Quality Contact	Senior Vice President/Chief Quality Officer		Golderman	Renee		5186413240				5186413208	renee.golderman@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Reconciliation Contact	Actuarial Director		Budhiraja	Puneet		5186415568					puneet.budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Recovery Audit Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Surveillance Contact	Medicare Compliance Officer		Dibble	Laura		5853397745				5186414605	laura.dibble@lifethc.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	System Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Third Party Administrator (TPA) Liaison	Revenue Accountant		Ogden	Wendy		5186414057					wendy.ogden@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	User Access Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Utilization Management Contact	Director Utilization Management		Hannan	Priscilla		5186413423				5186413205	Priscilla.Hannan@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3388	Utilization Review Contact	Director Utilization Management		Hannan	Priscilla		5186413423					Priscilla.Hannan@cdphp.com	6 Wellness Way		Latham	NY	12110	04/17/2024	2026	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	Local CCP	CDPHP Medicare Advantage	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3404	Agent/Broker Compensation Data Contact	Director, Financial Systems		Lazar	Lisa		9197653359					Lisa.Lazar@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/28/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Automated TrOOP Balance Transfer Contact	Director, Operations		Allie	Cindy		6127771330					EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Backup User Access Contact	EDI Analyst		Umstead	Kamala		9197654363					kamala.umstead@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	07/12/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Bid Audit Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Bid Audit Site Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Bid Primary Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	CAP Report Contact for Public Website	Manager, Internal Communications		Stinneford	Mark		9197653005					media.inquiry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/20/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	CEO - CMS Administrator Contact	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	CEO - Senior Official for Contracting	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	9197653923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/21/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Chief Operating Officer	SVP, Chief Operations & Member Experience Officer	Ms.	Mizelle	Karla		9849603787					karla.mizelle@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	02/09/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Chief Information Officer	AVP, IT Solution Delivery	Mrs.	Moum	Aldara		9196160924					Aldara.Moum@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	08/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Chief Information Security Officer	Chief Information Security Officer	Mr.	Chilton	Richard		9197652021					Rick.Chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	01/15/2016	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	CMS Casework Communication Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Complaints Tracking Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Contact for Fraud Investigations	Manager, Special Investigations Unit		Meyer	John		9842752360					John.Meyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Coordination of Benefits Contact	Manager, Operations		Pridgen	David		3362014141					David. Pridgen@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	04/11/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Corporate Mailing						3362014460				3366592969	deborah.washington-mcneill@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		9197657057					Renita.Woods@bcbsnc.com	4613 University Drive		Durham	NC	27707	03/26/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	DIR Contact	AVP, Head of Actuarial Services & Valuation		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Discount Program Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					Tola.Onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Emergency Part D Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Emergency Part D Contact (Secondary)	Head of CIG Operations		Perry	Endya		9197775504					endya.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Employer Waiver Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment		Kimbrell	Tammy		9844448393					Tammy.Kimbrell2@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Enrollment Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	EOB Transfer Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536				9197657291	Corporate.pharmacy@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Financial Audit Contact	Director, Audit	Ms.	Ferrell	Kim		3362014038					kim.ferrell@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Financial Reporting Contact	Director, Corporate Financial Reporting		Lindsey	Elizabeth		5022108328					Elizabeth.Lindsey@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/05/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Formulary Contact	Manager, Pharmacy		Hiller	Debra		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics Inc	2900 Ames Crossing Road	Eagan	MN	55121	03/07/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	General Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Government Relations Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	HIPAA Privacy Officer	Director, Privacy, Ethics & Corp Policies		Hamlet	Lynne		9197657416					lynne.hamlet@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/18/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	HIPAA Security Officer	Chief Information Security Official		Chilton	Rick		9197652021					rick.chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/30/2014	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Hospice Contact	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Interoperability Contact	Director, Corporate Compliance Official		Haith	Elenor		9842125897					Elenor.Haith@bcbsnc.com	PO Box 2291		Durham	NC	27702	07/20/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	MA Appeals/Grievances Contact	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna		9197654061					Adonna.McFall@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/12/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	MA Claims Processing Contact for Public Website	Manager, Operations		Cooper	Eva		9197651808					Eva.Cooper@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Marketing Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Medical Director	VP, Chief Medical Officer	Dr.	Wallace	Marcus		9843891622					Marcus.Wallace@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	06/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Medicare Compliance Officer	Director, Corporate Compliance	Mrs.	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/09/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Medicare Coordinator	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Medicare Part D Opioid Overutilization Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Medication Therapy Management Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	OffShore Subcontractor Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Online Enrollment Center Contact (Back-up)	Manager, Membership Services		Brackett	Latrese		3362019770					latrese.brackett@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Online Enrollment Center Contact (Primary)	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part C Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part C Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Appeals	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna							Adonna.McFall@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/08/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active	8882987520				PPO - BBA		C	Atlanta
H3404	Part D Appeals Contact (Secondary)	Mgr, MA and PDP Appeals and Grievances		Lanier	Paige						8883758836	paige.lanier@bcbsnc.com	PO Box 17509	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active	8774947647				PPO - BBA		C	Atlanta
H3404	Part D Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Benefits Contact	Manager, Pharmacy		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Claims Submission Contact	Functional Business Consultant - Govt Prgms		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2900  Ames Crossing Road	Eagan	MN	55121	10/13/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Exceptions Contact	Director, Pharmacy		Moore	Jim							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	04/18/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active	8882969790				PPO - BBA		C	Atlanta
H3404	Part D Exceptions Contact (Secondary)	Team Leader, Clinical Pharmacy Reviews - Medicare		Parikh	Swati							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	01/03/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active	8882969790				PPO - BBA		C	Atlanta
H3404	Part D Price File Contact (Back-up)	Manager, Pharmacy		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Price File Contact (Optional)	Price File Analyst Sr		Trudeau	Ashley		6127771338					ashley.trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/13/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Price File Contact (Primary)	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Quality Assurance Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Part D Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3362014460					deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Patient Safety Contact	Manager, Pharmacy		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	10/03/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Pharmacy Director	VP, Pharmacy Services		Trautman	Suzanne		7045988684					Suzanne.Trautman@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	10/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Pharmacy Network Management Contact	AVP, Corporate Pharmacy		Rooker	Todd		6024181702					Todd.Rooker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy		Hiller	Debra		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							bret.schultz@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active	8772777893				PPO - BBA		C	Atlanta
H3404	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Bunch	Jon							jonathan.bunch@primetherapeutics.com	Prime Therapeutics, LLC 2900 Ames Crossing Road		Eagan	MN	55121	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active	8772777893				PPO - BBA		C	Atlanta
H3404	Physician Incentive Contact	AVP, Provider Network and Reimbursement		Page	Troy		9197652408					troy.page@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/17/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Plan Directory Contact for Public Website	Call Center support		Services	Member		8882969790					renita.woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Plan to Plan Reconciliation Contact	Sr Accountant		Taylor	Krystal		9849603607					krystal.taylor@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	02/28/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Processor Contact	Director, Operations		Allie	Cindy		6127776722					CAllie@primetherapeutics.com	Prime Therapeutics, LLC	2655 Eagan Woods Drive	Eagan	MN	55122	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Quality Contact	VP, Quality, Health Equity and Risk Adjustment		Bartholomew	Charmaine		6789208681					Charmaine.Bartholomew@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/24/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Reconciliation Contact	AVP, Head of Actuarial Services & Valuation		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	09/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Recovery Audit Contact	Director, Corporate Compliance	Mrs	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina,	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Surveillance Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	System Contact	Director, IT Solution Delivery		Keltner	Doug		9194607400					Doug.Keltner@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Third Party Administrator (TPA) Liaison	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	User Access Contact	Electronic Data Interchange Analyst		Dunn	Lorrie		9197653669					lorrie.dunn@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	07/12/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Utilization Management Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3404	Utilization Review Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	Local PPO		CuraCor Solutions Corp.	884	Yes	Active					PPO - BBA		C	Atlanta
H3407	Agent/Broker Compensation Data Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Automated TrOOP Balance Transfer Contact	Manager, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/14/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Backup User Access Contact	Director of Systems and Networks		Martinez	Jesus		9152987198	1061				jmartinez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Best Available Evidence Contact	Director of Member Services		Ontiveros	Nellie		9152987198	1112				mespinoza@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	11/14/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Bid Audit Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Bid Audit Site Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Bid Primary Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	CAP Report Contact for Public Website	Director Of Compliance		Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	CEO - CMS Administrator Contact	President & CEO	Mrs.	Smallwood	Carol	G	9152987198	1257				csmallwood@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/25/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	CEO - Senior Official for Contracting	President & CEO	Mrs.	Smallwood	Carol	G	9152987198	1257				csmallwood@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/25/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Chief Financial Officer	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/23/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Chief Operating Officer	President & CEO	Mrs.	Smallwood	Carol	G	9152987198	1257				csmallwood@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/25/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Chief Information Officer	Chief Information Officer	Ms,	Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/21/2019	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Chief Information Security Officer	Chief Information Officer	Ms,	Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/21/2019	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	CMS Casework Communication Contact	Director of Compliance		Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Complaints Tracking Contact	Complaints and Appeals Manager		Diaz	Corina		9152987198	1092				cdiaz@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/18/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Contact for Fraud Investigations	Director of Compliance	Ms	Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Coordination of Benefits Contact	Chief Finanical Officer		Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	09/26/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Corporate Mailing						9152987198	1258				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/19/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Customer Service Operations Contact	Director of Member Services		Ontiveros	Nellie		9152987198	1112				mespinoza@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	11/14/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	DIR Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/23/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Discount Program Payment Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/23/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Electronic Health Record Contact	Chief Information Officer	Ms,	Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/21/2019	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Emergency Part D Contact	Director of Pharmacy		Palacios	Angel		9152987198	1085				apalacios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/22/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Encounter Data & Risk Adjustment Operations Contact	Director of IS Applications		Sanchez	Javier		9152897198	1229				jsanchez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Enrollment Contact	Director of IS Applications		Sanchez	Javier		9152987198	1229				jsanchez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	EOB Transfer Contact			Carreon	Diana		9152987198	1190			9155322877	dcarreon@elpasohealth.com	1145 Westmoreland		El Paso	TX	79928	03/07/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Financial Audit Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/23/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Financial Reporting Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/23/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Formulary Contact	Director of Pharmacy		Palacios	Angel		9152987198	1085				apalacios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/22/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	deanna.paddock@navitus.com	361 Integrity Drive		Madison	WI	53713	10/11/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	General Contact	Director of Compliance	Ms	Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Government Relations Contact	Director of Compliance		Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	HIPAA Privacy Officer	Chief Compliance & Privacy Officer		Gibson	Catherine		9155217523					CGibson@umcelpaso.org	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	HIPAA Security Officer	Chief Information Officer	Ms,	Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/21/2019	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Hospice Contact	Director of Health Services		Navedo-Sanchez	Vianka		9152987198	1135				VSanchez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	07/19/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Interoperability Contact	Chief Information Officer		Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	12/16/2021	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	MA Appeals/Grievances Contact	Complaints & Appeals Manager		Diaz	Corina		9152987198	1092				cdiaz@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	MA Claims Processing Contact for Public Website			Carreon	Diana		9152987198	1190			9155322877	dcarreon@elpasohealth.com	1145 Westmoreland		El Paso	TX	79928	03/07/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Marketing Contact	Director of Bussiness Development and Marketing		Call	Eric		9152987198	1255				Ecall@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Medical Director	Medical Director	MD	Guzman	Jorge		9152987198	1221				JGuzman@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	11/09/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Medicare Compliance Officer	Director of Compliance	Ms.	Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Medicare Coordinator	President & CEO	Mrs.	Smallwood	Carol	G	9152987198	1257				csmallwood@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/25/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Medicare Part D Opioid Overutilization Contact	Director Of Pharmacy		Palacios	Angel		9152987198	1085				Apalacios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Medication Therapy Management Contact	Director of Pharmacy		Palacios	Angel		9152987198	1085				apalacios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/22/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	OffShore Subcontractor Contact	Director of Compliance		Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Online Enrollment Center Contact (Back-up)	Chief Information Officer		Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/18/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Online Enrollment Center Contact (Optional)	Enrollment & Eligibility Manager		Ramirez	Juanita		9152987198	1063				jramirez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/27/2021	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Online Enrollment Center Contact (Primary)	Director of IS applications		Sanchez	Javier		9152987198	1229				jsanchez@elpasohealth.com	1145 Westmorealnd		El Paso	TX	79925	04/27/2021	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part C Application Contact	Director of Compliance		Berrios	Vanessa		9155323778	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part C Reporting Contact	Director of IS Applications	Mr	Sanchez	Javier		9152987198	1229				jsanchez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Appeals	Complaints and Appeals Manager		Diaz	Corina							cdiaz@elpasohealth.com	1145 Westmoreland Dr.		El Paso	TX	79925	05/18/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active	9152987872	1092			HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Application Contact	Director of Compliance		Berrios	Vanessa		9155323778	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Benefits Contact	Director of Pharmacy		Palacios	Angel		9152987198	1085				apalacios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/22/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Claims Submission Contact	Manager, Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@NAVITUS.COM	1025 West Navitus Drive		Appleton	WI	54913	10/14/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Exceptions Contact	Assoc Director, Clinical Prior Authorization		LeClair	Christophe						9202214676	Christopher.LeClair@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/02/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Price File Contact (Back-up)	Navitus Plan Finder		Plan Finder	Navitus		6087291578					Plan.Finder@navitus.com	2601 West Beltline Highway Suite 600		Madison	WI	53713	05/18/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Price File Contact (Primary)			Plan Finder	Navitus		5212313140					plan.finder@navitus.com	361 Integrity Drive		Madison	WI	53713	10/11/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Quality Assurance Contact	Director of Quality Improvement		Chagolla	Angelica		9152987198	1165				Abaca@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Part D Reporting Contact	Director of Pharmacy		Palacios	Angel		9152987198	1085				apalacios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/22/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Patient Safety Contact	Medical Officer	MD	Guzman	Jorge		9152987198	1221				JGuzman@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	11/09/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Payment Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Personal Health Record Contact	Director of Compliance		Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	08/06/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Pharmacy Director			Kurznski	Adam		9202214272					adam.kurznski@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/06/2019	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Pharmacy Network Management Contact	VP Network Management Contact		Santos	Christina		6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	04/02/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						9202214724	Danielle.nett@navitus.com	1025 West Navitus		Appleton	WI	54913	10/14/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H3407	Physician Incentive Contact	President & CEO	Mrs.	Smallwood	Carol	G	9152987198	1257				csmallwood@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/25/2022	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Plan Directory Contact for Public Website			Garcia	Viridiana		9152987198	1079				vrodriguez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/08/2021	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Plan to Plan Reconciliation Contact	Director of Pharmacy		Palacios	Angel		9152987198	1085				apalacios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/22/2024	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Processor Contact			Carreon	Diana		9152987198	1190			9155322877	dcarreon@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	03/07/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Quality Contact	Director of Quality Improvement		Chagolla	Angelica		9152987198	1165				abaca@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/18/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Reconciliation Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	04/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Recovery Audit Contact	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	SNP Application Contact	Vice President of Medicare Operations		Lopez-Holguin	Maritza		9152987198	1071				mlopez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	SNP State Contact	Vice President of Medicare Operations		Lopez-Holguin	Martiza		9152987198	1071				mlopez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/27/2025	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Surveillance Contact	Compliance Supervisor		Berrios	Vanessa		9152987198	1040				vberrios@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/18/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	System Contact	Chief Information Officer	Ms,	Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	05/21/2019	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr.	Gonzalez	Gustavo		9152987198	1117				ggonzalez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	01/24/2020	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	User Access Contact	Chief Information Officer	Ms	Perkins	Sharon		9152987198	1103				sperkins@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	09/09/2021	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Utilization Management Contact	Director of Health Services		Navedo-Sanchez	Vianka		9152987198	1135				VSanchez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	07/19/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3407	Utilization Review Contact	Director of Health Services		Navedo-Sanchez	Vianka		9152987198	1135				VSanchez@elpasohealth.com	1145 Westmoreland		El Paso	TX	79925	07/19/2023	2026	EL PASO FIRST HEALTH PLANS, INC.	Local CCP	El Paso Health Medicare Advantage	HMO/HMOPOS		El Paso County Hospital District	736	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3418	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H3418	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H3418	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H3418	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H3418	Plan Directory Contact for Public Website			Customer Service	UHC		8668709604					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3418	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H3419	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	CAP Report Contact for Public Website	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	03/24/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	CEO - CMS Administrator Contact	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	03/17/2021	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	CEO - Senior Official for Contracting	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	03/17/2021	2026	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	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/05/2023	2026	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 Operating Officer	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	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 Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	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		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Contact for Fraud Investigations	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd. Suite 300		Westerville	OH	43082	03/24/2023	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Corporate Mailing						8447886959					customerservice@perennialadvantage.com	P.O. Box 2190		Glen Allen	VA	230582190	12/15/2021	2026	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		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Discount Program Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/05/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	EOB Transfer Contact			Lowry	Kristy		8448546886				8336102390	kristy.lowry@curanahealth.com	P.O. Box 5849		Glen Allen	VA	23058	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Financial Audit Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/05/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Financial Reporting Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	12/05/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	General Contact	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	12/15/2021	2026	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		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	HIPAA Privacy Officer	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	03/24/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	HIPAA Security Officer	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	03/24/2023	2026	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		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Marketing Contact	Marketing Director		Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Medical Director		Dr.	Papernek	Holly		9374703285					holly.papanek@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	12/15/2021	2026	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	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	03/24/2023	2026	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 Coordinator	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Appeals	Supervisor, Grievance and Appeals		LaCrosse	Justin						8442689791	Justin.LaCrosse@navitus.com	Navitus Health Solutions,	P.O. Box 1039	Appleton	WI	54912	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	9202214149				HMO - Health Maintenance Organization		C	Chicago
H3419	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3419	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	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						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H3419	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3419	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	01/03/2025	2026	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 Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	01/03/2025	2026	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 Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	12/05/2023	2026	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 Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Network Management Contact			Robinson	Jan		6087291688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	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 Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H3419	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H3419	Physician Incentive Contact	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	12/15/2021	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Plan Directory Contact for Public Website			Sidlinger	Rocio		8558550489	1664				rocio.sidlinger@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Reconciliation Contact (Secondary)	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/05/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Recovery Audit Contact	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	03/24/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Surveillance Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	User Access Contact	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	03/24/2023	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF COLORADO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3419	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Backup User Access Contact	VP of IT	Mr	Clark	Arthur		7275234050				7275234006	arthurclark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	01/19/2023	2026	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	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Bid Primary Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	CAP Report Contact for Public Website	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	CEO - CMS Administrator Contact	CEO	Mr	Fleece	Jonathan		9415527525					JFleece@EmpathHealth.org	5955 Rand Blvd		Sarasota	FL	34238	10/31/2024	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	CEO - Senior Official for Contracting	CEO	Mr	Fleece	Jonathan		9415527525					JFleece@EmpathHealth.org	5955 Rand Blvd		Sarasota	FL	34238	10/31/2024	2026	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		7275233339				7275232122	sbouhamid@tidewell.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	06/09/2021	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Chief Operating Officer	COO	Ms	Lowry	Tarrah		5612275277					tlowry@trustbridge.com	5771 Roosevelt Blvd		Clearwater	FL	33760	04/14/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Chief Information Officer	VP IT	Mr.	Clark	Arthur		9413743213					ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	05/02/2023	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Chief Information Security Officer	VP IT	Mr.	Clark	Arthur		9413743213					ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	05/02/2023	2026	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	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Complaints Tracking Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Contact for Fraud Investigations	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	04/29/2025	2026	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	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Corporate Mailing						8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd.	Suite 625	Clearwater	FL	33760	04/29/2025	2026	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	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	DIR Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	DIR Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Discount Program Payment Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Emergency Part D Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Emergency Part D Contact (Secondary)	Health Plan Medicare Specialist		Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Encounter Data & Risk Adjustment Operations Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Enrollment Contact	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	EOB Transfer Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716				7272458892	jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Financial Audit Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Financial Reporting Contact	CFO	Ms	Bouhamid	Saida		7275233339					SaidaBouhamid@EmpathHealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/01/2023	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Formulary Contact	Interim Program Director	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Formulary Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	General Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Government Relations Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	HIPAA Privacy Officer	Vice Presidnet, Compliance	Mrs	Mosby	Laura		7275232106					LauraMosby@EmpathHealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	05/31/2024	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	HIPAA Security Officer	Director of Organizational Integrity	Ms	Mosby	Laura		7275232106					lauramosby@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	05/15/2017	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Interoperability Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	MA Appeals/Grievances Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	MA Claims Processing Contact for Public Website	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Marketing Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Medical Director	Medical Director	Mr	Alokeh	Wael		7272890062					waelalokeh@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/11/2025	2026	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		7275232106				7275232122	lauramosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	10/17/2016	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Medicare Coordinator	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Medicare Part D Opioid Overutilization Contact	Director of Health Plan Operations		Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Medication Therapy Management Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Online Enrollment Center Contact (Back-up)	Interim Program Director	Ms.	Schulte	Komal		7272890062					komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Online Enrollment Center Contact (Primary)	Director of Health Plan Operatons	Ms.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part C Application Contact	Director of Health Plan Operations	Mr//	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part D Appeals	Director of Health Plan Operations	Mr.	Pettry	Jason							jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	7277355716				PACE - Nat		C	Atlanta
H3430	Part D Appeals Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H3430	Part D Application Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part D Benefits Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part D Claims Submission Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	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	Director of Health Plan Operations	Mr.	Pettry	Jason							jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	7277355716				PACE - Nat		C	Atlanta
H3430	Part D Exceptions Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H3430	Part D Price File Contact (Back-up)	Director of Health Plan Operations		Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part D Price File Contact (Primary)	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part D Quality Assurance Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Part D Reporting Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Patient Safety Contact	Director of Heath Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Payment Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Personal Health Record Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Pharmacy Director	Director of Pharmacy	Ms	Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	04/14/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Pharmacy Network Management Contact	Pharmacy Director		Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33765	04/14/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Pharmacy Network Management Contact (Secondary)	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	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	Pharmacy Director		Harvey	Tracey							tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33765	04/14/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	7275232530				PACE - Nat		C	Atlanta
H3430	Pharmacy Technical Help Desk Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H3430	PHR Beneficiary Contact																	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE	Empath Health	Empath Health, Inc.	635	Yes	Active	8136512851				PACE - Nat		C	Atlanta
H3430	Plan Directory Contact for Public Website	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	04/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Plan to Plan Reconciliation Contact	Director of Health Plan Operations	Ms.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Processor Contact	Pharmacy Director		Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	04/14/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Quality Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Reconciliation Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Reconciliation Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Recovery Audit Contact	Director of Organizational Integrity	Ms	Mosby	Laura		7275232106					lauramosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	05/15/2017	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Surveillance Contact	Director of Organizational Integrity	Ms	Mosby	Laura		7275232106					lauramosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	05/22/2017	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	System Contact	VP of IT	Mr	Clark	Arthur		7275234050				7275234006	ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	01/19/2023	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Third Party Administrator (TPA) Liaison	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	User Access Contact	VP of IT	Mr	Clark	Arthur		7275234050				7275234006	arthurclark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	01/19/2023	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Utilization Management Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3430	Utilization Review Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	SUNCOAST PACE, INC.	National PACE	Suncoast PACE, Inc.	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H3443	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	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	Chicago
H3443	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H3443	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	05/16/2025	2026	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	Chicago
H3443	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H3443	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H3443	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	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	Chicago
H3443	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	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	Chicago
H3443	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	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	Chicago
H3443	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	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	Chicago
H3443	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H3443	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3443	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	04/11/2025	2026	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			HMO - Health Maintenance Organization		C	Chicago
H3443	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	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	Chicago
H3443	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	04/11/2025	2026	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	Chicago
H3443	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3443	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	04/11/2025	2026	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				HMO - Health Maintenance Organization		C	Chicago
H3443	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	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	Chicago
H3443	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	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	Chicago
H3443	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	04/11/2025	2026	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	Chicago
H3443	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				HMO - Health Maintenance Organization		C	Chicago
H3443	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				HMO - Health Maintenance Organization		C	Chicago
H3443	PHR Beneficiary Contact																	04/11/2025	2026	ALIGNMENT HEALTH PLAN OF ARIZONA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				HMO - Health Maintenance Organization		C	Chicago
H3443	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	04/11/2025	2026	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	Chicago
H3443	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	04/11/2025	2026	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	Chicago
H3443	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3443	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	04/11/2025	2026	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	Chicago
H3447	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/06/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	05/01/2023	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/15/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/15/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	04/07/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3447	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3447	PHR Beneficiary Contact																	02/07/2019	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H3447	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/15/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/06/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/15/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/15/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3447	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3448	Automated TrOOP Balance Transfer Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Backup User Access Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Best Available Evidence Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Bid Primary Contact	Health Plan Specialist	Ms	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	CAP Report Contact for Public Website	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	CEO - CMS Administrator Contact	CEO and President	Mr.	Surowitz	Dale		8189422295				8187743020	dale.surowitz@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	CEO - Senior Official for Contracting	CEO and President	Mr.	Surowitz	Dale		8189422295				8187743020	dale.surowitz@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Chief Financial Officer	Chief Financial Officer	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Chief Operating Officer	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Chief Information Officer	Director of Information Services	Mr.	Lucich	Tony		8187743350				8187743389	tony.lucich@jha.org	7150 Tampa Ave.		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Chief Information Security Officer	DIrector of Information Services	Mr.	Lucich	Tony		8187743350				8187743389	tony.lucich@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	CMS Casework Communication Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Complaints Tracking Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Contact for Fraud Investigations	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Coordination of Benefits Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Corporate Mailing						8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Customer Service Operations Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	DIR Contact	Health Plan Specialist		Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	DIR Contact (Secondary)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Discount Program Payment Contact	Health Plan Specialist		Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Emergency Part D Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Emergency Part D Contact (Secondary)	COO		Stepanians	Larissa		8184300709					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Encounter Data & Risk Adjustment Operations Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Enrollment Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	EOB Transfer Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Financial Audit Contact	CFO	Mrs.	Ruditsky	Crystal		8187743336				8187745907	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Financial Reporting Contact	CFO	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Formulary Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Formulary Contact (Secondary)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	General Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Government Relations Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	HIPAA Privacy Officer	Chief Nursing & Compliance Officer	Mr.	Carlson	Timothy		8187743397				8187742424	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	HIPAA Security Officer	Director of Information Technology	Mr.	Lucich	Tony		8187743350				8187743020	tony.lucich@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Interoperability Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	MA Appeals/Grievances Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	MA Claims Processing Contact for Public Website	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Marketing Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Medical Director	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Medicare Compliance Officer	Compliance Officer	Mr.	Carlson	Timothy		8187743397				8187742424	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Medicare Coordinator	Health Plan Specialist	Ms	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Medicare Part D Opioid Overutilization Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/28/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Medication Therapy Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	OffShore Subcontractor Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Online Enrollment Center Contact (Optional)	COO	Ms.	Stepanians	Larissa		8184300709					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Online Enrollment Center Contact (Primary)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part C Application Contact			Fishenfeld	Susie		8187743274					susie.fishenfeld@jha.org	7150 Tampa Avenue		Reseda	CA	91335	01/12/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part D Appeals	Vice President	Mrs.	Stratman	Kim						8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending	8186548643				PACE - Nat		C	San Francisco
H3448	Part D Appeals Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie						8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending	8187574458				PACE - Nat		C	San Francisco
H3448	Part D Application Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part D Benefits Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574588				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part D Claims Submission Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part D Exceptions Contact	Health Plan Specialist	Ms.	Ilcken	Leslie						8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending	8187574458				PACE - Nat		C	San Francisco
H3448	Part D Exceptions Contact (Secondary)	Vice President	Mrs.	Stratman	Kim							kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending	8186548643				PACE - Nat		C	San Francisco
H3448	Part D Price File Contact (Back-up)	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part D Price File Contact (Primary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part D Quality Assurance Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187748444				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Part D Reporting Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Patient Safety Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Payment Contact	CFO	Mrs.	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Personal Health Record Contact	Director of Operations	Ms.	Graham	Amy		8187743328				8187745900	amy.graham@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Pharmacy Director	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Pharmacy Network Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Pharmacy Network Management Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Pharmacy Technical Help Desk Contact	Pharmacist	Ms.	Aramyan	Ani						8187745900	ani.aramyan@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending	8556543023				PACE - Nat		C	San Francisco
H3448	PHR Beneficiary Contact																	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE	Los Angeles Jewish Health	LAJHealth - Coachella Valley, LLC	881	Yes	Pending	8187743274				PACE - Nat		C	San Francisco
H3448	Plan Directory Contact for Public Website	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Plan to Plan Reconciliation Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Processor Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Quality Contact	Chief Nursing & Compliance	Ms.	Carlson	Timothy		8187743397				8187745907	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Reconciliation Contact	CFO	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Reconciliation Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Recovery Audit Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Surveillance Contact	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	System Contact	Director of Information Technology	Mr.	Lucich	Tony		8187743350				8187743020	tony.lucich@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Third Party Administrator (TPA) Liaison	Vice President	Mrs.	Stratman	Kim		8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Ave		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	User Access Contact	Vice President	Mrs.	Stratman	Kim		8186548643					kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Utilization Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3448	Utilization Review Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/26/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE - COACHELLA VALLEY, LLC	National PACE	Brandman Centers for Senior Care - Coachella Valley	National PACE		LAJHealth - Coachella Valley, LLC	881	Yes	Pending					PACE - Nat		C	San Francisco
H3449	Agent/Broker Compensation Data Contact	Director, Financial Systems		Lazar	Lisa		9197653359					Lisa.Lazar@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/28/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations		Hanson	Michelle		6127776706					eobp2p@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Backup User Access Contact	EDI Analyst		Umstead	Kamala		9197654363					kamala.umstead@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	09/26/2019	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Bid Audit Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Bid Audit Site Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Bid Primary Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	CAP Report Contact for Public Website	Manager, Internal Communications		Stinneford	Mark		9197653005					media.inquiry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/20/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	CEO - CMS Administrator Contact	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	CEO - Senior Official for Contracting	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	9197653923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/21/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Chief Operating Officer	SVP, Chief Operations & Member Experience Officer	Ms.	Mizelle	Karla		9849603787					karla.mizelle@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/22/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Chief Information Officer	AVP, IT Solution Delivery	Mrs.	Moum	Aldara		9196160924					Aldara.Moum@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	08/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Chief Information Security Officer	Chief Information Security Officer	Mr.	Chilton	Richard		9197652021					Rick.Chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	01/15/2016	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	CMS Casework Communication Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Complaints Tracking Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Contact for Fraud Investigations	Manager, Special Investigations Unit		Meyer	John		9842752360					John.Meyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Coordination of Benefits Contact	Team Lead, Operations		Pridgen	David		3362014141					David. Pridgen@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Corporate Mailing						3362014460				3366592969	deborah.washington-mcneill@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		9197657057					Renita.Woods@bcbsnc.com	4613 University Drive		Durham	NC	27707	03/26/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	DIR Contact	Director, Actuarial Services		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	03/15/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Discount Program Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					Tola.Onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Emergency Part D Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Emergency Part D Contact (Secondary)	Head of CIG Operations		Perry	Endya		9197775504					endya.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Employer Waiver Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment		Kimbrell	Tammy		9844448393					Tammy.Kimbrell2@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Enrollment Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	EOB Transfer Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536				9197657291	Corporate.pharmacy@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Financial Audit Contact	Director, Audit	Ms.	Ferrell	Kim		3362014038					kim.ferrell@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Financial Reporting Contact	Director, Corporate Financial Reporting		Lindsey	Elizabeth		5022108328					Elizabeth.Lindsey@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/05/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Formulary Contact	Manager, Pharmacy Programs		Hiller	Debra		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics Inc	2900 Ames Crossing Road	Eagan	MN	55121	03/07/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	General Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Government Relations Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	HIPAA Privacy Officer	Director, Privacy, Ethics & Corp Policies		Hamlet	Lynne		9197657416					lynne.hamlet@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/18/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	HIPAA Security Officer	Chief Information Security Official		Chilton	Rick		9197652021					rick.chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/30/2014	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Hospice Contact	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Interoperability Contact	Director, Corporate Compliance Official		Haith	Elenor		9842125897					Elenor.Haith@bcbsnc.com	PO Box 2291		Durham	NC	27702	07/20/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	MA Appeals/Grievances Contact	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna		9197654061					Adonna.McFall@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/12/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	MA Claims Processing Contact for Public Website	Manager, Operations		Cooper	Eva		9197651808					Eva.Cooper@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Marketing Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Medical Director	VP, Chief Medical Officer	Dr.	Wallace	Marcus		9843891622					Marcus.Wallace@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	06/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Medicare Compliance Officer	Director, Corporate Compliance	Mrs.	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/09/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Medicare Coordinator	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Medicare Part D Opioid Overutilization Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Medication Therapy Management Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	OffShore Subcontractor Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Online Enrollment Center Contact (Back-up)	Manager, Membership Services		Brackett	Latrese		3362019770					latrese.brackett@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Online Enrollment Center Contact (Primary)	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part C Application Contact		Ms.	Washington-McNeill	Deborah		3362014460					deborah.washington-mcneill@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part C Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Appeals	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna							Adonna.McFall@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/08/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882987520				HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Appeals Contact (Secondary)	Mgr, MA and PDP Appeals and Grievances		Lanier	Paige						8883758836	paige.lanier@bcbsnc.com	PO Box 17509	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8774947647				HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Benefits Contact	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Claims Submission Contact	Functional Business Consultant - Govt Prgms		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2900  Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Exceptions Contact	Director, Pharmacy		Moore	Jim							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	04/18/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882969790				HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Exceptions Contact (Secondary)	Team Leader, Clinical Pharmacy Reviews - Medicare		Parikh	Swati							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	01/04/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882969790				HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Price File Contact (Back-up)	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Price File Contact (Optional)	Price File Analyst Sr		Trudeau	Ashley		6127771338					ashley.trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Price File Contact (Primary)	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Quality Assurance Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Part D Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3362014460					deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Patient Safety Contact	Manager, Pharmacy		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	10/03/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Pharmacy Director	VP, Pharmacy Services		Trautman	Suzanne		7045988684					Suzanne.Trautman@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	10/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Pharmacy Network Management Contact	AVP, Corporate Pharmacy		Rooker	Todd		6024181702					Todd.Rooker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy		Hiller	Debra		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	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	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8772777893				HMO - Health Maintenance Organization		C	Atlanta
H3449	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Bunch	Jon							jonathan.bunch@primetherapeutics.com	Prime Therapeutics, LLC 2900 Ames Crossing Road		Eagan	MN	55121	12/14/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8772777893				HMO - Health Maintenance Organization		C	Atlanta
H3449	Physician Incentive Contact	AVP, Provider Network and Reimbursement		Page	Troy		9197652408					troy.page@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/17/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Plan Directory Contact for Public Website	Call Center support		Services	Member		8882969790					renita.woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Plan to Plan Reconciliation Contact	Sr Accountant		Taylor	Krystal		9849603607					krystal.taylor@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	02/28/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Processor Contact	Dir Govt Programs & Ops		Zeien	Daniel		6127776775					daniel.zeien@primetherapeutics.com	Prime Therapeutics, LLC	2655 Eagan Woods Drive	Eagan	MN	55122	05/31/2019	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Quality Contact	VP, Quality, Health Equity and Risk Adjustment		Bartholomew	Charmaine		6789208681					Charmaine.Bartholomew@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/24/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Reconciliation Contact	Director, Actuarial Services		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	03/11/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Recovery Audit Contact	Director, Corporate Compliance	Mrs	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina,	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	SNP Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556					deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	02/10/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	SNP State Contact	Mgr, CMS Contract Administration		Brown	Alison		9198674599					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	02/10/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Surveillance Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	System Contact	Director, IT Solution Delivery		Keltner	Doug		9194607400					Doug.Keltner@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Third Party Administrator (TPA) Liaison	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	User Access Contact	Electronic Data Interchange Analyst		Dunn	Lorrie		9197653669					lorrie.dunn@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	09/26/2019	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Utilization Management Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3449	Utilization Review Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3467	Agent/Broker Compensation Data Contact	Sales Manager		Angel	Jose		2149544114					jose.angel@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	03/21/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Bid Audit Contact	COO		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Bid Audit Site Contact	COO		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Bid Primary Contact	COO		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	CAP Report Contact for Public Website	Executive Director		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	05/30/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	CEO - CMS Administrator Contact	CEO, Procare Advantage	Ms.	Underhill	Robin		2146639263					runderhill@cantexcc.com	2537 Golden Bear Drive		Carollton	TX	75006	12/31/2019	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	CEO - Senior Official for Contracting	CEO, Procare Advantage	Ms.	Underhill	Robin		2149544114					runderhill@cantexcc.com	2537 Golden Bear Drive		Carollton	TX	75006	03/20/2019	2026	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		2127584311	117				shladky@lbbelon.com	430 Park Avenue	7th Floor	New York	NY	10022	02/02/2022	2026	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 Operating Officer	Chief Operating Officer	Mr.	Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	03/21/2024	2026	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 Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	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 Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	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		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Contact for Fraud Investigations	Executive Director		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	05/30/2024	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Corporate Mailing						8442063719					procarecustomerservice@allyalign.com	P.O. Box 5849		Glen Allen	VA	230585849	02/16/2022	2026	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		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Discount Program Payment Contact	VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/19/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	EOB Transfer Contact			Lowry	Kristy		8448546886				8336102390	kristy.lowry@curanahealth.com	P.O. Box 5849		Glen Allen	VA	23058	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Financial Audit Contact	VP Finance	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road Ste 110		Glen Allen	VA	23060	09/24/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Financial Reporting Contact	Chief Financial Officer, ProCare Advantage	Mr.	Hladky	Sean		2127584311	117				shladky@lbbelon.com	430 Park Avenue	7th Floor	New York	NY	10022	02/02/2022	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	General Contact	Chief Compliance Officer		Urfi	Nakis		2149544114					nakis.urfi@cantexcc.com	2537 Golden Bear Drive		Carollton	TX	75006	08/13/2025	2026	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	CFO		Hladky	Sean		2149544114					shladky@lbbelon.com	2537 Golden Bear Drive		Carollton	TX	75006	03/21/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	HIPAA Privacy Officer	CIO		Wilkins	Tony		2149544114					twilkins@cantexcc.com	2537 Golden Bear Drive		Carollton	TX	75006	05/30/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	HIPAA Security Officer	CIO		Wilkins	Tony		2149544114					twilkins@cantexcc.com	2537 Golden Bear Drive		Carollton	TX	75006	03/21/2024	2026	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	COO	Mr.	Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	03/21/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	03/21/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Marketing Contact	Sales Admin Manager		Clark	David		8034464921					David.Clark@allyalign.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Medical Director	Chief Medical Officer		Kamali	Robert		2145667766					rkamali@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	08/18/2021	2026	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	Mr	Urfi	Nakis		2149544114	114				nakis.urfi@cantexcc.com	2537 Golden Bear Drive		Carollton	TX	75006	05/15/2025	2026	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 Coordinator	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/14/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 C Application Contact	Chief Financial Officer, ProCare Advantage	Mr.	Hladky	Sean		2127584311	117				shladky@lbbelon.com	430 Park Avenue 7th Floor		New York	NY	10022	02/02/2022	2026	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 C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Appeals	Supervisor, Grievance and Appeals		LaCrosse	Justin						8442689791	Justin.LaCrosse@navitus.com	Navitus Health Solutions,	P.O. Box 1039	Appleton	WI	54912	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	9202214149				HMO - Health Maintenance Organization		C	Dallas
H3467	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Dallas
H3467	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	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						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Dallas
H3467	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Dallas
H3467	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	01/03/2025	2026	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 Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	12/31/2019	2026	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 Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Payment Contact	Chief Financial Officer, ProCare Advantage	Mr.	Hladky	Sean		2127584311	117				shladky@lbbelon.com	430 Park Avenue	7th Floor	New York	NY	10022	09/28/2022	2026	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 Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Network Management Contact			Robinson	Jan		6087291688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	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 Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H3467	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Dallas
H3467	Physician Incentive Contact			Howells	Heather		8049215196					heather.howells@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	03/21/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Plan Directory Contact for Public Website			Sidlinger	Rocio		8558550489	1664				rocio.sidlinger@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Reconciliation Contact (Secondary)	VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/19/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Recovery Audit Contact	Executive Director	Mr	Guzman	Armando		2149544114	114				aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	05/30/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	SNP Application Contact	COO		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	SNP State Contact	COO		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Surveillance Contact	COO		Guzman	Armando		2149544114					aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	03/21/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Third Party Administrator (TPA) Liaison	Chief Financial Officer, ProCare Advantage	Mr.	Hladky	Sean		2127584311	117				shladky@lbbelon.com	430 Park Avenue	7th Floor	New York	NY	10022	09/28/2022	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	User Access Contact	Executive Director	Mr	Guzman	Armando		2149544114	114				aguzman@procareadvantageplan.com	2537 Golden Bear Drive		Carollton	TX	75006	05/30/2024	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3467	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PROCARE ADVANTAGE, LLC	Local CCP	ProCare Advantage	HMO/HMOPOS		First Sacramento Capital Funding LLC	735	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3473	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie		7203929719				3039961600	lteter@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Operating Officer	Market President	Mr.	Jones	Steve		8049442904				3039961600	sjones2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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 Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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 Information Security Officer	SVP of Information Technology	Mr.	Naus	Cole		7209210443				3039961600	MNaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Complaints Tracking Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Corporate Mailing						3038694664				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	DIR Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	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	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Interoperability Contact	SVP of Applications		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	07/28/2023	2026	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	MA Appeals/Grievances Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	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	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	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 Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	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 Appeals	Director of Compliance		Licht	Hannah						3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H3473	Part D Appeals Contact (Secondary)	Director of Compliance		Licht	Hannah						3039961600	hlicht@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H3473	Part D Application Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H3473	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Philadelphia
H3473	Part D Price File Contact (Back-up)	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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 Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Quality Assurance Contact	SVP, Clinical Strategic Partnerships Clinical Oper		Cinque	Michael		7207444048				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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 Reporting Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H3473	PHR Beneficiary Contact																	07/28/2023	2026	INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC	National PACE	InnovAge Virginia PACE - Blue Ridge	National PACE	Total Longterm Care Inc	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Philadelphia
H3473	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	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	Plan to Plan Reconciliation Contact	Finance and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	akizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	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	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Reconciliation Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Recovery Audit Contact	Director of Finance	Mrs.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	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	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	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	System Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	User Access Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	Backup User Access Contact	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	Bid Primary Contact	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	CAP Report Contact for Public Website	Executive Director	Sr.	Sullivan	Margaret		8566753654				8566753666	marge.sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/11/2025	2026	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	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	CEO - Senior Official for Contracting	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	02/20/2023	2026	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	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	07/27/2023	2026	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 Operating Officer	Chief Operating Officer	Ms.	Lewis	Anne		4066472980				8566753659	anne.lewis@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	04/23/2019	2026	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 Information Officer	Director Enterprise IT Operations	Mr	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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 Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083					Preston.Jennings@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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	Complaints Tracking Contact	Director Quality Assurance	Mr	Singer	Vincent		8566753654				8566753666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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	Contact for Fraud Investigations	Director Quality Assurance	Mr	Singer	Vincent		8566753654				8566753666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	Corporate Mailing						8566753643				8566753659	jruprecht@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/17/2019	2026	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	Executive Director	Sr.	Sullivan	Margaret		8566753353				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/11/2025	2026	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	DIR Contact	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	Discount Program Payment Contact	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	Emergency Part D Contact	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	10/25/2019	2026	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	Enrollment Contact	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	EOB Transfer Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533				2679917618	David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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	Financial Audit Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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	Financial Reporting Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2679917601				2679917618	joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	08/02/2023	2026	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	General Contact	Executive Director	Sr	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	02/20/2023	2026	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		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	02/20/2023	2026	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	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	Interoperability Contact	Director Enterprise IT Operations		Gillespie	Jeff		7343433079					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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	MA Appeals/Grievances Contact	Director Quality Assurance	Mr	Singer	Vincent		8566753654				8566753666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	03/10/2020	2026	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	MA Claims Processing Contact for Public Website	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	Marketing Contact	Director Marketing & Communications	Ms	Lark	Azia		9735182754					azia.lark@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	02/03/2023	2026	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	Medical Director	Medical Director	Dr	Bansal	Mukta		8566753662				8566753659	Mukta.Bansal@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	09/16/2024	2026	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	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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 Coordinator	Executive Director	Sr.	Sullivan	Margaret		8566753353				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/11/2025	2026	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 Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	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	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@trinity-health.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	09/15/2023	2026	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 C Application Contact	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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 Appeals	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	09/15/2023	2026	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	New York
H3493	Part D Application Contact	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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 Benefits Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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 Claims Submission Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	09/15/2023	2026	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	New York
H3493	Part D Price File Contact (Back-up)	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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 Price File Contact (Primary)	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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 Quality Assurance Contact	Director Quality Assurance	Mr	Singer	Vincent		8566753654				8566753666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	03/10/2020	2026	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 Reporting Contact	Finance Director	Ms	Ruprecht	Janice	K	8566753643				8566753659	jruprecht@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	01/16/2019	2026	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	Patient Safety Contact	Director Quality Assurance	Mr	Singer	Vincent		8566753654				8566753666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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	Payment Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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 Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@mercyhealth.org	1930 South Broad Street		Philadelphia	PA	19145	08/02/2023	2026	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 Network Management Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	08/11/2025	2026	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	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	08/11/2025	2026	LIFE AT LOURDES, INC.	National PACE	Trinity Health LIFE New Jersey	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	New York
H3493	Plan Directory Contact for Public Website	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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	Plan to Plan Reconciliation Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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	Processor Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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	Quality Contact	Director Quality Assurance	Mr	Singer	Vincent		8566753654				8566753666	vincent.singer@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	03/10/2020	2026	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	Reconciliation Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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	Recovery Audit Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/02/2023	2026	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	Surveillance Contact	Executive Director	Sr.	Sullivan	Margaret		8566753663				8566753659	Marge.Sullivan@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	08/02/2023	2026	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	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	Third Party Administrator (TPA) Liaison	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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	Utilization Management Contact	Medical Director	Dr	Bansal	Mukta		8566753662				8566753659	Mukta.Bansal@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	09/16/2024	2026	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	Utilization Review Contact	Medical Director	Dr	Bansal	Mukta		8566753662				8566753659	Mukta.Bansal@trinity-health.org	2475 McClellan Avenue	Building C	Pennsauken	NJ	08109	09/16/2024	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	07/31/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	03/30/2021	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H3499	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H3499	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H3499	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H3499	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/11/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H3499	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H3499	PHR Beneficiary Contact																	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H3499	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/02/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3499	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3514	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd., Suite 140		Columbia	SC	29209	11/03/2025	2026	PACE GEORGIA, INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H3514	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd., Suite 140		Columbia	SC	29209	11/03/2025	2026	PACE GEORGIA, INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H3517	Automated TrOOP Balance Transfer Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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	Backup User Access Contact	Director, Redwood Coast PACE	Ms	LaHaie	Barbara		7074439747	3221			7074433498	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	09/18/2020	2026	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		7074439747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	Bid Primary Contact	CEO	Ms.	Hooven	Melissa		7074439747	1213			7074439747	mhooven@humsenior.org	1910 California Street		Eureka	CA	95501	05/31/2024	2026	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	CAP Report Contact for Public Website	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Hooven	Melissa		7074439747	1213			7074433498	mhooven@humsenior.org	1910 California Street		Eureka	CA	95501	08/10/2020	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms	Hooven	Melissa		7074439747	1213			7074433498	mhooven@humsenior.org	1910 California Street		Eureka	CA	95501	08/10/2020	2026	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	Alvarado	Nicole		7074439747	1214			7074433498	nalvarado@humsenior.org	1910 California St		Eureka	CA	95501	05/31/2024	2026	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 Operating Officer	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7074433498	blahaie@humsenior.org	1910 California St.		Eureka	CA	95501	11/17/2020	2026	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 Information Officer	Director of Communication and Marketing	Ms.	Arche	Rene		7074439747	1256				rarche@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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 Information Security Officer	Director of Communication and Marketing	Ms.	Arche	Rene		7074439747	1256				rarche@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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		7074439747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	Complaints Tracking Contact	Quality Assurance Manager		Kimbell-Auth	Tristin		7074439747					tkimbell-auth@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2025	2026	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	Contact for Fraud Investigations	Quality Assurance Manager		Kimbell-Auth	Tristin		7074439747					tkimbell-auth@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2025	2026	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		7074439747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	Corporate Mailing						7074439747					reception@humsenior.org	1910 California Street		Eureka	CA	95501	12/20/2013	2026	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		7074439747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	DIR Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231			7074433498	dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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	DIR Contact (Secondary)	Chief Executive Officer	Ms	Hooven	Melissa		7074439747	1213			7074433498	mhooven@humsenior.org	1910 California Street		Eureka	CA	95501	08/10/2020	2026	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	Discount Program Payment Contact			Alvarado	Nicole		7074439747					nalvarado@humsenior.org	1910 California St		Eureka	CA	95501	02/07/2025	2026	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	Emergency Part D Contact	Senior Financial Analyst		Van Reusen	David	A	7074439747					dvanreusen@humsenior.org	1910 California St		Eureka	CA	95501	12/30/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California St		Eureka	CA	95503	09/09/2024	2026	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	Enrollment Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221				blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	EOB Transfer Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231			7074433498	dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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	Financial Audit Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California St		Eureka	CA	95501	09/09/2024	2026	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	Financial Reporting Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California St		Eureka	CA	95501	09/09/2024	2026	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	Formulary Contact	Medical Director	Dr.	Heidmann	Jennifer		7074439747	3205			7074433498	jheidmann@humsenior.org	1910 California Street		Eureka	CA	95501	09/18/2020	2026	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	Formulary Contact (Secondary)	Director, Redwood Coast PACE	Ms	LaHaie	Barbara		7074439747	3221			7074433498	blahaie@humsenior.org	1910 California St		Eureka	CA	95501	09/18/2020	2026	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	General Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	HIPAA Privacy Officer	Director of Communication and Marketing		Arche	Rene		7074439747	1256				rarche@humsenior.org	1910 California Street		Eureka	CA	95501	01/13/2017	2026	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	HIPAA Security Officer	Director of Communication and Marketing		Arche	Rene		7074439747	1256				rarche@humsenior.org	1910 California Street		Eureka	CA	95501	12/20/2013	2026	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	Interoperability Contact			LaHaie	Barbara		7074439747	3221			7074433498	blahaie@humsenior.org	1910 California St.		Eureka	CA	95501	05/24/2022	2026	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	MA Appeals/Grievances Contact	Quality Assurance Manager		Kimbell-Auth	Tristin		7074439747					tkimbell-auth@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2025	2026	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	MA Claims Processing Contact for Public Website	Senior Financial Analyst	Mr	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California St		Eureka	CA	95501	09/09/2024	2026	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	Marketing Contact	Director of Communication and Marketing		Arche	Rene		7074439747	1256				rarche@humsenior.org	1910 California Street		Eureka	CA	95501	12/20/2013	2026	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	Medical Director	Medical Director	Dr	Heidmann	Jennifer		7074439747	3205				jheidmann@humsenior.org	1910 California Street		Eureka	CA	95501	05/08/2014	2026	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	Ms.	Kimbell-Auth	Tristin		7074439747					tkimbell-auth@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2025	2026	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 Coordinator	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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 Part D Opioid Overutilization Contact	Quality Assurance Manager		Kimbell-Auth	Tristin		7074339747					tkimbell-auth@humsenior.org	1910 California St		Eureka	CA	95501	03/28/2025	2026	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	Medication Therapy Management Contact	Medical Director	Dr	Heidmann	Jennifer		7074439747	3205				jheidmann@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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 C Application Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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 Appeals	Quality Assurance Manager		Kimbell-Auth	Tristin	M						tkimbell-auth@humsenior.org	1910 California St		Eureka	CA	95501	03/28/2025	2026	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active	7074439747				PACE - Nat		C	San Francisco
H3517	Part D Application Contact	Director of Finance	Ms.	Alvarado	Nicole		7074439747	1214			7074433498	nalvarado@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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 Benefits Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	12/30/2024	2026	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 Claims Submission Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	12/30/2024	2026	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	Quality Assurance Manager		Kimbell-Auth	Tristin							tkimbell-auth@humsenior.org	1910 California St		Eureka	CA	95501	03/28/2025	2026	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active	7074439747				PACE - Nat		C	San Francisco
H3517	Part D Price File Contact (Back-up)	Owner		Tanner	Bob		7158522983					btanner@pharmastarpbm.com	PO Box  3127		Eau Claire	WI	54702	12/20/2013	2026	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 Price File Contact (Primary)	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	12/30/2024	2026	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 Quality Assurance Contact	Quality Assurance Manager		Kimbell-Auth	Tristin		7074439747					tkimbell-auth@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2025	2026	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 Reporting Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	12/30/2024	2026	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	Patient Safety Contact	Quality Assurance Manager		Kimbell-Auth	Tristin		7074439747					tkimbell-auth@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2025	2026	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	Payment Contact	Director of Finance	Ms	Alvarado	Nicole		7074439747	1214				nalvarado@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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 Director	Medical Director	Dr	Heidmann	Jennifer		7074439747	3205				jheidmann@humsenior.org	1910 California Street		Eureka	CA	95501	12/30/2024	2026	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 Network Management Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	12/30/2024	2026	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	Quality Assurance Manager		Kimbell-Auth	Tristin							tkimbell-auth@humsenior.org	1910 California St		Eureka	CA	95501	03/28/2025	2026	HUMBOLDT SENIOR RESOURCE CENTER, INC.	National PACE	Redwood Coast PACE	National PACE		Humboldt Senior Resource Center, Inc.	602	Yes	Active	7074439747				PACE - Nat		C	San Francisco
H3517	Plan Directory Contact for Public Website	Director of Communication and Marketing		Arche	Rene		7074439747	1256				rarche@humsenior.org	1910 California Street		Eureka	CA	95501	12/20/2013	2026	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	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Alvarado	Nicole		7074439747	1214			7074433498	nalvarado@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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	Processor Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	Quality Contact	Quality Assurance Manager		Kimbell-Auth	Tristin		7074439747					tkimbell-auth@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2025	2026	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	Reconciliation Contact	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231			7074433498	dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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	Reconciliation Contact (Secondary)	Director of Finance	Ms.	Alvarado	Nicole		7074439747	1214				nalvarado@humsenior.org	1910 California St		Eureka	CA	95501	09/09/2024	2026	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	Recovery Audit Contact	Director of Finance	Ms	Alvarado	Nicole		7074439747	1214				nalvarado@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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	Surveillance Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	System Contact	Director of Communication and Marketing		Arche	Rene		7074439747	1256			7074433498	rarche@humsenior.org	1910 California Street		Eureka	CA	95501	08/20/2018	2026	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	Third Party Administrator (TPA) Liaison	Senior Financial Analyst	Mr.	Van Reusen	David		7074439747	1231				dvanreusen@humsenior.org	1910 California Street		Eureka	CA	95501	09/09/2024	2026	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	User Access Contact	Director of Communications and Marketing	Ms.	Arche	Rene		7074439747	1256			7074433498	rarche@humsenior.org	1910 California Street		Eureka	CA	95501	09/18/2020	2026	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	Utilization Management Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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	Utilization Review Contact	Director, Redwood Coast PACE	Ms.	LaHaie	Barbara		7074439747	3221			7072691332	blahaie@humsenior.org	1910 California Street		Eureka	CA	95501	03/28/2016	2026	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		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	11/30/2023	2026	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	New York
H3522	Backup User Access Contact	Executive Assistant		Marcum	Suzie		7659358812					suzanne.marcum@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Best Available Evidence Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Bid Primary Contact	Director		Fanning	Shannon		7659358958					Shannon.Fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	CAP Report Contact for Public Website	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	CEO - CMS Administrator Contact	President	CEO	Wells	Ben		7659833122					Ben.Wells@ReidHealth.org	1100 Reid Parkway, Administration	Administration	Richmond	IN	47374	04/25/2025	2026	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	New York
H3522	CEO - Senior Official for Contracting	President	CEO	Wells	Ben		7659833122					Ben.Wells@reidhealth.org	1100 Reid Parkway, Administration	Administration	Richmond	IN	47374	04/25/2025	2026	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	New York
H3522	Chief Financial Officer	Chief Financial Officer	CFO	Wells	Ben		7659833225					ben.wells@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	01/16/2025	2026	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	New York
H3522	Chief Operating Officer	Vice President, Ambulatory Care & Service Lines	COO	Kester	Billie		7659838542	8542				billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Chief Information Officer	Vice President	CIO	Siddiqui	Muhammad		7659833412					Muhammad.Siddiqui@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Chief Information Security Officer	Director of Health Information Management	CISO	Morrison	Julie		7659833286					julie.morrison@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	CMS Casework Communication Contact	Director		Fanning	Shannon		7659358959					Shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	04/15/2024	2026	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	New York
H3522	Complaints Tracking Contact	Director		Fanning	Shannon		7659358959					shannon.fanning@reidhealth.org	2300 National Road		Richmond	IN	47374	04/15/2024	2026	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	New York
H3522	Contact for Fraud Investigations	Director of Audit Services	CCO	Bierman	Randall		7659833418					randall.bierman@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Coordination of Benefits Contact	Director		Fanning	Shannon		7659358958	17906				Shannon.Fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Corporate Mailing						7659833314					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Customer Service Operations Contact	Director		Fanning	Shannon		7659358958					Shannon.Fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	DIR Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.com	2300 National Rd W		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	DIR Contact (Secondary)	Associate Director		Johnson	Britney		7659358959					britney.johnson@reidhealth.org	2300 National Road West		Richmond	IN	47374	06/06/2024	2026	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	New York
H3522	Discount Program Payment Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Emergency Part D Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Emergency Part D Contact (Secondary)	Associate Director		Johnson	Britney		7659358958					britney.johnson@reidhealth.org	2300 National Road West		Richmond	IN	47374	06/06/2024	2026	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	New York
H3522	Encounter Data & Risk Adjustment Operations Contact	Director		Fanning	Shannon		7659358958				7659358960	Shannon.Fanning@ReidHealth.org	2300 National Road West		Richmond	IN	47374	04/25/2025	2026	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	New York
H3522	Enrollment Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	EOB Transfer Contact	Director		Fanning	Shannon		7659358958				7659358960	Shannon.Fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Financial Audit Contact	Director	Mrs.	Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Financial Reporting Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Formulary Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Formulary Contact (Secondary)	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	General Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Government Relations Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	HIPAA Privacy Officer	Director of Health Information Management		Morrison	Julie		7659833286					julie.morrison@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	HIPAA Security Officer	Director of Health Information Management		Morrison	Julie		7659833286					julie.morrison@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Interoperability Contact	Director		Fanning	Shannon		7659358958					Shannon.Fanning@reidhealth.org	2300 National Rd W		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	MA Appeals/Grievances Contact	Director		Fanning	Shannon		7659358959					Shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	04/15/2024	2026	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	New York
H3522	MA Claims Processing Contact for Public Website	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Marketing Contact	Director of Marketing & Communications		Willett	Judi		7659358823					judi.willett@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Medical Director	Medical Director of PACE	Dr.	Wegg	Daniel		7659358959					Daniel.Wegg@reidhealth.org	1100 Reid Parkway, Administration	Administration	Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Medicare Compliance Officer	Director of Audit Services	CCO	Bierman	Randall		7659833418					randall.bierman@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Medicare Coordinator	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Medicare Part D Opioid Overutilization Contact	Director		Fanning	Shannon		7659358958					Shannon.Fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Medication Therapy Management Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Online Enrollment Center Contact (Back-up)	Executive Assistant		Marcum	Suzie		7659358812					suzanne.marcum@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Online Enrollment Center Contact (Optional)	Associate Director PACE		Johnson	Britney		7659358959					britney.johnson@reidhealth.org	2300 National Road West		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Online Enrollment Center Contact (Primary)	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Part C Application Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Part D Appeals	Director		Fanning	Shannon						7659358960	Shannon.Fanning@ReidHealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	7659358958				PACE - Nat		C	New York
H3522	Part D Appeals Contact (Secondary)	Quality Assurance Manager		Fanning	Shannon						7659358969	Shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	04/15/2024	2026	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	7659358959				PACE - Nat		C	New York
H3522	Part D Application Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Part D Benefits Contact	Director		Fanning	Shannon		7659358958					Shannon.Fanning@reidhealth.com	2300 National Rd W		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Part D Claims Submission Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Part D Exceptions Contact	Director		Fanning	Shannon							shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/14/2023	2026	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	7659358958				PACE - Nat		C	New York
H3522	Part D Exceptions Contact (Secondary)	Director		Fanning	Shannon							Shannon.Fanning@reidhealth.org	2300 National Rd W		Richmond	IN	47374	04/15/2024	2026	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	7659358959				PACE - Nat		C	New York
H3522	Part D Price File Contact (Back-up)	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.com	2300 National Rd W		Richmond	IN	47374	12/14/2023	2026	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	New York
H3522	Part D Price File Contact (Optional)	Executive Assistant		Marcum	Suzie		7659358812					suzanne.marcum@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Part D Price File Contact (Primary)	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Part D Quality Assurance Contact	Director		Fanning	Shannon		7659358959					Shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	04/15/2024	2026	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	New York
H3522	Part D Reporting Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	Patient Safety Contact	Quality Manager		Forth	Teresa		7659358959					Teresa.Forth@reidhealth.org	2300 National Road West		Richmond	IN	47374	04/17/2024	2026	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	New York
H3522	Payment Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	Pharmacy Director	Medical Director of PACE	Dr.	Wegg	Daniel		7659358959					daniel.wegg@reidhealth.org	2300 National Road West		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Pharmacy Network Management Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	Pharmacy Network Management Contact (Secondary)	Associate Director PACE		Johnson	Britney		7659358959					britney.johnson@reidhealth.org	2300 National Road West		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Pharmacy Technical Help Desk Contact	Director		Fanning	Shannon							shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	7659358958	3314			PACE - Nat		C	New York
H3522	Pharmacy Technical Help Desk Contact (Secondary)			Johnson	Britney							britney.johnson@reidhealth.org	2300 National Road West		Richmond	IN	47374	03/04/2025	2026	REID HOSPITAL & HEALTH CARE SERVICES, INC.	National PACE	Reid Health PACE Center	National PACE		Reid Hospital & Health Care Services, Inc.	745	Yes	Active	7659358959				PACE - Nat		C	New York
H3522	Plan Directory Contact for Public Website	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Plan to Plan Reconciliation Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	Processor Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	Quality Contact	Quality Manager		Forth	Teresa		7659368959					Teresa.Forth@reidhealth.org	2300 National Road West		Richmond	IN	47374	04/17/2024	2026	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	New York
H3522	Reconciliation Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Reconciliation Contact (Secondary)	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	Recovery Audit Contact	Director of Audit Services	CCO	Bierman	Randall		7659833418					randall.bierman@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/09/2020	2026	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	New York
H3522	Surveillance Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	System Contact	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	Third Party Administrator (TPA) Liaison	Director		Fanning	Shannon		7659358958					shannon.fanning@reidhealth.org	2300 National Road West		Richmond	IN	47374	12/18/2023	2026	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	New York
H3522	User Access Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Utilization Management Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3522	Utilization Review Contact	Vice President, Ambulatory Care & Service Lines		Kester	Billie		7659838542					billie.kester@reidhealth.org	1100 Reid Parkway, Administration		Richmond	IN	47374	03/04/2025	2026	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	New York
H3528	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	CMMI Model Point of Contact	Director, Medicare Compliance/MCO		Borenkind	Carly		3479784977					cborenkind@emblemhealth.com	55 Water street		New York	NY	10041	05/29/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Employer Waiver Contact	AVP, Product Dev., Admin., & Perf. Analysis		Averyanova	Nataliya		6464475044					naveryanova@emblemhealth.com	55 Water Street		New York	NY	10041	05/29/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Formulary Contact (Secondary)	VP, Pharmacy Solutions		Colby	Andrew		6464473340					acolby@emblemhealth.com	55 Water St		New York	NY	10041	05/29/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Online Enrollment Center Contact (Back-up)	Knowledge Manager, Enroll. & Bill.		Gonzalez	Gabriel		6464477722					gabriel.gonzalez@emblemhealth.com	55 Water Street		New York	NY	10041	05/29/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Online Enrollment Center Contact (Optional)	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	05/29/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H3528	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H3528	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H3528	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H3528	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/29/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Price File Contact (Primary)	Sr. Manager Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	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	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8009221557	2			HMO - Health Maintenance Organization		C	New York
H3528	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H3528	PHR Beneficiary Contact																	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS	ConnectiCare Inc	Molina Healthcare, Inc.	165	Yes	Active	8002242273				HMO - Health Maintenance Organization		C	New York
H3528	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3528	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	06/02/2025	2026	CONNECTICARE, INC.	Local CCP	ConnectiCare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3533	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	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	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	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	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	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	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H3533	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H3533	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H3533	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H3533	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H3533	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH COMPANY OF NEW YORK, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H3533	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	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	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	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	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	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	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3536	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3536	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3536	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3536	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3536	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3536	PHR Beneficiary Contact																	11/05/2015	2026	MATTHEW THORNTON HEALTH PLAN, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H3536	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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
H3551	Agent/Broker Compensation Data Contact	Chief Finance Officer		Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Automated TrOOP Balance Transfer Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Backup User Access Contact	CCO		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Best Available Evidence Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Bid Audit Contact	Product Director		Cassidy	Cheryl	L	4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Bid Audit Site Contact	Product Director		Cassidy	Cheryl	L	4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Bid Primary Contact	Product Director		Cassidy	Cheryl	L	4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	CAP Report Contact for Public Website	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Ika	Pooja	V	5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Ika	Pooja	V	5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Chief Financial Officer	Chief Financial Officer	Mr.	Lawless	Tom		6085091628					tom.lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Chief Operating Officer	Chief Operating Officer	Mr.	Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Chief Information Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Chief Information Security Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	CMS Casework Communication Contact	VP Clinical Operations		Dougherty	Laurene		8136015063					laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Complaints Tracking Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Contact for Fraud Investigations	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Coordination of Benefits Contact	COO		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Corporate Mailing						5088046904					pooja.sammeta@rxadvance.com	136 Turnpike Road		Southborough	MA	01772	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Customer Service Operations Contact	Chief Operating Officer		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	DIR Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	DIR Contact (Secondary)	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Discount Program Payment Contact	CFO		Lawless	Tom		6172450509					Tom.Lawless@eternalhealth.com	31 St James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Emergency Part D Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Encounter Data & Risk Adjustment Operations Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Enrollment Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	EOB Transfer Contact	Chief Operating Officer		Price	John		2158806876				8664371627	john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Financial Audit Contact	VP FInance	Mr.	Taxeria	Edward		6175280920					edward.texeria@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Financial Reporting Contact	COO		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Formulary Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Formulary Contact (Secondary)	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	32 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	General Contact	Chief Executive Officer		Ika	Pooja		5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Government Relations Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	HIPAA Privacy Officer	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	HIPAA Security Officer	IT Manager	Mr.	Harsha	Vijay		6176657331					vijay.harsha@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Hospice Contact	VP Clinical Operations		Dougherty	Laurene		8136015063					laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Interoperability Contact	Chief Compliance Officer		Ross	Cheyenne	L	6178404477					cheyenne.ross@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	MA Appeals/Grievances Contact	Chief Operating Officer		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	08/22/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	MA Claims Processing Contact for Public Website	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Marketing Contact	Senior Director, Marketing		Cardinal	Brittany		4136524780					brittany.cardinal@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Medical Director	Medical Director	Dr.	London	Robert		3038083311					robert.london@nirvanahealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Medicare Coordinator	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Medicare Part D Opioid Overutilization Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Medication Therapy Management Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	OffShore Subcontractor Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave		Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Online Enrollment Center Contact (Back-up)	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Online Enrollment Center Contact (Primary)			Rao	Chanukya		8565031661					chanukya.rao@rxadvance.com	136 Turnpike Rd.		Southborough	MA	01772	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part C Application Contact	Product Director		Cassidy	Cheryl	L	4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part C Reporting Contact	Chief Compliance Officer		Ross	Cheyenne	L	6239103321					cheyenne.ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Appeals	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	6126326838				HMO - Health Maintenance Organization		C	Boston
H3551	Part D Appeals Contact (Secondary)	Chief Operating Officer		Price	John							john.price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	08/22/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	2158806876				HMO - Health Maintenance Organization		C	Boston
H3551	Part D Application Contact	Product Director		Cassidy	Cheryl	L	4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Benefits Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Claims Submission Contact	Director		Pereira	Michael		9494753456					pereira.mj@optum.com	2300 Main Street		Irvine	CA	92614	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Exceptions Contact	Manager		Bricker	Bryce							bryce.m.bricker@optum.com	2441 Warrenville Road		Lisle	IL	60532	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	6126326838				HMO - Health Maintenance Organization		C	Boston
H3551	Part D Price File Contact (Back-up)			Moore-Elliot	Shalandria		6514955363					mailto:MedOps-Planfinder_DL@ds.uhc.com	1600 McConnor Pkwy		Schaumburg	IL	60173	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Price File Contact (Optional)			Vargas	Danielle		4437101262					MedOps-Planfinder_DL@ds.uhc.com	1600 McConnor Pkwy		Schaumburg	IL	60173	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Price File Contact (Primary)			Rx	Optum		6514955363					medops_planfinder@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Quality Assurance Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Part D Reporting Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Patient Safety Contact	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Payment Contact	Chief Executive Officer		Ika	Pooja		5083098810					pooja.ika@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Pharmacy Director	VP Pharmacy		Vellutato	John		8573134678					john.vellutato@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	04/23/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Pharmacy Network Management Contact	Director		Ashby	JoLynn		7637326364					JAshby@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Pharmacy Technical Help Desk Contact			Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	06/04/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active	8553122306				HMO - Health Maintenance Organization		C	Boston
H3551	Physician Incentive Contact	Chief Compliance Officer		Ross	Cheyenne		6178404477					cheyenne.ross@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	09/26/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Plan Directory Contact for Public Website			Services	Provider		8006809255					providerrelations@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Plan to Plan Reconciliation Contact	COO		Price	John		2158806876					john.price@eternalhealth.com	31 St. James Ave.	Suite 950,	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Processor Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Quality Contact	Interim Medical Director		London	Robert		3038083311	339				robert.london@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Reconciliation Contact	CFO		Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Recovery Audit Contact	Chief Financial Officer	Mr.	Lawless	Tom		6085091628					Tom.Lawless@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	SNP Application Contact	Product Director		Cassidy	Cheryl	L	4019529706					cheryl.cassidy@eternalHealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	01/11/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Surveillance Contact	Chief Compliance Officer		Ross	Cheyenne		6239103321					Cheyenne.Ross@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	System Contact	Chief Operating Officer		Price	John		2158806876					John.Price@eternalhealth.com	31 St. James Ave.	Suite 950	Boston	MA	02116	07/31/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Third Party Administrator (TPA) Liaison	Controller		Tran	Jessica		6175131910					jessica.tran@eternalHealth.com	901 St. James Ave.	Suite 950	Boston	MA	02116	12/09/2024	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	User Access Contact	Chief Compliance Officer		Ross	Cheyenne		6174067035					cheyennelross@live.com	31 St James Ave, Boston, MA, 02116	Suite 950	Boston	MA	02116	12/21/2023	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Utilization Management Contact	VP Clinical Operations		Dougherty	Laurene		8136015063	339				laurene.dougherty@eternalhealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3551	Utilization Review Contact	Medical Director	Dr.	London	Robert		3038083311					robert.london@nirvanahealth.com	31 Saint James Avenue	Suite # 950	Boston	MA	02116	05/19/2025	2026	ETERNALHEALTH OF ARIZONA INC	Local CCP	eternalHealth	HMO/HMOPOS		Eternal Health of Delaware, Inc.	769	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3557	Agent/Broker Compensation Data Contact	Director, Sales		Geyer	Rebecca		4014591343					rebecca.geyer@bcbsri.org	500 Exchange Street		Providence	RI	02903	11/25/2025	2026	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	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management		Bhesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/12/2025	2026	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	Backup User Access Contact	Medicare Compliance Officer	Ms.	Pennypacker	Regan		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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		Wisniewski	Ivona		4014591721				4014595089	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Bid Audit Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Bid Audit Site Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Bid Primary Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Pennypacker	Regan		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	8006373718	2100			PPO - BBA		C	Boston
H3557	CEO - CMS Administrator Contact	CEO	Ms	Wofford	Martha		4014591200					martha.wofford@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/06/2025	2026	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	CEO - Senior Official for Contracting	CEO	Ms	Wofford	Martha		4014591200					martha.wofford@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/06/2025	2026	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	Interim CFO, VP Strategic Financial Management	Ms.	Soucy	Stacia		4014595304					stacia.soucy@bcbsri.org	500 Exchange Street		Providence	RI	02903	12/03/2025	2026	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 Operating Officer	SVP, Chief Operating Officer	Ms.	DeMoura	Tara		4014592308					tara.demoura@bcbsri.org	500 Exchange Street		Providance	RI	02903	08/08/2024	2026	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 Information Officer	Chief Information Officer	Mr.	Comella	David		4014591687					david.comella@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Information Security Officer	Managing Director, Information Security	Mr	Webster	Frederick		4014595728					fred.webster@bcbsri.org	500 Exchange Street		Providence	RI	02903	11/26/2024	2026	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	CMMI Model Point of Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Team Leader		Johnson	Shannon		4014592252				4014595668	shannon.johnson@bcbsri.org	500 Exchange St.		Providence	RI	02903	05/27/2025	2026	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	Complaints Tracking Contact	Team Leader		Johnson	Shannon		4014592252				4014595668	shannon.johnson@bcbsri.org	500 Exchange St.		Providence	RI	02903	05/27/2025	2026	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	Contact for Fraud Investigations	Director, Special Investigations Unit		Casilli	Brian		4014591727				4014591648	brian.casilli@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Mgr Project & Program Management		Bhesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/12/2025	2026	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	Corporate Mailing						4014592100					regan.pennypacker@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/31/2025	2026	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		4014591721				4014595089	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	DIR Contact	Sr. Health Data Analyst		Simas	Heather		4014595286				4014591754	heather.simas@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	DIR Contact (Secondary)	Director, Actuarial Services		Eynatian	Chris		4014591741					chris.eynatian@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Discount Program Payment Contact	Team Leader Treasury Ops		Gulino	Samuel		4014595968					samuel.gulino@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Emergency Part D Contact	Director Pharmacy Operations		Sifakis	Gina		4017418686					gina.sifakis@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Emergency Part D Contact (Secondary)	Lead Medicare Part D Auditor		Higgins	Aimee		4016168583				4014591754	aimee.higgins@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Government Programs Revenue Officer		Rangarajan	Kiran		4014595247					kiran.rangarajan@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Enrollment Contact	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721					Ivona.Wisniewski@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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	EOB Transfer Contact	Mgr Project & Program Management		Bhesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	Financial Audit Contact	VP & Chief Actuary	Mr.	Mackintosh	Brian		4014591700					brian.mackintosh@bcbsri.org	500 Exchange Street		Providence	RI	02903	09/24/2025	2026	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	Financial Reporting Contact	Manager, Financial Operations		Bettencourt	Mike		4014595932				4014591875	mike.bettencourt@BCBSRI.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Formulary Contact	Director, Pharmacy Performance		Dunn	David		4014591409				4014591754	david.dunn@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/07/2025	2026	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	General Contact	Medicare Compliance Officer	Ms.	Pennypacker	Regan		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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		4014591103					christina.pitney@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	HIPAA Privacy Officer	SVP and General Counsel		McLean	Kristen		4014591383					kristen.mclean@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	HIPAA Security Officer	Managing Director of Information Security		Webster	Fred		4014595728					fred.webster@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Lead, Outsourced Medicare Operations		Storti	Jane		4018378818					jane.storti@bcbsri.org	500 Exchange St.		Providence	RI	02903	08/08/2024	2026	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	Interoperability Contact	Director, Enterprise Analytics		Pant	Lokesh		6123003095					lokesh.pant@bcbsri.org	500 Exchange St.		Providence	RI	02903	08/08/2024	2026	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	MA Appeals/Grievances Contact	Team Leader		Johnson	Shannon		4014592252				4014595668	shannon.johnson@bcbsri.org	500 Exchange St.		Providence	RI	02903	05/27/2025	2026	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	MA Claims Processing Contact for Public Website	Manager Claims Operations		DeLuca	Melissa		4012153989					Melissa.DeLuca@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/20/2025	2026	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	Marketing Contact	Managing Director, Marketing & Communications		Battista	Stephanie		4014592595					stephanie.battista@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/13/2025	2026	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	Medical Director	Senior Medical Director	Dr.	Pinkes	Victor		4014592054					victor.pinkes@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/13/2024	2026	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		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Coordinator	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Part D Opioid Overutilization Contact	Supervisor Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	11/26/2024	2026	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	Medication Therapy Management Contact	Director Pharmacy Performance		Dunn	David		4014591409				4014591754	David.Dunn@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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	OffShore Subcontractor Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690				4014591598	elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Online Enrollment Center Contact (Back-up)	Lead, Outsourced Medicare Operations		Storti	Jane		4014595588				4014595649	jane.storti@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Online Enrollment Center Contact (Primary)	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721				4014595649	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 C Application Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 C Reporting Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690					elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/12/2025	2026	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 Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8006936651				PPO - BBA		C	Boston
H3557	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/12/2025	2026	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	8006936651				PPO - BBA		C	Boston
H3557	Part D Application Contact	Managing Director, Medicare Product		Marfeo	Jessica		4014592321				4014591754	Jessica.Marfeo@bcbsri.org	500 Exchange Street		Providence	RI	02903	02/10/2025	2026	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 Benefits Contact	Senior Director Benefits Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	Prime Therapeutics	1440 Northland Drive	Mendota Heights	MN	55120	03/12/2025	2026	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 Claims Submission Contact	Functional Business Consultant- Government Program		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	08/08/2024	2026	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 Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8006936651				PPO - BBA		C	Boston
H3557	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8006936651				PPO - BBA		C	Boston
H3557	Part D Price File Contact (Back-up)	Price File Analyst Sr.		Trudeau	Ashley		6127771338					ashley.trudeau@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	08/08/2024	2026	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 Price File Contact (Optional)	Network Pricing Data Analyst		Tastad	Emily		6518085779					emily.tastad@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Rd	Eagan	MN	55121	08/08/2024	2026	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 Price File Contact (Primary)	Director Pharmacy Performance		Dunn	David		4014591409					david.dunn@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Quality Assurance Contact	Lead Medicare Part D Auditor		Higgins	Aimee		4014595555					aimee.higgins@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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 Reporting Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690					elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Patient Safety Contact	Director Pharmacy Performance		Dunn	David		4014591409				4014591754	david.dunn@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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	Payment Contact	Sr. Financial Analyst		Souza	Cheryl		4014592749					cheryl.souza@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/10/2025	2026	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 Director	Director Pharmacy Operations		Sifakis	Gina		4014595704					gina.sifakis@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Network Management Contact	VP, Network Management		Conlin	Marci		6127772842				8778236373	Marci.Conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	08/08/2024	2026	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 Network Management Contact (Secondary)	Senior Director Network Client Services		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	08/08/2024	2026	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	Sr Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8554571207				PPO - BBA		C	Boston
H3557	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8554571207				PPO - BBA		C	Boston
H3557	Plan Directory Contact for Public Website	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721					Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Health Data Analyst		Simas	Heather		4014595286				4014591198	heather.simas@bcbsri.org	PO Box 1057		Providence	RI	02901	08/08/2024	2026	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	Processor Contact	Director PBM Operations		Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	08/08/2024	2026	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	Quality Contact	Director, Quality and Stars		Mitchell	Catherine		4014592644					Catherine.Mitchell@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Reconciliation Contact	Sr. Health Data Analyst		Simas	Heather		4014595286				4014591754	heather.simas@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Reconciliation Contact (Secondary)	Director, Actuarial Services		Eynatian	Chris		4014591741					chris.eynatian@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Recovery Audit Contact	SVP Government Programs	Ms.	Pitney	Christina		4014591103				4014591598	christina.pitney@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	SNP Application Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	SNP State Contact	Managing Director Duals		Moran	Leanna		4014591331					leanna.moran@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Surveillance Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	System Contact	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721				4014595649	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Third Party Administrator (TPA) Liaison	Sr. Health Data Analyst		Simas	Heather		4014595286					heather.simas@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	User Access Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690				4014591598	elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Utilization Management Contact	Managing Director Utilization Management		Labbe	Karen		4014591796				4014595072	Karen.Labbe@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Utilization Review Contact	Managing Director Utilization Management		Labbe	Karen		4014591796				4014595072	Karen.Labbe@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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
H3560	Part C Application Contact			Wu	Dorothy		7637323917					dorothywu@optum.com	1 Penn Plaza, 8th Floor		New York	NY	10119	11/03/2025	2026	LUCIDA HEALTH LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H3560	Part D Application Contact			Wu	Dorothy		7637323917					dorothywu@optum.com	1 Penn Plaza, 8th Floor		New York	NY	10119	11/03/2025	2026	LUCIDA HEALTH LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H3561	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Medical Director	Chief Medical Officer	Dr.	Chen	Alex		8186766564					alex.y.chen@healthnet.com	21281 Burbank Blvd		Woodland Hills	CA	91367	03/30/2021	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H3561	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H3561	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H3561	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H3561	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H3561	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H3561	PHR Beneficiary Contact																	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H3561	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/31/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3561	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET COMMUNITY SOLUTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H3563	Automated TrOOP Balance Transfer Contact	QI and Compliance Director	Ms.	Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	Backup User Access Contact	Executive Director		Smith	Renata		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	02/21/2025	2026	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		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	02/21/2025	2026	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	Bid Primary Contact	Executive Director		Smith	Renata		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	02/21/2025	2026	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	CAP Report Contact for Public Website	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	CEO - CMS Administrator Contact	President and CEO	Mr.	Lash	Timothy	A	7602802230					tlash@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	CEO - Senior Official for Contracting	President and CEO	Mr.	Lash	Timothy	A	7602802230					tlash@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	Business and Finance Director and CFO	Mr.	Meyer	Patricia		7605188274					pmeyer@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	01/03/2025	2026	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 Operating Officer	Executive Director and COO	Ms.	Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	01/03/2025	2026	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 Information Officer		Mr.	McBride	David		7606025789					dwmcbride@westdevllc.com	5800 Armada Dr.	Suite 100	Carlsbad	CA	92008	10/02/2019	2026	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 Information Security Officer		Mr.	McBride	David		7606025789					dwmcbride@westdevllc.com	5796 Armada Drive	Suite 300	Carlsbad	CA	92008	12/19/2018	2026	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		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	Complaints Tracking Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	Contact for Fraud Investigations	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	QI and Compliance Director	Mrs.	Kannan	Kannamma		7602802230					kkannan@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	03/15/2023	2026	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	Corporate Mailing						7602802230					kkannan@westpace.org	1706 Descanso Avenue		San Marcos	CA	92078	10/02/2019	2026	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		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	02/21/2025	2026	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	DIR Contact	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	01/03/2025	2026	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	DIR Contact (Secondary)	QI and Compliance Director		Kannan	Kannamma		7602802230					kkannan@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	01/10/2025	2026	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	Discount Program Payment Contact	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/03/2025	2026	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	Emergency Part D Contact	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	02/21/2025	2026	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	Emergency Part D Contact (Secondary)	QI and Compliance Director	Mrs.	Kannan	Kannamma		7602802230					kkannan@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	03/15/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/18/2019	2026	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	Enrollment Contact	Community Engagement Director		Jurgensen	Mary		7602802236					mjurgensen@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	01/03/2025	2026	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	EOB Transfer Contact	Executive Director		Smith	RENATA		7602802230				7602802277	rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	Financial Audit Contact	Business and Finance Director	Ms	Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/03/2025	2026	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	Financial Reporting Contact	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/03/2025	2026	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	Formulary Contact	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	05/23/2025	2026	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	Formulary Contact (Secondary)	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/02/2019	2026	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	General Contact	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	HIPAA Privacy Officer	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	HIPAA Security Officer	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	Interoperability Contact	QI and Compliance Director		Kannan	Kannamma		7602802230					kkannan@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	03/15/2023	2026	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	MA Appeals/Grievances Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	MA Claims Processing Contact for Public Website	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	Marketing Contact	Community Engagement Director		Jurgensen	Mary		7602802236					mjurgensen@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/03/2025	2026	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	Medical Director	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	05/23/2025	2026	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		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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 Coordinator	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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 Part D Opioid Overutilization Contact	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	Descanso Ave		San Marcos	CA	92078	05/23/2025	2026	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	Medication Therapy Management Contact	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	05/23/2025	2026	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	Online Enrollment Center Contact (Optional)	Community Engagement Director		Jurgensen	Mary		7602802236					mjurgensen@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/03/2025	2026	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	Online Enrollment Center Contact (Primary)	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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 C Application Contact	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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 Appeals	QI and Compliance Director		Kannan	Kannamma							kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	8009207098				PACE - Nat		C	San Francisco
H3563	Part D Appeals Contact (Secondary)	Business and Finance Director		Meyer	Patricia							pameyer@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	01/03/2025	2026	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	7605188274				PACE - Nat		C	San Francisco
H3563	Part D Application Contact	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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 Benefits Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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 Claims Submission Contact	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	05/23/2025	2026	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	Interim Medical Director	Dr.	Palencia	Don							dpalencia@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	05/23/2025	2026	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	8009207098				PACE - Nat		C	San Francisco
H3563	Part D Exceptions Contact (Secondary)	QI and Compliance Director		Kannan	Kannamma							kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	8009207098				PACE - Nat		C	San Francisco
H3563	Part D Price File Contact (Back-up)	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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 Price File Contact (Primary)	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/03/2025	2026	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 Quality Assurance Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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 Reporting Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	Patient Safety Contact	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	Payment Contact	Business and Finance Director	Mrs.	Meyer	Patricia		7602802230					pameyer@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/10/2025	2026	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 Director	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	Descanso Ave		San Marcos	CA	92078	05/23/2025	2026	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 Network Management Contact	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	Descanso Ave		San Marcos	CA	92078	05/23/2025	2026	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 Network Management Contact (Secondary)	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	Interim Medical director	Dr.	Palencia	Don							dpalencia@westpace.org	Descanso Ave		San Marcos	CA	92078	05/23/2025	2026	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	8009207098				PACE - Nat		C	San Francisco
H3563	Pharmacy Technical Help Desk Contact (Secondary)	Executive Director		Smith	RENATA							rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	8009207098				PACE - Nat		C	San Francisco
H3563	Plan Directory Contact for Public Website	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	Plan to Plan Reconciliation Contact	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	01/03/2025	2026	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	Processor Contact	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92708	10/01/2019	2026	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	Quality Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	Reconciliation Contact	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	01/03/2025	2026	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	Reconciliation Contact (Secondary)	QI and Compliance Director		Kannan	Kannamma		7602802230					kkannan@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	01/10/2025	2026	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	Recovery Audit Contact	QI and Compliance Director	Mrs	Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	Surveillance Contact	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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	System Contact	QI and Compliance Director		Kannan	Kannamma		7602802232					kkannan@westpace.org	1706 Descanso Ave		San Marcos	CA	92078	10/01/2019	2026	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	Third Party Administrator (TPA) Liaison	Business and Finance Director		Meyer	Patricia		7605188274					pameyer@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	01/03/2025	2026	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	User Access Contact	QI and Compliance Director	Mrs.	Kannan	Kannamma		7602802230					kkannan@westpace.org	1706 DESCANSO AVE		San Marcos	CA	92078	03/15/2023	2026	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	Utilization Management Contact	Interim Medical Director	Dr.	Palencia	Don		7602802230					dpalencia@westpace.org	Descanso Ave		San Marcos	CA	92078	05/23/2025	2026	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	Utilization Review Contact	Executive Director		Smith	RENATA		7602802230					rsmith@westpace.org	1706 Descanso Ave.		San Marcos	CA	92078	04/12/2022	2026	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
H3595	Automated TrOOP Balance Transfer Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Backup User Access Contact	Director of Information Technology		Stark	Clifford		5308138050					cstark@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Best Available Evidence Contact	Director of Communications		Valdez	Rocio		5307513761					rvaldez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Bid Primary Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	CAP Report Contact for Public Website	Director of Communications		Valdez	Rocio		5307513761					rvaldez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	CEO - CMS Administrator Contact	Chief Senior Care Officer	Ms.	Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	CEO - Senior Official for Contracting	Chief Senior Care Officer	Ms.	Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Chief Financial Officer	Chief Senior Care Officer	Ms.	Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Chief Operating Officer	Chief Operating Officer	Mr.	Peralta	Carlos		5307513726					cperalta@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Chief Information Officer	Director of Information Technology	Mr.	Stark	Clifford		5308138050					cstark@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Chief Information Security Officer	Director of Information Technology	Mr.	Stark	Clifford		5308138050					cstark@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	CMS Casework Communication Contact	Director of Patient Support Services		Manriquez	Catharin		5307494137					cmanriquez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Complaints Tracking Contact	Director of Patient Support Services		Manriquez	Catharin		5307494137					cmanriquez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Contact for Fraud Investigations	Corporate Compliance Officer		Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Coordination of Benefits Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Corporate Mailing						5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Customer Service Operations Contact	Director of Communications		Valdez	Rocio		5307513761					rvaldez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	DIR Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	DIR Contact (Secondary)	Chief Senior Care Officer	Ms.	Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Discount Program Payment Contact	Chief Senior Care Officer	Ms.	Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Emergency Part D Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Emergency Part D Contact (Secondary)	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Encounter Data & Risk Adjustment Operations Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Enrollment Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	EOB Transfer Contact	Chief Senior Care Officer		Walker	Kathy		5307513736				5305323401	kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Financial Audit Contact	Chief Financial Officer	Ms.	Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Financial Reporting Contact	Chief Financial Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Formulary Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Formulary Contact (Secondary)	Chief Senior Care Officer		Dunlop	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street	935 Market Street	Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	General Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Government Relations Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	HIPAA Privacy Officer	Corporate Compliance Officer		Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	HIPAA Security Officer	Corporate Compliance Officer		Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Interoperability Contact	Director of Information Technology	Mr.	Stark	Clifford		5308138050					cstark@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	MA Appeals/Grievances Contact	Corporate Compliance Officer		Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	MA Claims Processing Contact for Public Website	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Marketing Contact	Director of Communications		Valdez	Rocio		5307513761					rvaldez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Medical Director	Chief Medical Officer		Ammar	Mustafa		5306744261					mammar@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Medicare Compliance Officer	Corporate Compliance Officer	Mr.	Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Medicare Coordinator	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Medication Therapy Management Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	OffShore Subcontractor Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Online Enrollment Center Contact (Back-up)	Director of Communications		Valdez	Rocio		5307513761					rvaldez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Online Enrollment Center Contact (Optional)	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Online Enrollment Center Contact (Primary)	Director of Communications		Valdez	Rocio		5307513761					rvaldez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part C Application Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Appeals	Director of Pharmacy		Dunlop	Deven							ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending	5304347140				PACE - Nat		C	San Francisco
H3595	Part D Appeals Contact (Secondary)	Chief Senior Care Officer		Walker	Kathy							kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending	5307513736				PACE - Nat		C	San Francisco
H3595	Part D Application Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Benefits Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Claims Submission Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Exceptions Contact	Director of Pharmacy		Dunlop	Deven							ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending	8663589791				PACE - Nat		C	San Francisco
H3595	Part D Exceptions Contact (Secondary)	Chief Senior Care Officer		Walker	Kathy							kwalker@amplahealth.org	935 Market Street	935 Market Street	Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending	8663589791				PACE - Nat		C	San Francisco
H3595	Part D Price File Contact (Back-up)	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Price File Contact (Optional)	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Price File Contact (Primary)	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Quality Assurance Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Part D Reporting Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Patient Safety Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Payment Contact	Chief Financial Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Personal Health Record Contact	Director of Information Technology		Stark	Clifford		5308138050					cstark@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Pharmacy Director	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Pharmacy Network Management Contact	Director of Pharmacy		Dunlop	Deven		5304347140					ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Pharmacy Network Management Contact (Secondary)	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Pharmacy Technical Help Desk Contact	Director of Pharmacy		Dunlop	Deven							ddunlop@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending	8663589791				PACE - Nat		C	San Francisco
H3595	Pharmacy Technical Help Desk Contact (Secondary)	Chief Senior Care Officer		Walker	Kathy							kwalker@amplahealth.org	935 Market Street	935 Market Street	Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending	8663589791				PACE - Nat		C	San Francisco
H3595	PHR Beneficiary Contact																	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE	Ampla Health PACE	Ampla Health	889	Yes	Pending	8663589791				PACE - Nat		C	San Francisco
H3595	Plan Directory Contact for Public Website	Director of Communications		Valdez	Rocio		5307513761					rvaldez@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Plan to Plan Reconciliation Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Processor Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Quality Contact	Director of Quality	Mr.	Mann	Bimal		5307494191					bmann@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Reconciliation Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Reconciliation Contact (Secondary)	Corporate Compliance Officer		Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Recovery Audit Contact	Corporate Compliance Officer	Mr.	Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Surveillance Contact	Corporate Compliance Officer		Jhikka	Harjit		5306744261					hjhikka@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	System Contact	Director of Information Technology		Stark	Clifford		5308138050					cstark@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Third Party Administrator (TPA) Liaison	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	User Access Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Utilization Management Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3595	Utilization Review Contact	Chief Senior Care Officer		Walker	Kathy		5307513736					kwalker@amplahealth.org	935 Market Street		Yuba City	CA	95991	09/18/2025	2026	AMPLA HEALTH	National PACE	Ampla Health PACE	National PACE		Ampla Health	889	Yes	Pending					PACE - Nat		C	San Francisco
H3597	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3597	PHR Beneficiary Contact																	04/23/2012	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H3597	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3597	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (ME)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3613	Automated TrOOP Balance Transfer Contact	Director of Health Plan Management	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Dr		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Backup User Access Contact	CEO	Ms.	Conn	Ann		2168518200	2050				ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/18/2022	2026	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 Health Plan Management	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Dr		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Bid Primary Contact	CFO	Ms.	Hayes	Jennifer	L	2162688670					jennifer.hayes@mcgregoramasa.org	14900 Private Dr		Cleveland	OH	44112	06/03/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	CAP Report Contact for Public Website	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	11/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	CEO - CMS Administrator Contact	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	11/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	CEO - Senior Official for Contracting	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	08/13/2020	2026	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	2168518200	2010				jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	08/09/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Chief Operating Officer	CSO	Ms.	Dicesare	Svetlana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	03/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Chief Information Officer	CFO	Ms.	Hayes	Jennifer	L	2168518200	2010				jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	08/09/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Chief Information Security Officer	CSO	Ms.	DiCesare	Svetlana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/18/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	CMS Casework Communication Contact	CSO	Ms.	DiCesare	Svetlana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	12/04/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Complaints Tracking Contact		Ms.	DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Contact for Fraud Investigations	Compliance Officer	Ms.	Bentley	Leah		2162688402					Leah.Bentley@mcgregoramasa.org	26310 Emery Rd		Cleveland	OH	44128	01/10/2023	2026	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 Health Plan Management	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Corporate Mailing						2167913580					tangi.mccoy@mcgregorctr.org	23610 Emery Road		Warrensville Heights	OH	44128	11/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Customer Service Operations Contact	Clinical Services Officer	Ms.	DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	DIR Contact	CFO	Ms.	Hayes	Jennifer		2162688670	2048			2168516634	jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	06/03/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	DIR Contact (Secondary)	CEO	Ms.	Conn	Ann		2168518200	2050				ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Discount Program Payment Contact	CFO	Ms.	Hayes	Jennifer		2162688670				2168516634	jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	01/22/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Emergency Part D Contact	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Emergency Part D Contact (Secondary)	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	11/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Encounter Data & Risk Adjustment Operations Contact	Director of Health Plan Management	Ms.	Harden	Lesley		2162730881	2048				lesley.harden@mcgregorctr.org	14900 Private Dr		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Enrollment Contact	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	EOB Transfer Contact	Director of Health Plan Management	Ms.	Harden	Lesley		2162730881				2168516634	lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Financial Audit Contact	CFO	Ms.	Hayes	Jennifer		2162688670					jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	12/05/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Financial Reporting Contact	CFO	Ms.	Hayes	Jennifer		2162688670					jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	12/05/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Formulary Contact	CCO	Ms.	Bentley	Leah		2168518200	2048				leah.bentley@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	12/05/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Formulary Contact (Secondary)	Clinical Services Officer		DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Rd		Cleveland	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	General Contact	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/18/2022	2026	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		2168518200	2050				ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/18/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	HIPAA Privacy Officer	CCO	Ms.	Bentley	Leah		2162688402					leah.bentley@mcgregoramasa.org	14900 Private Dr		Cleveland	OH	44112	06/03/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	HIPAA Security Officer	CCO	Ms.	Bentley	Leah		2162688402					leah.bentley@mcgregoramasa.org	14900 Private Dr		Cleveland	OH	44112	06/03/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Interoperability Contact	CSO	Ms.	Dicesare	Svetlana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/18/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	MA Appeals/Grievances Contact	Clinical Services Officer	Ms.	DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	MA Claims Processing Contact for Public Website	CEO	Ms.	Conn	Ann		2168518200	2050			2168516634	ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Marketing Contact	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Medical Director	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	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.	Bentley	Leah		2162688402					Leah.Bentley@mcgregoramasa.org	26310 Emery Rd		Cleveland	OH	44128	01/10/2023	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Medicare Coordinator	Clinical Services Director	Ms.	DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Medicare Part D Opioid Overutilization Contact	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Medication Therapy Management Contact	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Online Enrollment Center Contact (Back-up)	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	11/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part C Application Contact	CEO	Ms.	Conn	Ann		2168518200	2050			2168516634	ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/18/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part D Appeals	Clinical Services Officer	Ms.	DiCesare	Lana							lana.dicesare@mcgregorctr.org	26310 Emery Rd		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active	2167913580				PACE - Nat		C	Chicago
H3613	Part D Appeals Contact (Secondary)	Dir. of Health Plan Operations	Ms.	Harden	Lesley							lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	12/09/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active	2162730881				PACE - Nat		C	Chicago
H3613	Part D Application Contact	CEO	Ms.	Conn	Ann		2168518200	2050			2168516634	ann.conn@mcgregoramasa.org	14900 Private Dr.		Cleveland	OH	44112	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part D Benefits Contact	Director of Health Plan Management	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part D Claims Submission Contact	Director of Health Plan Management	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	03/11/2025	2026	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 Health Plan Management	Ms.	Harden	Lesley							lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active	2162730881				PACE - Nat		C	Chicago
H3613	Part D Exceptions Contact (Secondary)	CEO	Ms.	Conn	Ann							ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active	2168518200	2050			PACE - Nat		C	Chicago
H3613	Part D Price File Contact (Back-up)	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	11/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part D Price File Contact (Primary)	Director of Health Plan Management	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	03/11/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part D Quality Assurance Contact	Clinical Services Officer	Ms.	DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Part D Reporting Contact	Director of Health Plan Operations	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	06/03/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Patient Safety Contact	Clinical Services Officer	Ms.	DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Payment Contact	CFO	Ms.	Hayes	Jennifer		2162688670					jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	12/05/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Pharmacy Director	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Pharmacy Network Management Contact	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	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	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active	2167913580				PACE - Nat		C	Chicago
H3613	Plan Directory Contact for Public Website	CEO	Ms.	McCoy	Tangi		2167913580					tangi.mccoy@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	11/05/2021	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Plan to Plan Reconciliation Contact	CCO	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	06/03/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Processor Contact	Dir. of Health Plan Operations	Ms.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive		Cleveland	OH	44112	12/09/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Quality Contact	Clinical Services Director	Ms.	DiCesare	Lana		2167913580					lana.dicesare@mcgregorctr.org	26310 Emery Road		Warrensville Heights	OH	44128	09/24/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Reconciliation Contact	CFO	Ms.	Hayes	Jennifer		2162688670				2168516634	jennifer.hayes@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	12/05/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Recovery Audit Contact	CEO	Ms.	Conn	Ann		2168518200	2050			2168516634	ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Surveillance Contact	CEO	Ms.	Conn	Ann		2162688680					Ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	09/08/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	System Contact	CEO	Ms.	Conn	Ann		2168518200	2050			2168516634	ann.conn@mcgregoramasa.org	14900 Private Drive		Cleveland	OH	44112	02/15/2022	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Third Party Administrator (TPA) Liaison	Director of Health Plan Operations	Mrs.	Harden	Lesley		2162730881					lesley.harden@mcgregorctr.org	14900 Private Drive	See attached order form	Cleveland	OH	44112	09/30/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	User Access Contact	CCO		Bentley	Leah		2162688402					leah.bentley@mcgregoramasa.org	14900 Private Dr		Cleveland	OH	44112	06/03/2025	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Utilization Management Contact	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3613	Utilization Review Contact	Medical Director		Balina	Cynthia		2162054000					cynthia.balina@mcgregorctr.org	7570 Northcliff Ave		Brooklyn	OH	44144	02/23/2024	2026	MCGREGOR PACE	National PACE	McGregor PACE	National PACE		McGregor at Overlook	450	Yes	Active					PACE - Nat		C	Chicago
H3653	Agent/Broker Compensation Data Contact	Dir, Administrative Expense Management		Fiala	Ladimir		2166877820					ladimir.fiala@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Automated TrOOP Balance Transfer Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Backup User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Best Available Evidence Contact	Medicare Operations Analyst II		Crowley	Lauren		2166876585					BAEdocs@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Bid Audit Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Bid Audit Site Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Bid Primary Contact	Lead Medicare Products Analyst		Kotecki	Bradley		2166872762					bradley.kotecki@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	CAP Report Contact for Public Website	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	CEO - CMS Administrator Contact	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	CEO - Senior Official for Contracting	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Chief Financial Officer	VP, Chief Financial Officer	Mr.	McNutt	Jim		2166877006					james.mcnutt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Chief Operating Officer	EVP, President of Paramount Health	Ms.	Johnston	Lori		2166877000					lori.johnston@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Chief Information Officer	Chief Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Chief Information Security Officer	Chief Data & Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	CMS Casework Communication Contact	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Complaints Tracking Contact	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Contact for Fraud Investigations	Manager, Financial Investigations		Jorz	Nicholas		2166877433					nicholas.jorz@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Coordination of Benefits Contact	Manager, COB and Workers Comp		Njaim	Stephanie		4194737733					Stephanie.Njaim@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Corporate Mailing						2166877000					macompliance@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Customer Service Operations Contact	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	DIR Contact	Mgr, Financial Reporting		Spruch	Kevin		2166872759					kevin.spruch@medmutual.com	100 American Road		Cleveland	OH	44144	07/01/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	DIR Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Discount Program Payment Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					michelle.stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Electronic Health Record Contact	Manager, Compliance		Dean	Herbert		2166877000					herbert.dean@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Emergency Part D Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Emergency Part D Contact (Secondary)	Mgr, Medicare Pharmacy Operations		Lamento	Angela		2166877917					angela.lamento@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Employer Waiver Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Encounter Data & Risk Adjustment Operations Contact	Dir, Risk Adjutment Program		Curry	Deborah		4198872215					deborah.curry@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Enrollment Contact	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	EOB Transfer Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344				2166877675	katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Financial Audit Contact	Lead Financial Analyst	Ms.	Lohrke	Maureen		2162933190					maureen.lohrke@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Financial Reporting Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					cory.hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Formulary Contact	Clinical Pharmacist		Ivec	Carl		2166876017					Carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Formulary Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katherine		2166877344					Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	General Contact	Medicare Compliance Officer		Beadle	Nicole		3976812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Government Relations Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	HIPAA Privacy Officer	Chief Compliance and Privacy Officer		Fichter	Lynn		2166872617					Lynn.Fichter@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	HIPAA Security Officer	EVP, Chief Data and Information Officer		Donovan	Chris		4408786450					Chris.Donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Hospice Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Interoperability Contact	Manager, EDI Compliance		Huebler	Kathleen		4408785420					kathleen.huebler@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	MA Appeals/Grievances Contact	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	MA Claims Processing Contact for Public Website	Director, Claims Operations		Rittner	Kim		2166874377					kim.rittner@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Marketing Contact	Director, Acquisition Marketing Govermnt Prgms		Schultz	Melissa		2166877000					Melissa.Schultz@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Medical Director	VP, Sr. Medical Officer	Dr.	Bialecki-Haase	Dee		2166877000					dee.bialeckihaase@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Beadle	Nicole		2166877830					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Medicare Coordinator	Lead Compliance Analyst		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44115	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Medicare Part D Opioid Overutilization Contact	Pharmacist		Hall	Sarah		3306479145					sarah.hall@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Medication Therapy Management Contact	Clinical Pharmacist		Ivec	Carl		2166876017					carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	OffShore Subcontractor Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Online Enrollment Center Contact (Back-up)	Manager, Member Services & System Administration		Bartholomai	Diane		2166877357					Diane.Bartholomai@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Online Enrollment Center Contact (Optional)	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Online Enrollment Center Contact (Primary)	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part C Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part C Reporting Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Appeals	Dir, Pharmacy - Medicare and Information		Goff	Katie							katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Appeals Contact (Secondary)	Dir, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Benefits Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Claims Submission Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877830					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Exceptions Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie							katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Exceptions Contact (Secondary)	Mgr, Medicare Pharmacy Operations		Lamento	Angela							angela.lamento@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877917				HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Price File Contact (Back-up)	Senior Consultant, Finance Med D		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd	MC121	Scottsdale	AZ	85260	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Price File Contact (Optional)	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877830				2166872623	katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Price File Contact (Primary)	Senior Manager, Regulatory Reporting		Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	9501 E. Shea Blvd	MC121	Scottsdale	AZ	85260	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Quality Assurance Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Part D Reporting Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Patient Safety Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Payment Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					Cory.Hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Personal Health Record Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Pharmacy Director	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Pharmacy Network Management Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					lisa.trost@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Pharmacy Network Management Contact (Secondary)	Mgr, Medicare Pharmacy Operations		Lamento	Angela		2166877917					angela.lamento@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Rodriguez	Alex							alex.rodriguez@cvs.health	2401 Cherahala Blvd		Knoxville	TN	37932	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H3653	Pharmacy Technical Help Desk Contact (Secondary)	Dir, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				HMO - Health Maintenance Organization		C	Chicago
H3653	Physician Incentive Contact	Mgr, Clinical QUality Improvement		Brooks	Melissa		4408784163					melissa.brooks@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Plan Directory Contact for Public Website	Provider and Claims Operations AVP		Curtland	Tanya		4194731631					tanya.curtland@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Plan to Plan Reconciliation Contact	PAR - Financial Analyst III		Short	Nicole		4193498621					Nicole.Short@medmutual.com	100 American Road		Cleveland	OH	44144	11/03/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Processor Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Quality Contact	Mgr, Clinical QUality Improvement		Hoskins	Julie		4198872940					julie.hoskins@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Reconciliation Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Reconciliation Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Recovery Audit Contact	VP, Health Plan Payment Integrity	Mr.	Palace	Ted		2166872807					Ted.Palace@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Surveillance Contact	Director, Individual Sales and Compliance		Coyne	Jaime		2166872676					MASalesCompliance@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	System Contact	VP, Chief Technology Officer		Stein	Matt		4408786460					matt.stein@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Third Party Administrator (TPA) Liaison	PAR - Financial Analyst III		Short	Nicole		4193498621					Nicole.Short@medmutual.com	100 American Road		Cleveland	OH	44144	11/03/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Utilization Management Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3653	Utilization Review Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT CARE, INC.	Local CCP	Paramount Elite Medicare Plans	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3655	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3655	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3655	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H3655	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H3655	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/29/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3655	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H3655	PHR Beneficiary Contact																	11/05/2015	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H3655	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Relations		Kinaitis	Tracie		3309965207	65207			3309968454	kinaitist@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	03/12/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Automated TrOOP Balance Transfer Contact	Program Manager II	Ms	Cuevas	Lauren		8587907031				8587906052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/12/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Backup User Access Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy		3309968228				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	03/11/2024	2026	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		Elrod	Hayley		3309968401				3309968953	enrollmentrecon@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	12/02/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Bid Audit Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/16/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Bid Primary Contact	Manager, Financial Analysis		Werstler	Julie		3309968716					werstlerj@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	CAP Report Contact for Public Website	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	4409152569				HMO - Health Maintenance Organization		C	Chicago
H3660	CEO - CMS Administrator Contact	President	Mr.	Epling	William	C	3309968808				3309968454	eplingw@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	CEO - Senior Official for Contracting	President	Mr.	Epling	William	C	3309968808				3309968454	eplingw@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	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		3309968565				3309968454	fehlnera@summacare.com	1200 East Market Stree	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Chief Operating Officer	VP, Operations and Administration	Ms.	Rusk	Melissa		3306976906					ruskm@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	02/02/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Chief Information Officer	Senior VP, IT&S/CIO	Mr.	Locklear	Elbridge		2343126200					lockleare@summahealth.org	1077 Gorge Blvd		Akron	OH	44310	02/02/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Chief Information Security Officer	Chief Information Security Officer	Ms	West	Swathi		2344750137					westsw@summahealth.org	1077 Gorge Blvd		Akron	OH	44310	03/11/2024	2026	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		3309965605				3309968726	donnenwirtht@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	02/02/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Complaints Tracking Contact	Compliance Coordinator		Donnenwirth	Terry		3309965605				3309968726	donnenwirtht@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Contact for Fraud Investigations	Interim Chief Compliance Officer	Ms	Jones	Tracy		3309965605				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	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, Eligibility		Elrod	Hayley		3309968401				3309968953	enrollmentrecon@summacare.com	1200 East Market Street, Ste 400	P.O. Box 3620	Akron	OH	44305	12/02/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Corporate Mailing						3309968410				3309968454	www@summacare.com	SummaCare Inc.	P.O. Box 3620	Akron	OH	443093620	04/12/2006	2026	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	Vice President, Product Development		Armao	Anne		8009968411	62326			3309968454	armaoa@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	02/28/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	DIR Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	DIR Contact (Secondary)	Manager  Financial Planning and Operations		O'Neill	Mike		3309968565				3309968454	o'neillm@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	02/28/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Discount Program Payment Contact	Senior Accountant	Mr	Weals	Michael		3309965112					wealsm@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Emergency Part D Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Emergency Part D Contact (Secondary)	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Employer Waiver Contact	Vice President, Product Development		Armao	Anne		8009968411	62326			3309968454	armaoa@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Encounter Data & Risk Adjustment Operations Contact	Director, ACA Risk Adjustment	Mr	Alexsonshk	Rick		3309968676				3309968553	alexsonr@summacare.com	1200 East Main Street	Ste 400	Akron	OH	44305	03/11/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Enrollment Contact	Supervisor, Medicare eligibility		Domer	Megan		3309968928				3309968726	medicareeligbill@summacare.com	1200 East Market Street, Ste 400	P.O. Box 3620	Akron	OH	44305	12/02/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	EOB Transfer Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Financial Audit Contact	Manager, Internal Audit	Ms	Smith	Kimberly		3309965138				3309968454	smithk@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	02/29/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Financial Reporting Contact	Financial Accounting Analyst		Coyne	Eric		3309968298					coynee@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	07/12/2023	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Formulary Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Formulary Contact (Secondary)	Manager, Formulary Administration & Maintenance		Nyawabila	Christina		8587906297				8583572410	Christina.Nyawabila@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/29/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	General Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	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	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	HIPAA Privacy Officer	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	HIPAA Security Officer	Interim Chief Compliance Officer	Ms	Jones	Tracy		3309968228				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	03/11/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Hospice Contact	Director, Clinical Management		Potelicki	Jacquie		3309968481					potelickij@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Interoperability Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	MA Appeals/Grievances Contact	Director, Appeals and Grievances		Beck	Robert		3309968299				3309968545	beckr@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	MA Claims Processing Contact for Public Website	Director of Claims		Rusk	Melissa		3309968970				3309968977	ruskm@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Marketing Contact	Director, Payer Marketing		Richard	Lesley		3309968926				3309968866	richardla@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	02/28/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Medical Director	Chief Medical Officer	Dr.	Voll	Matt		3309968270					vollma@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	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	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/16/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Medicare Coordinator	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Medicare Part D Opioid Overutilization Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Medication Therapy Management Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Online Enrollment Center Contact (Back-up)	Compliance Coordinator		Donnenwirth	Terry		3309968828				3309968553	DonnewirthT@summacare.com	1200 East Market Street, Ste 400	P.O. Box 3620	Akron	OH	443093620	10/17/2018	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Online Enrollment Center Contact (Primary)	Supervisor, Medicare eligibility		Domer	Megan		3309968928				3309968726	medicareeligbill@summacare.com	1200 East Market Street, Ste 400	P.O. Box 3620	Akron	OH	44305	12/02/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part C Application Contact	Vice President, Product Development		Armao	Anne		8009968411	62326			3309968454	armaoa@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part C Reporting Contact	Compliance Officer		Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/19/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Appeals	Director, Appeals and Grievances		Beck	Robert						3309968545	beckr@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	8009966250				HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Appeals Contact (Secondary)			Tarle	Alexis						3309968580	tarlea@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	01/11/2021	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	8009966250				HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Application Contact	Vice President, Product Development		Armao	Anne		8009968411	62326			3309968454	armaoa@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Benefits Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Claims Submission Contact	VP Government Programs	Ms	Davis-Jones	DeLonga		8587907415				8587906529	MedicarePartDProjectManagers@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/12/2024	2026	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						8587906529	Don.grondin@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/12/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	8587906536				HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Exceptions Contact (Secondary)	Manager, PA Processing		Tjaden	Karen						8587906529	Karen.tjaden@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/12/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	8587906163				HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Price File Contact (Back-up)	Program Manager		Keller	Shanon		8587907104				8587906529	planfindercommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/12/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Price File Contact (Optional)	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Price File Contact (Primary)	Program Manager		Keller	Shanon		8587907104				8587906529	planfindercommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/12/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Quality Assurance Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Part D Reporting Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Patient Safety Contact	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Payment Contact	President	Mr.	Epling	William	C	3309968808				3309968454	eplingw@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Personal Health Record Contact	Director, Clinical Management		Potelicki	Jacquie		3309968481				3309968611	potelickij@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Pharmacy Director	Manager, Formulary and Pharmacy Benefits		Clavecilla	Kelly		3309968602				3309968580	clavecillak@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	11/24/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		8587907148				8587906011	Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/06/2013	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Pharmacy Network Management Contact (Secondary)	Pharmacy Relationship Manager		Hunt	Brian		8587907092				8587906529	Glen.tong@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/12/2024	2026	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, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/23/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active	8773911109				HMO - Health Maintenance Organization		C	Chicago
H3660	PHR Beneficiary Contact																	03/01/2007	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS	SummaCare	Summa Health	675	Yes	Active	3309968775				HMO - Health Maintenance Organization		C	Chicago
H3660	Plan Directory Contact for Public Website	Director of Contracting and Network Development	Mr	Stahler	Kurt		3309968972					stahlerk@summacare.com	1200 East Main Street	Ste 400	Akron	OH	44305	03/11/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Plan to Plan Reconciliation Contact	Financial Accounting Analyst		Coyne	Eric		3309968298					coynee@summacare.com	1200 East Market Street	Suite 400	Akron	OH	44305	07/12/2023	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Processor Contact	Senior Vice President,  Government Programs and Se		Helmus	Scott		8584373471				8587906529	Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/02/2025	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Quality Contact	Director, Quality		Sich	Julie		3309968779					sichj@summacare.com	1200 East Main Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Reconciliation Contact	Director, Risk Adjustment	Mr	Alexsonshk	Rick		3309968676				3309968553	alexsonr@summacare.com	1200 East Main Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Recovery Audit Contact	Director, ACA Risk Adjustment	Mr	Alexsonshk	Rick		3309968676				3309968553	alexsonr@summacare.com	1200 East Main Street	Ste 400	Akron	OH	44305	03/11/2024	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Surveillance Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	System Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Third Party Administrator (TPA) Liaison	Senior Accountant	Mr	Weals	Michael		3309965112					wealsm@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	User Access Contact	Interim Chief Compliance Officer	Ms	Jones	Tracy	L	4409152569				3309968726	jonestl@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/18/2022	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Utilization Management Contact	Director, Clinical Management		Potelicki	Jacquie		3309968481				3309968611	potelickij@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3660	Utilization Review Contact	Director, Clinical Management		Potelicki	Jacquie		3309968481				3309968611	potelickij@summacare.com	1200 East Market Street	Ste 400	Akron	OH	44305	08/03/2020	2026	SUMMACARE INC.	Local CCP	SummaCare Medicare Advantage Plans	HMO/HMOPOS		Summa Health	675	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Agent/Broker Compensation Data Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Automated TrOOP Balance Transfer Contact	Medicare Part D Supervisor		Schrock	Ranada		3303633132					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Backup User Access Contact	Sr Compliance Specialist		Perrenoud	Terri		3303633369				3303633066	tperrenoud@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	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		3303634149					lpalmer@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Bid Audit Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Bid Audit Site Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Bid Primary Contact	Medicare CEO		Scheetz	Michael		3302681983				3303637644	mscheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	02/21/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	CAP Report Contact for Public Website	Medicare CEO		Scheetz	Michael		3302681983					mscheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	02/21/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	CEO - CMS Administrator Contact	Medicare CEO	Mr.	Scheetz	Michael		3302681983					mscheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	02/21/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	CEO - Senior Official for Contracting	Medicare CEO	Mr.	Scheetz	Michael		3302681983					mscheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	02/21/2023	2026	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	Vice President, CFO	Mrs	Rapp	Melissa		3303634880				3304382911	melissa.rapp@aultman.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/31/2024	2026	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 Operating Officer		Mr.	Scheetz	Michael		3302681983					mscheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	03/05/2025	2026	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 Information Officer	VP Information Services	Mr	Fayyaz	Raza		3303634470					rfayyaz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	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 Information Security Officer	VP Information Services	Mr	Fayyaz	Raza		3303634470					rfayyaz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	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		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Complaints Tracking Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Contact for Fraud Investigations	FWA Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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		3303633132				3305806764	rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Corporate Mailing						3303637407				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	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		3303632206				3303637714	lbowling-shaffer@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	DIR Contact	Medicare Part D Supervisor		Schrock	Ranada		3303633132				3305806764	rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	DIR Contact (Secondary)	Sr Compliance Specialist		Sibley	Camille		3303632480				3303633066	csibley@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/14/2021	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Discount Program Payment Contact	Accounts Payable		Maglott	Mark		3303634034					mmaglott@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	11/15/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Emergency Part D Contact	Medicare Part D Supervisor		Schrock	Ranada		3308016051					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	12/27/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Emergency Part D Contact (Secondary)	Pharmacy Director		Harvey	Michael		3302125701					mharvey@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/14/2021	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Employer Waiver Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Encounter Data & Risk Adjustment Operations Contact	Medicare CEO		Scheetz	Michael		3302681983	34093				MScheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	02/21/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Enrollment Contact	Enrollment Coordinator		Palmer	Laura		3303634149				3305806764	lpalmer@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	EOB Transfer Contact	Medicare Part D Supervisor		Schrock	Ranada		3303633132				3305806764	rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Financial Audit Contact	Sr Compliance Specialist	Mrs	Sibley	Camille		3304012510				3303633066	csibley@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/26/2025	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Financial Reporting Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Formulary Contact	Clinical Pharmacist		Landis	Laura		3303274646					llandis@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/30/2025	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Formulary Contact (Secondary)	Medicare Part D Supervisor		Schrock	Ranada		3303633132					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	General Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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		3303633199				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	HIPAA Privacy Officer	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	HIPAA Security Officer	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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		3303633132				3305806764	rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Interoperability Contact	Medicare Compliance Officer		Lab	Kari		3309337662					klab@aultcare.com	2600 Sixth St. SW	Morrow House	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	MA Appeals/Grievances Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	MA Claims Processing Contact for Public Website	Claims Supervisor		Peters	Tara		3303637269					tpeters@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Marketing Contact	Compliance Specialist		Kellar	Amy		3304377169				3303633066	akellar@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	06/14/2021	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Medical Director	Medical Director	Dr.	Wymyslo	Edmund		3303634421					ewymyslo@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	06/05/2023	2026	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		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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 Coordinator	Compliance Officer	Mrs	Lab	Kari		3309337662					klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist		Landis	Laura		3303274646				3303633284	llandis@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/30/2025	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Medication Therapy Management Contact	Director of Pharmacy		Harvey	Michael		3302125701					mharvey@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/14/2021	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Online Enrollment Center Contact (Back-up)	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Online Enrollment Center Contact (Optional)	Sr Compliance Specialist		Perrenoud	Terri		3303633369					tperrenoud@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Online Enrollment Center Contact (Primary)	Enrollment Supervisor		Palmer	Laura		3303634149					lpalmer@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	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 C Application Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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 C Reporting Contact	Sr Compliance Specialist		Perrenoud	Terri		3303633369				3303633066	tperrenoud@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	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 Appeals	Compliance Officer		Lab	Kari						3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	8005775084				HMO - Health Maintenance Organization		C	Chicago
H3664	Part D Appeals Contact (Secondary)	Medicare Part D Supervisor		Schrock	Ranada						3305806407	rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	8005775084				HMO - Health Maintenance Organization		C	Chicago
H3664	Part D Application Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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 Benefits Contact	Medicare Part D Supervisor		Schrock	Ranada		3303633132					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	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 Claims Submission Contact	Medicare Part D Supervisor		Schrock	Ranada		3303633132					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	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	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	8005775084	2248			HMO - Health Maintenance Organization		C	Chicago
H3664	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Landis	Laura							llandis@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/16/2025	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	8005775084				HMO - Health Maintenance Organization		C	Chicago
H3664	Part D Price File Contact (Back-up)	Sr Compliance Specialist		Sibley	Camille		3303632480				3303633066	csibley@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/14/2021	2026	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 Price File Contact (Optional)			OptumRx	Optum Rx		6514955363					medops_planfinder@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/12/2022	2026	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 Price File Contact (Primary)	Medicare Part D Supervisor		Schrock	Ranada		3303633132					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	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 Quality Assurance Contact	Director of Pharmacy		Harvey	Michael		3302125701					mharvey@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/14/2021	2026	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 Reporting Contact	Sr Compliance Specialist		Sibley	Camille		3303632480					csibley@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/14/2021	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Patient Safety Contact	Clinical Pharmacist		Landis	Laura		3303274646					llandis@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/30/2025	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Payment Contact	Medicare CEO		Scheetz	Michael		3302681983				3303637644	mscheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	02/21/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Personal Health Record Contact	Compliance Officer		Lab	Kari		3309337662					klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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 Director	Director of Pharmacy		Harvey	Michael		3302125701					mharvey@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	10/14/2021	2026	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 Network Management Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	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 Network Management Contact (Secondary)	Medicare Part D Supervisor		Schrock	Ranada		3303633132					rschrock@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	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	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	8668682373				HMO - Health Maintenance Organization		C	Chicago
H3664	Pharmacy Technical Help Desk Contact (Secondary)	Director of Pharmacy		Harvey	Michael							mharvey@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	07/01/2022	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active	8668682373				HMO - Health Maintenance Organization		C	Chicago
H3664	PHR Beneficiary Contact																	01/20/2011	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS	PrimeTime Health Plan	Aultman Health Foundation	446	Yes	Active	8005775084				HMO - Health Maintenance Organization		C	Chicago
H3664	Physician Incentive Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Plan Directory Contact for Public Website	Customer Service Supervisor		Bowling-Shaffer	Lisa		3303637407					lbowling-shaffer@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Plan to Plan Reconciliation Contact	Reconciliation Analyst		David	Darrin		3307057988					ddavid@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Processor Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Quality Contact	AVP, Clinical Quality and Accreditation		Vojtush	Lisa		3303637407					LVojtush@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Reconciliation Contact	Medicare CEO		Scheetz	Michael		3302681983				3303637644	mscheetz@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	02/21/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Reconciliation Contact (Secondary)	Reconciliation Analyst		David	Darrin		3307057988					ddavid@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Recovery Audit Contact	Compliance Officer	Mrs	Lab	Kari		3303632022				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Surveillance Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	System Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Third Party Administrator (TPA) Liaison	Reconciliation Analyst		David	Darrin		3307057988					ddavid@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	09/24/2020	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	User Access Contact	Compliance Officer		Lab	Kari		3309337662				3303633066	klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Utilization Management Contact	Compliance Officer		Lab	Kari		3309337662					klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3664	Utilization Review Contact	Compliance Officer		Lab	Kari		3309337662					klab@aultcare.com	Morrow House	2600 Sixth Street SW	Canton	OH	44710	05/24/2023	2026	AULTCARE HEALTH INSURING CORPORATION	Local CCP	PrimeTime Health Plan	HMO/HMOPOS		Aultman Health Foundation	446	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Agent/Broker Compensation Data Contact	Director of Sales		Dues	Travis		6145463157				6145463131	Travis.Dues@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		6145463183				6145463131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Backup User Access Contact	Sr. Application Specialist		Crawford	Carl		6145463215				6145463144	ccrawford@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Bid Audit Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463211	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Bid Audit Site Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Bid Primary Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	CAP Report Contact for Public Website	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	CEO - CMS Administrator Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	Jack.Randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/06/2025	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	CEO - Senior Official for Contracting	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463211				6145463131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Chief Operating Officer	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Chief Information Officer	VP Service Optimization	Mr.	Trimmer	Matt		3017547190					matt.trimmer@trinity-health.org	3100 Easton Square Place		Columbus	OH	43219	07/17/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Chief Information Security Officer	Sr Security Manager, Enterprise Information Securi	Mr.	Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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	6147068474				6142348372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Complaints Tracking Contact	Compliance Specialist	Mr	Jordan	David	A	6147068474					djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Contact for Fraud Investigations	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Corporate Mailing						4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	DIR Contact	CEO		Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square  Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	DIR Contact (Secondary)	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Discount Program Payment Contact	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Electronic Health Record Contact	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Emergency Part D Contact	Chief Compliance Officer		Suffern	Patricia		4124780244				6145463132	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/23/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Emergency Part D Contact (Secondary)	Pharmacy Director	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/17/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Employer Waiver Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Reconciliation Analyst		Sloan	Mike		6145463134					mike.sloan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Enrollment Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	EOB Transfer Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Financial Audit Contact	Chief Compliance Officer	Ms.	Suffern	Patricia	A	4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/24/2025	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Financial Reporting Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Formulary Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	General Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	HIPAA Privacy Officer	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	HIPAA Security Officer	Sr Security Manager, Enterprise Information Securi		Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Interoperability Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	MA Appeals/Grievances Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	MA Claims Processing Contact for Public Website	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Marketing Contact	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Medical Director	MD	Dr.	Wise	Greg		6145463151				6145463131	gwise@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Medicare Coordinator	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Medicare Part D Opioid Overutilization Contact	Pharmacy Data Analyst	Ms.	Houk	Kimberly		6145463183					kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Medication Therapy Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	OffShore Subcontractor Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment	Ms	Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Online Enrollment Center Contact (Optional)	Director, Enrollment and Premium Billing		Caudle	Jeff		6145463224				6145463148	jcaudle@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Part C Application Contact	Director, Product Management and Business Devlpt		Mauck	Brandon		6145955681					brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Part C Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Appeals	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H3668	Part D Appeals Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H3668	Part D Application Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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 Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Claims Submission Contact	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H3668	Part D Exceptions Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H3668	Part D Price File Contact (Back-up)	Formulary Consultant		Scott	Sarah		4803109219					sarah.scott@CVSHealth.com	9501 E. Shea		Scottsdale	AZ	85260	05/02/2025	2026	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 Price File Contact (Primary)	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Quality Assurance Contact	Director of Pharmacy, Health Plans	Ms.	McGhee	Anna		2165345375				6142346481	anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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 Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Patient Safety Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Payment Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Pharmacy Director	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Pharmacy Network Management Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H3668	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Data Analyst	Mrs	Miller	Kim							kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H3668	PHR Beneficiary Contact																	12/05/2016	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS	MediGold	Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H3668	Physician Incentive Contact	Interim VP, Health Services	Ms	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Plan Directory Contact for Public Website	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Processor Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Quality Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Reconciliation Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Reconciliation Contact (Secondary)	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Recovery Audit Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Surveillance Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	System Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Third Party Administrator (TPA) Liaison	Sr Finance Analyst		Fountain	Lisa		6145463220					lfountain@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	User Access Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Utilization Management Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3668	Utilization Review Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN, INC.	Local CCP	MediGold	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3672	Agent/Broker Compensation Data Contact	Director, Medicare Sales		Christian	Cindy		3308342303					CChristian@healthplan.org	The Health Plan	100 Lillian Gish Blvd	Massillon	OH	44647	10/25/2018	2026	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	Chicago
H3672	Automated TrOOP Balance Transfer Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Backup User Access Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/07/2019	2026	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	Chicago
H3672	Best Available Evidence Contact	Manager Medicare Enrollment		Bliss	Tonya		7406996990				7406996164	tbliss@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/19/2023	2026	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	Chicago
H3672	Bid Audit Contact	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	Bid Audit Site Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	Bid Primary Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	04/26/2021	2026	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	Chicago
H3672	CAP Report Contact for Public Website	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	CEO - CMS Administrator Contact	VP of Medicare	Ms	Pennybacker	Vicki		3042805069					VickiP@healthplan.org	The Health Plan	1110 Main Streeet	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	CEO - Senior Official for Contracting	CEO	Mr	Knight	Jeff		7406957585					JeffK@healthplan.org	The Health Plan	1110 Main Streeet	Wheeling	WV	26003	11/07/2019	2026	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	Chicago
H3672	Chief Financial Officer	Chief Financial Officer	Mr	Ralston	Ryan		7406996236				7406996161	rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/13/2019	2026	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	Chicago
H3672	Chief Operating Officer	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	01/04/2023	2026	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	Chicago
H3672	Chief Information Officer	CIO	Mr	Bryan	Ken		7406957877					kbyran@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/20/2020	2026	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	Chicago
H3672	Chief Information Security Officer	Director, IT Security	Mr.	Brossman	Phil		7406957694					pbros@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/20/2023	2026	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	Chicago
H3672	CMS Casework Communication Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3672	Complaints Tracking Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3672	Contact for Fraud Investigations	Director SIU		Howell	Rich		7406957665					rhowell@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/20/2023	2026	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	Chicago
H3672	Coordination of Benefits Contact	Manager COB		Fetty	Jackie		7406957699				7406996163	jfetty@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2026	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	Chicago
H3672	Corporate Mailing						7406953585					info@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	01/10/2018	2026	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	Chicago
H3672	Customer Service Operations Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3672	DIR Contact	Controller		Marsh	Jane		7406996121					jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/10/2020	2026	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	Chicago
H3672	DIR Contact (Secondary)	Chief Financial Officer		Ralston	Ryan		7406996236					rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/10/2020	2026	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	Chicago
H3672	Discount Program Payment Contact	Assistant Controller	Mr	Blinco	David		7406996151				7406996161	dblinco@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/04/2018	2026	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	Chicago
H3672	Emergency Part D Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Emergency Part D Contact (Secondary)	Director, Pharmacy Services		Peluchette	Katelyn		3046392392				3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Employer Waiver Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment		Davis	Matt		7406996283					mdavis@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/23/2019	2026	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	Chicago
H3672	Enrollment Contact	Manager Medicare Enrollment		Bliss	Tonya		7406996990				7406996164	tbliss@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/19/2023	2026	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	Chicago
H3672	EOB Transfer Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3672	Financial Audit Contact	VP of Medicare	Ms	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	09/25/2024	2026	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	Chicago
H3672	Financial Reporting Contact	Chief Financial Officer	Mr	Ralston	Ryan		7406996236				7406996161	rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/07/2019	2026	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	Chicago
H3672	Formulary Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Formulary Contact (Secondary)	Director, Pharmacy Services		Peluchette	Katelyn		3046392392				3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	General Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	Government Relations Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	HIPAA Privacy Officer	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	HIPAA Security Officer	Director, IT Security	Mr.	Brossman	Phil		7406957694					pbros@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/20/2023	2026	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	Chicago
H3672	Hospice Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Interoperability Contact	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	1110 Main Street		Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	MA Appeals/Grievances Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3672	MA Claims Processing Contact for Public Website	Manager Medicare Claims		Westfall	Vickie		7406957636				7406996163	VickieW@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2026	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	Chicago
H3672	Marketing Contact	Director, Medicare Sales		Christian	Cindy		3308342303					CChristian@healthplan.org	The Health Plan	100 Lillian Gish Blvd	Massillon	OH	44647	11/04/2021	2026	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	Chicago
H3672	Medical Director	Medical Director	Dr	Cross	Robert		7406996976				7406955297	rcross@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/19/2023	2026	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	Chicago
H3672	Medicare Compliance Officer	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	Medicare Coordinator	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2026	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	Chicago
H3672	Medicare Part D Opioid Overutilization Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/07/2025	2026	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	Chicago
H3672	Medication Therapy Management Contact	Director, Clinical & Trend Solutions		Muralidharan	Adrienne		3143131932					AMuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	12/22/2022	2026	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	Chicago
H3672	OffShore Subcontractor Contact	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	Online Enrollment Center Contact (Back-up)	Enrollment Service Representative		Fleming-Henry	Nicole		7406996253					nhenry@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/16/2025	2026	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	Chicago
H3672	Online Enrollment Center Contact (Primary)	Manager Medicare Enrollment		Bliss	Tonya		7406996990				7406996164	tbliss@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/19/2023	2026	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	Chicago
H3672	Part C Application Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	05/20/2020	2026	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	Chicago
H3672	Part C Reporting Contact	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2026	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	Chicago
H3672	Part D Appeals	Appeal & Grievance Supervisor		Devault	Paige						7406996163	appeals_grievances_department@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	03/30/2022	2026	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active	8778477907				HMO - Health Maintenance Organization		C	Chicago
H3672	Part D Appeals Contact (Secondary)	VP Compliance		Jones	Heather						7406996163	appeals_grievances_department@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active	8778477907				HMO - Health Maintenance Organization		C	Chicago
H3672	Part D Application Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	05/20/2020	2026	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	Chicago
H3672	Part D Benefits Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Part D Claims Submission Contact	Director Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	10/14/2022	2026	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	Chicago
H3672	Part D Exceptions Contact	Senior Clinical Pharmacist		Kovalski	Amy						3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active	8006246961	6627			HMO - Health Maintenance Organization		C	Chicago
H3672	Part D Exceptions Contact (Secondary)	Director, Pharmacy Services		Peluchette	Katelyn						3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active	8006246961	6608			HMO - Health Maintenance Organization		C	Chicago
H3672	Part D Price File Contact (Back-up)	Manager, Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	Express Scripts	4865 Dixie Hwy	Fairfield	OH	45014	04/10/2023	2026	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	Chicago
H3672	Part D Price File Contact (Optional)	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	Express Scripts	One Express Way - Building 1	St. Louis	MO	63121	10/28/2024	2026	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	Chicago
H3672	Part D Quality Assurance Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Part D Reporting Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Patient Safety Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Payment Contact			Piergallini	Jeremy		7406996138				7406996161	jpiergallini@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	09/04/2018	2026	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	Chicago
H3672	Pharmacy Director	Director, Pharmacy Services		Peluchette	Katelyn		3046392392				3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	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	Chicago
H3672	Pharmacy Network Management Contact	Network Account Dir, Retail Strategy & Contracting		Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	01/12/2023	2026	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	Chicago
H3672	Pharmacy Technical Help Desk Contact	Sr. Director, Customer Service		Sahs	Dale							dale_sahs@express-scripts.com	One Express Way Mail Stop S13NB		St. Louis	MO	63121	10/16/2025	2026	THE HEALTH PLAN OF WEST VIRGINIA, INC.	Local CCP	The Health Plan	HMO/HMOPOS		The Health Plan of West Virginia, Inc.	354	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H3672	Physician Incentive Contact	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2026	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	Chicago
H3672	Plan Directory Contact for Public Website	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3672	Plan to Plan Reconciliation Contact	Controller		Marsh	Jane		7406996121				7406996161	jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/30/2018	2026	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	Chicago
H3672	Processor Contact	Director, Government Programs, Medicare		Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	Express Scripts	One Expressway	St. Louis	MO	63121	10/20/2023	2026	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	Chicago
H3672	Quality Contact	VP of Quality Improvement		Tomer	Kerri		7406996168					ktomer@healthplan.org	The Health Plan	1110 Main Street	Wheeling WV	WV	26003	06/21/2024	2026	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	Chicago
H3672	Reconciliation Contact	Controller		Marsh	Jane		7406996121					jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/21/2023	2026	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	Chicago
H3672	Reconciliation Contact (Secondary)	Chief Financial Officer		Ralston	Ryan		7406996236					rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/21/2023	2026	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	Chicago
H3672	Recovery Audit Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	SNP Application Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	05/20/2020	2026	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	Chicago
H3672	SNP State Contact	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/06/2019	2026	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	Chicago
H3672	Surveillance Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	System Contact	CIO	Mr	Bryan	Ken		7406957877					kbryan@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	11/02/2020	2026	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	Chicago
H3672	Third Party Administrator (TPA) Liaison	Assistant Controller		Blinco	David		7406996151					dblinco@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/11/2018	2026	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	Chicago
H3672	User Access Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	02/19/2024	2026	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	Chicago
H3672	Utilization Management Contact	VP Clinical Services		Jones	Heather		7406996980					hjones@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3672	Utilization Review Contact	VP Clinical Services		Jones	Heather		7406996980					hjones@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	07/25/2024	2026	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	Chicago
H3706	Agent/Broker Compensation Data Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					sagar.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Automated TrOOP Balance Transfer Contact	Director, Member Enrollment & Fulfillment		Rhodes	Trent	R	7877582500	5434				trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Backup User Access Contact	Compliance AVP		Ramos Batiz	Kelsey		7877582500	5796				KRamos@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	08/13/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Best Available Evidence Contact	Director, Enrollment and Fulfillment		Rhodes	Trent		4052805871					trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	02/16/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Bid Audit Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					sagar.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Bid Audit Site Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					sagar.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Bid Primary Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					sagar.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	CAP Report Contact for Public Website	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	7877582500	2040			HMO - Health Maintenance Organization		C	Dallas
H3706	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	O'Drobinak	Jim		7879998771					jim.odrobinak@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	O'Drobinak	Jim		7879998771					jim.odrobinak@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Chief Financial Officer	Chief Financial Officer	Mr.	Aponte	Jose		7877582500	5022				joseap@medicalcardsystem.com	210 Park Ave	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Chief Operating Officer	Chief Operating Officer	Mr.	Torres	Roberto		7877582500	5380				roberto.torres@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	06/26/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Chief Information Officer	Chief Information Officer	Mr.	Adhia	Kevin		4052805765					kevin.adhia@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	09/20/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Chief Information Security Officer	IT Security & Risk Management VP	Mr.	Torres	Jorge		7877582500	5864				JTorresV@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/24/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	CMMI Model Point of Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					Sagar.Patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	CMS Casework Communication Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Complaints Tracking Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Contact for Fraud Investigations	Special Investigation AVP		Roussel Guzman	Elizabeth		7877582500	2071			7876201342	elizabeth.roussel@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	05/23/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Coordination of Benefits Contact	Director, Enrollment and Fulfillment		Rhodes	Trent		4052805871					trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	02/16/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Corporate Mailing						7877582500	2424				CSolis@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/12/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Customer Service Operations Contact	Director, Customer Care		Thomas	Daniel		4055261126					Daniel.Thomas@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	DIR Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					sagar.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	DIR Contact (Secondary)	Financial Analysis Director		Vazquez Lloret	Jason		7877582500	2195				jason.vazquez@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Discount Program Payment Contact	VP, Finance		Harris	Tayla		4052805724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Electronic Health Record Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Emergency Part D Contact	Chief Pharmacy Officer		Rodriguez Rivera	Carolyn		7877582500	5746				carodriguez@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Emergency Part D Contact (Secondary)	VP, Pharmacy		Patel	Monank		4052805761					monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Employer Waiver Contact	VP, Finance		Harris	Tayla		4052805724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Encounter Data & Risk Adjustment Operations Contact	Encounter Data System AVP		Soler	Eva	Y	7877582500	2599				RAPS_EDS@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	10/20/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Enrollment Contact	Director, Enrollment and Fulfillment		Rhodes	Trent		4052805871					trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	02/16/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	EOB Transfer Contact	VP, Adjudication and Configurations		Thakkar	Rahul		4052805716				4055523098	rahul.thakkar@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Financial Audit Contact	VP, Government Business Strategy	Mr.	Patel	Sagar		9084003601					sagar.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Financial Reporting Contact	VP, Finance		Harris	Tayla		4052805724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Formulary Contact	Pharmacy Formulary Management & Benefits Director		Ammin	Aisha		7877582500	4132				aamin@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/19/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Formulary Contact (Secondary)	Pharmacy Formulary Management & Benefits Manager		Perez Rivera	Luis		7877582500	5744				luperez@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/19/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	General Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Government Relations Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	HIPAA Privacy Officer	Privacy Officer		Lourido Rodriguez	Gustavo		7877582500	5702				glourido@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	10/19/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	HIPAA Security Officer	IT Security & Risk Management VP	Mr.	Torres	Jorge		7877582500	5864				JTorresV@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/24/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Hospice Contact	VP, Health Services		Stouffer	Kelly		4052805608					kelly.stouffer@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Interoperability Contact	Chief Information Officer	Mr.	Adhia	Kevin		4052805765					kevin.adhia@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	09/20/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	MA Appeals/Grievances Contact	VP, Health Services		Stouffer	Kelly		4052805608				4052805294	kelly.stouffer@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	MA Claims Processing Contact for Public Website	VP, Adjudication and Configurations		Thakkar	Rahul		4052805716				4055523098	rahul.thakkar@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Marketing Contact	Marketing AVP		Agosto Ramos	Mariel		7877582500	5233				mariel.agosto@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Medical Director	Chief Medical Officer	Dr.	Hernandez Roses	Ines		7877582500	2381				irhernandez@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Medicare Compliance Officer	Medicare Compliance Officer	Mrs	Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/16/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Medicare Coordinator	Senior VP & Medicare Compliance Officer		Pastrana Lopez	Isis		7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Medicare Part D Opioid Overutilization Contact	Pharmacy Quality & Clinical Programs Manager		Arriaga	Yolismarie		7877582500	2385				yarriaga@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	09/05/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Medication Therapy Management Contact	Pharmacy Clinical Service Director		Arroyo	Viviana		7877582500	5718				viviana.arroyo@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	05/20/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	OffShore Subcontractor Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Online Enrollment Center Contact (Back-up)	Manager, Eligibility		Jenkins	Jessica		4052805862					jessica.jenkins@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	08/13/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Online Enrollment Center Contact (Optional)	Sr. Enrollment Representative		Johnson	Nikki		4052805862					nikki.johnson@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	08/13/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Online Enrollment Center Contact (Primary)	Director, Enrollment and Fulfillment		Rhodes	Trent		4052805871				4055523012	trent.rhodes@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	02/16/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part C Application Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					Sagar.Patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part C Reporting Contact	Auditing and Monitoring AVP		Reyes Villegas	Yarelis		7877582500	2774				yarelis.reyes@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Appeals	Pharmacy Utilization Management Director		Burgos Nieves	Grace							grace.burgos@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	05/30/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	7877582500	5747			HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Appeals Contact (Secondary)	VP, Pharmacy		Patel	Monank						4052805613	monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	8664943927				HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Application Contact	VP, Government Business Strategy		Patel	Sagar		9084003601					Sagar.Patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Benefits Contact	Manager, Health Plan Benefits		Stavinoha	Rosalie		4052805637					rosalie.stavinoha@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025631	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Claims Submission Contact	Chief Pharmacy Officer		Rodriguez rivera	Carolyn		7877582500	5746				carodriguez@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/16/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Exceptions Contact	Pharmacy Utilization Management & Specialty Progra		Ramos Marrero	Gladiany							gramosm@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	8664943927				HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Exceptions Contact (Secondary)	VP, Pharmacy		Patel	Monank						4052805613	monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	8664943927				HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Price File Contact (Back-up)	Pharmacy Formulary Management & Benefits Manager		Perez	Luis		7877582500	5744				luperez@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Price File Contact (Optional)	VP, Pharmacy		Patel	Monank		4052805761					monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	09/03/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Price File Contact (Primary)	Cost Management Director		Busquets Villegas	Rebeca		7877582500	5434				rbusquets@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Quality Assurance Contact	Pharmacy Clinical Service Director		Arroyo	Viviana		7877582500	5718				viviana.arroyo@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Part D Reporting Contact	VP, Pharmacy		Patel	Monank		4052805761					monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	06/29/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Patient Safety Contact	Pharmacy Clinical Service Director		Arroyo	Viviana		7877582500	5718				viviana.arroyo@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Payment Contact	VP, Finance		Harris	Tayla		4052805724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Personal Health Record Contact	Privacy Officer		Lourido Rodriguez	Gustavo		7877582500	5702				glourido@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	10/19/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Pharmacy Director	VP, Pharmacy		Patel	Monank		4052805761					monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	06/29/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Pharmacy Network Management Contact	Pharmacy Regulations & Audit Monitoring Director		Izquierdo Hernandez	Delmarie		7877582500	5719				dizquierdo@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Pharmacy Network Management Contact (Secondary)	VP, Pharmacy		Patel	Monank		4052805761				4052805613	monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Pharmacy Technical Help Desk Contact	Pharmacy Regulations & Audit Monitoring Director		Izquierdo Hernandez	Delmarie							dizquierdo@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	08/29/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Dallas
H3706	Pharmacy Technical Help Desk Contact (Secondary)	VP, Pharmacy		Patel	Monank							monank.patel@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	09/03/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Dallas
H3706	PHR Beneficiary Contact																	06/19/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS	GlobalHealth	MHH Healthcare, L.P.	669	Yes	Active	8442805555				HMO - Health Maintenance Organization		C	Dallas
H3706	Physician Incentive Contact	VP Provider Contracting, Credentialing and Network		Echols	Patricia		2147636941					patricia.echols@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Plan Directory Contact for Public Website	VP Provider Contracting, Credentialing and Network		Echols	Patricia		4052805738					patricia.echols@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/09/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Plan to Plan Reconciliation Contact	VP, Finance		Harris	Tayla		4052805724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/05/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Processor Contact	Manager, Claims Processing		Schultz	Patricia		4052805338					patricia.schultz@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Quality Contact	VP, Health Services		Stouffer	Kelly		4052805608					kelly.stouffer@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Reconciliation Contact	VP, Finance		Harris	Tayla		4052805724					Tayla.Harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Reconciliation Contact (Secondary)	VP, Finance		Harris	Tayla		4052805724					Tayla.Harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	06/12/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Recovery Audit Contact	Medicare Compliance Officer	Mrs.	Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	SNP Application Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	SNP State Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	10/20/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Surveillance Contact	Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	01/31/2024	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	System Contact	Chief Information Officer	Mr.	Adhia	Kevin		4052805765					kevin.adhia@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	09/20/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Third Party Administrator (TPA) Liaison	VP, Finance		Harris	Tayla		4052805724					tayla.harris@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	User Access Contact	Compliance AVP		Ramos Batiz	Kelsey		7877582500	5796				KRamos@medicalcardsystem.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	731025621	08/13/2025	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Utilization Management Contact	VP, Health Services		Stouffer	Kelly		4052805608					kelly.stouffer@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3706	Utilization Review Contact	VP, Health Services		Stouffer	Kelly		4052805608					kelly.stouffer@globalhealth.com	210 Park Avenue	Suite 2900	Oklahoma City	OK	73102	07/07/2023	2026	GLOBALHEALTH, INC.	Local CCP	GlobalHealth	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3708	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8665834649				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	DIR Contact	Manager, Health Plans Finance		Parkin	Frank		2038148504					fparkin@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	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	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Discount Program Payment Contact	Director, Finance	Ms.	Tilley	Stephanie		9312420499					stilley@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/05/2024	2026	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	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4057066535				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8665834649				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8665834649				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Coordinator	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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 Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	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	Medication Therapy Management Contact	Director of Clinical Programs	Mr	Poore	Richard		6036285133					rpoore@healthdialog.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	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	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8665834649				HMO - Health Maintenance Organization		C	Dallas
H3708	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Ms	McCauley	Angela						3304058081	appeals@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8665834649				HMO - Health Maintenance Organization		C	Dallas
H3708	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H3708	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8665834649				HMO - Health Maintenance Organization		C	Dallas
H3708	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@Elixirsolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/17/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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 Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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@Elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8446331063				HMO - Health Maintenance Organization		C	Dallas
H3708	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn							lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	02/12/2024	2026	OKLAHOMA SUPERIOR SELECT, INC.	Local CCP	American Health Advantage of Oklahoma	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8334786370				HMO - Health Maintenance Organization		C	Dallas
H3708	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8665834649				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	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	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	SNP State Contact	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Third Party Administrator (TPA) Liaison	Director, Finance	Ms.	Tilley	Stephanie		9312420499					stilley@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/05/2024	2026	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	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Agent/Broker Compensation Data Contact	FDR Oversight Manager		Risher	Laura		5138140651				5136056845	laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Automated TrOOP Balance Transfer Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Backup User Access Contact	Compliance Specialist		Nadler	Kristina		5138018146					kristina.nadler@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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 of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Bid Audit Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Bid Audit Site Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Bid Primary Contact	VP Operations		Muldowney	Jessica		5138355228				5136056845	jmuldowney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	CAP Report Contact for Public Website	Chief Compliance Officer		Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	CEO - CMS Administrator Contact	CEO	Mr.	Hager	Robert		5134699593				5136056845	rhager@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	CEO - Senior Official for Contracting	CEO	Mr.	Hager	Robert		5134699593				5136056845	rhager@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	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		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Chief Operating Officer	CFO	Mr.	Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Chief Information Officer	CFO	Mr.	Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Chief Information Security Officer	CFO	Mr.	Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	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	VP Healthcare & Quality Operations		Parente	Robin		5138026452					Robin.Parente@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Complaints Tracking Contact	Member Advocate/ Grievance Specialist		Lightfoot	Matt		5134699587				5136056830	mlightfoot@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Contact for Fraud Investigations	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Corporate Mailing						8337992273				5136056845	rhager@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	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	Vice President of Operations		Muldowney	Jessica		5138358228				5136056845	jmuldowney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	DIR Contact	Program Manager, Gov Program and Services		Anwar	Khawar		8587903097					khawar.anwar@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	DIR Contact (Secondary)	Program Manager, Gov Program and Services		Hayes	Khalif		8582915016					khalif.hayes@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Discount Program Payment Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Emergency Part D Contact	Pharmacy Services Manager		Warner	Betsy		3044448811				5136056845	betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Emergency Part D Contact (Secondary)	VP of Clinical Pharmacy		Lewis	Katherine		3305238212				5136056845	Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Encounter Data & Risk Adjustment Operations Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Enrollment Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063				5136056845	kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	EOB Transfer Contact	CFO		Heimgartner	Jeremy		5132404810	4810			5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Financial Audit Contact	Director Medicare Compliance	Mr.	Ehrman	James	A	5139170302				5136056845	James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Financial Reporting Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Formulary Contact	Vice President of Clinical Pharmacy		Lewis	Katherine		3305238212					Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Formulary Contact (Secondary)	Manager Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	General Contact	Chief Compliance Officer		Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	HIPAA Privacy Officer	Chief Compliance Officer		Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	HIPAA Security Officer	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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.	Char	Kalpana		4127209956					Kalpana.Char@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	05/20/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Interoperability Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	MA Appeals/Grievances Contact	Member Advocate/ Grievance Specialist		Lightfoot	Matt		5134699587				5136056830	mlightfoot@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	MA Claims Processing Contact for Public Website	Appeal Analyst		Colangelo	Krystle		5133790316				5136056830	krystle.colangelo@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Marketing Contact	FDR Oversight Manager		Risher	Laura		5138140651				5136056845	laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Medical Director	CMO	Dr.	Char	Kalpana		4127209956					Kalpana.Char@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	05/20/2025	2026	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.	Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Medicare Coordinator	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Medicare Part D Opioid Overutilization Contact	Pharmacy Services Manager		Warner	Betsy		3044448811				5136056845	betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Medication Therapy Management Contact	VP Clinical Pharmacy		Lewis	Katherine		3305238212				5136056845	Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Online Enrollment Center Contact (Back-up)	Associate Director Enrollment and Fulfillment Ops		Torres	Rosalie		8132442081					Rosalie.Torres@HealthAxis.com	400 N. Ashley Dr.	Suite 920	Tampa	FL	33602	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Online Enrollment Center Contact (Primary)	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Part C Application Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Part C Reporting Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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 Appeals	Pharmacy Services Manager		Warner	Betsy							betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3044448811				HMO - Health Maintenance Organization		C	Chicago
H3727	Part D Appeals Contact (Secondary)	Director Clinical Operations		Collins	Andrea						3304058081	andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Chicago
H3727	Part D Application Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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 Benefits Contact	Pharmacy Services Manager		Warner	Betsy		3044448811				5136056845	betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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 Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	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	Pharmacy Services Manager		Warner	Betsy							betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	01/15/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3044448811				HMO - Health Maintenance Organization		C	Chicago
H3727	Part D Exceptions Contact (Secondary)	Director Clinical Operations		Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Chicago
H3727	Part D Price File Contact (Back-up)	Director Reporting & Analytics, Govt. Programs		Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	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 Price File Contact (Primary)	Manager of Reporting & Analytics		Wentz	Christophe		9547672633					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	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 Quality Assurance Contact	Pharmacy Services Manager		Warner	Betsy		3044448811				5136056845	betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	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 Reporting Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063				5136056845	kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Patient Safety Contact	CMO	Dr.	Char	Kalpana		4127209956					kalpana.char@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Payment Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Pharmacy Director	Vice President of Clinical Pharmacy		Lewis	Katherine		3305238212				5136056845	Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Pharmacy Network Management Contact	Pharmacy Services Manager		Warner	Betsy		3044448811					betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	01/15/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Pharmacy Network Management Contact (Secondary)	Director Pharmacy Network Administration		Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	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	MedImpact VP Operations		Conn	Todd							todd.conn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	8336978516				HMO - Health Maintenance Organization		C	Chicago
H3727	Physician Incentive Contact	VP of Network and Provider Operations		Acker	Amy		7037891929					aacker@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Plan Directory Contact for Public Website	FDR Oversight Manager		Risher	Laura		8559695861					laura.risher@communicare-advantge.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Plan to Plan Reconciliation Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Processor Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Quality Contact	Director of Health Plan Quality		Dawson	Jennifer		5133790334				5132470589	jdawson@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Reconciliation Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Reconciliation Contact (Secondary)	Pharmacy Services Manager		Warner	Betsy		3044448811				5136056845	betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Recovery Audit Contact	CFO	Mr	Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	SNP Application Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Surveillance Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	System Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Third Party Administrator (TPA) Liaison	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	User Access Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Utilization Management Contact	VP Healthcare & Quality Operations		Parente	Robin		5138026452					Robin.Parente@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3727	Utilization Review Contact	VP Healthcare & Quality Operations		Parente	Robin		5138026452					Robin.Parente@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	OH CHS SNP INC.	Local CCP	Communicare Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3740	Automated TrOOP Balance Transfer Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Backup User Access Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Best Available Evidence Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Bid Primary Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	CAP Report Contact for Public Website	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active	7575094141				PACE - Nat		C	Philadelphia
H3740	CEO - CMS Administrator Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	CEO - Senior Official for Contracting	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Chief Financial Officer	Finance Manager	Mr	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Chief Operating Officer	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Chief Information Officer	Program Director/Center Manager	Mr.	Lomax	Dowel		4848839912					dowel.lomax@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Chief Information Security Officer	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	CMS Casework Communication Contact	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Complaints Tracking Contact	Director of Quality and Compliance	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Contact for Fraud Investigations	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Coordination of Benefits Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Corporate Mailing						4439343807					silvia.boswell@pacewb.org	3201 A Tioga Parkway	Edenbridge PACE	Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Customer Service Operations Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	11/28/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	DIR Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	DIR Contact (Secondary)	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Discount Program Payment Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Emergency Part D Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Emergency Part D Contact (Secondary)	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Encounter Data & Risk Adjustment Operations Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Enrollment Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	EOB Transfer Contact	Finance Manager	Mr.	Morillo	Tony		7035934000				0000000000	tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Financial Audit Contact	Finance Manager	Mr	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Financial Reporting Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Formulary Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	General Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	11/28/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Government Relations Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	HIPAA Privacy Officer	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	HIPAA Security Officer	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Interoperability Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	MA Appeals/Grievances Contact	Director of Quality and Compliance	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	MA Claims Processing Contact for Public Website	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Marketing Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Medical Director	Medical Director	Dr.	Adu Sakodie	Nana Yaw		9174471464					nana.yaw@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Medicare Compliance Officer	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	11/28/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Medicare Coordinator	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Medicare Part D Opioid Overutilization Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Medication Therapy Management Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part C Application Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Appeals	Finance Manager	Mr.	Morillo	Tony							tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active	7035934000				PACE - Nat		C	Philadelphia
H3740	Part D Application Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Benefits Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Claims Submission Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Exceptions Contact	Finance Manager	Mr.	Morillo	Tony							tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active	7035934000				PACE - Nat		C	Philadelphia
H3740	Part D Exceptions Contact (Secondary)	Finance Manager	Mr.	Morillo	Tony							tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active	0000000000				PACE - Nat		C	Philadelphia
H3740	Part D Price File Contact (Back-up)	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Price File Contact (Optional)	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Price File Contact (Primary)	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Quality Assurance Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Part D Reporting Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Patient Safety Contact	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Payment Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Personal Health Record Contact	Program Director/Center Manager	Mr.	Lomax	Dowel		4109353728					dowel.lomax@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Pharmacy Director	Chief Operating Officer	RPh	Greenhalgh	Michael		8889742763	4867				mgreenhalgh@trhc.com	228 Strawbridge Drive		Moorestown	NJ	08057	04/08/2024	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Pharmacy Network Management Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Pharmacy Technical Help Desk Contact	Finance Manager	Mr.	Morillo	Tony							tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active	0000000000				PACE - Nat		C	Philadelphia
H3740	Plan Directory Contact for Public Website	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Plan to Plan Reconciliation Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Processor Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Quality Contact	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	10/03/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Reconciliation Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Reconciliation Contact (Secondary)	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Recovery Audit Contact	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Surveillance Contact	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	System Contact	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Third Party Administrator (TPA) Liaison	Finance Manager	Mr.	Morillo	Tony		7035934000					tony.morillo@pacewb.org	3201-A Tiago Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	User Access Contact	Executive Director	Ms.	Boswell	Silvia		4439610796					silvia.boswell@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	12/16/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Utilization Management Contact	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3740	Utilization Review Contact	Compliance and Quality Director	Ms.	Flanagan	Ruth	E	7575094141					elizabeth.flanagan@pacewb.org	3201-A Tioga Parkway		Baltimore	MD	21215	04/23/2025	2026	WEST BALTIMORE PACE COMMUNITY COALITION	National PACE	PACE of West Baltimore	National PACE		West Baltimore PACE Community Coalition LLC	887	Yes	Active					PACE - Nat		C	Philadelphia
H3748	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Medicare Coordinator	AVP, Service Operations		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3748	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/10/2018	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3748	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF WASHINGTON, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3755	Agent/Broker Compensation Data Contact	Director Sales & Account Management	Ms.	Inman	Jerica		9185945295	5376				jsivadon@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/09/2025	2026	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	Automated TrOOP Balance Transfer Contact	Operations, Manager,Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/11/2025	2026	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	Backup User Access Contact	Ex Admin Assistant		Stover Yasseri	Dawn		9185945295	4627			9185945260	dyasseri@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Medicare Projects Specialist		East	Shawn		9185945295	6903				seast@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/28/2024	2026	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	Bid Audit Contact	Director, Underwriting	Ms.	Tull	Karla		9185945295	2009				ktull@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	Bid Primary Contact	Director, Underwriting	Ms.	Tull	Karla		9185945295	2009				ktull@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	CAP Report Contact for Public Website	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	CEO - CMS Administrator Contact	President & CEO	Mr.	Sutton	Josiah		9185945295	5375				jsutton@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	CEO - Senior Official for Contracting	President & CEO	Mr.	Sutton	Josiah		9185945295	5375				jsutton@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	Chief Financial Officer (CFO)	Mr.	Ziemann	Ryan		9185945291					rziemann@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	07/10/2025	2026	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 Operating Officer	President & CEO	Mr.	Sutton	Josiah		9185945295	5375				jsutton@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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 Information Officer	SVP Chief Technology & Transformation Officer	Mr.	Wyrick	Rusty		9185945295	5233				rwyrick@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/22/2025	2026	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 Information Security Officer	SVP Chief Technology & Transformation Officer	Mr.	Wyrick	Rusty		9185945295	5233				rwyrick@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/22/2025	2026	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		9185945295	6808			9188794309	aburke@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Complaints Tracking Contact	Director, Customer Service	Ms.	Bass	Kimberly		9185945295	6494				kbass@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/09/2025	2026	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	Contact for Fraud Investigations	Lead Investigator, SIU		McMaster	Mary		9185945295	6389				mmcmaster@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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		9185945295	6401				coordinationofbenefits@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Corporate Mailing						9185945295	6326				mlang@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Director, Customer Service	Ms.	Bass	Kimberly		9185945295	6494				kbass@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/09/2025	2026	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	DIR Contact	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479				cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	DIR Contact (Secondary)	Director, Financial Planning & Analysis	Mr.	Brenner	Matthew		9185945295	4119				mbrenner@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	Discount Program Payment Contact	Accountant II		Wilson	Jamar		9185945295	6488				jwilson@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Emergency Part D Contact	Supervisor, Pharmacy Services		Burke	Amy		9185945295	6808			9188794309	aburke@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Emergency Part D Contact (Secondary)	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479			9188794309	cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Manager Data Risk Adjustment		Schoon	Kim		9185945369					kschoon@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/06/2025	2026	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	Enrollment Contact	Medicare Projects Specialist		East	Shawn		9185945295	6903				seast@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/28/2024	2026	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	EOB Transfer Contact	Supervisor, Pharmacy Services		Burke	Amy		9185945295	6808			9188794309	aburke@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Financial Audit Contact	Controller	Ms.	Twilley	Shirley		9185945295	5285				stwilley@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	09/26/2024	2026	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	Financial Reporting Contact	Controller	Ms.	Twilley	Shirley		9185945295	5285				stwilley@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	02/06/2025	2026	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	Formulary Contact	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479				cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@navitus.com	361 Integrity Drive		Madison	WI	53717	12/02/2025	2026	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	General Contact	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	HIPAA Privacy Officer	Privacy Officer		Crissup	Michelle		9185945295	6912				mcrissup@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	HIPAA Security Officer	SVP Chief Technology & Transformation Officer	Mr.	Wyrick	Rusty		9185945295	5233				rwyrick@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/22/2025	2026	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		9185945295	6808			9188794309	aburke@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Interoperability Contact	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	MA Appeals/Grievances Contact	Manager, Grievance and Appeals		Pugh	Nicole		9185945295	6315			9185945260	cpugh@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Operations	Ms.	Lang	Michelle		9185945295	6326				mlang@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/28/2024	2026	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	Marketing Contact	Director of Marketing	Ms.	Pearson	Jerri	K	9185945249					jpearson@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	09/30/2025	2026	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	Medical Director	Medical Director	Dr.	Segal	Aaron		9185945200					asegal@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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 Coordinator	Medicare Compliance Specialist		Kanner	Dee		9185945295	6862				dkanner@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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 Part D Opioid Overutilization Contact	Director, Pharmacy	Mr.	Abdo	Mike		9185945295	6395				mabdo@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	Medication Therapy Management Contact	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479				cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	Online Enrollment Center Contact (Back-up)	Enrollment Specialist		Baur	Amanda		9185945295	4503				abaur@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Online Enrollment Center Contact (Primary)	Supervisor Enrollment		Eldredge	Allison		9185945295					aeldredge@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/28/2024	2026	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 C Application Contact	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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 C Reporting Contact	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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 Appeals	Supervisor, Grievance & Appeals		Blair	Rachel						8442689791	Rachel.Blair@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/11/2025	2026	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Dallas
H3755	Part D Appeals Contact (Secondary)	Manager, Grievance & Appeals		Pugh	Nicole						9185945260	cpugh@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	12/11/2025	2026	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	9185945295	6315			HMO - Health Maintenance Organization		C	Dallas
H3755	Part D Application Contact	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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 Benefits Contact	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479				cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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 Claims Submission Contact	Manager, Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/02/2025	2026	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	Assoc. Director, Clinical PA	Mr.	LeClair	Christophe						9202214676	Christopher.LeClair@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/11/2025	2026	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	9202214676				HMO - Health Maintenance Organization		C	Dallas
H3755	Part D Exceptions Contact (Secondary)	Supervisor, Pharmacy Services		Burke	Amy						9188794309	aburke@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	12/11/2025	2026	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	8772938628	6808			HMO - Health Maintenance Organization		C	Dallas
H3755	Part D Price File Contact (Back-up)			Plan Finder	Navitus		5122313140					Plan.Finder@navitus.com	361 Integrity Drive		Madison	WI	53717	12/02/2025	2026	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 Price File Contact (Primary)	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479				cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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 Quality Assurance Contact	Director, Pharmacy	Mr.	Abdo	Mike		9185945295	6395				mabdo@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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 Reporting Contact	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479				cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	Patient Safety Contact	Ex Dir, Clinical Operations	Ms.	Watts	Catherine		9185945295	5375				cwatts@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/17/2024	2026	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	Payment Contact	Accounts Receivable Supervisor		Fell	Jill		9185945295	6271				jfell@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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 Director	Director, Pharmacy	Mr.	Abdo	Mike		9185945295	6395				mabdo@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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 Network Management Contact	Sr. Manager & Pharmacy Benefits Administrator		Perez	Charles		9185945295	6479				cperez@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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 Network Management Contact (Secondary)	VP Network Management	Ms.	Santos	Christina		6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	12/11/2025	2026	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	Sr Manager, Customer Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/11/2025	2026	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H3755	Pharmacy Technical Help Desk Contact (Secondary)	Supervisor, Pharmacy Services		Burke	Amy						9188794309	aburke@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	12/11/2025	2026	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	Local CCP	CommunityCare Senior Health Plan (HMO)	HMO/HMOPOS		St Francis Health System & St John Health System	621	Yes	Active	8772938628	6808			HMO - Health Maintenance Organization		C	Dallas
H3755	Plan Directory Contact for Public Website	Director, Customer Service	Ms.	Bass	Kimberly		9185945295	6494				kbass@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/09/2025	2026	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	Plan to Plan Reconciliation Contact	Senior Financial Analyst		Mack	Lynda		9185945295	6320				lmack@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Processor Contact	Strategic Account Executive, CVS/Caremark		Tibus	Daniel		8475595726					daniel.tibus@CVSHealth.com	9501 E Shea Blvd MC042		Scottsdale	AZ	85260	08/27/2024	2026	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	Quality Contact	Ex Dir, Clinical Operations	Ms.	Watts	Catherine		9185945295	5373				cwatts@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	Reconciliation Contact	Controller	Ms.	Twilley	Shirley		9185945295	5285				stwilley@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	09/05/2025	2026	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	Reconciliation Contact (Secondary)	Director, Financial Planning & Analysis	Mr.	Brenner	Matthew		9185945295	4119				mbrenner@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/01/2025	2026	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	Recovery Audit Contact	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	SNP Application Contact	Director, Underwriting	Ms.	Tull	Karla		9185945295	2009				ktull@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Surveillance Contact	Compliance and Risk Officer	Ms.	Blades	Rebecca		9185945295	6281				rblades@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	System Contact	SVP Chief Technology & Transformation Officer	Mr.	Wyrick	Rusty		9185945295	5233				rwyrick@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	04/22/2025	2026	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	Third Party Administrator (TPA) Liaison	Senior Financial Analyst		Mack	Lynda		9185945295	6320				lmack@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	User Access Contact	Medicare Compliance Specialist		Kanner	Dee		9185945295	6862				dkanner@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Utilization Management Contact	Senior Manager, Medical Management		Gordon	Michelle		9185945295	6398				mgordon@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	08/27/2024	2026	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	Utilization Review Contact	Director, Medical Management	Ms.	La Bass	Barbara		9185945295	6031				blabass@ccok.com	Williams Center Tower II	Two West Second Street, Suite 100	Tulsa	OK	74103	10/15/2024	2026	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	Agent/Broker Compensation Data Contact	Director, Financial Systems		Lazar	Lisa		9197653359					Lisa.Lazar@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/28/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Automated TrOOP Balance Transfer Contact			Therapeutics	Prime		6127776747					eobp2@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/03/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Backup User Access Contact	Sr. Business Systems Analyst		Dunn	Lorrie		9849603809					lorrie.dunn@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27707	07/12/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Bid Audit Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	PO Box 2291		Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Bid Audit Site Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	PO Box 2291		Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Bid Primary Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	PO Box 2291		Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	CAP Report Contact for Public Website	Manager, Internal Communications		Stinneford	Mark		9197653005					media.inquiry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/20/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	CEO - CMS Administrator Contact	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	CEO - Senior Official for Contracting	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Chief Financial Officer	SVP, Chief Financial Officer	Mr	Perry	Mitchell		9197653923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	07/06/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Chief Operating Officer	SVP, Chief Operations & Member Experience Officer	Ms.	Mizelle	Karla		9849603787					karla.mizelle@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	10/02/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Chief Information Officer	AVP, IT Solution Delivery	Mrs.	Moum	Aldara		9196160924					Aldara.Moum@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	08/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Chief Information Security Officer	Chief Information Security Officer	Mr	Chilton	Richard		9197652021					rick.chilton@bcbsnc.com	PO Box 2291		Durham	NC	27702	06/01/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	CMS Casework Communication Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Complaints Tracking Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Contact for Fraud Investigations	Manager, Special Investigations Unit		Meyer	John		9842752360					John.Meyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Coordination of Benefits Contact	Team Lead, Operations		Pridgen	David		3362014141					David. Pridgen@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Corporate Mailing						3362014460				3366592969	deborah.washington-mcneill@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		9197657057					Renita.Woods@bcbsnc.com	4613 University Drive		Durham	NC	27707	03/26/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	DIR Contact	Director, Actuarial Services		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Discount Program Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					Tola.Onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Emergency Part D Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Emergency Part D Contact (Secondary)	Head of CIG Operations		Perry	Endya		9197775504					endya.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment		Kimbrell	Tammy		9844448393					Tammy.Kimbrell2@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Enrollment Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	EOB Transfer Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536				9197657291	Corporate.pharmacy@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Financial Audit Contact	Director, Audit	Ms.	Ferrell	Kim		3362014038					kim.ferrell@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Financial Reporting Contact	Director, Subsidiary Reporting		Hill	Adam		5044950050					Adam.Hill@bcbsnc.com	PO Box 2291		Durham	NC	27702	05/10/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Formulary Contact	Manager, Pharmacy Programs		Hiller	Debra		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics Inc	2900 Ames Crossing Road	Eagan	MN	55121	03/07/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	General Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Government Relations Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	HIPAA Privacy Officer	Director, Privacy, Ethics & Corp Policies		Hamlet	Lynne		9197657416					lynne.hamlet@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/18/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	HIPAA Security Officer	Chief Information Security Official		Chilton	Rick		9197652021					rick.chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Hospice Contact	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Interoperability Contact	Director, Corporate Compliance Official		Haith	Elenor		9842125897					Elenor.Haith@bcbsnc.com	PO Box 2291		Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	MA Appeals/Grievances Contact	Director, Comm. & Medicare Appeals & Grievances	Ms.	McFall	Adonna		9197654061					adonna.mcfall@bcbsnc.com	PO Boc 2291		Durham	NC	27702	03/03/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	MA Claims Processing Contact for Public Website	Manager, Operations		Cooper	Eva		9197651808					Eva.Cooper@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Marketing Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Medical Director	VP, Chief Medical Officer	Dr.	Wallace	Marcus		9843891622					Marcus.Wallace@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	06/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Medicare Compliance Officer	VP, Medicare Compliance & Chief Compliance Officer	Mrs.	Haith	Elenor		9842125897					Elenor.Haith@bcbsnc.com	PO Box 2291		Durham	NC	27702	06/15/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Medicare Coordinator	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Medicare Part D Opioid Overutilization Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Medication Therapy Management Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	OffShore Subcontractor Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Online Enrollment Center Contact (Back-up)	Manager, Membership Services		Brackett	Latrese		3362019770					latrese.brackett@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Online Enrollment Center Contact (Primary)	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part C Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part C Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Appeals	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna							Adonna.McFall@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882987520				HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Appeals Contact (Secondary)	Mgr, MA and PDP Appeals and Grievances		Lanier	Paige						8883758836	paige.lanier@bcbsnc.com	PO Box 17509	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8774947647				HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Benefits Contact	Manager, Medicare Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/13/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Claims Submission Contact	Functional Business Consultant - Govt Prgms		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2900  Ames Crossing Road	Eagan	MN	55121	05/30/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Exceptions Contact	Director, Pharmacy		Moore	Jim							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	04/18/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882969790				HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Exceptions Contact (Secondary)	Team Leader, Clinical Pharmacy Reviews - Medicare		Parikh	Swati							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	10/02/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882969790				HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Price File Contact (Back-up)	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Price File Contact (Optional)	Database Reporting Analyst		Thoung	Randy		6127776812					Randy.Thoung@PrimeTherapeutics.com	1440 Northland Drive		Mendota Heights	MN	55120	07/08/2019	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Price File Contact (Primary)	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/31/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Quality Assurance Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Part D Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3362014460					deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Patient Safety Contact	Manager, Pharmacy		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Payment Contact	AVP, Head of Actuarial Services & Valuation		Pigg	Ryland		9847776107					Ryland.Pigg@bcbsnc.com	PO Box 2291		Durham	NC	27702	05/12/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Pharmacy Director	VP, Pharmacy Services		Trautman	Suzanne		7045988684					Suzanne.Trautman@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	10/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Pharmacy Network Management Contact	AVP, Corporate Pharmacy		Rooker	Todd		6024181702					Todd.Rooker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Pharmacy Network Management Contact (Secondary)	Manager, Medicare Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	PO Box 2291		Durham	NC	27702	08/13/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	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	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8772777893				HMO - Health Maintenance Organization		C	Atlanta
H3777	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Bunch	Jon							jonathon.bunch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/14/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	5055152017				HMO - Health Maintenance Organization		C	Atlanta
H3777	Physician Incentive Contact	AVP, Provider Network and Reimbursement		Page	Troy		9197652408					troy.page@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/17/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Plan Directory Contact for Public Website	Call Center support		Services	Member		8882969790					renita.woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Plan to Plan Reconciliation Contact	Sr Accountant		Taylor	Krystal		9849603607					krystal.taylor@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	P.O. Box 30060 Mailstop 700-1AP	Durham	NC	27702	02/28/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Processor Contact	Director Government Programs & Ops		Zdelen	Daniel		6127776775					daniel.zelen@primetherapeutics.com	Prime Therapeutics, LLC	2655 Eagen Woods Drive	Eagen	MN	55122	03/02/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Quality Contact	VP, Quality, Health Equity & Risk Adjustment	Ms.	Bartholomew	Charmaine		6789208681					Charmaine.Bartholomew@bcbsnc.com	PO Box 2291		Durham	NC	27702	06/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Reconciliation Contact	Director Actuarial Services		Pigg	Ryland		9847776107					Ryland.Pigg@bcbsnc.com	PO Box 2291		Durham	NC	27702	02/15/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Recovery Audit Contact	Director, Corporate Compliance	Mrs	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina,	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Surveillance Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	System Contact	Director, IT Solution Delivery		Keltner	Doug		9194607400					Doug.Keltner@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Third Party Administrator (TPA) Liaison	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	User Access Contact	Electronic Data Interchange Analyst		Umstead	Kamala		9849603640					kamala.umstead@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	07/12/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Utilization Management Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3777	Utilization Review Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	Local CCP	Experience Health	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3794	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H3794	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3794	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3794	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H3794	Plan Directory Contact for Public Website			Customer Service	UHC		8003961942					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3794	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3800	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H3800	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H3800	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H3800	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H3800	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H3800	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Dallas
H3800	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/03/2025	2026	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	Dallas
H3800	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Dallas
H3800	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Dallas
H3800	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/03/2025	2026	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	Dallas
H3800	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H3800	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/03/2025	2026	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	Dallas
H3800	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H3800	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3800	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H3805	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H3805	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3805	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3805	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H3805	Plan Directory Contact for Public Website			Customer Service	UHC		8773703249					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3805	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3809	Automated TrOOP Balance Transfer Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Backup User Access Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153861				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Best Available Evidence Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	05/22/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Bid Primary Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	CAP Report Contact for Public Website	Health Plan Operations Manager		Wachsmuth	Rosalie		5032156556				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	CEO - CMS Administrator Contact		Ms.	Tuller	Susan		2066048256					susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/27/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	CEO - Senior Official for Contracting	Chief Executive for PACE	Ms.	Tuller	Susan		2063205325					susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Chief Financial Officer	Health Plan & Finance Director	Ms.	Barr	Natalie		5032153859				5032150685	natalie.barr@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Chief Operating Officer		Ms.	Schultz	Elizabeth		2066048256					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Chief Information Officer		Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Chief Information Security Officer		Ms.	Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	CMS Casework Communication Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Complaints Tracking Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Contact for Fraud Investigations			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Coordination of Benefits Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Corporate Mailing						5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Customer Service Operations Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	DIR Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	DIR Contact (Secondary)			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Discount Program Payment Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Emergency Part D Contact			Schultz	Elizabeth		2066048256					elizabeth.schultz@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	12/27/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Encounter Data & Risk Adjustment Operations Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	10/23/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Enrollment Contact			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	EOB Transfer Contact			Chambers	Perry		5032153672				5032150685	Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Financial Audit Contact	Health Plan Operations Manager	Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Ste 200		Portland	OR	97213	01/28/2021	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Financial Reporting Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Formulary Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Formulary Contact (Secondary)			Hart	Tish		5032153533					LaTisha.Hart@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	General Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Government Relations Contact			Noordijk	Cindy		5032154124				5032150685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	HIPAA Privacy Officer	Compliance Officer		Noordijk	Cindy		5032154124				5032150685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	HIPAA Security Officer	Compliance Officer		Noordijk	Cindy		5032154124				5032150685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Interoperability Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	MA Appeals/Grievances Contact			Chinn	Velaa		2063205325					velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	MA Claims Processing Contact for Public Website			Chinn	Velaa		2063205325					velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Marketing Contact			Frederick	Jeannie		5032153741					jeannie.frederick@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Medical Director	Medical Director	Dr.	Sasovetz	Erik		5032155665				5032150685	erik.sasovetz@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	04/16/2025	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Medicare Compliance Officer	Compliance Officer	Ms.	Noordijk	Cindy		5032154124				5032150685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Medicare Coordinator			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Medicare Part D Opioid Overutilization Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Medication Therapy Management Contact			Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part C Application Contact	Compliance Officer		Noordijk	Cindy		5032154124				5032150685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Appeals	Health Plan Operations Manager		Wachsmuth	Rosalie						5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active	5032153681				PACE - Nat		C	Seattle
H3809	Part D Appeals Contact (Secondary)			Chinn	Velaa							velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active	2063205325				PACE - Nat		C	Seattle
H3809	Part D Application Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Benefits Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Claims Submission Contact			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	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	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active	5032153672				PACE - Nat		C	Seattle
H3809	Part D Exceptions Contact (Secondary)			Wachsmuth	Rosalie							rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active	5032153681				PACE - Nat		C	Seattle
H3809	Part D Price File Contact (Back-up)			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Price File Contact (Optional)			Chinn	Velaa		2063205325					velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Price File Contact (Primary)			Chambers	Perry		5032153672					velaa.chinn@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Quality Assurance Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Part D Reporting Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Patient Safety Contact			Reed	Rebecca		5032153465					rebecca.reed@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Payment Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Personal Health Record Contact			Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Pharmacy Director			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Pharmacy Network Management Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Pharmacy Network Management Contact (Secondary)			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Pharmacy Technical Help Desk Contact			Service	Customer							Rosalie.Wachsmuth@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active	8884455518				PACE - Nat		C	Seattle
H3809	Pharmacy Technical Help Desk Contact (Secondary)			Wachsmuth	Rosalie							rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	05/02/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active	5032153681				PACE - Nat		C	Seattle
H3809	Plan Directory Contact for Public Website			Bering	Rika		5032156556				5032150685	rika.bering@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Plan to Plan Reconciliation Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Processor Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Quality Contact			Reed	Rebecca		5032153465					rebecca.reed@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Reconciliation Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	44400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Reconciliation Contact (Secondary)			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	02/22/2021	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Recovery Audit Contact	Health Plan & Finance Director	Ms.	Wachsmuth	Rosalie		5032154124					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/24/2022	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Surveillance Contact	Compliance Officer	Ms.	Noordijk	Cindy		5032154124				5032150685	cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	System Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Third Party Administrator (TPA) Liaison			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	User Access Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Utilization Management Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3809	Utilization Review Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	03/20/2019	2026	PROVIDENCE HEALTH & SERVICES - OREGON	National PACE	Providence PACE - Oregon	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H3810	Agent/Broker Compensation Data Contact	Director of Marketing	Ms.	LaFond	Nicole		5414714106	8113			5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	04/28/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Automated TrOOP Balance Transfer Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Backup User Access Contact	Lead Developer	Mr.	Eyman	John		5414714106					john.eyman@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Best Available Evidence Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		9712226045					amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Bid Audit Contact	CEO	Mr.	Janasik	Max		5414714106	8463			5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/05/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Bid Audit Site Contact	CEO	Mr.	Janasik	Max		5414714106	8463			5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/05/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Bid Primary Contact	Director of Marketing	Ms.	LaFond	Nicole		5414714106				5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/21/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	CAP Report Contact for Public Website	CEO	Mr.	Janasik	Max		5414714106	8463			5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/05/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	CEO - CMS Administrator Contact	VP Compliance	Ms.	Matola	Laura	K	5414714106	8145				laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/28/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	CEO - Senior Official for Contracting	CEO	Mr.	Janasik	Max		5414714106	8463			5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/05/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Chief Financial Officer	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Chief Operating Officer	COO	Mr.	Norman	Chris		5414714106	8428			5414711524	chris.norman@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	03/17/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Chief Information Officer	CIO	Mr.	Zesiger	Justin		5414714106					justin.zesiger@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	08/20/2018	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Chief Information Security Officer	CIO	Mr.	Zesiger	Justin		5414714106					justin.zesiger@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	08/20/2018	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	CMS Casework Communication Contact	VP Compliance	Ms.	Matola	Laura		5414714106				5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	07/17/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Complaints Tracking Contact	VP Compliance	Ms.	Matola	Laura		5414714106	3121			5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Contact for Fraud Investigations	VP Compliance	Ms.	Matola	Laura	K	5414714106	8145			5414711524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/28/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Coordination of Benefits Contact	Enrollment Director	Ms.	Anders	Sheila		5414714106	5111			5419561674	sheila.anders@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Corporate Mailing						5414714106				5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/21/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Customer Service Operations Contact	Customer Care Supervisor	Ms.	Torres	Madison		5414714106				5414711524	madison.torres@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/21/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	DIR Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	DIR Contact (Secondary)	VP Compliance	Ms.	Matola	Laura	K	5414714106	8145			5414711524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/28/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Discount Program Payment Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Electronic Health Record Contact	CIO	Mr.	Zesiger	Justin		5414714106					justin.zesiger@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/31/2019	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Emergency Part D Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		9712226045					amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Emergency Part D Contact (Secondary)	VP Compliance	Ms.	Matola	Laura		5417615291				5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Encounter Data & Risk Adjustment Operations Contact	VP, Claims Administration & Business Services	Ms.	Gillespie	Lori		5414714106				5414711524	Lori.Gillespie@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97520	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Enrollment Contact	Enrollment Director	Ms.	Anders	Sheila		5414714106				5414711524	sheila.anders@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	EOB Transfer Contact	VP, Claims Administration & Business Services	Ms.	Gillespie	Lori		5414714106				5414711524	lori.gillespie@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Financial Audit Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Financial Reporting Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Formulary Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Formulary Contact (Secondary)			Nyawabila	Christina		8587906350				8586891799	FAS@medimpact.com	10181  Scripps Gateway Court		San Diego	CA	92131	02/26/2019	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	General Contact	CEO	Mr.	Janasik	Max		5414714106	8463			5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/05/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Government Relations Contact	CEO	Mr.	Janasik	Max		5414714106	8463			5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/05/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	HIPAA Privacy Officer	VP Compliance	Ms.	Matola	Laura	K	5414714106	8145			5414711524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/28/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	HIPAA Security Officer	Chief Information Officer	Mr.	Zesiger	Justin		5414714106				5414711524	Justin.zesiger@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/28/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Hospice Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106					amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Interoperability Contact	CIO		Zesiger	Justin		5414714106					justin.zesiger@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	11/30/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	MA Appeals/Grievances Contact	VP Compliance	Ms.	Matola	Laura		5414714106	8145			5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	MA Claims Processing Contact for Public Website	VP, Claims Administration & Business Services	Ms.	Gillespie	Lori		5414714106				5414711524	lori.gillespie@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Marketing Contact	Director of Marketing	Ms.	LaFond	Nicole		5414714106	8113			5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	04/28/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Medical Director	Chief Medical Officer	Dr.	Williams	Rick		5414714106				5414711524	Rick.Williams@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	09/04/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Medicare Compliance Officer	VP Compliance	Ms.	Matola	Laura		5414714106	8115			5414711524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/24/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Medicare Coordinator	VP Compliance	Ms.	Matola	Laura		5414714106	8145			5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Medicare Part D Opioid Overutilization Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106				5414711524	Amy.Burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Medication Therapy Management Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	OffShore Subcontractor Contact	VP Compliance	Ms.	Matola	Laura	K	5414714106	8145			5414711524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/28/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Online Enrollment Center Contact (Back-up)	Marketing & Sales Associate	Mr.	Welo	Shawn		5414714106				5414711524	shawn.welo@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/21/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Online Enrollment Center Contact (Primary)	Director of Marketing	Ms.	LaFond	Nicole		5414714106	8113			5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	04/28/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part C Application Contact	Director of Marketing	Ms.	LaFond	Nicole		5414714106	8113			5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	04/28/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part C Reporting Contact	VP Compliance	Ms.	Matola	Laura		5414714106				5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Appeals	VP Compliance	Ms.	Matola	Laura						5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active	8884600185				HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Application Contact	Director of Marketing	Ms.	LaFond	Nicole		5414714106	8113			5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	04/28/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Benefits Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Claims Submission Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active	8884600185				HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Price File Contact (Back-up)	Lead Developer	Mr.	Eyman	John		5414714106	8202				john.eyman@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Price File Contact (Optional)	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106				5414711524	amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Price File Contact (Primary)			Niemi	Kirstin		8587906455					PlanFinderCommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	09/17/2019	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Quality Assurance Contact	VP Compliance	Ms.	Matola	Laura		5414714106				5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Part D Reporting Contact	VP Compliance	Ms.	Matola	Laura		5414714106				5414713789	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Patient Safety Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106					amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Payment Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Pharmacy Director	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Pharmacy Network Management Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/23/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active	8884600185				HMO - Health Maintenance Organization		C	Dallas
H3810	Physician Incentive Contact	CEO	Mr.	Janasik	Max		5414714106	8463			5414711524	max.janasik@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	02/05/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Plan Directory Contact for Public Website	Director of Marketing	Ms.	LaFond	Nicole		8884600185	8113			5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	04/28/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Plan to Plan Reconciliation Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Processor Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106				5414711524	amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Quality Contact	VP Compliance	Ms.	Matola	Laura		5414714106				5414711524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/08/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Reconciliation Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Recovery Audit Contact	VP Controller	Ms.	Crow	Jennifer	N	5414714106				5414711524	jennifer.crow@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/31/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	SNP Application Contact	Director of Marketing	Ms.	LaFond	Nicole		5414714106	8113				nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	04/28/2023	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	SNP State Contact	Director of Marketing	Ms.	LaFond	Nicole		5414714106				5414711524	nicole.lafond@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	06/21/2024	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Surveillance Contact	VP Compliance	Ms.	Matola	Laura	K	5414714106	8145			5414711524	laura.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/28/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	System Contact	Developer	Mr.	Ridenour	Joseph		5414714106					joe.ridenour@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Third Party Administrator (TPA) Liaison	Reinsurance & Accounting Manager	Ms.	Carrick	Shay		5414714106				5414711524	shay.carrick@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/01/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	User Access Contact	Chief Compliance Officer   EPOC	Ms.	Matola	Laura		5414714106					laua.matola@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	01/24/2025	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Utilization Management Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3810	Utilization Review Contact	VP, Benefit Management & Pharmacy Services	Ms.	Burns	Amy		5414714106	8202				amy.burns@allcarehealth.com	1701 NE 7th Street		Grants Pass	OR	97526	10/05/2021	2026	ALLCARE HEALTH PLAN, INC.	Local CCP	AllCare Advantage	HMO/HMOPOS		AllCare Health, Inc.	660	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3811	Agent/Broker Compensation Data Contact	Manager - SHP Business Development		Hunter	Danielle		5417685190					dhunter@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/02/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Services		Albeke	Sheila		5417685207					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Backup User Access Contact	Compliance & Integrity Analyst		Keyser	Staci		5417684670				5417689791	shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Best Available Evidence Contact	AVP Financial Ops		Began	Trent		5417687993					tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Bid Audit Contact	AVP Financial Ops		Began	Trent		5417687993					tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Bid Audit Site Contact	AVP Financial Ops		Began	Trent		5417687993					tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Bid Primary Contact	Chief Executive Officer		Butler	Bruce		5417685484				5417684294	bbutler@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	CAP Report Contact for Public Website	Compliance Officer		Daly	Anne		2028095285				5417684294	shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	02/18/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Butler	Bruce		5417685184				5417684294	bbutler@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	CEO - Senior Official for Contracting	CEO	Mr.	Butler	Bruce		5417685484				5417684294	bbutler@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/26/2019	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Chief Financial Officer	AVP of Finance	Mr.	Began	Trent		5417687993				5417684294	tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Chief Operating Officer	Chief Operations Officer	Ms.	Fowler	Annette		5417684271				5417684294	afowler@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/03/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Chief Information Officer	VP, Information Services	Mr.	Bernarding	Trevin		5417681681					Tbernardin@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	06/22/2023	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Chief Information Security Officer	AVP-IS Information Security	Mr.	Kelly	James		5417684507					jkelly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	CMS Casework Communication Contact	AVP - SHP Operations		Fakki	Marjan		5417685514					mfakki@samhealth.org	2300 nw walnut blvd		corvallis	OR	97330	09/26/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Complaints Tracking Contact	AVP SHP Operations		Fakki	Marjan		3104979464					mfakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Contact for Fraud Investigations	Compliance & Integrity Analyst		Keyser	Staci		5419051611					shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	06/26/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Coordination of Benefits Contact	Compliance Officer		Daly	Anne		2028095285					shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	02/18/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Corporate Mailing						5417686326				5417684294	shpocompliance@samhealth.org	PO Box M		Corvallis	OR	97339	03/18/2014	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Customer Service Operations Contact	Manager of Customer Service		Taylor	Philip		5417686757				5417684294	ptaylor@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	DIR Contact	Manager Risk & Revenue		Penner	Wade		5417687895					wpenner@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	03/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	DIR Contact (Secondary)	Encounter Data Specialist II		Ceniceros	Angela		5417684559					aceniceros@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	06/17/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Discount Program Payment Contact	AVP of Finance	Mr.	Began	Trent		5417687993				5417684294	tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	10/09/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Emergency Part D Contact	Director of Pharmacy Services		Albeke	Sheila		5415509566					halbeke@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Emergency Part D Contact (Secondary)	Manager-SHP Pharmacy Op		Stradling	Jonathan		5417685207					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut BLVD		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Encounter Data & Risk Adjustment Operations Contact	Manager Risk & Revenue		Penner	Wade		5417687895					wpenner@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	03/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Enrollment Contact	AVP, SHP Operations		Fakki	Marjan		5417684550				5417684294	MFakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/01/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	EOB Transfer Contact	Program Manager II		Legee	Melissa		5417686926				5417684294	MLegee@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Financial Audit Contact	Manager Financial Planning	Mr.	Boyer	Benjamin		5417684210				5417684294	Bboyer@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	08/31/2021	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Financial Reporting Contact	AVP Financial Ops		Began	Trent		5417687993					tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Formulary Contact	Pharmacy Director		Albeke	Sheila		5417685207					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Formulary Contact (Secondary)	Optum Formulary Consultant		Maloney	Julia		2242312718					Julia.Maloney@Optum.com	1600 McConnor Parkway		Shaumburg	IL	60173	12/11/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	General Contact	VP-Chief Compliance Officer	Mrs.	Daly	Anne		5419054914				5417689791	adaly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Government Relations Contact	Government Relations Director		Easton	Andi		5035591059				5417684294	aeaston@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	HIPAA Privacy Officer	Privacy Officer		Smith	Scott		5417682165					scottsmith@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	HIPAA Security Officer	AVP-IS Information Security		Kelly	James		5417684507					jkelly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Hospice Contact	Pharmacy Director		Ableke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Interoperability Contact	AVP - SHP Operations		Fakki	Marjan		5417685514				5417684294	mfakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/26/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	MA Appeals/Grievances Contact	AVP SHP Operations		Fakki	Marjan		3104979464					mfakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	MA Claims Processing Contact for Public Website	AVP, SHP Operations		Fakki	Marjan		5417684550				5417684294	MFakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/01/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Marketing Contact	Director, Sales and Bus. Development		Loach	Tom		2089956866					tloach@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/02/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Medical Director	Medical Director	Dr.	Godek	Brent		5417684889				5417684518	shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	03/02/2023	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Medicare Compliance Officer	VP-Chief Compliance Officer	Mrs.	Daly	Anne		2028095285					adaly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Medicare Coordinator	Compliance & Integrity Analyst		Keyser	Staci		5417684670				5417689791	shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Molina	Katie		5417685207					kmolina@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Medication Therapy Management Contact	Director of Pharmacy Services		Albeke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	OffShore Subcontractor Contact	VP-Chief Compliance Officer	Mrs.	Daly	Anne		5419054914					adaly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Online Enrollment Center Contact (Optional)	AVP, SHP Operations		Fakki	Marjan		5417684550				5417684294	MFakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/01/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Online Enrollment Center Contact (Primary)	AVP, SHP Operations		Fakki	Marjan		5417684550				5417684294	MFakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/01/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part C Application Contact	Director of Sales and Development		Loach	Tom		2089956866				5417684294	tloach@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part C Reporting Contact	Director of Pharmacy Services		Albeke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Appeals	Director-SHP Pharmacy Svcs		Albeke	Sheila							SHPPharmacyLeadership@samhealth.org	2300 nw walnut blvd		corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active	5417685207				HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Appeals Contact (Secondary)	AVP, SHP Operations		Fakki	Marjan						5417689765	mfakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/01/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active	5417684550				HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Application Contact	Director of Sales and Development		Loach	Tom		2089956866				5417684294	tloach@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Benefits Contact	Director of Pharmacy Services		Albeke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Claims Submission Contact	Manager Risk & Revenue		Penner	Wade		5417687895				5417684294	wpenner@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	03/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Exceptions Contact	Director of Pharmacy Services		Albeke	Sheila							SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active	5417685207				HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Exceptions Contact (Secondary)	Manager-SHP Pharmacy Ops		Stradling	Jonathan							SHPPharmacyLeadership@samhealth.org	2300 NW Walnut BLVD		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active	5417685207				HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Price File Contact (Back-up)	Director		Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	12/11/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Price File Contact (Optional)	Pharmacy Director		Albeke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/11/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Price File Contact (Primary)	OptumRX		Lyman	Dorothy		5414955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	07/06/2020	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Quality Assurance Contact	Director of Pharmacy Services		Albeke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Part D Reporting Contact	Director of Pharmacy Services		Albeke	Sheila		5415501998					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Patient Safety Contact	Pharmacy Director		Albeke	Sheila		5417685207					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Payment Contact	AVP Financial Ops		Began	Trent		5417687993					tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Personal Health Record Contact	Privacy Officer		Smith	Scott		5417682165					scottsmith@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Pharmacy Director	Director of Pharmacy Services		Albeke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Pharmacy Network Management Contact	Director of Pharmacy Services		Albeke	Sheila		5415509566					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Pharmacy Network Management Contact (Secondary)	Manager-SHP Pharmacy Ops		Stradling	Jonathan		5417685207					SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Pharmacy Technical Help Desk Contact	Manager-SHP Pharmacy Ops		Stradling	Jonathan							SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active	5417685207				HMO - Health Maintenance Organization		C	Chicago
H3811	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Director		Albeke	Sheila							SHPPharmacyLeadership@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	12/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active	5415509566				HMO - Health Maintenance Organization		C	Chicago
H3811	Physician Incentive Contact	AVP of Finance		Began	Trent		5417687993				5417684294	shpocompliance@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Plan Directory Contact for Public Website	Director, Sales and Bus. Development		Loach	Tom		2089956866					tloach@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	07/02/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Plan to Plan Reconciliation Contact	Manager Risk & Revenue		Penner	Wade		5417687895				5417684294	wpenner@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	03/04/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Processor Contact	AVP, SHP Operations		Fakki	Marjan		5417684550				5417684294	MFakki@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Quality Contact	AVP-SHP Clinical Svcs Division	Mrs.	Kuffour	Nana Ama		2672417523				5417685015	nkuffour@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	06/26/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Reconciliation Contact	AVP of Finance		Began	Trent		5417687993				5417684294	tbegan@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Reconciliation Contact (Secondary)	Manager Reimbursement		Ligterink	Jamie		5417685352				5417684294	jligterink@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Recovery Audit Contact	Manager Financial Planning	Mr.	Boyer	Benjamin		5417684210				5417684294	Bboyer@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	SNP Application Contact	VP-COO Health Plan Operations	Mrs.	Fowler	Annette		5417684271				5417684294	afowler@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	SNP State Contact	VP-COO Health Plan Operations	Mrs.	Fowler	Annette		5417684271				5417684294	afowler@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Surveillance Contact	VP-Chief Compliance Officer	Mrs.	Daly	Anne		5419054914					adaly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	System Contact	VP-Chief Compliance Officer	Mrs.	Daly	Anne		5419054914					adaly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Third Party Administrator (TPA) Liaison	Encounter Data Specialist II		Ceniceros	Angela		5417684559					aceniceros@samhealth.org	2300 NW Walnut Boulevard		Corvallis	OR	97330	06/30/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	User Access Contact	VP-Chief Compliance Officer	Mrs.	Daly	Anne		5417684119				5417689791	adaly@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	01/07/2025	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Utilization Management Contact	Director of Care Management		Sasso	Tracy		5417684550				5417684294	tsasso@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3811	Utilization Review Contact	Director of Care Management		Sasso	Tracy		5417684550				5417684294	tsasso@samhealth.org	2300 NW Walnut Blvd		Corvallis	OR	97330	09/16/2024	2026	SAMARITAN HEALTH PLANS, INC.	Local CCP	Samaritan Advantage Health Plans	HMO/HMOPOS		Samaritan Health Services, Inc.	201	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3814	Agent/Broker Compensation Data Contact	VP Sales Operations		Hohenberg	Brandon		5058600441					brandon.hohenberg@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		8587906445					PartDCAT@MedImpact.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Backup User Access Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/02/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/02/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Bid Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/02/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Bid Audit Site Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/02/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Bid Primary Contact	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	CAP Report Contact for Public Website	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	6026924381				HMO - Health Maintenance Organization		C	Dallas
H3814	CEO - CMS Administrator Contact	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	CEO - Senior Official for Contracting	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Chief Financial Officer	CFO	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Chief Operating Officer	Chief Operations Officer	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Chief Information Officer	Chief Information Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Chief Information Security Officer	Information Security Officer	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Complaints Tracking Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Contact for Fraud Investigations	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Coordination of Benefits Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Corporate Mailing						8776728620				5035841772	compliance@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Customer Service Operations Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	DIR Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Discount Program Payment Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Emergency Part D Contact	Chief Medical Officer	Dr.	Work	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Enrollment Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	EOB Transfer Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441				9512067316	jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Financial Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Financial Reporting Contact	CFO	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Formulary Contact	Chief Medical Officer	Dr.	Work	Aelaf		9179920101				5035841772	aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Formulary Contact (Secondary)	Supervisor, Formulary Services		Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	General Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Government Relations Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	HIPAA Privacy Officer	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	HIPAA Security Officer	ISO	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Hospice Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Interoperability Contact	Chief Technology Officer		Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	MA Appeals/Grievances Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	MA Claims Processing Contact for Public Website	customer service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Marketing Contact	Compliance Manager	Mr.	Allotta	Tony		8303090299					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Medical Director	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Medicare Compliance Officer	Vice President of Compliance	Mr	Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Medicare Coordinator	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	OffShore Subcontractor Contact	Chief Legal Officer, General Counsel		Wilson	Charles		5039677387				5035841772	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Online Enrollment Center Contact (Optional)	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Online Enrollment Center Contact (Primary)	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part C Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part C Reporting Contact	VP of Audits, Communications and Privacy	Mrs.	Luma	Yoleine		9172080084					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Appeals	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	8776728620	3			HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Appeals Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	9179920101				HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Benefits Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Claims Submission Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	8776728620	3			HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Exceptions Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	9179920101				HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Price File Contact (Back-up)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Price File Contact (Optional)	Medicare Part D Project Manager		Maldonado	Cheryl		8587906397					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct,		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Price File Contact (Primary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Part D Reporting Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Patient Safety Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Payment Contact	Chief Financial Officer		Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Personal Health Record Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Pharmacy Director	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Pharmacy Network Management Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	8006819571				HMO - Health Maintenance Organization		C	Dallas
H3814	Pharmacy Technical Help Desk Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	9179920101				HMO - Health Maintenance Organization		C	Dallas
H3814	PHR Beneficiary Contact																	05/09/2018	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS	ATRIO Health Plans	ATRIO Health Plans	5	Yes	Active	8776728620				HMO - Health Maintenance Organization		C	Dallas
H3814	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Processor Contact	Director, Medicare Programs		Scherlippens	Carine		8587907415					Carine.Scherlippens@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Quality Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Reconciliation Contact	Chief Financial Officer		Kirkpatrick	James		5034285602				5035841772	james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Recovery Audit Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602				5035841772	james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	SNP Application Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	SNP State Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Surveillance Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	System Contact	Chief Technology Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	User Access Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Utilization Management Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3814	Utilization Review Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3815	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				HMO - Health Maintenance Organization		C	Chicago
H3815	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				HMO - Health Maintenance Organization		C	Chicago
H3815	PHR Beneficiary Contact																	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				HMO - Health Maintenance Organization		C	Chicago
H3815	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3815	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3817	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Encounter Data & Risk Adjustment Operations Contact	AD Risk Adjustment Analytics		Aryal	Binaya		5032255305					Binaya.Aryal@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/06/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	MA Appeals/Grievances Contact	Healthcare Svcs Program Mgr Sr	Ms.	Huque	Nita		5035531462					Nita.Huque@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	MA Claims Processing Contact for Public Website	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part C Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part C Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H3817	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H3817	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H3817	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				PPO - BBA		C	Dallas
H3817	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				PPO - BBA		C	Dallas
H3817	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				PPO - BBA		C	Dallas
H3817	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Quality Contact	Director, Quality Management	Mr.	Mcclure	Andy		5032206189					Andrew.Mcclure@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Utilization Management Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3817	Utilization Review Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H3821	Automated TrOOP Balance Transfer Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Backup User Access Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Best Available Evidence Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Bid Primary Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	CAP Report Contact for Public Website	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	CEO - CMS Administrator Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	CEO - Senior Official for Contracting	Chief Administrative Officer	Mrs	Wong	Joann		5107353131					joannwong@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Chief Financial Officer	CFO	Mr	Chen	James	Z	5107353131					JamesChen@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Chief Operating Officer	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Chief Information Officer	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Chief Information Security Officer	Chief Administrative Officer	Mrs	Wong	Joann		5107353131					joannwong@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	CMS Casework Communication Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Complaints Tracking Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Contact for Fraud Investigations	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Coordination of Benefits Contact	Human Resources Manager	Mr	Martinez	John		5107353158					JMartinez@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Corporate Mailing						5107353364					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Customer Service Operations Contact	Director of Clinic Operations	Mrs	Chang-Fong	Mariana		5107353322					mchang@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	DIR Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Discount Program Payment Contact	Revenue Cycle Manager	Mrs	Olaguer	Alma		5107353131					aolaguer@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Emergency Part D Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Encounter Data & Risk Adjustment Operations Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Enrollment Contact	Senior Member Services Manager		Ly	Dinh		5107353131					DLy@ahschc.org	818 Webster Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	EOB Transfer Contact	CEO	Mrs	Liou	Julia		5107353131				5107353131	jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Financial Audit Contact	Partner	Mr	Church	Robert		5599994327					bchurch@chwllp.org	7797 N. First Street #15		Fresno	CA	93720	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Financial Reporting Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Formulary Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	General Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Government Relations Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	HIPAA Privacy Officer	Chief Administrative Officer	Mrs	Wong	Joann		5107353131					joannwong@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	HIPAA Security Officer	Chief Administrative Officer	Mrs	Wong	Joann		5107353131					joannwong@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Interoperability Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	MA Appeals/Grievances Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	MA Claims Processing Contact for Public Website	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Marketing Contact	Marketing and Communications Manager	Mrs	Wu	Daphne		5107353131					DAPwu@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Medical Director	Chief Medical Officer		Nguyen	Mychi		5107353131					mnguyen@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Medicare Compliance Officer	Compliance & Administrative Operations Manager	Mrs	Matsuoka	Karen		5107353115					KMatsuoka@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Medicare Coordinator	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Medicare Part D Opioid Overutilization Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Medication Therapy Management Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part C Application Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street, Suite 100		Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part D Appeals	CEO	Mrs	Liou	Julia							jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending	5107353131				PACE - Nat		C	San Francisco
H3821	Part D Application Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street, Suite 100		Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part D Benefits Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part D Claims Submission Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part D Exceptions Contact	CEO	Mrs	Liou	Julia							jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending	5107353131				PACE - Nat		C	San Francisco
H3821	Part D Price File Contact (Back-up)	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part D Price File Contact (Primary)	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part D Quality Assurance Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Part D Reporting Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Patient Safety Contact	Director of Clinic Operations	Mrs	Chang-Fong	Mariana		5107353322					mchang@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Payment Contact	Revenue Cycle Manager	Mrs	Olaguer	Alma		5107353131					aolaguer@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Pharmacy Director	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Pharmacy Network Management Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Pharmacy Technical Help Desk Contact	CEO	Mrs	Liou	Julia							jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending	5107353131				PACE - Nat		C	San Francisco
H3821	Plan Directory Contact for Public Website	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Plan to Plan Reconciliation Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Processor Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Quality Contact	Quality Improvement Director	Mrs	Trowbridge	Sarah		5107353364					STrowbridge@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Reconciliation Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Recovery Audit Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Surveillance Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	System Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Third Party Administrator (TPA) Liaison	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	User Access Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Utilization Management Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3821	Utilization Review Contact	CEO	Mrs	Liou	Julia		5107353131					jliou@ahschc.org	101 8th Street	Suite 100	Oakland	CA	94607	03/14/2024	2026	ASIAN HEALTH SERVICES	National PACE	Asian Health Services, Inc.	National PACE		Asian Health Services	839	Yes	Pending					PACE - Nat		C	San Francisco
H3822	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/26/2025	2026	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	Chicago
H3822	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H3822	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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	Chicago
H3822	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H3822	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Chicago
H3822	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Chicago
H3822	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Chicago
H3822	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H3822	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H3822	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H3822	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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	Chicago
H3822	Chief Operating Officer	hcsc_medicare_ceo@hcsc.net DSVP Government Program	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H3822	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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	Chicago
H3822	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	Chicago
H3822	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H3822	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Chicago
H3822	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H3822	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	Chicago
H3822	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	Chicago
H3822	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H3822	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Chicago
H3822	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Chicago
H3822	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H3822	Encounter Data & Risk Adjustment Operations Contact	Exec Dir Risk Adjustment	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/29/2025	2026	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	Chicago
H3822	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Chicago
H3822	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H3822	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Chicago
H3822	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Chicago
H3822	Formulary Contact	Director Pharmacy Medicare	Mr	Chavez	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Chicago
H3822	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	Chicago
H3822	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H3822	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/26/2025	2026	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	Chicago
H3822	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2026	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	Chicago
H3822	Interoperability Contact	Head of DAS Platform Ops	Ms	Wahmann	Cara		6308246197					cara_wahmann@bcbsil.com	Health Care Service Corporation	3500 Lacey Road	Downers Grove	IL	60515	09/29/2025	2026	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	Chicago
H3822	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	Chicago
H3822	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H3822	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Chicago
H3822	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/29/2025	2026	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	Chicago
H3822	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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	Chicago
H3822	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H3822	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Chicago
H3822	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	Chicago
H3822	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H3822	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Chicago
H3822	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H3822	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H3822	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	Part D Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3822	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3822	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H3822	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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	Chicago
H3822	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	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	Chicago
H3822	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3822	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3822	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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	Chicago
H3822	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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	Chicago
H3822	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H3822	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H3822	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Chicago
H3822	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H3822	Personal Health Record Contact	Exec Dir Technology Delivery	Mr.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	09/26/2025	2026	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	Chicago
H3822	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H3822	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/21/2023	2026	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	Chicago
H3822	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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	Chicago
H3822	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8772777898				HMO - Health Maintenance Organization		C	Chicago
H3822	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	0000000000				HMO - Health Maintenance Organization		C	Chicago
H3822	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	09/21/2018	2026	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	Chicago
H3822	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, 2A Finance	Richardson	TX	75082	09/29/2025	2026	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	Chicago
H3822	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Chicago
H3822	Quality Contact	DVP Government Performance	Ms.	Gonzalez	Eugenia		3126533413				3128199474	Eugenia_M_Gonzalez@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/12/2022	2026	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	Chicago
H3822	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H3822	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Chicago
H3822	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	09/29/2025	2026	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	Chicago
H3822	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H3822	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H3822	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E Randolph Street	Chicago	IL	60601	09/29/2025	2026	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	Chicago
H3822	System Contact	Exec Dir Technology Delivery	Ms	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/29/2025	2026	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	Chicago
H3822	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Chicago
H3822	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Chicago
H3822	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Chicago
H3822	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Chicago
H3828	Agent/Broker Compensation Data Contact	Director of Sales		Dues	Travis		6145463157				6145463131	Travis.Dues@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		6145463183				6145463131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Backup User Access Contact	Sr. Application Specialist		Crawford	Carl		6145463215				6145463144	ccrawford@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Bid Audit Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463211	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Bid Audit Site Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Bid Primary Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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	CAP Report Contact for Public Website	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	Jack.Randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/06/2025	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463211				6145463131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Operating Officer	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Information Officer	VP Service Optimization	Mr.	Trimmer	Matt		3017547190					matt.trimmer@trinity-health.org	3100 Easton Square Place		Columbus	OH	43219	07/17/2023	2026	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 Information Security Officer	Sr Security Manager, Enterprise Information Securi	Mr.	Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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	6147068474				6142348372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Complaints Tracking Contact	Compliance Specialist	Mr	Jordan	David	A	6147068474					djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Corporate Mailing						4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	DIR Contact	CEO		Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square  Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	DIR Contact (Secondary)	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Discount Program Payment Contact	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Electronic Health Record Contact	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Emergency Part D Contact	Chief Compliance Officer		Suffern	Patricia		4124780244				6145463132	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/23/2022	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Director	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/17/2024	2026	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	Employer Waiver Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Reconciliation Analyst		Sloan	Mike		6145463134					mike.sloan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Enrollment Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	EOB Transfer Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Financial Audit Contact	Chief Compliance Officer	Ms.	Suffern	Patricia	A	4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/24/2025	2026	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	Financial Reporting Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Formulary Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	General Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	HIPAA Privacy Officer	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	HIPAA Security Officer	Sr Security Manager, Enterprise Information Securi		Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Interoperability Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	MA Appeals/Grievances Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	MA Claims Processing Contact for Public Website	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	Marketing Contact	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Medical Director	MD	Dr.	Wise	Greg		6145463151				6145463131	gwise@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Coordinator	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Part D Opioid Overutilization Contact	Pharmacy Data Analyst	Ms.	Houk	Kimberly		6145463183					kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	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	Medication Therapy Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	OffShore Subcontractor Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment	Ms	Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Online Enrollment Center Contact (Optional)	Director, Enrollment and Premium Billing		Caudle	Jeff		6145463224				6145463148	jcaudle@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 C Application Contact	Director, Product Management and Business Devlpt		Mauck	Brandon		6145955681					brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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 C Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Appeals	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H3828	Part D Appeals Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H3828	Part D Application Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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 Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Claims Submission Contact	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H3828	Part D Exceptions Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H3828	Part D Price File Contact (Back-up)	Formulary Consultant		Scott	Sarah		4803109219					sarah.scott@CVSHealth.com	9501 E. Shea		Scottsdale	AZ	85260	05/02/2025	2026	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 Price File Contact (Primary)	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Quality Assurance Contact	Director of Pharmacy, Health Plans	Ms.	McGhee	Anna		2165345375				6142346481	anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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 Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Patient Safety Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Payment Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Director	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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 Network Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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 Network Management Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	8666934620				PPO - BBA		C	Chicago
H3828	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Data Analyst	Mrs	Miller	Kim							kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO		Trinity Health Corporation	234	Yes	Active	8666934620				PPO - BBA		C	Chicago
H3828	PHR Beneficiary Contact																	02/01/2022	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	Local PPO	MediGold	Trinity Health Corporation	234	Yes	Active	8002403851				PPO - BBA		C	Chicago
H3828	Physician Incentive Contact	Interim VP, Health Services	Ms	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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	Plan Directory Contact for Public Website	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Processor Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	Quality Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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	Reconciliation Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Reconciliation Contact (Secondary)	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Recovery Audit Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Surveillance Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	System Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Third Party Administrator (TPA) Liaison	Sr Finance Analyst		Fountain	Lisa		6145463220					lfountain@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	User Access Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	Utilization Management Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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	Utilization Review Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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	Agent/Broker Compensation Data Contact	Supervisor, Medicare Sales		Guzman	Tati		8089485463				8089486585	tati_guzman@hmsa.com	P.O. Box 860	8 AMS	Honolulu	HI	96808	12/29/2021	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Automated TrOOP Balance Transfer Contact	Senior Business Analyst		Kalino	Karen		8089486262				8089486585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	11/27/2020	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Backup User Access Contact	VP, Chief Compliance Officer		Nakamura	Carrie		8089485369					carrie_nakamura@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Best Available Evidence Contact	Enrollment Specialist, IO Liaison		Jose	Angelica		8089485705				8089486285	Angelica_Jose@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	02/13/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Bid Audit Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Bid Audit Site Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Bid Primary Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Rivad	Maila		8089485767				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	01/23/2020	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	CEO - CMS Administrator Contact	CEO	Mr.	Mugiishi	Mark		8089485021				8089485999	mark_mugiishi@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	CEO - Senior Official for Contracting	CEO	Mr.	Mugiishi	Mark		8089485021				8089485999	mark_mugiishi@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Chief Financial Officer	EVP, Chief Financial Officer	Ms.	Smith	Xuejun		8089486621					jenny_smith@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808	11/27/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Chief Operating Officer	President and COO	Ms.	Smith	Jenny		8089486621				8089485999	Jenny_smith@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Chief Information Officer	EVP and Chief Information Officer	Mr.	Hopfer	Rick		8089486025				8089485999	rick_hopfer@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Chief Information Security Officer	CISO	Mr.	Gummadi	Sudhakar		8087434389				8089527580	sudhakar_gummadi@hmsa.com	P.O. Box 860	10 - IPP	Honolulu	HI	96808	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	CMMI Model Point of Contact	Manager, Medicare Programs		Lyons	Malia		8089485191				8089486887	malia_lyons@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/11/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	CMS Casework Communication Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		8089485347				8089527546	Renee_Hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	12/29/2021	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Complaints Tracking Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		8089485347				8089527546	renee_hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	11/24/2021	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Contact for Fraud Investigations	Director, Special Investigations Unit		Aronson	Virginya		8089528548					virginya_aronson@hmsa.com	P.O. Box 860	10 SIU	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Coordination of Benefits Contact	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	11/27/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Corporate Mailing						8089486000					!MedicarePrograms@hmsa.com	P.O. Box 860	9 - MP	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Customer Service Operations Contact	Senior Manager, Customer Relations		Forsyth	Clarice		8089485224				8089485567	Customer-service@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	DIR Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	DIR Contact (Secondary)	Sr Business Analyst		Smith	Nicolette		8089485631					nicolette_smith@hmsa.com	P.O. Box 860	6 - FA	Honolulu	HI	96808	11/27/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Discount Program Payment Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Emergency Part D Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Emergency Part D Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus		8089527772				8089485618	medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Encounter Data & Risk Adjustment Operations Contact	Manager, Financial Services - HMO & Govt Reporting		Nakashima	Mark		8089486594				8089485063	mark_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Enrollment Contact	Enrollment Specialist, IO Liaison		Jose	Angelica		8089485705				8089486285	Angelica_Jose@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	02/13/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	EOB Transfer Contact	Senior Business Analyst, Medicare Programs		Refuerzo	Marilou		8084970295				8089486585	marilou_refuerzo@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Financial Audit Contact	Director, Government Accounting and Reporting	Ms.	Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Financial Reporting Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Formulary Contact	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Formulary Contact (Secondary)	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	12/04/2020	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	General Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Government Relations Contact	SVP, Government		Diesman	Jennifer		8085616397				8089486860	jennifer_diesman@hmsa.com	P.O. Box 860	11 EXEC	Honolulu	HI	96808	11/16/2023	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	HIPAA Privacy Officer	AVP, Compliance & Prv Officer		Borje-Bonkowski	Maria		8089486205					maria_borje-bonkowski@hmsa.com	P.O. Box 860	10 - C&E	Honolulu	HI	96808	12/02/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	HIPAA Security Officer	CISO	Mr.	Gummadi	Sudhakar		8087434389				8089527580	sudhakar_gummadi@hmsa.com	P.O. Box 860	10 - IPP	Honolulu	HI	96808	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Hospice Contact	Business Analyst - Medicare Part D		Kanda	Jordan		8089527749				8089485611	jordan_kanda@hmsa.com	P.O. Box 860	10 - KB-PM	Honolulu	HI	96808	12/03/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Interoperability Contact	VP, Health Data Integ & Analytic		Dobbs	David	C	8089486030					david_dobbs@hmsa.com	P.O. Box 860	6 CORP	Honolulu	HI	96808	04/08/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	MA Appeals/Grievances Contact	Senior Manager, Member Advocacy and Appeals		Inouye	Marissa		8089527792				8089527546	marissa_inouye@hmsa.com	P.O. Box 860		Honolulu	HI	96808	10/17/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	MA Claims Processing Contact for Public Website	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	12/04/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Marketing Contact	Sr. Business Analyst		Peters	Kristen	A	8089481180					Kristen_Peters@hmsa.com	PO Box 860	8 - MP	Honolulu	HI	96808	10/10/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Medical Director	Medicare Medical Director		Percy	David		8089486252				8089486340	david_percy@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Medicare Compliance Officer	AVP, Regulatory Compliance and SIU	Ms.	Aronson	Virginya		8089528584				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Medicare Coordinator	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	07/02/2021	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Medication Therapy Management Contact	BH Business Analyst		Francis	Teesha		8089527564					teesha_francis@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	12/13/2023	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	OffShore Subcontractor Contact	Manager, Medicare Programs		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/11/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Online Enrollment Center Contact (Back-up)	Manager, Medicare Programs		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	10/10/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Online Enrollment Center Contact (Optional)	Sr. Business Analyst		Peters	Kristen	A	8089481180					Kristen_Peters@hmsa.com	PO Box 860	8 - MP	Honolulu	HI	96808	10/10/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Online Enrollment Center Contact (Primary)	Enrollment Specialist, IO Liaison		Jose	Angelica		8089485705				8089486285	Angelica_Jose@hmsa.com	P.O. Box 860	7 MS	Honolulu	HI	96808	02/13/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part C Application Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part C Reporting Contact	Manager, Medicare Program		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Appeals	Senior Manager, Member Advocacy and Appeals		Inouye	Marissa						8089527546	marissa_inouye@hmsa.com	P.O. Box 860		Honolulu	HI	96808	10/17/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8089527792				PPO - BBA		C	Boston
H3832	Part D Appeals Contact (Secondary)	Senior Business Analyst		Kalino	Karen						8089486585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	11/27/2020	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8089486262				PPO - BBA		C	Boston
H3832	Part D Application Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Benefits Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Claims Submission Contact	Manager, Financial Services - HMO & Govt Reporting		Nakashima	Mark		8089486594				8089485063	mark_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Exceptions Contact	Clinical Pharmacist, Government Programs		Iwaishi	Brandon							brandon_Iwaishi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8009485618				PPO - BBA		C	Boston
H3832	Part D Exceptions Contact (Secondary)	Manager, Clinical Pharmacy		Kuniyoshi	Derek							derek_kuniyoshi@hmsa.com	P.O. Box 860	10-KB-PM	Honolulu	HI	96808	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8084622085				PPO - BBA		C	Boston
H3832	Part D Price File Contact (Back-up)	Manager of Financial Operations		Albert	Sebastian		4802519123					Sebastian.Albert2@CVSHealth.com	9501 E Shea Blvd	CVS Caremark	Scottsdale	AZ	85260	10/10/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Price File Contact (Optional)	Program Manager   PBM Finance Operations		Pertgen	Richard		8045258502					Richard.Pertgen@cvshealth.com	9501 E. Shea Blvd. MC080	CVS Caremark	Scottsdale	AZ	85260	12/29/2021	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Price File Contact (Primary)	Sr. Analyst		Scott	Sara		4803109219					sarah.scott@cvshealth.com	9501 E. Shea Blvd.	CVS Caremark	Scottsdale	AZ	85260	11/03/2023	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Quality Assurance Contact	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Part D Reporting Contact	Manager, Medicare Program		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Patient Safety Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	12/04/2020	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Payment Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Pharmacy Director	Director, Pharmacy Operations		Goo	Roy		8082225910					roy_goo@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	12/13/2023	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Pharmacy Network Management Contact	Director		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd., MC080	CVS Caremark	Scottsdale	AZ	85260	12/20/2019	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Pharmacy Network Management Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Pharmacy Technical Help Desk Contact	Sr. Manager		Stauffer	Grace							grace.stauffer@cvshealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/06/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8666934620				PPO - BBA		C	Boston
H3832	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus							medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8089527772				PPO - BBA		C	Boston
H3832	Plan Directory Contact for Public Website	Manager, Medicare Program		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Plan to Plan Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Processor Contact	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	12/09/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Quality Contact	Director, Medicare Stars		Loo	Trisha		8089486103					Trisha_Loo@hmsa.com	P.O. Box 860	6-QM	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Reconciliation Contact (Secondary)	Sr Business Analyst		Smith	Nicolette		8089485631					nicolette_smith@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	12/09/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Recovery Audit Contact	Director, Government Accounting and Reporting	Ms.	Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	SNP Application Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	SNP State Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Surveillance Contact	Supervisor, Medicare Sales		Guzman	Tati		8089485463				8089486585	tati_guzman@hmsa.com	P.O. Box 860	8 AMS	Honolulu	HI	96808	12/04/2020	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	System Contact	Solution Delivery Advisor		Ng	Philip		8089486688				8089486799	philip_ng@hmsa.com	P.O. Box 860	5 - IS	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Third Party Administrator (TPA) Liaison	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	User Access Contact	Medicare Compliance Officer	Ms.	Rivad	Maila		8089485767				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	06/08/2021	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Utilization Management Contact	Director, Utilization Management		Hoppe	Miki		8089486739				8089445611	miki_hoppe@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	12/09/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3832	Utilization Review Contact	Director, Utilization Management		Hoppe	Miki		8089486739				8089445611	miki_hoppe@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	12/09/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION	Local CCP	HMSA Akamai Advantage	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	Boston
H3864	Agent/Broker Compensation Data Contact	Regional Sales Manager - Medicare		Fox	Ryan		5412252612					Ryan.Fox@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Automated TrOOP Balance Transfer Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Backup User Access Contact	Compliance Project Specialist	Mrs.	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	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	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Bid Audit Contact	Compliance Project Specialist	Ms.	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Bid Audit Site Contact	Compliance Project Specialist	Ms.	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Bid Primary Contact	Executive VP, Lines of Business		Hopper	Lindsey		5417065066					Lindsey.Hopper@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	CAP Report Contact for Public Website	President and Chief Executive Officer (CEO)	Mr.	Espinola	John		5416845286					John.Espinola@pacificsource.com	555 International Way		Springfield	OR	97477	04/03/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	CEO - CMS Administrator Contact	President and Chief Executive Officer (CEO)	Mr.	Espinola	John		5416845286					John.Espinola@PacificSource.com	555 International Way		Springfield	OR	97477	04/03/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	CEO - Senior Official for Contracting	President and Chief Executive Officer (CEO)	Mr.	Espinola	John		5416845286					John.Espinola@pacificsource.com	555 International Way		Springfield	OR	97477	04/03/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Chief Financial Officer	Senior Vice President and Chief Financial Officer	Mr	Fellner	Brian		2085632342					Brian.Fellner@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	10/28/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Chief Operating Officer	Senior Vice President, Health Plan Operations	Mr	Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	555 International Way		Springfield	OR	97477	03/17/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Chief Information Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Chief Information Security Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	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		5417065031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Complaints Tracking Contact	Team Leader Appeals and Grievances		Downey	Reanna		5417065031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Contact for Fraud Investigations	Director, Corporate Compliance - Commercial		Holliday	Gary		5416845251					Gary.Holliday@pacificsource.com	555 International Way		Springfield	OR	97477	03/20/2025	2026	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		5412253765					Dena.Keeler@pacificsource.com	555 International Way		Springfield	OR	97477	04/14/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Corporate Mailing						5413855315				5413853008	Lindsey.Hopper@pacificsource.com	PO Box 7469		Bend	OR	97708	02/12/2025	2026	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	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	DIR Contact	Pharmacy Services Compliance Team		Services	Pharmacy		5413304999				8003664873	PharmacyCompliance@pacificsource.com	PO Box 7469		Bend	OR	97708	05/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	DIR Contact (Secondary)	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413304999				8003664873	connie.riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Discount Program Payment Contact	Senior Accounts Receivable Accountant		Beaty	Charlene		5416845250					Charlene.Beaty@pacificsource.com	555 International Way		Springfield	OR	97477	08/08/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Emergency Part D Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999				8003664873	RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Analytic Manager		Kellogg	Ariel		5412253719					Ariel.Kellogg@pacificsource.com	555 International Way		Springfield	OR	97477	12/20/2021	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Enrollment Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	EOB Transfer Contact	Senior Vice President, Health Plan Operations	Mr	Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Financial Audit Contact	Vice President of Finance	Ms	Patterson	Kari		5416845594					Kari.Patterson@pacificsource.com	408 E Parkcenter Boulevard, Suite 100		Boise	ID	83706	09/26/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Financial Reporting Contact	Executive VP and Chief Financial Officer (CFO)	Mr.	Davidson	Peter		5416845212				5413853008	Peter.Davidson@pacificsource.com	555 International Way		Springfield	OR	97477	09/16/2020	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Formulary Contact	Rx Clinical Services Team		Services	Pharmacy		5038025965				5413853008	rxclinical@pacificsource.com	PO Box 7469		Bend	OR	97708	12/05/2019	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Formulary Contact (Secondary)	Pharmacy Compliance Specialist		Ryan	Alyssa		5418023031					Alyssa.Ryan@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	General Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327				5413853008	Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Government Relations Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327				5413853008	Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	HIPAA Privacy Officer	HIPAA Privacy Specialist		Olson	Terrie		5416408765					Terrie.Olson@pacificsource.com	555 International Way		Springfield	OR	97477	08/08/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	HIPAA Security Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Hospice Contact	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413307309				8003664873	Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Interoperability Contact	VP of IT Infrastructure and Analytics		Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	MA Appeals/Grievances Contact	Team Leader Appeals and Grievances		Downey	Reanna		5417065031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	MA Claims Processing Contact for Public Website	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Marketing Contact	Executive VP and Chief Sales and Marketing Officer		Havens	Jim		2532384011					Jim.Havens@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Medical Director	Medical Director	Dr.	McDonell	Miriam		5417493571					Miriam.McDonell@pacificSource.com	33 Nichols Pkwy	Suite 120	Hood River	OR	97031	01/23/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Medicare Compliance Officer	Interim Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	11/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Medicare Coordinator	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Medicare Part D Opioid Overutilization Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Medication Therapy Management Contact	Pharmacy Clinical Team		Clinical	Pharmacy		5413304999					RxClinical@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	OffShore Subcontractor Contact	Compliance Project Specialist		Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Online Enrollment Center Contact (Primary)	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part C Application Contact	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part C Reporting Contact	Compliance Project Specialist	Mrs.	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Appeals	Team Leader Appeals and Grievances		Downey	Reanna							Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active	5417065031				HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Appeals Contact (Secondary)	Manager of Appeals and Grievances		Waltman	Jessica						5413226424	Jessica.Waltman@pacificsource.com	408 E Parkcenter Boulevard, Suite 100		Boise	ID	83706	11/12/2019	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active	2089085825				HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Application Contact	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Benefits Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Claims Submission Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	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	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active	5413304999				HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Price File Contact (Back-up)			Loveland	Chet		4806064873				4013357984	Chet.Loveland@CVSHealth.com	CVS Caremark |Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	01/10/2020	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Price File Contact (Optional)	SR. Manager, PBM Financial Operations		Okrie	Courtney		4803181864					Courtney.Okrie@CVSHealth.com	CVS Caremark | Caremark	9501 E. Shea Blvd.	Scottsdale	AZ	85260	01/06/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Price File Contact (Primary)	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Quality Assurance Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Part D Reporting Contact	Compliance Project Specialist	Mrs.	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Patient Safety Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Payment Contact	Executive VP and Chief Financial Officer (CFO)	Mr.	Davidson	Peter		5416845212				5413853008	Peter.Davidson@pacificsource.com	555 International Way		Springfield	OR	97477	09/16/2020	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Pharmacy Director	Director of Clinical Pharmacy Services		Briones	Danielle		5413304999				8003664873	rxleadership@pacificsource.com	408 E Parkcenter Boulevard, Suite 100		Boise	ID	83706	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Pharmacy Network Management Contact	SR. Manager, PBM Financial Operations		Okrie	Courtney		4803181864					Courtney.Okrie@CVSHealth.com	9501 E. Shea Blvd, MC080		Scottsdale	AZ	85620	01/06/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Pharmacy Network Management Contact (Secondary)	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	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							pharmacy@pacificsource.com	PO Box 7469		Bend	OR	97708	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active	8884377728				HMO - Health Maintenance Organization		C	Seattle
H3864	Pharmacy Technical Help Desk Contact (Secondary)			Help Desk	Pharmacy								CVS Health	9501 E. Shea Blvd.	Scottsdale	AZ	85260	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active	8003646331				HMO - Health Maintenance Organization		C	Seattle
H3864	Physician Incentive Contact	VP of Provider Network		McGarry	Peter		5038025338					Peter.McGarry@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Plan Directory Contact for Public Website	Customer Service		Service	Customer		5413855315					MedicareCS@PacificSource.com	PO Box 7469		Bend	OR	97708	02/12/2019	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Plan to Plan Reconciliation Contact	Enrollment and Billing Representative		Yeakey	Paula		5417065172					P2Padmin@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Processor Contact	SR. Manager, PBM Financial Operations		Okrie	Courtney		4803181864					Courtney.Okrie@CVSHealth.com	CVS Caremark | Caremark	9501 E. Shea Blvd	Scottsdale	AZ	85260	01/06/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Quality Contact	Director, Quality Improvement Programs		Farmer	Melodie		5038025328					Melodie.Farmer@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	01/23/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Reconciliation Contact	Pharmacy Services Compliance Team		Services	Pharmacy		5413304999				8003664873	PharmacyCompliance@pacificsource.com	PO Box 7469		Bend	OR	97708	05/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Reconciliation Contact (Secondary)	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413307309				8003664873	Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Recovery Audit Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	SNP Application Contact	Compliance Project Specialist - Medicare		Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	SNP State Contact	Medicaid Contract Manager		Joseph	Kristin		5417065030					Kristin.Joseph@pacificsource.com	PO Box 7469		Bend	OR	97708	07/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Surveillance Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	System Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Third Party Administrator (TPA) Liaison	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413307309					Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	User Access Contact	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Utilization Management Contact	Vice President of Medical Management		Mussenden	Tracy-Ann		2532384017					Tracy-Ann.Mussenden@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3864	Utilization Review Contact	Vice President of Medical Management		Mussenden	Tracy-Ann		2532384017					Tracy-Ann.Mussenden@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	HMO/HMOPOS		PacificSource	429	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H3868	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H3868	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3868	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H3868	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H3868	Plan Directory Contact for Public Website			Customer Service	UHC		8669444983					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3868	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3890	Agent/Broker Compensation Data Contact	Executive Director of Sales and Marketing	Mr.	Persons	James		8134764931					JPersons@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Automated TrOOP Balance Transfer Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Backup User Access Contact	Sr. Director IT	Mr.	Reppas	Soterios		4104244620					sreppas@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Best Available Evidence Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Bid Audit Contact	Chief Actuary	Ms.	McAleer	Bethany		2026588702					BMcAleer@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Bid Primary Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	CEO - CMS Administrator Contact	President Medicare Advantage	Ms.	Rund	Lori		2488243735					LRund@jhhp.org	7231 Parkway Drive,	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	CEO - Senior Official for Contracting	President Medicare Advantage	Ms.	Rund	Lori		2488243735					LRund@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Chief Financial Officer	Chief Financial Officer	Mr.	Chojnowski	Daniel		2078072496					DChojnowski@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Chief Operating Officer	Chief Operating Officer	Mr.	O'Donnell	Ryan		7038876201					RODonnell@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Chief Information Officer	Vice President Information Technology	Mr.	Mukherjee	Joydeep		6038922211					JMukherjee@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Chief Information Security Officer	Assistant Director of Information Security, IT/IS	Mr.	Ross	Willie		4104244642					wross@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4436180786					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Complaints Tracking Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Contact for Fraud Investigations	Director of Special Investigations	Mr.	Waugh	John		4106891079					JWaugh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Coordination of Benefits Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					Sriaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Corporate Mailing						4104244955					PGillan@jhhp.org	Johns Hopkins Health Plans	Attn:Paul Gillan, Esq., 7231 Parkway Drive, Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Customer Service Operations Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	DIR Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	DIR Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					FatoduH@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Discount Program Payment Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Emergency Part D Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4438071292					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Emergency Part D Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4109256831					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Employer Waiver Contact	Manager  Medicare Business Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Encounter Data & Risk Adjustment Operations Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Enrollment Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	EOB Transfer Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740			4104242805	CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Financial Audit Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Financial Reporting Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Formulary Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Formulary Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	General Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					mdonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Government Relations Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	HIPAA Privacy Officer	Exec Director of Compliance and Regulatory Affairs	Ms.	Mohon	Melissa		4438570852					MMohon@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/24/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	HIPAA Security Officer	Chief Information Security Officer	Ms.	Rathod	Janet		6672088766					janet.rathod@jhu.edu	750 East Pratt Street		Baltimore	MD	21202	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Hospice Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					MBWexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Interoperability Contact	Exec.Director of Compliance and Regulatory Affairs	Ms.	Mohon	Melissa		4438570852					MMohon@jhhp.org	7231 Parkway Drive,	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	MA Appeals/Grievances Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	MA Claims Processing Contact for Public Website	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Marketing Contact	Manager, Marketing & Communications	Ms.	Heredia	Leslie		4104244633					LHeredia@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Medical Director	Associate Chief Medical Officer	Dr.	Gerry	Danielle		4103033422					DGerry@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Donnelly	Mary		4436180786					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Medicare Coordinator	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					SRiaz@jhhp.org	7231 Parkway Drive,	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Medication Therapy Management Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	OffShore Subcontractor Contact	Assistant Director Vendor Management	Ms.	Gomillion	Morgan		9419628261					MGomillion@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Online Enrollment Center Contact (Back-up)	Chief Operating Officer	Mr.	O'Donnell	Ryan		7038876201					RODonnell@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Online Enrollment Center Contact (Primary)	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part C Application Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	06/20/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part C Reporting Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					Sriaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Appeals	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				PPO - BBA		C	Boston
H3890	Part D Appeals Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				PPO - BBA		C	Boston
H3890	Part D Application Contact	Manager, Medicare Advantage Product Development	Ms.	Dechant	Joslyn		8146714800					jdechant@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Benefits Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Claims Submission Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Exceptions Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				PPO - BBA		C	Boston
H3890	Part D Exceptions Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	8002612396				PPO - BBA		C	Boston
H3890	Part D Price File Contact (Back-up)	Senior Analyst	Ms.	Scott	Sarah		4803109219					Sarah.Scott@cvshealth.com	9501 E. Shea Blvd.	MC121	Scottsdale	AZ	85260	12/03/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Price File Contact (Optional)	Senior Analyst	Ms.	Perry	Michele		6026211682					Michele.Perry@cvshealth.com	9501 E. Shea Blvd.	MC121	Scottsdale	AZ	85260	12/03/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Price File Contact (Primary)	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Quality Assurance Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					FatoduH@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Part D Reporting Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Patient Safety Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					Fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Payment Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Pharmacy Director	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Pharmacy Network Management Contact	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh		4104244671					fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy	Ms.	Wexler	Mary Beth		4107625938					mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Ms.	Wexler	Mary Beth							mbwexler@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/10/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	8666934620				PPO - BBA		C	Boston
H3890	Pharmacy Technical Help Desk Contact (Secondary)	Associate Vice President, Pharmacy	Mr.	Fatodu	Hugh							fatoduh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active	8666934620				PPO - BBA		C	Boston
H3890	Plan Directory Contact for Public Website	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Processor Contact	Director Medicare Operations	Mr.	Taddeo	Cory		4104244400	6740				CTaddeo@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Quality Contact	Associate Chief Medical Officer, QI	Dr.	Zeltser	Marina		7323225499					MZeltser@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Reconciliation Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Recovery Audit Contact	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Surveillance Contact	Director SIU	Mr.	Waugh	John		4106891079					JWaugh@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	11/26/2025	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	System Contact	Sr. Director Medicare Plan Administration	Ms.	Riaz	Salma		8636341202					SRiaz@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Shariff	Sadia		6095715406					SShariff@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	12/18/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	User Access Contact	Medicare Compliance Officer	Ms.	Donnelly	Mary		4104244855					MDonnelly@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	08/03/2023	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Utilization Management Contact	Executive Director of Health Services	Ms.	Poth	Kristin		4105822700					KPoth@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3890	Utilization Review Contact	Executive Director of Health Services	Ms.	Poth	Kristin		4105822700					KPoth@jhhp.org	7231 Parkway Drive	Suite 100	Hanover	MD	21076	09/27/2024	2026	HOPKINS HEALTH ADVANTAGE, INC.	Local CCP	Johns Hopkins Advantage MD	Local PPO		Johns Hopkins Healthcare LLC	616	Yes	Active					PPO - BBA		C	Boston
H3907	Agent/Broker Compensation Data Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Backup User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		8775393080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Bid Audit Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Bid Audit Site Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Bid Primary Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	CAP Report Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	CEO - CMS Administrator Contact	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	CEO - Senior Official for Contracting	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		4124545559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Chief Operating Officer	Chief Operating Officer	Ms.	Jenkins	Mary Beth	L	4124547764					jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	12/09/2015	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Chief Information Officer	Chief Information Officer	Mr.	McCallister	Ed		4124547711					mccallisterew@upmc.edu	USX Tower, 60th Floor	600 Grant Street	Pittsburgh	PA	15219	03/14/2016	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Chief Information Security Officer	Vice President, ISD	Mr	Haas	Scott		4124546162					haassm@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/14/2016	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	CMS Casework Communication Contact	Sr. Manager, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2022	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Complaints Tracking Contact	Sr. Manager, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2022	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Contact for Fraud Investigations	Sr. Director Fraud & Abuse		Workman	Craig		4124545524					workmanc@upmc.edu	USX Tower, 47th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Corporate Mailing						4124547500					upmchp@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		8775393080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2012	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	DIR Contact	Director, Pharmacy Finance		Bovier	Jacqueline		4124547584					bovierjd@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/18/2015	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	DIR Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Discount Program Payment Contact	Business Analyst III		Michalski	Jeff		4124545715				4124542110	michalskij@upmc.edu	USX Tower, 21st Floor	600 Grant Street	Pittsburgh	PA	15219	11/18/2024	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Emergency Part D Contact	Vice President, Customer Engagement & Enrollment		Palmerine	Anne		4129777828					palmerineac3@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Emergency Part D Contact (Secondary)	AVP, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	12/27/2023	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Encounter Data & Risk Adjustment Operations Contact	Director, Government Revenue		Plank	Tim		4124547747					planktm@upmc.edu	USX Tower, 36th Floor	600 Grant Street	Pittsburgh	PA	15219	10/28/2019	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Enrollment Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	EOB Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Financial Audit Contact	AVP, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	08/14/2020	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Financial Reporting Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Formulary Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Formulary Contact (Secondary)	Manager, Clinical Pharmacy Medicare	Ms.	Ryan	Maggie		4124547086					ryanm7@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	05/13/2025	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	General Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	02/16/2022	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	HIPAA Security Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		4124548589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Interoperability Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	02/16/2022	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	MA Appeals/Grievances Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	MA Claims Processing Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Marketing Contact	Director, Medicare Marketing		McVey	Alicia		4124545525					mcveyal@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	08/03/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Medical Director	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Medicare Coordinator	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Medicare Part D Opioid Overutilization Contact	Sr. Manager, Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Medication Therapy Management Contact	Sr. Manager Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Online Enrollment Center Contact (Back-up)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Online Enrollment Center Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Online Enrollment Center Contact (Primary)	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part C Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part C Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Appeals	Manager, C&G		Richards	Rebecca						4124547920	richardsr3@upmc.edu	600 Grant St., USX, 42nd Floor		Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active	4124540116				HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Appeals Contact (Secondary)	Manager, Pharmacy Compliance		Chaussinand	Matt							chaussinandm@upmc.edu	600 Grant St., USX, 12th Floor		Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active	4124545914				HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Benefits Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions		Dovico	Rosario		2012696398					rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	04/23/2019	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active	8003964139				HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Price File Contact (Back-up)	Sr. Manager, Government Programs		Dolfi	Amanda		6147613606					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Price File Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Price File Contact (Primary)	Director, Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107 St. #11202		Overland Park	KS	66207	07/28/2020	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Quality Assurance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Part D Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Patient Safety Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Payment Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Personal Health Record Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Pharmacy Director	Sr. Director, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H3907	PHR Beneficiary Contact																	05/04/2007	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS	MyHealth	UPMC Health System	249	Yes	Active	4128032065				HMO - Health Maintenance Organization		C	Dallas
H3907	Physician Incentive Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Plan Directory Contact for Public Website			Marketing	Medicare		8773813765					upmchp@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		4124545715				4124542110	medicarereporting@upmc.edu	US Steel Tower, 600 Grant Street, 9th Floor	c/o UPMC Health Plan Attn: Aunika Hall P2P - 09-257	Pittsburgh	PA	15219	08/11/2025	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Processor Contact	Sr Director - Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Quality Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Reconciliation Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Reconciliation Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Recovery Audit Contact	Sr. Director, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	SNP Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	SNP State Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Surveillance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	System Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Third Party Administrator (TPA) Liaison	Business Analyst III		Michalski	Jeff		4124545715				4124542110	michalskij@upmc.edu	c/o UPMC Health Plan Attn: Jeff Michalski P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	11/15/2024	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Utilization Management Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3907	Utilization Review Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/12/2018	2026	UPMC HEALTH PLAN, INC.	Local CCP	UPMC for Life	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3908	Automated TrOOP Balance Transfer Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Backup User Access Contact	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	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	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Bid Primary Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	CAP Report Contact for Public Website	Executive Director		Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	CEO - Senior Official for Contracting	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	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	Regional Director, Finance	Mr	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St		Philadelphia	PA	19139	11/24/2025	2026	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 Operating Officer	COO	Ms	Lewis	Anne		4066472980					Anne.Lewis@trinity-health.org	14508 Chestnut Street		Philadelphia	PA	19139	09/22/2020	2026	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 Information Officer	Director Enterprise IT Operations	Mr	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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 Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083					Preston.Jennings@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Complaints Tracking Contact	Quality and Compliance Director	Ms	Maddox	Tanida		2677878225					Tanida.Maddox@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/25/2024	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Contact for Fraud Investigations	Quality and Compliance Director	Ms	Maddox	Tanida		2677878225					Tanida.Maddox@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/25/2024	2026	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	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Corporate Mailing						2677878300					Lisa.johnson001@trinity-health.org	Mercy LIFE West Philadelphia	4508 Chestnut Street	Philadelphia	PA	19139	09/15/2023	2026	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	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	DIR Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Discount Program Payment Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Emergency Part D Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/03/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Enrollment Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	EOB Transfer Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150				6102719529	DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut Dr	Suite 1	Philadelphia	PA	19139	11/25/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Financial Audit Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Financial Reporting Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/03/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	General Contact	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	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	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Interoperability Contact	Director Enterprise IT Operations		Gillespie	Jeff		7343433079					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	MA Appeals/Grievances Contact	Quality and Compliance Director	Ms	Maddox	Tanida		2677878225					Tanida.Maddox@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/25/2024	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	MA Claims Processing Contact for Public Website	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Marketing Contact	Director Marketing & Communications	Ms.	Lark	Azia		9735182754					azia.lark@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	02/03/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Medical Director	Medical Director	Dr.	May	Kim		2677878225					kim.may@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/22/2020	2026	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	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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 Coordinator	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	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 Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/03/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/03/2023	2026	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 C Application Contact	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	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 Appeals	Manager Part D Compliance	Mr.	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	09/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H3908	Part D Application Contact	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	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 Benefits Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	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 Claims Submission Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	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@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	09/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H3908	Part D Price File Contact (Back-up)	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	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 Price File Contact (Primary)	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	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 Quality Assurance Contact	Quality and Compliance Director	Ms	Maddox	Tanida		2677878225					Tanida.Maddox@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/25/2024	2026	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 Reporting Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Patient Safety Contact	Quality and Compliance Director	Ms	Maddox	Tanida		2677878225					Tanida.Maddox@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/25/2024	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Payment Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	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 Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@mercyhealth.org	1930 South Broad Street		Philadelphia	PA	19145	08/03/2023	2026	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 Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	08/03/2023	2026	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	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/03/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H3908	Plan Directory Contact for Public Website	Executive Director	Ms	Ortiz	Lesly		2677878150					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Plan to Plan Reconciliation Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Processor Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Quality Contact	Quality and Compliance Director	Ms	Maddox	Tanida		2677878225					Tanida.Maddox@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/25/2024	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Reconciliation Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Recovery Audit Contact	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Surveillance Contact	Executive Director	Ms	Ortiz	Lesly		7343432668					LOrtiz@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/09/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Third Party Administrator (TPA) Liaison	Regional Director, Finance	Mr.	Schmotzer	David		2677878150					DAVID.SCHMOTZER@trinity-health.org	4508 Chestnut St.		Philadelphia	PA	19139	11/24/2025	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Utilization Management Contact	Medical Director	Dr.	May	Kim		2677878225					kim.may@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/22/2020	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3908	Utilization Review Contact	Medical Director	Dr.	May	Kim		2677878225					kim.may@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	09/22/2020	2026	TRINITY HEALTH LIFE PENNSYLVANIA, INC.	National PACE	Mercy LIFE - West Philadelphia	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3909	Agent/Broker Compensation Data Contact	Mgr. Sales Onboarding		Heckman	Jim		2152411994					jim.heckman@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	07/09/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Automated TrOOP Balance Transfer Contact	Lead Business Systems Support Admin		Jimenez	Barbara		2676751825					barbara.jimenez@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	02/27/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Backup User Access Contact	Reg. Performance Mgmt. Analyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/27/2020	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Best Available Evidence Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Bid Audit Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Bid Audit Site Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Bid Primary Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	CAP Report Contact for Public Website	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	CEO - CMS Administrator Contact	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	CEO - Senior Official for Contracting	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Chief Financial Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/22/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Chief Operating Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Chief Information Officer	EVP and Chief Strategy, Corp. Dev., & Info Officer	Mr.	Vennera	Michael		2152419525					Michael.Vennera@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	04/24/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Chief Information Security Officer	Director Information Security	Mr.	Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901 Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	CMS Casework Communication Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Complaints Tracking Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Contact for Fraud Investigations	Director, Financial Investigations		Deery	Christophe	E	2156407302	27302			2152382287	christopher.deery@ibx.com	1901 Market Street	42nd Floor	Philadelphia	PA	19103	12/30/2015	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Coordination of Benefits Contact	Manager, COB/OPL		Hawkins	Veronica		2156407507	27507				Veronica.Hawkins@ibx.com	1901 Market Street	17th Floor	Philadelphia	PA	19103	12/24/2020	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Corporate Mailing						2152412400				2155674542	mitchell.goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19103	08/13/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Customer Service Operations Contact	Director, Contact Center		Lentz	Michael		2157933262	63262				michael.lentz@ibx.com	1900 Market Street	5th Floor	Philadelphia	PA	19103	11/01/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	DIR Contact	Manager Gov. Markets - Commercial Risk Adjustment		Sanders	Sean		2152419420					Sean.Sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	06/29/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	DIR Contact (Secondary)	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2152417265					Geoffrey.Wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Discount Program Payment Contact	Lead Accountant		Murphy	Stacey		2152413522	23522				Stacey.Murphy@ibx.com	1901 Market Street, 36th Floor	Corporate Accounting Shared Services	Philadelphia	PA	19103	04/24/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Emergency Part D Contact	Process & Governance Dir   Pharmacy		Erdman	Kathy		6107723634					kathy.erdman@ibx.com	1901 Market Street		Philadelphia	PA	19103	12/17/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Emergency Part D Contact (Secondary)	Director Medicare Regulatory Peformance Mgmt.		Adams	Desiree		2153279829					Desiree.Adams@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	04/10/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Employer Waiver Contact	SVP Government Markets, Sales & Marketing Leadersh		Cruz	Kortney		2152414762					Kortney.Cruz@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Encounter Data & Risk Adjustment Operations Contact	Manager Data, Delivery and Reporting	Ms.	Heifetz	Nata		2152410511					Nata.Heifetz@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	12/19/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Enrollment Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	EOB Transfer Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Financial Audit Contact	VP Corporate Compliance	Mr	Zipfel	Michael		2152414908				2155674542	Michael.Zipfel@ibx.com	1901 Market Street		Philadelphia	PA	19103	09/05/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Financial Reporting Contact	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	05/19/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Formulary Contact	Clinical Pharmacist		Urbanek	Michael		2152419003				2152413526	Michael.Urbanek@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	10/01/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Formulary Contact (Secondary)	Clinical Consultant-Optum Rx		Sosinsky	Inna		7633616985					inna.sosinsky@Optum.com	1100 Optum Circle		Eden Parairie	MN	55344	04/18/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	General Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Government Relations Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	HIPAA Privacy Officer	Director, Privacy Officer		Rieben	Laura		2152414462					laura.rieben@ibx.com	1901 Market Street		Philadelphia	PA	19013	02/13/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	HIPAA Security Officer	Director Information Security		Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901 Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Hospice Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654					kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	06/29/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Interoperability Contact	Healthcare Interoperability Director		Denyer	James		2152410858					james.denyer@ibx.com	1901 Market Street	20th Floor	Philadelphia	PA	19103	04/10/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	MA Appeals/Grievances Contact	Manager, Medicare Member Appeals and Grievances		Tobias	Bobbi		2152410669					Bobbi.Tobias@ibx.com	1901 Market Street	Mailstop, 12TH floor	Philadelphia	PA	19103	04/19/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	MA Claims Processing Contact for Public Website	Director Claims Operations		Perfetto	Lisa		2152414126					lisa.perfetto@ibx.com	1901 Market Street, 15th Floor		Philadelphia	PA	19103	02/28/2018	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Marketing Contact	RPM Analyst II, NJMA Government		Dunn	DeVonda		2152413871					devonda.dunn@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/13/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Medical Director	Medical Director	Dr.	Ramos	Luz		2152414040					luz.ramos@ibx.com	1901 Market Street		Philadelphia	PA	19103	11/12/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Medicare Compliance Officer	Director, Corporate Compliance, Medicare and Comme	Mr.	Goldberg	Mitchell		2152419516				2155674542	Mitchell.Goldberg@ibx.com	1901 Market Street	42nd Floor	Philadelphia	PA	19103	02/13/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Medicare Coordinator	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Soribe	Nneka		2152414729				2152413526	nneka.soribe@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	03/05/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Medication Therapy Management Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Services		Kelley	Josh		2152414829	24829				Joshua.Kelley@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/19/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Online Enrollment Center Contact (Optional)	Regulatory Performance Mgmt. Analyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	12/19/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Online Enrollment Center Contact (Primary)	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part C Application Contact	Sr Product & Capability Mgr   Product Management		Keenan	Kate		2152419495					kate.keenan@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	02/28/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part C Reporting Contact	Manager, Government Markets Reporting		Pippett	Andrew		2152417416					Andrew.Pippett@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Appeals	Manager, Medicare Member Appeals and Grievances		Tobias	Bobbi							Bobbi.Tobias@ibx.com	1901 Market Street	Mailstop, 12TH floor	Philadelphia	PA	19103	04/19/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8887183333				PPO - BBA		C	Chicago
H3909	Part D Appeals Contact (Secondary)	Supervisor, Medicare Member Appeals and Grievances		Byrd	Kelly							Kelly.Byrd@ibx.com	1901 Market Street	Mailstop, 12TH floor	Philadelphia	PA	19103	06/28/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8887183333				PPO - BBA		C	Chicago
H3909	Part D Application Contact	Senior Product and Capability Mgr.		Keenan	Kate		2152419495					kate.keenan@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	02/28/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Benefits Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Claims Submission Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Exceptions Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8886787015				PPO - BBA		C	Chicago
H3909	Part D Exceptions Contact (Secondary)	Manager, Prior Authorization		Mourad	Hala							Hala.Mourad@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8886787015				PPO - BBA		C	Chicago
H3909	Part D Price File Contact (Back-up)	Senior Business Analyst, Plan Finder		Moore-Elliott	Shalandria		7637974305					Mshalandria.moore-elliott@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Price File Contact (Optional)	Project Leader		Coursey	Yaminah		2152413955					yaminah.coursey@ibx.com	1900 Market Street	29th Floor	Philadelphia	PA	19103	02/15/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Price File Contact (Primary)	Senior Business Analyst, Plan Finder		Lam	Annie		6124286588					annie.lam@optum.com	11000 Optum Circle		Eden Prairie Eden	MN	55344	10/25/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Quality Assurance Contact	Director Quality Management		Donohue	Kathleen		2152413277					Kathleen.Donohue@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/27/2018	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Part D Reporting Contact	Manager, Government Markets Reporting		Pippett	Andrew		2152417416					Andrew.Pippett@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Patient Safety Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Payment Contact	Manager, Risk Analytics		Buscher	Harry		2152410806					harry.buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/17/2015	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Pharmacy Director	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Pharmacy Network Management Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/30/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Perez	Felix	M	7632833503					felix.perez@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Pharmacy Technical Help Desk Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	12/19/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8886787015				PPO - BBA		C	Chicago
H3909	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir City		Eden Prairie	MN	55344	12/19/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8886787015				PPO - BBA		C	Chicago
H3909	Physician Incentive Contact	VP DGC & Asst. Corporate Secretary, Corp. Legal Ad		Dianno	Mark		2152412919					Mark.Dianno@ibx.com	1901 Market Street	43rd Floor	Philadelphia	PA	19103	07/09/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Plan Directory Contact for Public Website			Service	Customer		8887183333					info@ibxmedicare.com	PO Box 7799		Philadelphia	PA	191017799	04/29/2015	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Plan to Plan Reconciliation Contact	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2156407265				2152412408	Geoffrey.Wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	02/18/2022	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Processor Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Quality Contact	Director Quality Management		Donohue	Kathleen		2152413277					Kathleen.Donohue@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/27/2018	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Reconciliation Contact	Director Risk Adjustment & Data Delivery		Buscher	Harry		2152410806					harry.buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	03/27/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Reconciliation Contact (Secondary)	Mgr. Gov. Mkts. - Commercial Risk Analytics		Sanders	Sean		2152419420					Sean.Sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	01/15/2021	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Recovery Audit Contact	Director of Regulatory Performance Management	Ms.	Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	SNP Application Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	SNP State Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Surveillance Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	System Contact	VP Enterprise Data & Integrations		Varghese	John		2152414553					john.varghese@ibx.com	1901 Market Street	21th Floor	Philadelphia	PA	19103	07/09/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Third Party Administrator (TPA) Liaison	Lead Accountant		Murphy	Stacey		2152413522	23522				Stacey.Murphy@ibx.com	1901 Market Street, 36th Floor	Corporate Accounting	Philadelphia	PA	19103	04/24/2024	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	User Access Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22ndFloor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Utilization Management Contact	Director Care Management		McGurk	Cheryl		2152414542					Cheryl.mcgurk@ibx.com	1901 Market Street	30th Floor	Philadelphia	PA	19103	12/29/2017	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3909	Utilization Review Contact	Director Care Management		McGurk	Cheryl		2152414542					Cheryl.mcgurk@ibx.com	1901 Market Street	30th Floor	Philadelphia	PA	19103	12/29/2017	2026	QCC INSURANCE COMPANY	Local CCP	Independence Blue Cross	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H3916	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Bid Audit Site Contact	Director, Government Compliance & Audit Oversight	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/30/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/13/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	11/10/2017	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/28/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	09/25/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2020	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/15/2016	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/26/2019	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Corporate Mailing						4125447031					Thomas.Boettler@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/30/2020	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/17/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5182205661				5184232294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	06/23/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	06/23/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/07/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Encounter Data & Risk Adjustment Operations Contact	Director, Actuarial Services	Mr.	DelPrince	Vincent	M	4125443939					Vincent.Delprince@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	08/04/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Enrollment Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	EOB Transfer Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	bob.opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/26/2019	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					justine.patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	10/25/2019	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Interoperability Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	MA Appeals/Grievances Contact	Manager, Appeals & Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	MA Claims Processing Contact for Public Website	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/22/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	10/14/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Medical Director	VP, Executive Medical Director	Dr.	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	06/23/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	11/10/2017	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Medicare Coordinator	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/30/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	10/14/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing	Mr.	Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part C Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/07/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/31/2020	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125444579				PPO - BBA		C	Boston
H3916	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125441596				PPO - BBA		C	Boston
H3916	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/07/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/07/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	11/08/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite SPECARE	Pittsburgh	PA	15222	08/04/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8006002227				PPO - BBA		C	Boston
H3916	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	9013817109				PPO - BBA		C	Boston
H3916	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/07/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Payment Contact	Vice President, Accounting and Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		Buffalo	NY	14203	02/14/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/07/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
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	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8009221557				PPO - BBA		C	Boston
H3916	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	5705783579				PPO - BBA		C	Boston
H3916	PHR Beneficiary Contact																	07/23/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO	Highmark Inc	Highmark Health	123	Yes	Active	8665886967				PPO - BBA		C	Boston
H3916	Physician Incentive Contact	VP Prov Reimbursement & Network	Mr.	McDonald	Brendan		4125446611					brendan.mcdonald@highmarkhealth.org	120 5th Avenue Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Plan Directory Contact for Public Website			Service	Provider		8665886967					resourcecenter@highmark.com	120 Fifth Ave		Pittsburgh	PA	15222	06/07/2017	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	7173022748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 898820	Camp Hill	PA	170890407	06/28/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Quality Contact	Director, Clinical Quality		Christian	Shari		7168878811					shari.christina@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/17/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	04/07/2022	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/28/2025	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Utilization Management Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3916	Utilization Review Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK SENIOR HEALTH COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H3917	Automated TrOOP Balance Transfer Contact			PATNAIK	PADDY		9529834787					ESITroopTransfer@express-scripts.com	PITTSBURGH CARE PARTNERSHIP, INC	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/05/2009	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Backup User Access Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	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	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	09/12/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Bid Primary Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	09/12/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	CAP Report Contact for Public Website	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	CEO - CMS Administrator Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	CEO - Senior Official for Contracting	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Chief Financial Officer	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	09/15/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Chief Operating Officer	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Chief Information Officer	HEALTH INFORMATION MANAGER	MS	GAMBINO	ROBIN		4124361337				4122351340	gambinord@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/19/2016	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Chief Information Security Officer	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/19/2016	2026	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	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	09/12/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Complaints Tracking Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	09/12/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Contact for Fraud Investigations	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2026	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	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	09/12/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Corporate Mailing						4124361320				4122351341	CPSCLDataReview@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	01/22/2019	2026	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		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	DIR Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	09/12/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	DIR Contact (Secondary)	HEALTH PLAN MANAGER		FRANKS	AARON		4124361321				4122351344	franksad@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/15/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Discount Program Payment Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Emergency Part D Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4126641448				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Emergency Part D Contact (Secondary)	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4126641448				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	12/23/2014	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Encounter Data & Risk Adjustment Operations Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Enrollment Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	EOB Transfer Contact	ACCOUNTING MANAGER		PAVLIC	RENEE		4124361327				4122351344	pavlicrl2@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	12/18/2023	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Financial Audit Contact	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Financial Reporting Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Formulary Contact	MEDICAL DIRECTOR		HEBERT	RANDY		4122043424				4122351349	hebertrs3@upmc.edu	2400 ARDMORE BOULEVARD		PITTSBURGH	PA	15221	05/22/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	General Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	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		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	HIPAA Privacy Officer	HEALTH INFORMATION MANAGER		GAMBINO	ROBIN		4124361337				4122351340	gambinord@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	05/04/2012	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	HIPAA Security Officer	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Interoperability Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	MA Appeals/Grievances Contact	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	05/22/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	MA Claims Processing Contact for Public Website	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Marketing Contact	DIRECTOR OF MARKETING AND PUBLIC RELATIONS	MRS	KACZKOWSKI	STACI		4124361338				4122351347	kaczkowskiS@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	05/04/2012	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Medical Director	MEDICAL DIRECTOR		HEBERT	RANDY		4122043424				4122351349	hebertrs3@upmc.edu	2400 ARDMORE BOULEVARD		PITTSBURGH	PA	15221	05/22/2020	2026	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		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Medicare Coordinator	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Medicare Part D Opioid Overutilization Contact	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	12/24/2018	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Medication Therapy Management Contact	MEDICAL DIRECTOR		HEBERT	RANDY		4122043424				4122351349	hebertrs3@upmc.edu	2400 ARDMORE BOULEVARD		PITTSBURGH	PA	15221	05/22/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Online Enrollment Center Contact (Primary)	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part C Application Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part D Appeals	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA						4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	03/10/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active	8664191693				PACE - Nat		C	Philadelphia
H3917	Part D Appeals Contact (Secondary)	PRESIDENT	MS	HASHTROUDI	FATEMEH						4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active	8664191693				PACE - Nat		C	Philadelphia
H3917	Part D Application Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part D Benefits Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part D Claims Submission Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	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	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA						4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active	8664191693				PACE - Nat		C	Philadelphia
H3917	Part D Exceptions Contact (Secondary)	PRESIDENT	MS	HASHTROUDI	FATEMEH						4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active	8664191693				PACE - Nat		C	Philadelphia
H3917	Part D Price File Contact (Back-up)	INFORMATION SYSTEMS MANAGER	MRS	LENTZ	DEBORAH	L	4124361334				4122351344	lentzdl@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	03/10/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part D Price File Contact (Primary)	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part D Quality Assurance Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Part D Reporting Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Patient Safety Contact	MEDICAL DIRECTOR		HEBERT	RANDY		4122043424				4122351349	hebertrs3@upmc.edu	2400 ARDMORE BOULEVARD		PITTSBURGH	PA	15221	05/22/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Payment Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Personal Health Record Contact	HEALTH INFORMATION MANAGER		GAMBINO	ROBIN		4124361337				4122351340	gambinord@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	05/04/2012	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Pharmacy Director	MEDICAL DIRECTOR		HEBERT	RANDY		4122043424				4122351349	hebertrs3@upmc.edu	2400 ARDMORE BOULEVARD		PITTSBURGH	PA	15221	05/22/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Pharmacy Network Management Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	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	Chief Financial Officer		Bradley	Ryann	P					4122351341	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active	4124361333				PACE - Nat		C	Philadelphia
H3917	PHR Beneficiary Contact																	03/10/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE	PITTSBURGH CARE PARTNERSHIP, INC.	UPMC Health System	249	Yes	Active	8664191693				PACE - Nat		C	Philadelphia
H3917	Plan Directory Contact for Public Website	DIRECTOR OF MARKETING AND PUBLIC RELATIONS	MRS	KACZKOWSKI	STACI		4124361338				4122351347	kaczkowskiS@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	05/04/2012	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Plan to Plan Reconciliation Contact	HEALTH PLAN MANAGER		FRANKS	AARON		4124361321				4122351344	franksad@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	01/09/2023	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Processor Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Quality Contact	QUALITY ANALYST & PROGRAM COORDINATOR	MRS	HASHTROUDI	FATEMEH		4124361336				4124361322	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	04/11/2014	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Reconciliation Contact	CHIEF FINANCIAL OFFICER	MR	BRADLEY	RYANN	P	4122358425				4122351344	bradleyr6@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	10/24/2025	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Reconciliation Contact (Secondary)	HEALTH PLAN MANAGER		FRANKS	AARON		4124361321				4122351344	franksad@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/15/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Recovery Audit Contact	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Surveillance Contact	DIRECTOR OF COMPLIANCE AND RISK MANAGEMENT	MRS	STERN	PATRICIA		4124361344				4122351348	sternpa@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	02/13/2013	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	System Contact	MANAGER CLIENT SERVICES, IT	MR	ROGERS	PHILLIP	K	4127736844					rogerspk@upmc.edu	2310 JANE STREET		PITTSBURGH	PA	15203	11/18/2010	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Third Party Administrator (TPA) Liaison	HEALTH PLAN MANAGER		FRANKS	AARON		4124361321				4122351344	franksad@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	08/03/2021	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	User Access Contact	INFORMATION SYSTEMS MANAGER	MRS	LENTZ	DEBORAH	L	4124361334				4122351344	lentzdl@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	03/10/2020	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Utilization Management Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	PITTSBURGH CARE PARTNERSHIP, INC.	National PACE	Community LIFE	National PACE		UPMC Health System	249	Yes	Active					PACE - Nat		C	Philadelphia
H3917	Utilization Review Contact	PRESIDENT	MS	HASHTROUDI	FATEMEH		4124361341				4122351341	hashtroudif@upmc.edu	SUITE # 700	2400 ARDMORE BOULEVARD	PITTSBURGH	PA	15221	07/21/2022	2026	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	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Backup User Access Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Best Available Evidence Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Bid Primary Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	CAP Report Contact for Public Website	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	CEO - CMS Administrator Contact	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	CEO - Senior Official for Contracting	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Chief Financial Officer	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Chief Operating Officer	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	11/20/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Chief Information Officer	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	11/20/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Chief Information Security Officer	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	11/20/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	CMS Casework Communication Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Complaints Tracking Contact	Director of Quality and Compliance		Dickman	Johanna		4123888042				4123888055	JDickman@LIFEpittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/10/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Contact for Fraud Investigations	Director of Quality and Compliance		Dickman	Johanna		4123888042				4123888055	JDickman@LIFEPittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Coordination of Benefits Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Corporate Mailing						4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	12/13/2016	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Customer Service Operations Contact	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	DIR Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	DIR Contact (Secondary)	Sr. Director of Finance		Ardeno	Brandie		4123888042					bardeno@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Discount Program Payment Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Emergency Part D Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Emergency Part D Contact (Secondary)	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Encounter Data & Risk Adjustment Operations Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Enrollment Contact	Director of Eligibility		Collins	Lynn	C	4123888042				4123888055	lcollins@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	12/13/2016	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	EOB Transfer Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Financial Audit Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Financial Reporting Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Formulary Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	General Contact	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Government Relations Contact	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	HIPAA Privacy Officer	Director of Quality and Compliance	Ms.	Dickman	Johanna		4123888042				4123888055	JDickman@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	HIPAA Security Officer	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	11/20/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Interoperability Contact	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	MA Appeals/Grievances Contact	Director of Quality and Compliance		Dickman	Johanna		4123888042				4123888055	JDickman@LIFEPittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	MA Claims Processing Contact for Public Website	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Marketing Contact	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Medical Director	Medical Director		Dua	Divya		4123888042				4123888055	DDua@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	08/12/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Medicare Compliance Officer	CFO	Ms.	Dickman	Johanna		4123888042				4123888055	JDickman@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	09/24/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Medicare Coordinator	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Medicare Part D Opioid Overutilization Contact	Medical Director		Dua	Divya		4123888042				4123888055	DDua@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	08/12/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Medication Therapy Management Contact	Interim CEO	Mr	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part C Application Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Appeals	Interim CEO	Ms.	Krchmar	Aaron						4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active	4123888042				PACE - Nat		C	Philadelphia
H3918	Part D Appeals Contact (Secondary)	Director of Quality and Compliance		Dickman	Johanna							JDickman@LIFEPittsburgh.org	875 Greentree Road	One Parkway Center, Ste 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active	4123254228				PACE - Nat		C	Philadelphia
H3918	Part D Application Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Benefits Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Claims Submission Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Exceptions Contact	CFO	Ms.	Schmitt	Laura	B					4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active	4123888042				PACE - Nat		C	Philadelphia
H3918	Part D Price File Contact (Back-up)	Sr. Director of Finance		Ardeno	Brandie		4123775355				4123888055	bardeno@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/10/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Price File Contact (Optional)	Sr. Director of Finance		Ardeno	Brandie		4123888042				4123888055	bardeno@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/10/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Price File Contact (Primary)	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Quality Assurance Contact	Director of Quality and Compliance		Dickman	Johanna		4123888042				4123888055	JDickman@LIFEPittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Part D Reporting Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Patient Safety Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Payment Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Pharmacy Director	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Pharmacy Network Management Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Pharmacy Network Management Contact (Secondary)	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Pharmacy Technical Help Desk Contact	Medical Director		Dua	Divya						4123888055	DDua@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	08/12/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active	4123888055				PACE - Nat		C	Philadelphia
H3918	Plan Directory Contact for Public Website	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Plan to Plan Reconciliation Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Processor Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Quality Contact	Director of Quality and Compliance		Dickman	Johanna		4123888042				4123888055	JDickman@LIFEPittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Reconciliation Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Reconciliation Contact (Secondary)	Sr. Director of Finance		Ardeno	Brandie		4123888042					bardeno@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	02/09/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Recovery Audit Contact	CFO	Ms.	Schmitt	Laura	B	4123888042				4123888055	lschmitt@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	01/05/2021	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Surveillance Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	System Contact	Interim CEO		Krchmar	Aaron		4123888042				4123888055	AKrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	11/20/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Third Party Administrator (TPA) Liaison	Senior Director of Finance		Ardeno	Brandie		4123888042				4123888055	bardeno@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/10/2025	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	User Access Contact	Interim CEO		Krchmar	Aaron		4123888042				4123888055	AKrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	11/20/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Utilization Management Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3918	Utilization Review Contact	Interim CEO	Mr.	Krchmar	Aaron		4123888042				4123888055	Akrchmar@lifepittsburgh.org	875 Greentree Road	One Parkway Center, Suite 200	Pittsburgh	PA	15220	07/17/2024	2026	LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC	National PACE	LIFE Pittsburgh	National PACE		Living Independence for the Elderly Pittsburgh Inc	142	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Automated TrOOP Balance Transfer Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Backup User Access Contact	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	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		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Bid Primary Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	CAP Report Contact for Public Website	Regional VP Operations	Mrs.	Januszeski	Suzanne		2153394449				6102719530	suzanne.januszeski@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	CEO - Senior Official for Contracting	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/25/2022	2026	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		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Chief Operating Officer	COO	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	04/28/2022	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Chief Information Officer	Director, Enterprise IT Operations	Mr.	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	1930 S Broad Street	Suite 3	Philadelphia	PA	19145	09/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Chief Information Security Officer	VP Information Security	Ms	Jennings	Preston		6105503183					Preston.Jennings@trinity-health.org	3805 West Chester Pike	Ste. 100	Newtown Square	PA	19073	09/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	CMS Casework Communication Contact	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Complaints Tracking Contact	Director of Quality & Compliance	Mrs.	Yocum	Jennifer		2153394449					jennifer.yocum@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Contact for Fraud Investigations	Director of Quality & Compliance	Mrs.	Yocum	Jennifer		2153394449					jennifer.yocum@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	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		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Corporate Mailing						6106902516				2153394523	Dan.Drake@trinity-health.org	1930 S. Broad Street	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	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		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/25/2022	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	DIR Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Discount Program Payment Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Emergency Part D Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Enrollment Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	EOB Transfer Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Financial Audit Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Financial Reporting Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	09/03/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	General Contact	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/25/2022	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Government Relations Contact	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Interoperability Contact	Director Enterprise IT Operations		Gillespie	Jeff		7343433079					gillespij@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	MA Appeals/Grievances Contact	Director of Quality & Compliance	Mrs.	Yocum	Jennifer		2153394449					jennifer.yocum@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	MA Claims Processing Contact for Public Website	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Marketing Contact	Director of Marketing & Communications		Lark	Azia		9735182754				2153394523	azia.lark@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	02/03/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Medical Director	Medical Director	Dr	Johnson	Kristi		4848039722					kristi.johnson001@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	02/28/2022	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Medicare Compliance Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Medicare Coordinator	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	09/03/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	09/03/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part C Application Contact	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part D Appeals	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	09/03/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H3919	Part D Application Contact	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part D Benefits Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part D Claims Submission Contact	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	Mercy LIFE	1930 South Broad Street, Unit 3	Philadelphia	PA	19145	08/02/2023	2026	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	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H3919	Part D Price File Contact (Back-up)	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part D Price File Contact (Primary)	Regional Finance Director	Mr.	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part D Quality Assurance Contact	Director of Quality & Compliance	Mrs.	Yocum	Jennifer		2153394449					jennifer.yocum@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Part D Reporting Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Patient Safety Contact	Director of Quality & Compliance	Mrs.	Yocum	Jennifer		2153394449					jennifer.yocum@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Payment Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Pharmacy Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	09/03/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Pharmacy Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	09/03/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Pharmacy Technical Help Desk Contact	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H3919	Plan Directory Contact for Public Website	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Plan to Plan Reconciliation Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				2153395650	Joseph.Garbarino@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	09/03/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Processor Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Quality Contact	Director of Quality & Compliance	Mrs.	Yocum	Jennifer		2153394449					jennifer.yocum@trinity-health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Reconciliation Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Recovery Audit Contact	Regional Finance Director	Mr.	Schmotzer	David		2153394533					David.Schmotzer@Trinity-Health.org	1930 S. Broad St.	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Surveillance Contact	Regional VP Operations	Ms	Januszeski	Suzanne		8569044632					suzanne.januszeski@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/02/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Third Party Administrator (TPA) Liaison	Regional Finance Director	Mr.	Schmotzer	David		2153394533				2153395650	David.Schmotzer@Trinity-Health.org	1930 S. Broad St,	Suite 3	Philadelphia	PA	19145	08/13/2021	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Utilization Management Contact	Medical Director	Dr	Johnson	Kristi		4848039722					kristi.johnson001@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	02/28/2022	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3919	Utilization Review Contact	Medical Director	Dr	Johnson	Kristi		4848039722					kristi.johnson001@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	02/28/2022	2026	Mercy LIFE	National PACE	Mercy LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H3923	Agent/Broker Compensation Data Contact	Director, Government Program Sales	Mr.	McCook	Mike		7175417505					mike.mccook@capitalbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/05/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Backup User Access Contact	Sr. Medicare Compliance Specialist	Ms.	Peterson	Nicole		7175416419					nicole.peterson@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/20/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Best Available Evidence Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Bid Audit Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Bid Primary Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	11/25/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	CEO - CMS Administrator Contact	President and CEO	Mr.	Shamash	Todd		7175417747				7176518913	todd.shamash@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/04/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	CEO - Senior Official for Contracting	President and CEO	Mr.	Shamash	Todd		7175417747				7176518913	todd.shamash@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/04/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Chief Financial Officer	Chief Financial Officer	Mr.	Woodard	Ralph		7175417181					ralph.woodard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/24/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Chief Operating Officer	EVP & Chief Operating Officer	Mr.	Heisey	Glenn		7175417288				7176518497	glenn.heisey@capbluecross.com	2500 Elmenrton Avenue		Harrisburg	PA	17177	01/04/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Chief Information Officer	Senior Vice President and CIO	Mr.	Bhasin	Aman		7175417100					aman.bhasin@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	07/29/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Chief Information Security Officer	Chief Information Security Officer	Mr.	Burd	Aaron		7175416939					aaron.burd@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	CMS Casework Communication Contact		Ms.	Drawbaugh	Cindy		7175416257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/16/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Complaints Tracking Contact		Ms.	Drawbaugh	Cindy		7175416257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/16/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Contact for Fraud Investigations		Ms.	Livelsberger	Jennifer		7177753756					Jennifer.Livelsberger@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/16/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Coordination of Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Corporate Mailing						7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	171779799	03/26/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Customer Service Operations Contact	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	jonathan.koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	06/17/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	DIR Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	DIR Contact (Secondary)	Actuarial Business Consultant, Actuarial and Under	Mr.	Shafer	Brian		7175416263				7176514214	Brian.Shafer@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	02/19/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Discount Program Payment Contact			Balseiro	Julia	A	7175417458					Julia.Balseiro@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/24/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Emergency Part D Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7175864604				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/30/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Emergency Part D Contact (Secondary)	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Employer Waiver Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	11/25/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Encounter Data & Risk Adjustment Operations Contact			Matos	Tamara		7175416275					tamara.matos@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/27/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Enrollment Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	EOB Transfer Contact	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Financial Audit Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Financial Reporting Contact	VP Finance and Controller	Mr.	Hershberger	Josh		7173710410					Josh.Hershberger@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/13/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Formulary Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	Christa.Watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Formulary Contact (Secondary)	Manager Clinical Pharmacist Review		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	03/10/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	General Contact	Chief Government Programs Officer	Mr.	Biesecker	Gregory		7172520587					Gregory.Biesecker@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	09/05/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Government Relations Contact	Sr. VP & General Counsel	Mr.	Hopkins	Joel		7175416358				7176514445	Joel.Hopkins@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	07/19/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	HIPAA Privacy Officer	Privacy & Data Protection Officer	Mr.	Stambaugh	Alan		7175417077					Alan.Stambaugh@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	171779799	05/31/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	HIPAA Security Officer	Chief Information Security Officer	Mr.	Burd	Aaron		7175416939					aaron.burd@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Hospice Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	Christa.Watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Interoperability Contact	Senior Director, Information Technology		Blackwell	William		7175417246					William.Blackwell@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	11/24/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	MA Appeals/Grievances Contact	Director, Medicare Operations	Mr.	Koch	Jonathan		7178292114					Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/30/2019	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	MA Claims Processing Contact for Public Website	Director Medicare Operations	Mr.	Koch	Jonathan		8666882242					Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Marketing Contact	Director, Marketing	Mr.	Londre	Michael		7175416467				7175402499	Michael.Londre@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	11/24/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Medical Director	Chief Medical Officer	Dr.	Wigginton	Jeremy	A	7175417152					jeremy.wigginton@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/16/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Medicare Coordinator	Director, Government Programs Administration Team		Wilbert	Tiffany		7175417606					tiffany.wilbert@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/25/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Medicare Part D Opioid Overutilization Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	Christa.Watts@capbluecross.com	2500 Elmerton Avenue	P.O. Box 779846	Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Medication Therapy Management Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Online Enrollment Center Contact (Back-up)	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part C Application Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	11/25/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part C Reporting Contact		Ms.	Dale	Rasheda		7175416444					rasheda.dale@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/29/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Appeals	Regulatory Director	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/08/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				PPO - BBA		C	Chicago
H3923	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/29/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				PPO - BBA		C	Chicago
H3923	Part D Application Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	11/25/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Claims Submission Contact	Manager, Medicare Pharmacy Operations	Ms,	Cook	Tammy	L	7177038749				7173466836	tammy.cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/29/2018	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Exceptions Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa							christa.watts@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active	8669874213				PPO - BBA		C	Chicago
H3923	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist	Ms	Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55120	03/30/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				PPO - BBA		C	Chicago
H3923	Part D Price File Contact (Back-up)	QA Analyst Sr		Nguyen	Kim		6127776931					kim.nguyen@PrimeTherapeutics.com	Prime Therapeutics, LLC	1305 Corporate Center Drive	Eagan	MN	55121	09/08/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Price File Contact (Optional)	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Price File Contact (Primary)	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Quality Assurance Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Part D Reporting Contact		Ms.	Leonard	Kellie		7175417117					Kellie.Leonard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/26/2022	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Patient Safety Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Payment Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Pharmacy Director	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Pharmacy Network Management Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/14/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Pharmacy Network Management Contact (Secondary)			Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	09/08/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC 2655 Eagan Woods Drive		Eagan	MN	55122	12/16/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active	8888780151				PPO - BBA		C	Chicago
H3923	Plan Directory Contact for Public Website	Medicare Compliance Officer	Ms.	Leedock	Melissa		8666882242					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Plan to Plan Reconciliation Contact	Accountant II	Ms.	Balseiro	Julia		7175417458					FinanceP2P-CASH@CapBlueCross.com	2500 Elmerton Avenue	Mail Drop 3237	Harrisburg	PA	17177	05/07/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Processor Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		6127776755					MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	09/08/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Quality Contact	Sr. Medical Director	Dr.	Harr	Denise		7177038497					Denise.Harr@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	06/16/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Reconciliation Contact	VP and Chief Actuary	Mr.	Spitler	Mark		7175416613					mark.spitler@capbluecross.com	2500 Elmerton Ave.		Harrisburg	PA	17177	01/13/2025	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Reconciliation Contact (Secondary)	Actuarial Business Consultant	Mr.	Shafer	Brian		7175416263					Brian.Shafer@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/10/2021	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	SNP Application Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	11/25/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	SNP State Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	11/25/2020	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Surveillance Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	System Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Third Party Administrator (TPA) Liaison			Balseiro	Julia	A	7175417458					Julia.Balseiro@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/24/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	User Access Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Utilization Management Contact		Ms.	Yoder	Hollie		7177755884					Hollie.Yoder@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3923	Utilization Review Contact		Ms.	Yoder	Hollie		7177755884					Hollie.Yoder@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	CAPITAL ADVANTAGE INSURANCE COMPANY	Local CCP	Capital Blue Cross	Local PPO		CAPITAL BLUE CROSS	41	Yes	Active					PPO - BBA		C	Chicago
H3924	Agent/Broker Compensation Data Contact	Manager, Sales Operations	Ms.	Martz	Andrea	L	5705094265					amartz3@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223910	12/21/2021	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Automated TrOOP Balance Transfer Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Backup User Access Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Best Available Evidence Contact	Director, Health Plan Operations - Enrollment	Ms.	Felix	Noelle	C	5702149270					ncfelix@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	04/29/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Bid Audit Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Bid Audit Site Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Bid Primary Contact	VP, Government Programs	Ms.	Mastrandrea	Mary		4103037972					mmastrandrea@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/30/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Torrey	Sue		5702042180					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	CEO - Senior Official for Contracting	President, Geisinger Health Plan	Ms.	Murphy	Karen		5702718777					kmurphy12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	02/05/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Chief Financial Officer	Chief Financial Officer, Geisinger Health Plan	Mr.	Mccullough	Mark		5702143200					mmccullough2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	04/29/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Chief Operating Officer	Chief Operating Officer	Ms.	Torrey	Sue		5702143679					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Chief Information Officer	Chief Information Officer	Mr.	Bennett	Daniel		5702143120					drbennett@geisinger.edu	Geisinger Health System	100 N. Academy Avenue	Danville	PA	178223025	10/30/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Chief Information Security Officer	Chief Information Security Officer	Mr.	Gable	Zachary	A	5702142452					zagable@geisinger.edu	Geisinger Information Security Office	100 N. Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	CMS Casework Communication Contact	Senior Appeals Coordinator		Fracalossi	Kathleen		5702144533					kmfracalossi@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/21/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Complaints Tracking Contact	Senior Appeals Coordinator		Fracalossi	Kathleen		5702144533					kmfracalossi@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/21/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Contact for Fraud Investigations	Manager Program Integrity	Ms.	Coslett	Kathy	B	5702140639					kbcoslett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	06/01/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Coordination of Benefits Contact	Supervisor, Health Plan COB	Ms.	Corrall	Theresa		5702145414					COB@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223251	03/19/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Corporate Mailing						5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Customer Service Operations Contact	Director, Health Plan Operations, Customer Care	Mr.	Sanders	John	R	5702148046					jrsanders@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	10/31/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	DIR Contact	Pharmacy Data Analyst Lead	Ms.	Bertollo	Krista	L	5702145059				5702146768	klbertollo@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	DIR Contact (Secondary)	Manager, Pharmacy Data and Reporting	Ms.	Chesnick	Candy		5702715555	59687			5702146768	cjchesnick@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Discount Program Payment Contact	Manager, Government Programs	Mr.	Merkel	Patrick	W	5702144692				5702144692	pwmerkel@thehealthplan.com	Geisinger Health Plan, Federal Government Programs	100 North Academy Avenue	Danville	PA	17822	02/26/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Emergency Part D Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/19/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Emergency Part D Contact (Secondary)	Chief Operating Office	Ms.	Torrey	Sue		5702042180					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Encounter Data & Risk Adjustment Operations Contact	Actuarial Director		Trafton	Kristina	L	5702145043					kltrafton@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223225	10/29/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Enrollment Contact	Director, Health Plan Operations - Enrollment	Ms.	Felix	Noelle	C	5702149270					ncfelix@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	04/29/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	EOB Transfer Contact	Pharmacy Data Analyst Lead	Ms.	Bertollo	Krista		5702145059				5702146768	EOBP2P@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Financial Audit Contact	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Financial Reporting Contact	VP Financial Reporting and Operations	Mr.	Teska	Christophe	S	5702146766					csteska@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223251	04/17/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Formulary Contact	Pharmacy Coordinator		Astleford	Leslie		5702141230					lastleford@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	11/18/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Formulary Contact (Secondary)	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702146597				5702146768	tsponenberg@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	05/01/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	General Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Government Relations Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	HIPAA Privacy Officer	Chief Privacy Officer	Mr.	Friesen, JD	Jonathan	R	5702716525					jfriesen@geisinger.edu	Geisinger Privacy Office	100 North Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	HIPAA Security Officer	Chief Privacy Officer	Mr.	Friesen, JD	Jonathan	R	5702716525					jfriesen@geisinger.edu	Geisinger Privacy Office	100 North Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Hospice Contact	Claims and Benefits Auditor, GHP Pharmacy	Ms.	Seabrook	Naiki	A	5702147851				5703002122	naseabrook@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Interoperability Contact	Sr. Director Information Technology	Mr.	Niedjaco	Felix	C	5708088538					fcniedjaco@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223911	03/23/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	MA Appeals/Grievances Contact	Director, Member Resolution Team	Ms.	Piepszowski	BethAnn		5702717166				5702717225	bapiepszowski@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/31/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	MA Claims Processing Contact for Public Website	Manager GHP Customer Service Operations/Claims	Ms.	George	Karen	M	5702140876					kmgeorge@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/22/2021	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Marketing Contact	Sr. Director, Health Plan Marketing	Ms.	Kimberland	Kelly		4122983841				5702717218	kkimberland@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/28/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Medical Director	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	09/22/2015	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Medicare Coordinator	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Medicare Part D Opioid Overutilization Contact	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702146597					tsponenberg@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	06/02/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Medication Therapy Management Contact	Health Plan Pharmacist	Dr.	Scheib	Kristen		5702149238					kmscheib@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	11/01/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	OffShore Subcontractor Contact	Associate Vice President Legal Counsel	Mr.	Davis	F. Kelly		5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan Legal Services	100 N. Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Online Enrollment Center Contact (Back-up)	Supervisor Customer Service	Ms.	Biehl	Lori		5708082168					lbiehl@thehealthplan.com	Geisinger Health Plan Enrollment - GHP	100 N. Academy Avenue	Danville	PA	178222580	06/01/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Online Enrollment Center Contact (Primary)	Manager Customer Service Operations	Mr.	D'Elia	Russell		5708085038					rdelia@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	06/01/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part C Application Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435					krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/28/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part C Reporting Contact	Operations Specialist	Ms.	Utt	Bobbi	J	5702146718				5702148921	bjutt@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Appeals	Manager, Pharmacy Cust. Srvc.	Ms	Bitler	Jessie	M						jmbitler@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/30/2020	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8009884861				PPO - BBA		C	Dallas
H3924	Part D Application Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435					krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/28/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Benefits Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Claims Submission Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223229	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Exceptions Contact	Director, Pharmacy Services	Dr.	Miller	Jamie	L					5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8009884861				PPO - BBA		C	Dallas
H3924	Part D Exceptions Contact (Secondary)	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K					5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8009884861				PPO - BBA		C	Dallas
H3924	Part D Price File Contact (Back-up)	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702145059				5702146597	tsponenberg@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Price File Contact (Optional)			Plan Finder	Navitus		5122313140					Plan.Finder@navitus.com	361 Integrity Drive		Madison	WI	53717	04/08/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Price File Contact (Primary)	Manager, Government Programs Pharmacy Operations	Dr.	Bender	Kristen		5702715555	59687			5702149379	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17821	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	11/01/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Part D Reporting Contact	Operations Specialist	Ms.	Utt	Bobbi	J	5702146718				5702148921	bjutt@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Patient Safety Contact	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	11/01/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Payment Contact	Actuarial Director	Ms.	Trafton	Kristina	L	5702145043					kltrafton@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223225	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Pharmacy Director	Director, Pharmacy Services	Dr.	Miller	Jamie		5702715730				5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Pharmacy Network Management Contact	VP, Network Management, Navitas	Ms.	Santos	Christina		6088204408					Christina.Santos@navitus.com	Navitus	361 Integrity Drive	Madison	WI	53717	01/02/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Services	Dr.	Miller	Jamie		5702715730				5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	10/20/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts	Ms	Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus	1025 West Navitus Drive	Appleton	WI	54913	01/02/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8662703877	4224			PPO - BBA		C	Dallas
H3924	Physician Incentive Contact	Manager, Provider Management	Ms.	Profit	Massiel		5704920147					mprofit@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	08/01/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Plan Directory Contact for Public Website	Geisinger Health Plan		Care	Customer		5704989731				5702715871	ghp_customer+service@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223229	11/13/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Plan to Plan Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Processor Contact	Manager, Technical Operations, Part D Claims	Mr.	Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus	1025 West Navitus Drive	Appleton	WI	54913	01/02/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Quality Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	pwmerkel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	02/22/2021	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Reconciliation Contact (Secondary)	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Recovery Audit Contact	Associate Vice President Legal Counsel	Mr.	Davis	F Kelly		5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	SNP Application Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435				5702718921	krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/28/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	SNP State Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Surveillance Contact	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	System Contact	Technical Analyst Lead	Mr.	Sholder	Richard	J	5702717895				5702715162	rjsholder@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	07/25/2022	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Third Party Administrator (TPA) Liaison	PDE/Part D Analyst	Mr.	Baylor	Blaze	A	5702144692				5702141367	babaylor1@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	02/11/2025	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	User Access Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435				5702148921	krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/28/2024	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Utilization Management Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3924	Utilization Review Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER INDEMNITY INSURANCE COMPANY	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H3925	Automated TrOOP Balance Transfer Contact	NA	Mr.	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Backup User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Bid Primary Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	CAP Report Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	CEO - Senior Official for Contracting	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Chief Operating Officer	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Chief Information Officer	IT Director	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Chief Information Security Officer	IT Director	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Complaints Tracking Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Contact for Fraud Investigations	Executive Director	Mr.	Voeghtly	Robert		8145356000	22139			8142487902	SLJDirectors@seniorlifejohnstown.com	401 Broad Street		Johnstown	PA	15906	08/26/2024	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Corporate Mailing						8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	DIR Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Discount Program Payment Contact	CFO		Dodson	David	M	8145356000	22102				Ddodson@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/14/2025	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Emergency Part D Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Encounter Data & Risk Adjustment Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	10/18/2019	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Enrollment Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	EOB Transfer Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Financial Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Formulary Contact			N/A	N/A		8145356000	22100				N/A@n/a.com	N/A		N/A	PA	15906	05/17/2013	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	General Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	HIPAA Privacy Officer	IT Director	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	HIPAA Security Officer	IT Director		Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Interoperability Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	MIrwin@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	02/16/2022	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	MA Appeals/Grievances Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Marketing Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Medical Director	Medical Director		Ratchford	Donald		8145356000	26007				DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	02/26/2018	2026	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	Ms	Stephens	Alyssa		8145356000	22110			8142487902	SLJDirectors@seniorlifejohnstown.com	401 Broad Street		Johnstown	PA	15906	12/09/2024	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Medicare Coordinator	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Medicare Part D Opioid Overutilization Contact	Medical Director		Ratchford	Donald		8145356000	26007				DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	11/27/2018	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Medication Therapy Management Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/13/2019	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part C Application Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part D Appeals	Chief Financial Officer	Mr	Dodson	David						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H3925	Part D Appeals Contact (Secondary)	Chief Executive Officer	Mr.	Irwin	Mark						8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	12/29/2020	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active	8145356000	22101			PACE - Nat		C	Philadelphia
H3925	Part D Application Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part D Benefits Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part D Claims Submission Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H3925	Part D Price File Contact (Back-up)			N/A	N/A		8145356000	22100				N/A@N/A.com	N/A		N/A	PA	15906	05/17/2013	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part D Price File Contact (Primary)			N/A	N/A		8145356000	22100				N/A@N/A.com	N/A		N/A	PA	15906	05/17/2013	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part D Quality Assurance Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Part D Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Patient Safety Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Payment Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Pharmacy Director			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Pharmacy Network Management Contact			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active	7242751203	219			PACE - Nat		C	Philadelphia
H3925	Plan Directory Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Processor Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	11/13/2025	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Quality Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Reconciliation Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Recovery Audit Contact	CFO	Mr	Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	11/13/2025	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Surveillance Contact			Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	System Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Third Party Administrator (TPA) Liaison	VP Grane PBM		Baker	John		3306968345					jebaker@granepbm.com	209 Sigma Drive		Pittsburgh	PA	15238	03/14/2025	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Utilization Management Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3925	Utilization Review Contact	ChieExecutive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	PENNSYLVANIA PACE, INC.	National PACE	Senior LIFE Johnstown	National PACE		Pennsylvania PACE, Inc.	181	Yes	Active					PACE - Nat		C	Philadelphia
H3928	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/30/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3928	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3928	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (LA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/12/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@aetna.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	06/23/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/12/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8609006476					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	11/26/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3931	PHR Beneficiary Contact																	02/28/2007	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H3931	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3931	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3933	Automated TrOOP Balance Transfer Contact			Krantz	Amy		3096552850					Amy.M.Krantz@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Backup User Access Contact			Carrothers	Michelle		3096552850					Michelle.A.Carrothers@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Best Available Evidence Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Bid Primary Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	CAP Report Contact for Public Website			Riley	Brianne		3096552850					Brianne.L.Riley@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	CEO - CMS Administrator Contact		Mr.	Sehring	Robert		3096552850					Robert.C.Sehring@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	CEO - Senior Official for Contracting		Mr.	Sehring	Robert		3096552850					Robert.C.Sehring@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Chief Financial Officer		Ms.	Largent	Kirsten		3096552850					Kirsten.M.Largent@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	11/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Chief Operating Officer		Dr.	Cruz	Mike		3096552850					Mike.A.Cruz@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Chief Information Officer		Dr.	Hall	David		3096552850					David.M.Hall@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Chief Information Security Officer		Mr.	Alphonso	Quentin		3096552850					Quentin.J.Alphonso@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	CMS Casework Communication Contact			Tonozzi	Clinton		3096552850					Clinton.J.Tonozzi@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Complaints Tracking Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Contact for Fraud Investigations			Tonozzi	Clinton		3096552850					Clinton.J.Tonozzi@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Coordination of Benefits Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Corporate Mailing						3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Customer Service Operations Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	DIR Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	DIR Contact (Secondary)			Salverson	Sandra		3096552850					Sandra.M.Salverson@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Discount Program Payment Contact			Krantz	Amy		3096552850					Amy.M.Krantz@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Emergency Part D Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Emergency Part D Contact (Secondary)			Salverson	Sandra		3096552850					Sandra.M.Salverson@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Encounter Data & Risk Adjustment Operations Contact			Krantz	Amy		3096552850					Amy.M.Krantz@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Enrollment Contact			Krantz	Amy		3096552850					Amy.M.Krantz@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	EOB Transfer Contact			Pritzker	Nathan		3096552850				3093085972	nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Financial Audit Contact	Director	Mrs.	Gardiner	Lauren		3096552850					Lauren.E.Gardiner@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Financial Reporting Contact			Gardiner	Lauren		3096552850					Lauren.E.Gardiner@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Formulary Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Formulary Contact (Secondary)			Salverson	Sandra		3096552850					Sandra.M.Salverson@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	General Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/10/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Government Relations Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	HIPAA Privacy Officer			Hernandez	Elizabeth		3096552850					Elizabeth.Hernandez@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	09/06/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	HIPAA Security Officer			Hernandez	Elizabeth		3096552850					Elizabeth.Hernandez@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Interoperability Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	MA Appeals/Grievances Contact			Wallis	Carla		3096552850					Carla.A.Wallis@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	MA Claims Processing Contact for Public Website			Riley	Brianne		3096552850					Brianne.L.Riley@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Marketing Contact			Riley	Brianne		3096552850					Brianne.L.Riley@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Medical Director			Gorman	Matthew		3096552850					matthew.j.gorman@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/14/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Medicare Compliance Officer		Mr.	Tonozzi	Clinton		3096552850					Clinton.J.Tonozzi@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Medicare Coordinator			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Medicare Part D Opioid Overutilization Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Medication Therapy Management Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part C Application Contact			Pritzker	Nathan		3092293447					nathan.j.pritzker@osfhealthcare.org	1306 N. Berkeley Avenue		Peoria	IL	61603	02/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Appeals			Scheid	Jason							Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active	3096552850				PACE - Nat		C	New York
H3933	Part D Application Contact			Scheid	Jason		3092293447					Jason.M.Scheid@osfhealthcare.org	1306 N. Berkeley Avenue		Peoria	IL	61603	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Benefits Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Claims Submission Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Exceptions Contact			Scheid	Jason							Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active	3096552850				PACE - Nat		C	New York
H3933	Part D Exceptions Contact (Secondary)			Salverson	Sandra							Sandra.M.Salverson@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active	3096552850				PACE - Nat		C	New York
H3933	Part D Price File Contact (Back-up)			Salverson	Sandra		3096552850					Sandra.M.Salverson@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Price File Contact (Optional)			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Price File Contact (Primary)			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	12/16/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Quality Assurance Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Part D Reporting Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Patient Safety Contact			Wallis	Carla		3096552850					Carla.A.Wallis@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Payment Contact			Kurth	Aaron		3096552850					Aaron.T.Kurth@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Pharmacy Director			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Pharmacy Network Management Contact			Scheid	Jason		3096552850					Jason.M.Scheid@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Pharmacy Technical Help Desk Contact			Pritzker	Nathan								124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active	3096552850				PACE - Nat		C	New York
H3933	Plan Directory Contact for Public Website			Riley	Brianne		3096552850					Brianne.L.Riley@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Plan to Plan Reconciliation Contact			Kurth	Aaron		3096552850					Aaron.T.Kurth@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Processor Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Quality Contact			Wallis	Carla		3096552850					Carla.A.Wallis@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Reconciliation Contact			Kurth	Aaron		3096552850					Aaron.T.Kurth@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Reconciliation Contact (Secondary)			Gardiner	Lauren		3096552850					Lauren.E.Gardiner@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Recovery Audit Contact	Compliance Officer	Mr.	Tonozzi	Clinton		3096552850					Clinton.J.Tonozzi@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Surveillance Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	System Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Third Party Administrator (TPA) Liaison			Pritzker	Nathan		3096552850					Nathan.J.Pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	User Access Contact			Pritzker	Nathan		3096552850					nathan.j.pritzker@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	03/14/2023	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Utilization Management Contact			Wallis	Carla		3096552850					Carla.A.Wallis@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3933	Utilization Review Contact			Wallis	Carla		3096552850					Carla.A.Wallis@osfhealthcare.org	124 SW Adams Street		Peoria	IL	61602	06/08/2024	2026	OSF HEALTHCARE SYSTEM	National PACE	OSF Healthcare PACE	National PACE		OSF Healthcare System	823	Yes	Active					PACE - Nat		C	New York
H3942	Automated TrOOP Balance Transfer Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Backup User Access Contact	Dir. Quality and Compliance	Mrs.	Forney	Harriet		9107670928				9107650188	hforney@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Best Available Evidence Contact	Quality Manager	Mrs.	Sholar-Mason	Paula		9107670972				9107650188	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Bid Primary Contact	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463523	tchang@EveryAge.org	802 E. Center Street		Lexington	NC	27401	11/19/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	CAP Report Contact for Public Website	Quality Manager	Mrs.	Sholar-Mason	Paula		9107670972				9107650188	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	CEO - CMS Administrator Contact	Executive Director	Ms	Finch	Ruth		9107670932				9107650188	rfinch@EveryAge.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	CEO - Senior Official for Contracting	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463523	tchang@EveryAge.org	802 E. Center Street		Lexington	NC	27401	10/03/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Chief Financial Officer	CFO	Ms.	Jones	Tammy		8284658007				9103438836	tjones@EveryAge.org	100 Leonard Ave		Newton	NC	28658	02/01/2023	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Chief Operating Officer	Chief Operating Office	Ms.	Reimann	Aimee		8284658017				3367463523	areimann@EveryAge.org	100 Leonard Ave		Newton	NC	28658	10/03/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Chief Information Officer	Director of Information Technology	Mr.	Larew	Brantley		8284658016				9103438836	Blarew@EveryAge.org	100 Leonard Ave		Newton	NC	28658	11/18/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Chief Information Security Officer	Director of Information Technology	Mr.	Larew	Brantley		8284658016				9103438836	Blarew@EveryAge.org	100 Leonard Ave		Newton	NC	28658	11/18/2021	2026	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		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Complaints Tracking Contact	Dir. Quality and Compliance	Mrs.	Sholar-Mason	Paula		9107670972				9103438836	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Contact for Fraud Investigations	Dir. Quality and Compliance	Mrs.	Forney	Harriet		9107670928				9107650188	hforney@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Coordination of Benefits Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27295	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Corporate Mailing						9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Customer Service Operations Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27295	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	DIR Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27295	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	DIR Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463523	tchang@EveryAge.org	802 E. Center Street		Lexington	NC	27401	11/19/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Discount Program Payment Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Emergency Part D Contact	Business Analyst		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Emergency Part D Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463500				3367463565	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Encounter Data & Risk Adjustment Operations Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Enrollment Contact	Enrollmnet Coordinator	Mrs.	Wilkins	Aysha		9107670922				9107650188	awilkins@EveryAge.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	EOB Transfer Contact	Business Office Team Lead		Cornell	Jacob		3367463547				3368990573	jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Financial Audit Contact	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463523	tchang@everyage.org	802 E. Center Street		Lexington	NC	27292	01/16/2023	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Financial Reporting Contact	CFO	Ms.	Jones	Tammy		8284658007				9103438836	tjones@EveryAge.org	100 Leonard Ave		Newton	NC	28658	02/01/2023	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Formulary Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Formulary Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463500				3367463565	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	General Contact	Executive Director		Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Government Relations Contact	Executive Director		Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	HIPAA Privacy Officer	Dir. Quality and Compliance	Mrs.	Sholar-Mason	Paula		9107670972				9103438836	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	HIPAA Security Officer	Dir. Quality and Compliance	Mrs.	Sholar-Mason	Paula		9107670972				9103438836	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Interoperability Contact	Executive Director		Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	MA Appeals/Grievances Contact	Dir. Quality and Compliance	Mrs.	Sholar-Mason	Paula		9107670972				9103438836	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	MA Claims Processing Contact for Public Website	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Marketing Contact	Marketing Coordinator	Mrs.	Barrow	Lynda		9107670931				9107650188	lbarrow@EveryAge.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Medical Director	Medical Director	Dr.	Roddy	David		3367463500				3365283814	droddy@everyage.org	1380 North College Road		Wilmington	NC	28405	01/17/2023	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Medicare Compliance Officer	Dir. Quality and Compliance	Mrs.	Forney	Harriet		9107670928				9107650188	hforney@everyage.org	1380 N. College Rd.	Elderhaus, Inc.	Wilmington	NC	28405	08/08/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Medicare Coordinator	Business Office Team Lead	Mr.	Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Roddy	David		3367463500				3365283814	droddy@everyage.org	1380 North College Road		Wilmington	NC	28405	11/19/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Medication Therapy Management Contact	Medical Director	Dr.	Roddy	David		3367463500	145			3365283814	droddy@everyage.org	1380 North College Road		Wilmington	NC	28405	11/19/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Online Enrollment Center Contact (Back-up)	Executive Director	Mrs.	Barrow	Lynda		9107670931				9107650188	lbarrow@EveryAge.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Online Enrollment Center Contact (Optional)	Enrollment Coordinator	Mrs.	Wilkins	Alysha		9107670922				9107650188	awilkins@EveryAge.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Online Enrollment Center Contact (Primary)	Executive Director	Ms.	Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part C Application Contact	Executive Director	Ms.	Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Appeals	Dir. Quality and Compliance	Mrs.	Sholar-Mason	Paula						9103438836	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active	9107670972				PACE - Nat		C	Atlanta
H3942	Part D Appeals Contact (Secondary)	Medical Director	Dr.	Roddy	David						9103438836	droddy@everyage.org	1380 North College Road		Wilmington	NC	28405	11/19/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active	8883438209	161			PACE - Nat		C	Atlanta
H3942	Part D Application Contact	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463500				3367463565	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Benefits Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Claims Submission Contact	Business Office Team Lead	Mrs.	Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Exceptions Contact	Business Office Team Lead		Cornell	Jacob							jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active	3367463547				PACE - Nat		C	Atlanta
H3942	Part D Exceptions Contact (Secondary)	Business Analyst	Ms.	Chastain	Kelly						9107650188	kchastain@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active	9107670930				PACE - Nat		C	Atlanta
H3942	Part D Price File Contact (Back-up)	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463500				9103438836	tchang@everyage.org	802 East Center Street		Lexington	NC	27292	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Price File Contact (Optional)	Executive Director	Ms.	Finch	Ruth	H	9107670932				9107650188	rfinch@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Price File Contact (Primary)	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Quality Assurance Contact	Quality Manager	Mrs.	Sholar-Mason	Paula		9107670972				9107650188	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Part D Reporting Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Patient Safety Contact	Quality Manager	Mrs.	Sholar-Mason	Paula		9107670972				9107650188	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Payment Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Personal Health Record Contact	Executive Director	Ms.	Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Pharmacy Director	Medical Director	Dr.	Roddy	David		3367463500	145			3365283814	droddy@everyage.org	1380 North College Road		Wilmington	NC	28405	11/19/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Pharmacy Network Management Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Pharmacy Technical Help Desk Contact	Business Office Team Lead		Cornell	Jacob							jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active	3367463547				PACE - Nat		C	Atlanta
H3942	PHR Beneficiary Contact																	09/13/2016	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE	Elderhaus, Inc.	EveryAge	797	Yes	Active	8883438209	161			PACE - Nat		C	Atlanta
H3942	Plan Directory Contact for Public Website	Executive Director	Ms.	Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Plan to Plan Reconciliation Contact	Business Analyst	Ms.	Chastain	Kelly		9107670930				9107650188	kchastain@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Processor Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Quality Contact	Quality Manager	Mrs.	Sholar-Mason	Paula		9107670972				9107650188	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Reconciliation Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Reconciliation Contact (Secondary)	Sr. Director of HCBS	Mr.	Chang	Thomas	T	3367463519				3367463523	tchang@EveryAge.org	802 E. Center Street		Lexington	NC	27401	11/19/2021	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Recovery Audit Contact	Executive Director	Ms	Finch	Ruth		9107670932				9107650188	rfinch@everyage.org	1380 North College Road		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Surveillance Contact	Dir. Quality and Compliance	Mrs.	Sholar-Mason	Paula		9107670972				9103438836	psholarmason@everyage.org	1380 N. College Rd.		Wilmington	NC	28405	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	System Contact	IT Director	Mr.	Larew	Brantley		8284658022				8284658537	blarew@everyage.org	100 Leonard Ave		Newton	NC	28658	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Third Party Administrator (TPA) Liaison	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27295	09/10/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	User Access Contact	IT Director	Mr.	Larew	Brantley		8284658022				8284658537	blarew@everyage.org	100 Leonard Ave		Newton	NC	28658	08/14/2024	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Utilization Management Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3942	Utilization Review Contact	Business Office Team Lead		Cornell	Jacob		3367463547					jcornell@everyage.org	802 E Center St		Lexington	NC	27292	09/19/2025	2026	ELDERHAUS INC.	National PACE	Elderhaus PACE	National PACE		EveryAge	797	Yes	Active					PACE - Nat		C	Atlanta
H3949	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	07/03/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H3949	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H3949	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H3949	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H3949	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H3949	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H3949	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3949	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H3952	Agent/Broker Compensation Data Contact	Mgr. Sales Onboarding		Heckman	Jim		2152411994					jim.heckman@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	07/19/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Automated TrOOP Balance Transfer Contact	Lead Business Systems Support Admin		Jimenez	Barbara		2676751825				2152413526	barbara.jimenez@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	12/20/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Backup User Access Contact	Reg. Performance Mgmt. Analyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/27/2020	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Best Available Evidence Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Bid Audit Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Bid Audit Site Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Bid Primary Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	CAP Report Contact for Public Website	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	CEO - CMS Administrator Contact	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	CEO - Senior Official for Contracting	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Chief Financial Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Chief Operating Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Chief Information Officer	EVP and Chief Strategy, Corp. Dev., & Info Officer	Mr.	Vennera	Michael		2152419525					Michael.Vennera@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	04/24/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Chief Information Security Officer	Chief Information Security Leader	Mr.	Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901 Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	CMS Casework Communication Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Complaints Tracking Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Contact for Fraud Investigations	Director, Financial Investigations		Deery	Christophe	E	2156407302	27302			2152382287	christopher.deery@ibx.com	1901 Market Street	42nd Floor	Philadelphia	PA	19103	12/30/2015	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Coordination of Benefits Contact	Manager, COB/OPL		Hawkins	Veronica		2156407507	27507				Veronica.Hawkins@ibx.com	1901 Market Street	17th Floor	Philadelphia	PA	19103	12/24/2020	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Corporate Mailing						2152412400					mitchell.goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19103	02/27/2012	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Customer Service Operations Contact	Director, Contact Center		Lentz	Michael		2157933262	63262				michael.lentz@ibx.com	1900 Market Street	5th Floor	Philadelphia	PA	19103	11/01/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	DIR Contact	Manager Gov. Markets - Commercial Risk Adjustment		Sanders	Sean		2152419420					Sean.Sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	06/29/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	DIR Contact (Secondary)	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2152417265					Geoffrey.Wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Discount Program Payment Contact	Lead Accountant		Murphy	Stacey		2152413522	23522				Stacey.Murphy@ibx.com	1901 Market Street, 36th Floor	Corporate Accounting	Philadelphia	PA	19103	04/24/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Emergency Part D Contact	Pharmacy Services Mgr   Pharmacy		Parisi	Dana		2152413265					dana.parisi@ibx.com	1901 Market Street		Philadelphia	PA	19103	12/19/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Emergency Part D Contact (Secondary)	Director Medicare Regulatory Performance Mgmt.		Adams	Desiree		2153279829					Desiree.Adams@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	04/10/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Employer Waiver Contact	SVP Government Markets, Sales & Marketing Leadersh		Cruz	Kortney		2152414762					Kortney.Cruz@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	12/16/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Encounter Data & Risk Adjustment Operations Contact	Manager Data Delivery and Reporting	Ms.	Heifetz	Nata		2152410511					Nata.Heifetz@ibx.com	1901 Market Street	37th Floor	Phialdelphia	PA	19103	12/19/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Enrollment Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	EOB Transfer Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Financial Audit Contact	VP Corporate Compliance	Mr	Zipfel	Michael		2152414908				2155674542	Michael.Zipfel@ibx.com	1901 Market Street		Philadelphia	PA	19103	09/05/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Financial Reporting Contact	EVP, CFO, & Treasurer		Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	11/01/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Formulary Contact	Senior Clinical Pharmacist		Urbanek	Michael		2152419003				2152413526	Michael.Urbanek@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	12/19/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Formulary Contact (Secondary)	Clinical Consultant-Optum Rx		Sosinsky	Inna		7633616985					inna.sosinsky@Optum.com	1100 Optum Circle		Eden Parairie	MN	55344	04/18/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	General Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Government Relations Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	HIPAA Privacy Officer	Director, Privacy Officer		Reiben	Laura		2152414462					laura.rieben@ibx.com	1901 Market Street		Philadelphia	PA	19013	02/13/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	HIPAA Security Officer	Director Information Security		Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901 Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Hospice Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654					kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	06/29/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Interoperability Contact	Healthcare Interoperability Director		Denyer	James		2152410858					james.denyer@ibx.com	1901 Market Street	20th Floor	Philadelphia	PA	19103	04/10/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	MA Appeals/Grievances Contact	Manager, Medicare Member Appeals and Grievances		Tobias	Bobbi		2152410669					Bobbi.Tobias@ibx.com	1901 Market Street	Mailstop, 12TH floor	Philadelphia	PA	19103	04/19/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	MA Claims Processing Contact for Public Website	Director Claims Operations		Perfetto	Lisa		2152414126					lisa.perfetto@ibx.com	1901 Market Street, 15th Floor		Philadelphia	PA	19103	02/28/2018	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Marketing Contact	RPM Analyst II, NJMA Government		Dunn	DeVonda		2152413837					devonda.dunn@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/16/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Medical Director	Medical Director	Dr.	Ramos	Luz		2152414040					luz.ramos@ibx.com	1901 Market Street		Philadelphia	PA	19103	04/30/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Medicare Compliance Officer	Director, Corporate Compliance, Medicare and Comme	Mr.	Goldberg	Mitchell		2152419516				2155674542	mitchell.goldberg@ibx.com	1901 Market Street	42nd Floor	Philadelphia	PA	19103	02/13/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Medicare Coordinator	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Soribe	Nneka		2152414729				2152413526	nneka.soribe@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	03/05/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Medication Therapy Management Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Services		Kelley	Josh		2152414829					Joshua.Kelley@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/19/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Online Enrollment Center Contact (Optional)	Regulatory Performance Mgmt. Analyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	12/19/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Online Enrollment Center Contact (Primary)	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part C Application Contact	Senior Product and Capability Mgr.		Keenan	Kate		2152419495					kate.keenan@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	02/28/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part C Reporting Contact	Manager, Government Markets Reporting		Pippett	Andrew		2152417416					Andrew.Pippett@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Appeals	Manager Medicare Member Appeals and Grievances		Tobias	Bobbi							Bobbi.Tobias@ibx.com	1901 Market Street	Mailstop, 12TH floor	Philadelphia	PA	19103	04/19/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	8887183333				HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Appeals Contact (Secondary)	Supervisor, Medicare Member Appeals and Grievances		Byrd	Kelly							kelly.byrd@ibx.com	1901 Market Street Mailstop,	12th Floor	Philadelphia	PA	19103	12/27/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	8887183333				HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Application Contact	Senior Product and Capability Mgr.		Keenan	Kate		2152419495					kate.keenan@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	02/28/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Benefits Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Claims Submission Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Exceptions Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						2152412654	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	8886787015				HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Exceptions Contact (Secondary)	Manager, Prior Authorization Appeals		Le	Chrstina							christina.le@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	12/20/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	8886787015				HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Price File Contact (Back-up)	Senior Business Analyst, Plan Finder		Moore-Elliott	Shalandria		7637974305					Mshalandria.moore-elliott@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/16/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Price File Contact (Optional)	Project Leader		Coursey	Yarminah		2152413955					yaminah.coursey@ibx.com	1900 Market Street	29th Floor	Philadelphia	PA	19103	02/15/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Price File Contact (Primary)	Senior Business Analyst, Plan Finder		Lam	Annie	M	6124286588					annie.lam@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/03/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Quality Assurance Contact	Director Quality Management		Donohue	Kathleen		2152413277					Kathleen.Donohue@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/27/2018	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Part D Reporting Contact	Manager Government Markets Reporting		Pippett	Andrew		2152417416					Andrew.Pippett@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Patient Safety Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Payment Contact	Director Risk Adjustment & Data Delivery		Buscher	Harry		2152410806					Harry.Buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/08/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Pharmacy Director	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Pharmacy Network Management Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152413526	kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	01/03/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Pharmacy Network Management Contact (Secondary)	Manger, Retail Network Operations		Perez	Felix	M	7632833503					felix.perez@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/03/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Pharmacy Technical Help Desk Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy						2152413526	kathy.erdman@ibx.com	1901 Market Street		Philadelphia	PA	19103	12/19/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	8886787015				HMO - Health Maintenance Organization		C	Chicago
H3952	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	12/19/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	8886787015				HMO - Health Maintenance Organization		C	Chicago
H3952	Physician Incentive Contact	VP DGC & Asst. Corporate Secretary, Corp. Legal Ad		Dianno	Mark		2152412919					Mark.Dianno@ibx.com	1901 Market Street	43rd Floor	Philadelphia	PA	19103	07/09/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Plan Directory Contact for Public Website			Service	Customer		8006453965					info@ibxmedicare.com	PO Box 7799		Philadelphia	PA	191017799	04/29/2015	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Plan to Plan Reconciliation Contact	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2156407265				2152412408	geoffrey.wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	02/18/2022	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Processor Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/30/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Quality Contact	Director Quality Management		Donohue	Kathleen		2152413277					Kathleen.Donohue@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/27/2018	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Reconciliation Contact	Director Risk Adjustment & Data Delivery		Buscher	Harry		2152410806					harry.buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	03/27/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Reconciliation Contact (Secondary)	Mgr. Gov. Mkts. - Commercial Risk Analytics		Sanders	Sean		2152419420					Sean.Sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	01/15/2021	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Recovery Audit Contact	Director of Regulatory Performance Management	Ms.	Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	SNP Application Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	SNP State Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Surveillance Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	System Contact	VP Enterprise Data & Integrations		Varghese	John		2152414553					john.varghese@ibx.com	1901 Market Street	21th Floor	Philadelphia	PA	19103	07/09/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Third Party Administrator (TPA) Liaison	Lead Accountant		Murphy	Stacey		2152413522	23522				Stacey.Murphy@ibx.com	1901 Market Street, 36th Floor	Corporate Accounting	Philadelphia	PA	19103	04/24/2024	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	User Access Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Utilization Management Contact	Director Medical Management & Utilization Review		McGurk	Cheryl		2152414542					Cheryl.mcgurk@ibx.com	1901 Market Street	30th Floor	Philadelphia	PA	19103	08/29/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3952	Utilization Review Contact	Director Medical Management & Utilization Review		McGurk	Cheryl		2152414542					Cheryl.mcgurk@ibx.com	1901 Market Street	30th Floor	Philadelphia	PA	19103	08/29/2023	2026	KEYSTONE HEALTH PLAN EAST, INC.	Local CCP	Independence Blue Cross	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3954	Agent/Broker Compensation Data Contact	Manager, Sales Operations	Ms.	Martz	Andrea	L	5705094265					amartz3@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223910	12/21/2021	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Automated TrOOP Balance Transfer Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Backup User Access Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Best Available Evidence Contact	Director, Health Plan Operations - Enrollment	Ms.	Felix	Noelle	C	5702149270					ncfelix@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	04/29/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Bid Audit Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Bid Audit Site Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Bid Primary Contact	VP, Government Programs	Ms.	Mastrandrea	Mary		4103037972					mmastrandrea@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/31/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Torrey	Sue		5702042180					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	CEO - Senior Official for Contracting	President, Geisinger Health Plan	Ms.	Murphy	Karen		5702718777					kmurphy12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	02/05/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Chief Financial Officer	Chief Financial Officer, Geisinger Health Plan	Mr.	Mccullough	Mark		5702143200					mmccullough2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	04/29/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Chief Operating Officer	Chief Operating Officer	Ms.	Torrey	Sue		5702143679					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Chief Information Officer	Chief Information Officer	Mr.	Bennett	Daniel		5702143120					drbennett@geisinger.edu	Geisinger Health System	100 N. Academy Avenue	Danville	PA	178223025	10/30/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Chief Information Security Officer	Chief Information Security Officer	Mr.	Gable	Zachary	A	5702142452					zagable@geisinger.edu	Geisinger Information Security Office	100 N. Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	CMS Casework Communication Contact	Senior Appeals Coordinator		Fracalossi	Kathleen		5702144533					kmfracalossi@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/21/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Complaints Tracking Contact	Senior Appeals Coordinator		Fracalossi	Kathleen		5702144533					kmfracalossi@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/21/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Contact for Fraud Investigations	Manager Program Integrity	Ms.	Coslett	Kathy	B	5702140639					kbcoslett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	06/01/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Coordination of Benefits Contact	Supervisor, Health Plan COB	Ms.	Corrall	Theresa		5702145414					COB@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223251	03/19/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Corporate Mailing						5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Customer Service Operations Contact	Director, Health Plan Operations, Customer Care	Mr.	Sanders	John	R	5702148046					jrsanders@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	DIR Contact	Pharmacy Data Analyst Lead	Ms.	Bertollo	Krista	L	5702145059				5702146768	klbertollo@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	DIR Contact (Secondary)	Manager, Pharmacy Data and Reporting	Ms.	Chesnick	Candy		5702715555	59687			5702146768	cjchesnick@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Discount Program Payment Contact	Manager, Government Programs	Mr.	Merkel	Patrick	W	5702144692				5702144692	pwmerkel@thehealthplan.com	Geisinger Health Plan, Federal Government Programs	100 North Academy Avenue	Danville	PA	17822	02/26/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Emergency Part D Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/19/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Emergency Part D Contact (Secondary)	Chief Operating Office	Ms.	Torrey	Sue		5702042180					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Encounter Data & Risk Adjustment Operations Contact	Actuarial Director		Trafton	Kristina	L	5702145043					kltrafton@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223225	10/29/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Enrollment Contact	Director, Health Plan Operations - Enrollment	Ms.	Felix	Noelle	C	5702149270					ncfelix@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	04/29/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	EOB Transfer Contact	Pharmacy Data Analyst Lead	Ms.	Bertollo	Krista		5702145059				5702146768	EOBP2P@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Financial Audit Contact	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Financial Reporting Contact	VP Financial Reporting and Operations	Mr.	Teska	Christophe	S	5702146766					csteska@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223251	04/17/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Formulary Contact	Pharmacy Coordinator		Astleford	Leslie		5702141230					lastleford@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	11/18/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Formulary Contact (Secondary)	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702146597				5702146768	tsponenberg@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	05/01/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	General Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Government Relations Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	HIPAA Privacy Officer	Chief Privacy Officer	Mr.	Friesen, JD	Jonathan	R	5702716525					jfriesen@geisinger.edu	Geisinger Privacy Office	100 North Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	HIPAA Security Officer	Chief Privacy Officer	Mr.	Friesen, JD	Jonathan	R	5702716525					jfriesen@geisinger.edu	Geisinger Privacy Office	100 North Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Hospice Contact	Claims and Benefits Auditor, GHP Pharmacy	Ms.	Seabrook	Naiki	A	5702147851				5703002122	naseabrook@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Interoperability Contact	Sr. Director Information Technology	Mr.	Niedjaco	Felix	C	5708088538					fcniedjaco@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223911	03/23/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	MA Appeals/Grievances Contact	Director, Member Resolution Team	Ms.	Piepszowski	BethAnn		5702717166				5702717225	bapiepszowski@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/31/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	MA Claims Processing Contact for Public Website	Manager GHP Customer Service Operations/Claims	Ms.	George	Karen	M	5702140876					kmgeorge@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/22/2021	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Marketing Contact	Sr. Director, Health Plan Marketing	Ms.	Kimberland	Kelly		4122983841				5702717218	kkimberland@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/28/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Medical Director	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Medicare Coordinator	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Medicare Part D Opioid Overutilization Contact	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702146597					tsponenberg@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	06/02/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Medication Therapy Management Contact	Health Plan Pharmacist	Dr.	Scheib	Kristen		5702149238					kmscheib@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	OffShore Subcontractor Contact	Associate Vice President Legal Counsel	Mr.	Davis	F. Kelly		5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan Legal Services	100 N. Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Online Enrollment Center Contact (Back-up)	Supervisor Customer Service	Ms.	Biehl	Lori		5708082168					lbiehl@thehealthplan.com	Geisinger Health Plan Enrollment - GHP	100 N. Academy Avenue	Danville	PA	178222580	06/01/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Online Enrollment Center Contact (Primary)	Manager Customer Service Operations	Mr.	D'Elia	Russell		5708085038					rdelia@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	06/01/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part C Application Contact	Medicare Contract Specialist	Ms.	Wright	Kelly	R	5702146435					krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	04/17/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part C Reporting Contact	Operations Specialist	Ms.	Utt	Bobbi	J	5702146718				5702148921	bjutt@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Appeals	Manager, Pharmacy Cust. Srvc.	Ms	Bitler	Jessie	M						jmbitler@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/30/2020	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	8009884861				HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Application Contact	Medicare Contract Specialist	Ms.	Wright	Kelly	R	5702146435				5702148921	krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	04/17/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Benefits Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Claims Submission Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223229	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Exceptions Contact	Director, Pharmacy Services	Dr.	Miller	Jamie						5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/22/2017	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	8009884861				HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Exceptions Contact (Secondary)	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K					5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	8009884861				HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Price File Contact (Back-up)	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702145059				5702146597	tsponenberg@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	10/29/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Price File Contact (Optional)			Plan Finder	Navitus		5122313140					Plan.Finder@navitus.com	361 Integrity Drive		Madison	WI	53717	01/30/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Price File Contact (Primary)	Manager, Government Programs Pharmacy Operations	Dr.	Bender	Kristen		5702715555	59687			5702149379	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17821	07/10/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Part D Reporting Contact	Operations Specialist	Ms.	Utt	Bobbi	J	5702146718				5702148921	bjutt@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Patient Safety Contact	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Payment Contact	Actuarial Director		Trafton	Kristina	L	5702145043					kltrafton@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223225	10/29/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Pharmacy Director	Director, Pharmacy Services	Dr.	Miller	Jamie		5702715730				5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/22/2017	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Pharmacy Network Management Contact	VP, Network Management, Navitas	Ms.	Santos	Christina		6088204408					Christina.Santos@navitus.com	Navitus	361 Integrity Drive	Madison	WI	53717	01/02/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Services	Dr.	Miller	Jamie		5702715730				5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/22/2017	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts	Ms	Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus	1025 West Navitus Drive	Appleton	WI	54913	01/02/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H3954	Physician Incentive Contact	Manager, Provider Management	Ms.	Profit	Massiel		5704920147					mprofit@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	08/01/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Plan Directory Contact for Public Website	Geisinger Health Plan		Care	Customer		5704989731				5702715871	ghp_customer+service@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223229	11/13/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Plan to Plan Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Processor Contact	Manager, Technical Operations, Part D Claims	Mr.	Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus	1025 West Navitus Drive	Appleton	WI	54913	01/02/2024	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Quality Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	pwmerkel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	02/22/2021	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Reconciliation Contact (Secondary)	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Recovery Audit Contact	Associate Vice President Legal Counsel	Mr.	Davis	F Kelly		5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	SNP Application Contact	Medicare Contract Specialist	Ms.	Wright	Kelly	R	5702146435				5702718921	krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	04/17/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	SNP State Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Surveillance Contact	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	System Contact	Technical Analyst Lead		Sholder	Richard	J	5702717895				5702715162	rjsholder@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	07/25/2022	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Third Party Administrator (TPA) Liaison	PDE/Part D Analyst	Mr.	Baylor	Blaze	A	5702144692				5702141367	babaylor1@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	02/11/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	User Access Contact	Medicare Contract Specialist	Ms.	Wright	Kelly	R	5702146435				5702148921	krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	04/17/2025	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Utilization Management Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3954	Utilization Review Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER HEALTH PLAN	Local CCP	Geisinger Gold	HMO/HMOPOS		Risant Health, Inc.	96	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H3957	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/13/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/05/2017	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/10/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	09/25/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2020	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/15/2016	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/26/2019	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Corporate Mailing						4125447031					Thomas.Boettler@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/09/2020	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5182205661				5184232294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	06/23/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	06/23/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Encounter Data & Risk Adjustment Operations Contact	Director, Actuarial Services	Mr.	DelPrince	Vincent	M	4125443939					Vincent.Delprince@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	08/04/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Enrollment Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	EOB Transfer Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	bob.opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/26/2019	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					Justine.Patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	10/25/2019	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Interoperability Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	MA Appeals/Grievances Contact	Manager, Appeals & Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	MA Claims Processing Contact for Public Website	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/22/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	10/14/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Medical Director	VP, Executive Medical Director	Dr.	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	06/23/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/05/2017	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing	Mr.	Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part C Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/31/2020	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4125444579				HMO - Health Maintenance Organization		C	Boston
H3957	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4125441596				HMO - Health Maintenance Organization		C	Boston
H3957	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	11/08/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite SPECARE	Pittsburgh	PA	15222	08/04/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8006002227				HMO - Health Maintenance Organization		C	Boston
H3957	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	9013817109				HMO - Health Maintenance Organization		C	Boston
H3957	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Payment Contact	Vice President, Accounting and Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		Buffalo	NY	14203	02/14/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H3957	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	5705783579				HMO - Health Maintenance Organization		C	Boston
H3957	PHR Beneficiary Contact																	07/23/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS	Highmark Inc	Highmark Health	123	Yes	Active	8665886967				HMO - Health Maintenance Organization		C	Boston
H3957	Physician Incentive Contact	VP Prov Reimbursement & Network	Mr.	McDonald	Brendan		4125446611					brendan.mcdonald@highmarkhealth.org	120 5th Avenue Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Plan Directory Contact for Public Website			Service	Provider		8665886967					resourcecenter@highmark.com	120 Fifth Ave		Pittsburgh	PA	15222	12/05/2017	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	7173022748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 898820	Camp Hill	PA	170890407	06/28/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Quality Contact	Director, Clinical Quality		Christian	Shari		7168878811					shari.christina@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/28/2025	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Utilization Management Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3957	Utilization Review Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK CHOICE COMPANY	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H3959	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8887369118				8885547668	BAE/LISMailbox@aetna.com	Attn:  BAE	P.O. Box 14088	Lexington	KY	405124088	12/03/2018	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	3721 TecPort Drive		Harrisburg	PA	17111	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	HIPAA Privacy Officer	Senior Counsel		Dorazio	Jessica		8602734006					DorazioJ1@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/21/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	2222 Ewing Road		Moon Township	PA	15108	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Benefits Contact	Exec. Dir. , Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	01/18/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	1425 Union Meeting Road	Mail Code U22S	Blue Bell	PA	19422	01/05/2017	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburg	PA	15238	01/12/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	1425 Union Meeting Road	Mail Code U22S	Blue Bell	PA	19422	11/30/2020	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	07/02/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H3959	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3959	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H3962	Agent/Broker Compensation Data Contact	Director, Government Program Sales	Mr.	McCook	Mike		7175417505					mike.mccook@capitalbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/05/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Backup User Access Contact	Sr. Medicare Compliance Specialist	Ms.	Peterson	Nicole		7175416419				7173465811	nicole.peterson@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/12/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Best Available Evidence Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Bid Audit Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Bid Primary Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	CEO - CMS Administrator Contact	President and CEO	Mr.	Shamash	Todd		7175417747				7176518913	todd.shamash@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	CEO - Senior Official for Contracting	President and CEO	Mr.	Shamash	Todd		7175417747				7176518913	todd.shamash@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Chief Financial Officer	Chief Financial Officer	Mr.	Woodard	Ralph		7175417181					ralph.woodard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Chief Operating Officer	EVP & Chief Operating Officer	Mr.	Heisey	Glenn		7175417288				7176518497	glenn.heisey@capbluecross.com	2500 Elmenrton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Chief Information Officer	Senior Vice President and CIO	Mr.	Bhasin	Aman		7175417100					aman.bhasin@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	07/29/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Chief Information Security Officer	Chief Information Security Officer	Mr.	Burd	Aaron		7175416939					aaron.burd@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	CMS Casework Communication Contact		Ms.	Drawbaugh	Cindy		7175416257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Complaints Tracking Contact		Ms.	Drawbaugh	Cindy		7175416257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Contact for Fraud Investigations		Ms.	Livelsberger	Jennifer		7177753756					Jennifer.Livelsberger@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Coordination of Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Corporate Mailing						7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	171779799	03/26/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Customer Service Operations Contact	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	jonathan.koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	DIR Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	DIR Contact (Secondary)	Actuarial Business Consultant, Actuarial and Under	Mr.	Shafer	Brian		7175416263				7176514214	Brian.Shafer@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Discount Program Payment Contact			Balseiro	Julia	A	7175417458					Julia.Balseiro@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/24/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Emergency Part D Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7175864604				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Emergency Part D Contact (Secondary)	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Employer Waiver Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Encounter Data & Risk Adjustment Operations Contact			Matos	Tamara		7175416275					tamara.matos@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Enrollment Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	EOB Transfer Contact	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Financial Audit Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Financial Reporting Contact	VP Finance and Controller	Mr.	Hershberger	Josh		7173710410					Josh.Hershberger@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/13/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Formulary Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Formulary Contact (Secondary)	Manager Clinical Pharmacist Review		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	03/18/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	General Contact	Chief Government Programs Officer	Mr.	Biesecker	Gregory		7172520587					Gregory.Biesecker@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	09/05/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Government Relations Contact	Sr. VP & General Counsel	Mr.	Hopkins	Joel		7175416358				7176514445	Joel.Hopkins@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	HIPAA Privacy Officer	Privacy & Data Protection Officer	Mr.	Stambaugh	Alan		7175417077					Alan.Stambaugh@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	171779799	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	HIPAA Security Officer	Chief Information Security Officer	Mr.	Burd	Aaron		7175416939					aaron.burd@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Hospice Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Interoperability Contact	Senior Director, Information Technology		Blackwell	William		7175417246					William.Blackwell@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	MA Appeals/Grievances Contact	Director, Medicare Operations	Mr.	Koch	Jonathan		7178292114					Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	MA Claims Processing Contact for Public Website	Director Medicare Operations	Mr.	Koch	Jonathan		8666882242					Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Marketing Contact	Director, Marketing	Mr.	Londre	Michael		7175416467				7175402499	Michael.Londre@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Medical Director	Chief Medical Officer	Dr.	Wigginton	Jeremy	A	7175417152					jeremy.wigginton@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/16/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Medicare Coordinator			Wilbert	Tiffany		7175417606					tiffany.wilbert@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Medicare Part D Opioid Overutilization Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue	P.O. Box 779846	Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Medication Therapy Management Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Online Enrollment Center Contact (Back-up)	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part C Application Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part C Reporting Contact		Ms.	Dale	Rasheda		7175416444					rasheda.dale@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Appeals	Regulatory Director	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Application Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Claims Submission Contact	Manager, Medicare Pharmacy Operations	Ms,	Cook	Tammy	L	7177038749				7173466836	tammy.cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Exceptions Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa							christa.watts@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active	8669874213				HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist	Ms	Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55120	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Price File Contact (Back-up)	QA Analyst Sr		Nguyen	Kim		6127776931					kim.nguyen@PrimeTherapeutics.com	Prime Therapeutics, LLC	1305 Corporate Center Drive	Eagan	MN	55121	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Price File Contact (Optional)	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Price File Contact (Primary)	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Quality Assurance Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Part D Reporting Contact		Ms.	Leonard	Kellie		7175417117					Kellie.Leonard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Patient Safety Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Payment Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Pharmacy Director	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Pharmacy Network Management Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Pharmacy Network Management Contact (Secondary)			Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC 2655 Eagan Woods Drive		Eagan	MN	55122	12/16/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active	8888780151				HMO - Health Maintenance Organization		C	Chicago
H3962	Plan Directory Contact for Public Website	Medicare Compliance Officer	Ms.	Leedock	Melissa		8666882242					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Plan to Plan Reconciliation Contact	Accountant I	Ms.	Balseiro	Julia		7175417458					FinanceP2P-CASH@CapBlueCross.com	2500 Elmerton Avenue	Mail Drop 3237	Harrisburg	PA	17177	05/07/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Processor Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		6127776755					MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Quality Contact	Sr. Medical Director	Dr.	Harr	Denise		7177038497					Denise.Harr@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Reconciliation Contact	VP and Chief Actuary	Mr.	Spitler	Mark		7175416613					mark.spitler@capbluecross.com	2500 Elmerton Ave.		Harrisburg	PA	17177	01/13/2025	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Reconciliation Contact (Secondary)	Actuarial Business Consultant	Mr.	Shafer	Brian		7175416263					Brian.Shafer@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	SNP Application Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	SNP State Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Surveillance Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	System Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Third Party Administrator (TPA) Liaison			Balseiro	Julia	A	7175417458					Julia.Balseiro@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/24/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	User Access Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Utilization Management Contact		Ms.	Yoder	Hollie		7177755884					Hollie.Yoder@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	03/21/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3962	Utilization Review Contact		Ms.	Yoder	Hollie		7177755884					Hollie.Yoder@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	KEYSTONE HEALTH PLAN CENTRAL, INC.	Local CCP	Capital Blue Cross	HMO/HMOPOS		CAPITAL BLUE CROSS	41	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H3975	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H3975	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H3975	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H3975	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H3975	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H3975	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H3975	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H3975	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3975	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H3979	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H3979	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H3979	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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	Dallas
H3979	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H3979	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Dallas
H3979	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H3979	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Dallas
H3979	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H3979	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H3979	CEO - Senior Official for Contracting	President, CEO and Chair of Board	Ms.	Grober	Stephania		9185513202				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1400 S Boston Ave	Tulsa	OK	74119	05/29/2025	2026	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	Dallas
H3979	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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	Dallas
H3979	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H3979	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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	Dallas
H3979	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	Dallas
H3979	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H3979	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Dallas
H3979	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H3979	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	Dallas
H3979	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	Dallas
H3979	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H3979	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Dallas
H3979	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Dallas
H3979	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H3979	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H3979	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H3979	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H3979	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H3979	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Dallas
H3979	Formulary Contact	Director Pharmacy Medicare	Mr	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Dallas
H3979	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	Dallas
H3979	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H3979	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	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	Dallas
H3979	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2026	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	Dallas
H3979	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	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	Dallas
H3979	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	Dallas
H3979	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H3979	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Dallas
H3979	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H3979	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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	Dallas
H3979	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H3979	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Dallas
H3979	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	Dallas
H3979	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H3979	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H3979	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H3979	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H3979	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	Part D Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H3979	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H3979	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H3979	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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	Dallas
H3979	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	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	Dallas
H3979	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H3979	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H3979	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H3979	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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	Dallas
H3979	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H3979	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H3979	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Dallas
H3979	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H3979	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	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	Dallas
H3979	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H3979	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H3979	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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	Dallas
H3979	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8772777898				HMO - Health Maintenance Organization		C	Dallas
H3979	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/23/2022	2026	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	Local CCP	Blue Cross and Blue Shield of Oklahoma	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	0000000000				HMO - Health Maintenance Organization		C	Dallas
H3979	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	09/21/2018	2026	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	Dallas
H3979	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H3979	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Dallas
H3979	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H3979	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H3979	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Dallas
H3979	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H3979	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H3979	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H3979	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H3979	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H3979	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Dallas
H3979	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Dallas
H3979	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Dallas
H3979	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	09/21/2018	2026	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	Dallas
H3991	Automated TrOOP Balance Transfer Contact	Director of Business Operations		Bridges	Vincent		4057244325					Vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Backup User Access Contact	Director of Business Operations		Bridges	Vincent		4054642031					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Best Available Evidence Contact	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Bid Primary Contact	CEO		Kurtzig	Joshua		5717890770					Jkurtzig@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	CAP Report Contact for Public Website	Director of Compliance		Santilli	Lisa		4055531133					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	CEO - CMS Administrator Contact	CEO	Mr.	Kurtzig	Joshua		5717890770				5717753946	jkurtzig@valir.com	1901 N Beauregard St	Suite 110	Alexandria	VA	22311	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	CEO - Senior Official for Contracting	CEO	Mr.	Kurtzig	Joshua		5717890770				5717753946	jkurtzig@valir.com	1901 N Beauregard St	Suite 110	Alexandria	VA	22311	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Chief Financial Officer	CEO	Mr.	Kurtzig	Joshua		5717890770					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Chief Operating Officer	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Chief Information Officer	IT Project Manager	Mrs	Ford	Katie		4056093668					kford@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	07/01/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Chief Information Security Officer	IT Project Manager	Mrs	Ford	Katie		4056093668					kford@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	08/05/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	CMS Casework Communication Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr	Suite 200	Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Complaints Tracking Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Contact for Fraud Investigations	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Coordination of Benefits Contact	Director of Business Operationss		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Corporate Mailing						5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Customer Service Operations Contact	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	DIR Contact	CEO	Mr.	Kurtzig	Joshua		5717890770					Jkurtzig@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Discount Program Payment Contact	CEO	Mr.	Kurtzig	Joshua		5717890770					Jkurtzig@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Emergency Part D Contact	CEO	Mr.	Kurtzig	Joshua		5717890770					Jkurtzig@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Encounter Data & Risk Adjustment Operations Contact	Director of Business Operations	Mr.	Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Enrollment Contact	Director of Business Operations	Mr.	Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	EOB Transfer Contact	Director of Business Operations	Mr.	Bridges	Vincent		4057244325				5717753946	vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Financial Audit Contact	Executive Director	Mr	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Financial Reporting Contact	Executive Director	Mr	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Formulary Contact	Medical Director	Dr.	Arzomand	Humaira		5717890770					humaira.arzomand@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	General Contact	Executive Director	Mr.	Hess	Ronald		5717890770				5717753946	ronald.hess@cherryblossompace.com	1901 N Beauregard St	Suite 110	Alexandria	VA	22311	08/05/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Government Relations Contact	Quality Director	Mr.	Dan	Jennifer		4056093688					jennifer.dan@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	HIPAA Privacy Officer	Director of Compliance	Mrs	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	HIPAA Security Officer	IT Project Manager	Mrs	Ford	Katie		4052136544					kford@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	11/25/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Interoperability Contact	Medical Director	Dr.	Arzomand	Humaira		5717890770					humaira.arzomand@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	MA Appeals/Grievances Contact	Quality Director	Mrs	Dan	Jennifer		4056093688					jennifer.dan@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	11/25/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	MA Claims Processing Contact for Public Website	Executive Director	Dr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Marketing Contact	Director of Business Development	Dr.	Shannon	Cynthia		5717890829					cynthia.shannon@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Medical Director	Medical Director	Dr.	Arzomand	Humaira		5717890770					humaira.arzomand@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Medicare Compliance Officer	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Medicare Coordinator	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Medication Therapy Management Contact	Medical Director	Dr.	Arzomand	Humaira		5717890770					humaira.arzomand@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part C Application Contact	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Appeals	Executive Director	Mr.	Hess	Ronald							ronald.hess@cherryblossompace.com	1901 Beauregard Street		Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active	5717890729				PACE - Nat		C	Philadelphia
H3991	Part D Application Contact	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Benefits Contact	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Claims Submission Contact	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Exceptions Contact	Medical Director	Dr.	Arzomand	Humaira							humaira.arzomand@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active	5717890770				PACE - Nat		C	Philadelphia
H3991	Part D Price File Contact (Back-up)	Director of Business Operations		Bridges	Vincent		4057244325					Vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Price File Contact (Primary)	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Quality Assurance Contact	Director of Compliance	Mrs	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Part D Reporting Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Patient Safety Contact	Medical Director	Dr.	Arzomand	Humaira		5717890770					humaira.arzomand@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Payment Contact	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Pharmacy Director	Medical Director	Dr.	Arzomand	Humaira		5717890770					humaira.arzomand@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Pharmacy Network Management Contact	Director of Network Management		Bridges	Vincent		4056093668					vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	07/01/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Arzomand	Humaira							humaira.arzomand@cherryblossompace.com	1901 Beauregard Street	Suite 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active	5717890729				PACE - Nat		C	Philadelphia
H3991	Plan Directory Contact for Public Website	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Plan to Plan Reconciliation Contact	CEO	Mr.	Kurtzig	Joshua		5717890770					Jkurtzig@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Processor Contact	Director of Business Operations	Mr.	Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Quality Contact	Quality Director	Mrs	Dan	Jennifer		4056093688					jennifer.dan@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	11/25/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Reconciliation Contact	CEO	Mr.	Kurtzig	Joshua		5717890770					Jkurtzig@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Recovery Audit Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Surveillance Contact	Director of Business Development		Shannon	Cynthia		5717890770					cynthia.shannon@cherryblossompace.com	1901 Beauregard Street	Suite 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	System Contact	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Third Party Administrator (TPA) Liaison	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	User Access Contact	IT Project Manager		Ford	Katie		4052136544					kford@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Utilization Management Contact	Executive Director	Mr.	Hess	Ronald		5717890729					ronald.hess@cherryblossompace.com	1901 Beauregard Street	Suite 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H3991	Utilization Review Contact	Medical Director	Dr.	Arzomand	Humaira		5717890770					humaira.arzomand@cherryblossompace.com	1901 Beauregard Street	Ste 110	Alexandria	VA	22311	12/04/2025	2026	CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC	National PACE	Cherry Blossom PACE	National PACE		Valir PACE Virginia, LLC	886	Yes	Active					PACE - Nat		C	Philadelphia
H4003	Agent/Broker Compensation Data Contact	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Automated TrOOP Balance Transfer Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	04/01/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Best Available Evidence Contact	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Bid Audit Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Bid Audit Site Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	04/01/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Bid Primary Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	04/19/2023	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	CEO - CMS Administrator Contact	President	Mr	Rivera Cardona	Ricardo		7876330707				7873004886	ricardo.rivera-cardona@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	01/08/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	CEO - Senior Official for Contracting	President Medicare Programs	Ms	Dailey	Aimee	K	7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd	Maildrop VA28	Norfolk	VA	23502	09/05/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Chief Financial Officer	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Chief Operating Officer	Staff VP Operations Management	Ms	Garcia	Vilmari		7874478131				7873004886	vilmari.garcia@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Chief Information Officer	CIO	Mr.	Molinary	Rachid		7872496365				9395451239	rachid.molinary@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	04/19/2023	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Chief Information Security Officer	Director II Technology	Mr.	Arill	Juan		7875016127				7879991726	juan.arill@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	CMMI Model Point of Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	CMS Casework Communication Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Complaints Tracking Contact	Director Grievances & Appeals	Ms.	Rodriguez	Janice		9397173509				7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Contact for Fraud Investigations	Compliance Director	Ms.	Olivo Gonzalez	Ana		7874480003				7876253356	Ana.olivo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	10/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Coordination of Benefits Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Corporate Mailing						8132951367					marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/11/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Customer Service Operations Contact	Director II Customer Care	Ms.	Iglesias	Morayma		7876002047					morayma.iglesias-sustache@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	DIR Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	DIR Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Discount Program Payment Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Electronic Health Record Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	52259			HMO - Health Maintenance Organization		C	Chicago
H4003	Emergency Part D Contact	Staff VP Clinical & Spec Pharmacy	Ms	Morant	Iris		7873797592				8337404081	iris.morant-rodriguez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Emergency Part D Contact (Secondary)	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Employer Waiver Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	12/22/2023	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Encounter Data & Risk Adjustment Operations Contact	Staff VP Risk Adjustment	Mr	Kaplun	Alex		7866067836					akaplun@mmmhc.com	350 Avenida Chardon Torre Chardon	Suite 500	San Juan	PR	00918	10/09/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Enrollment Contact	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	EOB Transfer Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493				8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Financial Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367				7876253356	MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	04/01/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Financial Reporting Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Formulary Contact	Clinical Pharmacy Prog Dir (US)	Dr.	Lazaro	Maria	I	7876756858				8337404081	maria.lazaro@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/26/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Formulary Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	General Contact	Director II Compliance	Ms.	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/11/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	HIPAA Security Officer	Director II Technology	Mr.	Arill	Juan		7875016127				7879991726	juan.arill@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Hospice Contact	Director Pharmacy UM	Mrs	Albors	Gabriela		7872494544	58670			8337404081	Gabriela.Albors-Rivera@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	MA Appeals/Grievances Contact	Director Grievances & Appeals	Ms.	Rodriguez	Janice		9397173509				7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	MA Claims Processing Contact for Public Website	Staff VP Operations Management	Mr	Salinas	Gonzalo		7873832706				7879992177	Gonzalo.Salinas@mso-pr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Marketing Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Medical Director	Staff VP Medical Director	Dr.	Rosso	Diego		7874478148				7873005523	diego.rosso@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Medicare Part D Opioid Overutilization Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Medication Therapy Management Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	OffShore Subcontractor Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Online Enrollment Center Contact (Back-up)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Online Enrollment Center Contact (Primary)	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	03/21/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Appeals	Director Grievances & Appeals	Ms.	Rodriguez	Janice						7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	52537			HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Appeals Contact (Secondary)	Staff VP Medical Director	Dr.	Rosso	Diego						7873005523	Diego.Rosso@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	58722			HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	03/21/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Benefits Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493	58679			8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Claims Submission Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493	58679			8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Exceptions Contact	Director Pharmacy UM	Mrs	Albors	Gabriela						8337404081	gabriela.albors-rivera@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	58670			HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Exceptions Contact (Secondary)	Director Pharmacy Operations	Ms.	Ramos	Sara						8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	58660			HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Price File Contact (Back-up)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Price File Contact (Optional)	VP Government Programs Services		Davis	Daniel		6304877033					daniel.davis@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094838	01/22/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Price File Contact (Primary)	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Quality Assurance Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Patient Safety Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Payment Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Personal Health Record Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Pharmacy Director	Staff VP Clinical & Spec Pharmacy	Ms	Morant	Iris		7873797592				8337404081	iris.morant-rodriguez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Pharmacy Network Management Contact	AVP Network Strategy	Mr	Baker	David		8167833834					david.baker@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094830	01/04/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Pharmacy Network Management Contact (Secondary)	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Pharmacy Technical Help Desk Contact	Manager II Pharmacy Benefit	Mrs	Rivera	Erika						8337404081	erika.riveraserrano@mmmhc.com	PO BOX 71114		San Juan	PR	009368014	06/27/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8552019936				HMO - Health Maintenance Organization		C	Chicago
H4003	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Operations	Toro	Mercado Toro	Jose						8337404081	jose.mercado-toro@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	06/27/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8552019936				HMO - Health Maintenance Organization		C	Chicago
H4003	PHR Beneficiary Contact																	12/27/2013	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS	MMM Healthcare, Inc.	Elevance Health, Inc.	1	Yes	Active	8663335470				HMO - Health Maintenance Organization		C	Chicago
H4003	Physician Incentive Contact	Director II Finance	Ms.	Perez	Mireya		7874484061				7873005502	Mireya.perez@mso-pr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Plan Directory Contact for Public Website	Director II Customer Care	Ms.	Iglesias	Morayma		8666766060					morayma.iglesias-sustache@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Plan to Plan Reconciliation Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Processor Contact	VP Government Programs Services		Davis	Daniel		6304877033					daniel.davis@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094838	01/22/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Quality Contact	Director II-GBD Quality Management	Ms.	Miranda	Ana	B	7872218738				7873005510	Ana.olivo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	10/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Reconciliation Contact	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	PO Box 71114		San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Reconciliation Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Recovery Audit Contact	Director II Compliance	Ms.	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon Torre Chardon, Suite 500		San Juan	PR	00918	01/22/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	SNP Application Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	12/22/2023	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	03/21/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Surveillance Contact	Director II Compliance		Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon Torre Chardon, Suite 500		San Juan	PR	00918	01/22/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	System Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Third Party Administrator (TPA) Liaison	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Utilization Management Contact	Staff VP Total Health Mgmt.	Mrs	Gonzalez Suarez	Nilsa		7872218350				7879992177	Nilsa.Gonzalez-Suarez@inhealthpr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4003	Utilization Review Contact	Medical Director	Dr.	Guardiola	Benjamin		7876002889				7873005523	benjamin.guardiola-rivera@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	05/08/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Agent/Broker Compensation Data Contact	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Automated TrOOP Balance Transfer Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Best Available Evidence Contact	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Bid Audit Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Bid Audit Site Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Bid Primary Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	CEO - CMS Administrator Contact	President	Mr	Rivera Cardona	Ricardo		7876330707				7873004886	ricardo.rivera-cardona@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	CEO - Senior Official for Contracting	President Medicare Programs	Ms	Dailey	Aimee	K	7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd	Maildrop VA28	Norfolk	VA	23502	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Chief Financial Officer	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Chief Operating Officer	Staff VP Operations Management	Ms	Garcia	Vilmari		7874478131				7873004886	vilmari.garcia@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Chief Information Officer	CIO	Mr.	Molinary	Rachid		7872496365				9395451239	rachid.molinary@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Chief Information Security Officer	Director II Technology	Mr.	Arill	Juan		7875016127				7879991726	juan.arill@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	CMMI Model Point of Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	CMS Casework Communication Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Complaints Tracking Contact	Director Grievances & Appeals	Ms.	Rodriguez	Janice		9397173509				7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Contact for Fraud Investigations	Compliance Director	Ms.	Olivo Gonzalez	Ana		7874480003				7876253356	Ana.olivo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Coordination of Benefits Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Corporate Mailing						8132951367					marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Customer Service Operations Contact	Director II Customer Care	Ms.	Iglesias	Morayma		7876002047					morayma.iglesias-sustache@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	DIR Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	DIR Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Discount Program Payment Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Electronic Health Record Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	52259			HMO - Health Maintenance Organization		C	Chicago
H4004	Emergency Part D Contact	Staff VP Clinical & Spec Pharmacy	Ms	Morant	Iris		7873797592				8337404081	iris.morant-rodriguez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Emergency Part D Contact (Secondary)	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Employer Waiver Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Encounter Data & Risk Adjustment Operations Contact	Staff VP Risk Adjustment	Mr	Kaplun	Alex		7866067836					akaplun@mmmhc.com	350 Avenida Chardon Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Enrollment Contact	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	EOB Transfer Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493				8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Financial Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367				7876253356	MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Financial Reporting Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Formulary Contact	Clinical Pharmacy Prog Dir (US)	Dr.	Lazaro	Maria	I	7876756858				8337404081	maria.lazaro@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/26/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Formulary Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	General Contact	Director II Compliance	Ms.	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	HIPAA Security Officer	Director II Technology	Mr.	Arill	Juan		7875016127				7879991726	juan.arill@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Hospice Contact	Director Pharmacy UM	Mrs	Albors	Gabriela		7872494544	58670			8337404081	Gabriela.Albors-Rivera@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	MA Appeals/Grievances Contact	Director Grievances & Appeals	Ms.	Rodriguez	Janice		9397173509				7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	MA Claims Processing Contact for Public Website	Staff VP Operations Management	Mr	Salinas	Gonzalo		7873832706				7879992177	Gonzalo.Salinas@mso-pr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Marketing Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Medical Director	Staff VP Medical Director	Dr.	Rosso	Diego		7874478148				7873005523	diego.rosso@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Medicare Part D Opioid Overutilization Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Medication Therapy Management Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	OffShore Subcontractor Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Online Enrollment Center Contact (Back-up)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Online Enrollment Center Contact (Primary)	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Appeals	Director Grievances & Appeals	Ms.	Rodriguez	Janice						7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	52537			HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Appeals Contact (Secondary)	Staff VP Medical Director	Dr.	Rosso	Diego						7873005523	Diego.Rosso@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	58722			HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Benefits Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493	58679			8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Claims Submission Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493	58679			8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Exceptions Contact	Director Pharmacy UM	Mrs	Albors	Gabriela						8337404081	gabriela.albors-rivera@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	58670			HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Exceptions Contact (Secondary)	Director Pharmacy Operations	Ms.	Ramos	Sara						8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8663335470	58660			HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Price File Contact (Back-up)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Price File Contact (Optional)	VP Government Programs Services		Davis	Daniel		6304877033					daniel.davis@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094838	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Price File Contact (Primary)	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Quality Assurance Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Patient Safety Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Payment Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Personal Health Record Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Pharmacy Director	Staff VP Clinical & Spec Pharmacy	Ms	Morant	Iris		7873797592				8337404081	iris.morant-rodriguez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Pharmacy Network Management Contact	AVP Network Strategy	Mr	Baker	David		8167833834					david.baker@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094830	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Pharmacy Network Management Contact (Secondary)	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Pharmacy Technical Help Desk Contact	Manager II Pharmacy Benefit	Mrs	Rivera	Erika						8337404081	erika.riveraserrano@mmmhc.com	PO BOX 71114		San Juan	PR	009368014	06/27/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8552019936				HMO - Health Maintenance Organization		C	Chicago
H4004	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Operations	Toro	Mercado Toro	Jose						8337404081	jose.mercado-toro@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	06/27/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8552019936	58670			HMO - Health Maintenance Organization		C	Chicago
H4004	PHR Beneficiary Contact																	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS	MMM Healthcare, Inc.	Elevance Health, Inc.	1	Yes	Active	8663335470				HMO - Health Maintenance Organization		C	Chicago
H4004	Physician Incentive Contact	Director II Finance	Ms.	Perez	Mireya		7874484061				7873005502	Mireya.perez@mso-pr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Plan Directory Contact for Public Website	Director II Customer Care	Ms.	Iglesias	Morayma		8666766060					morayma.iglesias-sustache@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Plan to Plan Reconciliation Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Processor Contact	VP Government Programs Services		Davis	Daniel		6304877033					daniel.davis@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094838	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Quality Contact	Director II-GBD Quality Management	Ms.	Miranda	Ana	B	7872218738				7873005510	Ana.olivo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Reconciliation Contact	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Reconciliation Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Recovery Audit Contact	Director II Compliance	Ms.	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	SNP Application Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Surveillance Contact	Director II Compliance		Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	System Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Third Party Administrator (TPA) Liaison	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Utilization Management Contact	Staff VP Total Health Mgmt.	Mrs	Gonzalez Suarez	Nilsa		7872218350				7879992177	Nilsa.Gonzalez-Suarez@inhealthpr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4004	Utilization Review Contact	Medical Director	Dr.	Guardiola	Benjamin		7876002889				7873005523	benjamin.guardiola-rivera@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	05/08/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4005	Agent/Broker Compensation Data Contact	VP MA Sales and Promotions		Rivera	Carlos		7877494949	8324214				crivera1@ssspr.com	PO Box 363628		San Juan	PR	00936	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Automated TrOOP Balance Transfer Contact	MA Revenue Management Director	Mr	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Backup User Access Contact	Privacy Analyst	Ms	Mikasobe	Jessica		7877494949	8322443				jmikasobe@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Best Available Evidence Contact	MA Enrollment & Reconciliation Director		Toste	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Bid Audit Contact	Product Development  VP	Mrs	Rojas Sola	Marie	E	7877494949	8321325				marie.rojas@ssspr.com	PO Box 0363628		San Juan	PR	00936	10/17/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Bid Audit Site Contact	President for Triple S Salud	Mr.	Muchnicki	Michael		7877494949	8322322			7876200939	michael.muchnicki@ssspr.com	P.O. Box 11320		San Juan	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Bid Primary Contact	Product Development VP	Mrs	Rojas Sola	Marie	E	7877494949	8321325				marie.rojas@ssspr.com	P.O. Box 363628		San Juan	PR	00936	10/17/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	CAP Report Contact for Public Website	Digital Marketing Manager	Mrs.	Ruiz Martinez	Norma	J	7487494949	8321083				nruiz@ssspr.com	PO Box 363628		San Juan	PR	00936	02/11/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	CEO - CMS Administrator Contact	CEO & President, Triple-S Management	Mr.	Justice	Thurman	R	7873099118					thurman.justice@ssspr.com	PO BOX 11320		SAN JUAN	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	CEO - Senior Official for Contracting	CEO & President, Triple-S Management	Mr	Justice	Thurman	R	8605971073					thurman.justice@ssspr.com	PO BOX 11320		SAN JUAN	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Chief Financial Officer	Chief Financial Officer	Mr.	Petruzzellis	Dave		7877494949					dave.petruzzellis@ssspr.com	P.O. Box 363628		San Juan	PR	009363628	11/11/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Chief Operating Officer	Chief Operating Officer	Ms	Rivera	Ixel		7879304298					ixel.arivera@ssspr.com	P.O BOX 11320		San Juan	PR	00922	10/14/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Chief Information Officer	Chief Information Technology Officer	Mr	Ruocco	Robert		7877494949	8320463				robert.ruocco@ssspr.com	PO Box 363628		San Juan	PR	00936	01/31/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Chief Information Security Officer	Sr Cyber Director	Mr.	Morris	Ken		7877494949				7877744820	Ken.Morris@ssspr.com	PO Box 363628		San Juan	PR	00936	10/22/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	CMS Casework Communication Contact	Appeals and Grievances Manager	Mrs	Martinez	Aixa		7877494949	8322307			7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Complaints Tracking Contact	Appeals and Grievances Manager	Mrs.	Martinez	Aixa		7877494949	8322307			7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Contact for Fraud Investigations	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Coordination of Benefits Contact	MA Enrollment & Reconcilliation Director	Mrs.	Toste	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Corporate Mailing						7877494949	8322438				jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Customer Service Operations Contact	Customer Service Manager	Mr.	Jaxon	Harold		7876649288				7876200931	harold.jaxon@ssspr.com	PO Box 363628		San Juan	PR	00922	12/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	DIR Contact	Part D Reporting Analyst	Ms	Cortes	Johannie		7877494949	8322448			7879933257	johannie@ssspr.com	PO Box 11320		San Juan	PR	00922	12/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	DIR Contact (Secondary)	MA Premium Management Manager	Mrs	Ruiz Sanchez	Alexsandra		7877494949	8322185				alexsandra.ruiz@ssspr.com	PO Box 11320		San Juan	PR	00922	12/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Discount Program Payment Contact	Part D Reporting Analyst	Mrs	Cortes	Johannie		7877494949	832248			7876258717	johannie@ssspr.com	PO Box 11320		San Juan	PR	009229905	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Electronic Health Record Contact	VP Digital Solutions Delivery	Mr.	Saker	Alejandro		7877494949	8320585			7879933256	alejandro.saker@ssspr.com	PO Box 11320		San Juan	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Emergency Part D Contact	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 11320		San Juan	PR	00922	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Emergency Part D Contact (Secondary)	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Employer Waiver Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Encounter Data & Risk Adjustment Operations Contact	MA Revenue Management Director	Mr.	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Enrollment Contact	MA Enrollment & Reconcilliation Director	Mrs.	Toste Arana	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	01/31/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	EOB Transfer Contact	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Financial Audit Contact	Compliance Audit and Monitoring Director	Mrs	Marrero	Monica		7877494949	8322303				monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	00922	12/21/2021	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Financial Reporting Contact	Corporate Financial Reporting Director	Ms	Montes Santiago	Loyda	I	7877494949	8321967			7877494019	loyda.montes@ssspr.com	PO Box 363628		San Juan	PR	00936	03/18/2021	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Formulary Contact	Pharmacy Senior Manager		Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Formulary Contact (Secondary)	Clinical Pharmacist	Ms	Vargas	Viviana		7875231212	1171				viviana.vargas@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	01/19/2017	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	General Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Government Relations Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	HIPAA Privacy Officer	Privacy Officer	Ms	Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	HIPAA Security Officer	Sr Cyber Director	Mr	Morris	Ken		7877494949					Ken.Morris@ssspr.com	PO Box 363628		San Juan	PR	00936	10/22/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Hospice Contact	Health Management Programs Director	Mrs.	Lliteras	Jeannifer		7877494949	8322691				jeanieffer@ssspr.com	PO Box 11320		San Juan	PR	00922	10/14/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Interoperability Contact	VP Software Engineering & Delivery	Mr.	Tummala	Srinivasa		7877494949	8320463			7879933256	srinivasa.tummala@ssspr.com	PO Box 11320		San Juan	PR	00922	04/23/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	MA Appeals/Grievances Contact	Appeals and Grievances Manager	Mrs	Martinez	Aixa		7877494949	8322307			7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	MA Claims Processing Contact for Public Website	Claims Director	Mrs	Roldan-Marin	Francheska	M	7877494949	8324942				froldan@ssspr.com	PO Box 11320		San Juan	PR	00922	10/17/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Marketing Contact	Marketing & Content Department Manager	Mrs	Martin	Gabriela		7877494949	8321073			7877494060	gmartinb@ssspr.com	PO Box 363628		San Juan	PR	00936	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Medical Director	Chief Medical Officer	Dr	Novoa	Jose		7877494949	8325171			0000000000	jnovoa@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Medicare Compliance Officer	Compliance Officer & VP   Compliance & Privacy Off	Mrs	Cardenas	Jenny	D	7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	009229905	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Medicare Coordinator	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Medicare Part D Opioid Overutilization Contact	Pharmacy Senior Manager	Mrs	Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Medication Therapy Management Contact	Pharmacy Senior Manager		Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	OffShore Subcontractor Contact	Privacy Officer		Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Online Enrollment Center Contact (Back-up)	MA Enrollment Manager	Mrs	Marcano	Zoe		7877494949	8322628			7875224307	zoem@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Online Enrollment Center Contact (Optional)	Enrollment Manager	Ms	Marcano	Zoe	C	7877494949	8322628			7875224307	zoem@ssspr.com	PO Box 11320		San Juan	PR	009209905	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Online Enrollment Center Contact (Primary)	MA Enrollment & Reconciliation Director	Mrs	Toste	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part C Application Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part C Reporting Contact	Compliance Audit and Monitoring Director	Ms	Marrero	Monica		7877494949	8322303				monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	009229905	03/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Appeals	Appeals and Grievances Manager	Mrs	Martinez	Aixa						7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8322307			PPO - BBA		C	Dallas
H4005	Part D Appeals Contact (Secondary)	Quality Improvement Medical Director		Carrion	Wanda							wandavca@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8325107			PPO - BBA		C	Dallas
H4005	Part D Application Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Benefits Contact	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 11320		San Juan	PR	00922	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Claims Submission Contact	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Exceptions Contact	harmacy Regulatory & Compliance Manager	Mrs	Cordero	Cindy	N					7875224004	cindy.cordero@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8321797			PPO - BBA		C	Dallas
H4005	Part D Exceptions Contact (Secondary)	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N					7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363828	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8321797			PPO - BBA		C	Dallas
H4005	Part D Price File Contact (Back-up)	Data Analyst II		De Jes s	Cesar		7875231212	1169				cesar.dejesus@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	08/23/2019	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Price File Contact (Optional)	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Price File Contact (Primary)	Data Analyst II		Reed	Lindsay		9396428582	1125				lindsay.reed@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	08/23/2019	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Quality Assurance Contact	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Part D Reporting Contact	Compliance Audit and Monitoring Director	Ms	Marrero	Monica		7877494949	8322303				monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	009229905	03/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Patient Safety Contact	Pharmacy Senior Manager		Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Payment Contact	Revenue and Members Operation  Senior VP	Mrs	Reyes	Ivette		7877494949	8322419				ireyes@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Personal Health Record Contact	Privacy Officer	Ms	Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Pharmacy Director	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 11320		San Juan	PR	00922	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Pharmacy Network Management Contact	Director of Service Operations		Hernandez	Hector		7875231212	1123				hector.hernandez@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	01/04/2021	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Pharmacy Network Management Contact (Secondary)	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 363628		San Juan	PR	00939	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Pharmacy Technical Help Desk Contact	Director of Service Operations		Hernandez	Hector						7877771372	hector.hernandez@abarcahealth.com	1606 Avenida Ponce De Leon		San Juan	PR	00909	12/13/2023	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	8559222722				PPO - BBA		C	Dallas
H4005	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Vice-president	Mrs	Muniz	Omarys						7875224004	omaris.muniz@ssspr.com	PO Box 11320		San Juan	PR	00922	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8324535			PPO - BBA		C	Dallas
H4005	PHR Beneficiary Contact																	06/12/2015	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO	Triple-S Advantage	Guidewell Mutual Holding Corporation	594	Yes	Active	8886201919				PPO - BBA		C	Dallas
H4005	Physician Incentive Contact	Carepoint President SVP Network Strategy	Mrs	Molina Gonzalez	Yomaraly		7877494949	8320499				yomaraly.molina@ssspr.com	PO Box 11320		San Juan	PR	00922	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Plan Directory Contact for Public Website	Carepoint President SVP Network Strategy	Mrs	Molina Gonzalez	Yomaraly		7877494949	8320499				yomaraly.molina@ssspr.com	PO Box 11320		San Juan	PR	00922	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Plan to Plan Reconciliation Contact	MA Revenue Management Director	Ms	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Processor Contact	Claims Director	Ms	Roldan	Francheska		7877494949	8324942				froldan@ssspr.com	POBox 363628		San Juan	PR	009363628	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Quality Contact	Quality and Stars Director	Ms	Hernandez	Patricia		7877494949	8322554			7879933256	patriciah@ssspr.com	P.O. Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Reconciliation Contact	MA Revenue Management Director	Ms	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Reconciliation Contact (Secondary)	Revenue and Members Operation  Senior VP	Mrs	Reyes	Ivette		7877494949	8322419				ireyes@ssspr.com	P.O. Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Recovery Audit Contact	Compliance and Audit and Monitoring Director	Ms	Marrero	Monica		7877494494	8322303				monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	00922	03/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	SNP Application Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	SNP State Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Surveillance Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	System Contact	Privacy Officer	Ms.	Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Third Party Administrator (TPA) Liaison	Part D Reporting Analyst	Mrs.	Cortes	Johannie		7877494949	8322448			7876258717	johannie@ssspr.com	PO Box 11320		San Juan	PR	009229905	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	User Access Contact	Privacy Officer	Ms.	Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Utilization Management Contact	Chief Operating Officer	Ms	Rivera Caban	Ixel	A	7877494949					ixel.arivera@ssspr.com	PO Box 363628		San Juan	PR	009363628	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4005	Utilization Review Contact	Chief Operating Officer	Ms	Rivera Caban	Ixel	A	7877494949					ixel.arivera@ssspr.com	PO Box 363628		San Juan	PR	009363628	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple-S Advantage	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H4026	Agent/Broker Compensation Data Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	CEO - CMS Administrator Contact	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	CEO - Senior Official for Contracting	CEO	Dr.	Jain	Sachin		5629898314	8314				sjain@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Chief Financial Officer	CFO	Mr.	Plumb	Michael		5629971589	1589				mplumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Chief Information Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	CMS Casework Communication Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Complaints Tracking Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459				5629890101	tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	DIR Contact (Secondary)	Manager Revenue Accounting	Ms.	Moreno	Sonia		5623081122					smoreno@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Employer Waiver Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Encounter Data & Risk Adjustment Operations Contact	Chief Data Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Enrollment Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Financial Audit Contact	Sr. Dir Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	General Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Government Relations Contact	VP of Government Relations		Kazan	Matt		8005593500				5629899439	m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	MA Appeals/Grievances Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Medical Director	Chief Medical Officer		Kimura	Joe		5626377346				5629899439	j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Medicare Compliance Officer	Sr. Dir Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195					c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	OffShore Subcontractor Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part C Application Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part C Reporting Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Appeals	Sr. Director of Grievances and Appeals	Ms.	Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5629895100	1290			HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization	Ms.	Herbert	Joshua						5629890958	Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	1290			HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Application Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization	Mr.	Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	733326			HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4348			5629973196	a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Part D Reporting Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	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	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H4026	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Processor Contact	Senior Director Government Programs, Medicare	Ms.	Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346	4431			5629895120	j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Recovery Audit Contact	Sr. Dir Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	SNP Application Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	SNP State Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Surveillance Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	User Access Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4026	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (WA)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4032	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H4032	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4032	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4032	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H4032	Plan Directory Contact for Public Website			Customer Service	UHC		8773701131					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4032	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4036	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H4036	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H4036	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H4036	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H4036	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H4036	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H4036	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H4036	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Agent/Broker Compensation Data Contact	Manager, Medicare Outreach	Mr.	Ly	Thien		4088741941					tly@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Automated TrOOP Balance Transfer Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Backup User Access Contact	Medicare Compliance Program Manager		Zhao	Alicia		4088741882					Azhao@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/26/2024	2026	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	Boston
H4045	Best Available Evidence Contact	Manager, Medicare Oureach	Mr.	Ly	Thien		4088741941					tly@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Bid Audit Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Bid Primary Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	CAP Report Contact for Public Website	VP, Government Relations and Compliance	Mr.	Haskell	Tyler		4088741749				4088741970	TylerH@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/17/2024	2026	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	Boston
H4045	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Tomcala	Christine	M	4086126914					ctomcala@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Tomcala	Christine	M	4088741701					ctomcala@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Chief Financial Officer	Chief Financial Officer	Mr.	Jarecki	Neal		4088741892					NJarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Chief Operating Officer	Chief Operating Officer	Ms.	Turner	Christine		4088741834					cturner@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Chief Information Officer	Chief Information Officer	Mr.	Nautiyal	Manish		4088741912					ManishN@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	Chief Information Security Officer	Chief Information Officer	Mr.	Nautiyal	Manish		4088741912					ManishN@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	CMS Casework Communication Contact	Director, Operations		Oliveira	Mauro		4088572532					moliveira@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	03/06/2024	2026	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	Boston
H4045	Complaints Tracking Contact	Director, Operations		Oliveira	Mauro		4088572532					moliveira@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	03/06/2024	2026	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	Boston
H4045	Contact for Fraud Investigations	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Coordination of Benefits Contact			email	COB		4088741866					COB@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	04/20/2022	2026	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	Boston
H4045	Corporate Mailing						4083762000					mainoffice@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Customer Service Operations Contact	Director, Customer Services	Ms.	Nguyen	Tanya		4088741851					tnguyen@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	DIR Contact	Controller		Silva	Lynne		4084081747					lynnes@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	DIR Contact (Secondary)	Chief Financial Officer	Mr.	Jarecki	Neal		4088741892					njarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Discount Program Payment Contact	Chief Financial Officer	Mr.	Jarecki	Neal		4088741892					njarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Emergency Part D Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Emergency Part D Contact (Secondary)	VP, Health Services	Dr.	Huynh	Dang		4088741901					dhuynh@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Encounter Data & Risk Adjustment Operations Contact	Vice President, Strategies and Analytics	Ms	Bui-Tong	Ngoc		4088741881					nbuitong@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Enrollment Contact	Manager, Medicare Outreach	Mr.	Ly	Thien		4088741941					tly@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	EOB Transfer Contact	Director, Claims	Ms.	Bell	Arlene		4088741795				4088741925	abell@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Financial Audit Contact	Chief Financial Officer	Mr.	Jarecki	Neal		4088741892					njarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Financial Reporting Contact	Chief Financial Officer	Mr.	Jarecki	Neal		4088741892					njarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Formulary Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Otomo	Tami		4088741909					totomo@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	General Contact	Interim Compliance Officer	Mr.	Haskell	Tyler		4085021587				4088741970	TylerH@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Government Relations Contact	VP, Government Relations and Compliance	Mr.	Haskell	Tyler		4088741749					thaskell@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/17/2024	2026	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	Boston
H4045	HIPAA Privacy Officer	Interim Compliance Officer	Mr.	Haskell	Tyler		4088741749				4088741970	TylerH@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	HIPAA Security Officer	Chief Information Officer	Mr.	Nautiyal	Manish		4088741912					ManishN@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	Hospice Contact	Chief Medical Officer	Dr.	Paul	Ria		4088741832					rpaul@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/29/2024	2026	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	Boston
H4045	Interoperability Contact	Director, Application and Product Development		Chang	Linda		4088741958					LChang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	MA Appeals/Grievances Contact	Director, Operations		Oliveira	Mauro		4088572532					moliveira@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	03/06/2024	2026	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	Boston
H4045	MA Claims Processing Contact for Public Website	Director, Claims	Ms.	Bell	Arlene		4088741795				4088741925	abell@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Marketing Contact	Director, Marketing & Communications	Ms.	Byom	Chelsea		4086803175					cbyom@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Medical Director	Chief Medical Officer	Dr.	Paul	Ria		4088741832					rpaul@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/29/2024	2026	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	Boston
H4045	Medicare Compliance Officer	Director, Compliance	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	09/28/2023	2026	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	Boston
H4045	Medicare Coordinator	Medicare Compliance Program Manager		Zhao	Alicia		4088741882					azhao@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/26/2024	2026	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	Boston
H4045	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/17/2024	2026	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	Boston
H4045	Medication Therapy Management Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Part C Application Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Part C Reporting Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Part D Appeals	Director, Operations	Mr.	Oliveira	Mauro						4088741962	MOliveira@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	03/06/2024	2026	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active	8777234795	1966			HMO - Health Maintenance Organization		C	Boston
H4045	Part D Appeals Contact (Secondary)	Manager, Grievance and Appeals	Ms.	Marquez	Janine							janinem@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active	4088741707				HMO - Health Maintenance Organization		C	Boston
H4045	Part D Application Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Part D Benefits Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Part D Claims Submission Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Part D Exceptions Contact	Director, Pharmacy	Dr.	Yang	Anna							ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active	4088741839				HMO - Health Maintenance Organization		C	Boston
H4045	Part D Exceptions Contact (Secondary)	Clinical Pharmacist	Ms.	Otomo	Tami							totomo@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active	4088741909				HMO - Health Maintenance Organization		C	Boston
H4045	Part D Price File Contact (Back-up)	Clinical Pharmacist	Ms.	Otomo	Tami		4088741909					totomo@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Part D Price File Contact (Primary)	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Part D Quality Assurance Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Part D Reporting Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Patient Safety Contact	Chief Medical Officer	Dr.	Paul	Ria		4088741832					rpaul@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/29/2024	2026	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	Boston
H4045	Payment Contact	Controller		Silva	Lynne		4084021747					lynnes@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	Pharmacy Director	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Pharmacy Network Management Contact	Director, Pharmacy	Dr.	Yang	Anna		4088741839					ayang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	10/02/2023	2026	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	Boston
H4045	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist	Ms.	Otomo	Tami		4088741909					totomo@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
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	2026	SANTA CLARA COUNTY HEALTH AUTHORITY	Local CCP	Santa Clara Family Health Plan	HMO/HMOPOS		SANTA CLARA COUNTY HEALTH AUTHORITY	303	Yes	Active	8888078666				HMO - Health Maintenance Organization		C	Boston
H4045	Plan Directory Contact for Public Website			Services	Customer		8777234795				4088741965	callcentermanagement@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	03/26/2024	2026	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	Boston
H4045	Plan to Plan Reconciliation Contact	Controller		Silva	Lynne		4084021747					lynnes@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	Processor Contact	Director, Claims	Ms.	Bell	Arlene		4088741795				4088741925	abell@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Quality Contact	Director, Quality & Process Improvement		Chang	Mai		6692164917					mchang@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	03/23/2023	2026	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	Boston
H4045	Reconciliation Contact	Controller		Silva	Lynne		4084081747					lynnes@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	Reconciliation Contact (Secondary)	Chief Financial Officer	Mr.	Jarecki	Neal		4088741892					NJarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Recovery Audit Contact	Chief Financial Officer	Mr.	Jarecki	Neal		4088741892					NJarecki@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	SNP Application Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	SNP State Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Surveillance Contact	VP, Government Relations and Compliance	Mr.	Haskell	Tyler		4088741749				4088741970	TylerH@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/17/2024	2026	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	Boston
H4045	System Contact	Chief Information Officer	Mr.	Nautiyal	Manish		4088741912					ManishN@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	Third Party Administrator (TPA) Liaison	Controller		Silva	Lynne		4084081747					lynnes@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	User Access Contact	Medicare Compliance Manager	Mr.	Quan	Daniel		4085323349					dquan@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	02/09/2022	2026	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	Boston
H4045	Utilization Management Contact	VP, Health Services	Dr.	Huynh	Dang		4088741901					DangH@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	08/07/2025	2026	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	Boston
H4045	Utilization Review Contact	Chief Medical Officer	Dr.	Paul	Ria		4088741832					rpaul@scfhp.com	6201 San Ignacio Ave		San Jose	CA	95119	01/29/2024	2026	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	Boston
H4053	Automated TrOOP Balance Transfer Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Backup User Access Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Bid Primary Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	CAP Report Contact for Public Website	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	CEO - CMS Administrator Contact	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	CEO - Senior Official for Contracting	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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	Director	Mrs.	Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Chief Operating Officer	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Chief Information Officer	Director	Mrs.	Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Chief Information Security Officer	Director	Mrs.	Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	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		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Complaints Tracking Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Contact for Fraud Investigations	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Corporate Mailing						8647977851				8647977880	sarah.siler@prismahealth.org	32 Centennial Way		Greenville	SC	29605	04/08/2019	2026	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		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	DIR Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Discount Program Payment Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Emergency Part D Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Encounter Data & Risk Adjustment Operations Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Enrollment Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	EOB Transfer Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Financial Audit Contact	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Financial Reporting Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Formulary Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	General Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	HIPAA Privacy Officer	Corporate Compliance Officer		Pietras	Scott		8647977712					scott.pietras@prismahealth.org	300 East McBee Avenue	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	HIPAA Security Officer	Corporate Compliance Officer		Pietras	Scott		8647977712					scott.pietras@prismahealth.org	300 East McBee Avenue	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Interoperability Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	MA Appeals/Grievances Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	MA Claims Processing Contact for Public Website	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Marketing Contact	Manager - Outreach/Intake RN		Kitchens	Dan		8645221960				8645221955	dan.kitchens@prismahealth.org	32 Centennial Way		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Medical Director	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	07/08/2024	2026	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	Corporate Compliance Officer	Mr.	Pietras	Scott		8647977712					scott.pietras@prismahealth.org	300 E. McBee Ave	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Medicare Coordinator	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Medicare Part D Opioid Overutilization Contact	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	06/13/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Medication Therapy Management Contact	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part C Application Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part D Appeals	Director		Burnette	Alison						8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active	8034344421				PACE - Nat		C	Atlanta
H4053	Part D Application Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part D Benefits Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part D Claims Submission Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	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	Director, Pharmacy Services		Ranck	Steve							steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active	8644551325				PACE - Nat		C	Atlanta
H4053	Part D Price File Contact (Back-up)	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part D Price File Contact (Primary)	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part D Quality Assurance Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Part D Reporting Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Patient Safety Contact	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Payment Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Pharmacy Director	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Pharmacy Network Management Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	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	Director, Pharmacy Services		Ranck	Steve							steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active	8644551325				PACE - Nat		C	Atlanta
H4053	Plan Directory Contact for Public Website	Manager - Outreach/Intake RN		Kitchens	Dan		8645221960				8645221955	dan.kitchens@prismahealth.org	32 Centennial Way		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Plan to Plan Reconciliation Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Processor Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Quality Contact	Director, Quality		Mattison	Amy		8644329189					amy.mattison@prismahealth.org	300 East McBee Avenue	Suite 400	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Reconciliation Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Recovery Audit Contact	Director	Ms.	Burnette	Alison		8034344421					alison.burnette@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	02/27/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Surveillance Contact	Manager - Outreach/Intake RN		Kitchens	Dan		8645221960				8645221955	dan.kitchens@prismahealth.org	32 Centennial Way		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	System Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Third Party Administrator (TPA) Liaison	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/16/2025	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	User Access Contact	Corporate Compliance Officer		Pietras	Scott		8647977712					scott.pietras@prismahealth.org	300 E. Mcbee Ave.	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Utilization Management Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4053	Utilization Review Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-UPSTATE	National PACE	Prisma Health SeniorCare PACE-Upstate	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4054	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4054	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Dallas
H4054	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Dallas
H4054	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Dallas
H4054	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4054	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4054	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4054	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4057	Agent/Broker Compensation Data Contact	Senior Director of Delegation & Oversight		McGuire	Melissa		6616172642					melissa.mcguire@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Automated TrOOP Balance Transfer Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Backup User Access Contact	Compliance Manager, Audits & Investigations		Dhaliwal	Sandeep		6616645535					Sandeep.Dhaliwal@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Best Available Evidence Contact	Senior Director of Member Services		Scott	Nate		6616172503					nate.scott@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Bid Audit Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	05/30/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Bid Primary Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	05/30/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	CAP Report Contact for Public Website	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs.	Duran	Emily		6616645035					emily.duran@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs.	Duran	Emily		6616645035					emily.duran@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Chief Financial Officer	Chief Financial Officer	Mr.	Robert	Robert		6616645007					robert.landis@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Chief Operating Officer	Chief Operations Officer	Mr.	Avery	Alan		6616645005					alan.avery@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Chief Information Officer	Deputy Chief Information Officer	Mr.	Delgado	Cesar		6616172518					cesar.delgado@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Chief Information Security Officer	Cyber Security Manager -IT	Mr.	Taylor	Kenny		6616645057					Kenny.Taylor@khs-net.com	2900 Buck Owens Blvd		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	CMS Casework Communication Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Complaints Tracking Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Contact for Fraud Investigations	Compliance Manager, Audits & Investigations		Dhaliwal	Sandeep		6616645535					Sandeep.Dhaliwal@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Coordination of Benefits Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Corporate Mailing						6616172562					anthony.roberts@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Customer Service Operations Contact	Senior Director of Member Services		Scott	Nate		6616172503					nate.scott@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	DIR Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	DIR Contact (Secondary)	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Discount Program Payment Contact	Controller		Barker	Veronica		6616175024					veronica.barker@khs-net.com	2900 Buck Owens Blvd		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Emergency Part D Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Emergency Part D Contact (Secondary)	Pharmacist		Church	Michelle		6616645092					michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Encounter Data & Risk Adjustment Operations Contact	Director of Development, Enterprise Development		Kim	Ed		6614737453					ed.kim@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Enrollment Contact	Senior Director of Member Services		Scott	Nate		6616172503					nate.scott@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	EOB Transfer Contact	Senior Director of Claims		Dow-Morales	Robin		6616172598				6616645151	Robin.Dow-Morales@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Financial Audit Contact	Controller - Accounting	Ms.	Barker	Veronica		6616175024					veronica.barker@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Financial Reporting Contact	Controller - Accounting		Barker	Veronica		6616175024					veronica.barker@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Formulary Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Formulary Contact (Secondary)	Pharmacist		Church	Michelle		6616645092					michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	General Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Government Relations Contact	Senior Director of Project Management and Governme		McGuire	Jeremy		6616645018					jeremy.mcguire@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	HIPAA Privacy Officer	Chief Compliance and Fraud Prevention Officer		Murr	Deborah		6616645141					deborah.murr@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	HIPAA Security Officer	Deputy Chief Information Officer		Delgado	Ceasar		6616172518					cesar.delgado@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Hospice Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Interoperability Contact	Director of Development, Enterprise Development		Kim	Ed		6614737453					ed.kim@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	MA Appeals/Grievances Contact	Senior Director of Member Services		Scott	Nate		6616172503					nate.scott@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	MA Claims Processing Contact for Public Website	Senior Director of Claims		Dow-Morales	Robin		6616172598					Robin.Dow-Morales@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Marketing Contact	Senior Director of Marketing & Member Engagement		Iturriria	Louis		6616645120					louie.iturriria@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Medical Director	Population Health Medical Director		Sidhu	Sukhpreet		6616645106					sukhpreet.sidhu@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Medicare Compliance Officer	Chief Compliance and Fraud Prevention Officer	Mrs.	Murr	Deborah		6616645141					deborah.murr@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Medicare Coordinator	Senior Director of Delegation Oversight		McGuire	Melissa		6616172642					melissa.mcguire@khs-net.com	2900 Buck Owens Blvd.		Bakersfeild	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Medication Therapy Management Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Online Enrollment Center Contact (Back-up)	Member Services Manager		Parra	Maria		6616645129					maria.parra@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Online Enrollment Center Contact (Optional)	Member Services Manager		Sanders	Amy		6616645525					amy.sanders@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Online Enrollment Center Contact (Primary)	Senior Director of Member Services		Scott	Nate		6616172503					nate.scott@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part C Application Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6166645016					jane.macadam@khs-net.com	2900 Buck Owens		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part C Reporting Contact	Regulatory and  Government Program Manager		Pollock	Jeff		6616645149					jeffp@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Appeals	Director of Pharmacy		Wearda	Bruce							brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active	6616645100				HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Appeals Contact (Secondary)	Pharmacist		Church	Michelle							michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active	6616645092				HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Application Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Benefits Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Claims Submission Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Exceptions Contact	Director of Pharmacy		Wearda	Bruce							brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active	6616645100				HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Exceptions Contact (Secondary)	Pharmacist		Church	Michelle							michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active	6616645092				HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Price File Contact (Back-up)	Pharmacist		Church	Michelle		6616645092					michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Price File Contact (Optional)			Keller	Shanon		8587906455					PlanFinderCommunications@medimpact.com	11081 Scripps Gateway Ct		San Diego	CA	92131	12/05/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Price File Contact (Primary)	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Quality Assurance Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Part D Reporting Contact	Regulatory and  Government Program Manager		Pollock	Jeff		6616645149					jeffp@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Patient Safety Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Payment Contact	Controller - Accounting		Barker	Veronica		6616175024					veronica.barker@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Pharmacy Director	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Pharmacy Network Management Contact	Deputy Dir of Provider Network		Winfrey	James		6616645161					james.winfrey@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Pharmacy Network Management Contact (Secondary)	Pharmacist		Church	Michelle		6616645092					michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	MedImpact								10181 Scripps Gateway Ct		San Diego	CA	92131	12/05/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active	8335460101				HMO - Health Maintenance Organization		C	Dallas
H4057	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacist		Church	Michelle							michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active	6616645092				HMO - Health Maintenance Organization		C	Dallas
H4057	Plan Directory Contact for Public Website	Senior Director of Member Services		Scott	Nate		6616172503					nate.scott@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Plan to Plan Reconciliation Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Processor Contact	Senior Director of Claims		Dow-Morales	Robin		6616172598					Robin.Dow-Morales@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Quality Contact	Senior Director of Claims		Collier	Kailey		6616172680					kailey.collier@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Reconciliation Contact	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Reconciliation Contact (Secondary)	Pharmacist		Church	Michelle		6616645092					michelle.church@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Recovery Audit Contact	Senior Director of Claims	Mrs.	Dow-Morales	Robin		6616172598					Robin.Dow-Morales@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	SNP Application Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	SNP State Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Surveillance Contact	Senior Director of Delegation & Oversight		McGuire	Melissa		6616172642					melissa.mcguire@khs-net.com	2900 Buck Owens Blvd.		Bakersfeild	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	System Contact	Deputy Chief Information Officer		Delgado	Ceasar		6616172518					cesar.delgado@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Third Party Administrator (TPA) Liaison	Director of Pharmacy		Wearda	Bruce		6616645100					brucew@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	User Access Contact	Director of Compliance & Regulatory Affairs		MacAdam	Jane		6616645016					jane.macadam@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	05/30/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Utilization Management Contact	Director of Utilization Management		Gonzalez	Amanda		6613779477					Amanda.Gonzalez@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/07/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4057	Utilization Review Contact	Director of Utilization Management		Gonzalez	Amanda		6613779477					Amanda.Gonzalez@khs-net.com	2900 Buck Owens Blvd.		Bakersfield	CA	93308	02/08/2025	2026	KERN HEALTH SYSTEMS	Local CCP	Kern Family Health Care Medicare (D-SNP)	HMO/HMOPOS		Kern Health Systems (KHS)	876	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4073	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H4073	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H4073	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H4073	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H4073	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4073	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4073	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H4073	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4073	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4074	Automated TrOOP Balance Transfer Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Backup User Access Contact	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	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	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Bid Primary Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	CAP Report Contact for Public Website	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	CEO - Senior Official for Contracting	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	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	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	07/27/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Chief Operating Officer	COO	Ms	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	04/28/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Chief Information Officer	Director Enterprise IT Operations	Mr	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Chief Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083					Preston.Jennings@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Complaints Tracking Contact	Director, Quality and Compliance	Ms	Thomas	NeChelsey		2512878426					NeChelsey.Thomas@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/29/2025	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Contact for Fraud Investigations	Director, Quality and Compliance	Ms	Thomas	NeChelsey		2512878426					NeChelsey.Thomas@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/29/2025	2026	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	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Corporate Mailing						2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/15/2023	2026	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		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	DIR Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Discount Program Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Emergency Part D Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Enrollment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	EOB Transfer Contact	Regional director Finance	Ms.	Fuhrmeister	Nicole		2157788707				9104834930	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Financial Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Financial Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	General Contact	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	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		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Interoperability Contact	Director Enterprise IT Operations		Gillespie	Jeff		7343433079					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	MA Appeals/Grievances Contact	Director, Quality and Compliance	Ms	Thomas	NeChelsey		2512878426					NeChelsey.Thomas@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/29/2025	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	MA Claims Processing Contact for Public Website	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Marketing Contact	Director Marketing & Communications	Ms	Lark	Azia		9735182754					azia.lark@trinity-health.org	2900 Spring Hill Ave		Mobile	AL	36607	02/03/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Medical Director	Medical Director	Dr.	Amato	Alaina		2512878420				9104834930	Alaina.Amato@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	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	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Medicare Coordinator	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/27/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Part C Application Contact	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	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 Appeals	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	01/04/2021	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H4074	Part D Application Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	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 Benefits Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	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 Claims Submission Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	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@trinity-health.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	09/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H4074	Part D Price File Contact (Back-up)	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	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 Price File Contact (Primary)	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	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 Quality Assurance Contact	Director, Quality and Compliance	Ms	Thomas	NeChelsey		2512878426					NeChelsey.Thomas@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/29/2025	2026	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 Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Patient Safety Contact	Director, Quality and Compliance	Ms	Thomas	NeChelsey		2512878426					NeChelsey.Thomas@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/29/2025	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Pharmacy Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Pharmacy Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	08/04/2023	2026	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@trinity-health.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	09/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H4074	Plan Directory Contact for Public Website	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Plan to Plan Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Processor Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Quality Contact	Director, Quality and Compliance	Ms	Thomas	NeChelsey		2512878426					NeChelsey.Thomas@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	09/29/2025	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Recovery Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/03/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Surveillance Contact	Executive Director	Ms	Overton	Kathryn		2512878420				2512878478	kathryn.overton@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	08/24/2022	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Third Party Administrator (TPA) Liaison	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Utilization Management Contact	Medical Director	Dr.	Amato	Alaina		2512878420				2512878478	Alaina.Amato@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4074	Utilization Review Contact	Medical Director	Dr.	Amato	Alaina		2512878420				2512878478	Alaina.Amato@mercylifeal.com	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	MERCY LIFE OF ALABAMA	National PACE	Mercy LIFE of Alabama	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H4091	Agent/Broker Compensation Data Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility	Ms.	Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Backup User Access Contact	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Best Available Evidence Contact	COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Bid Audit Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Bid Audit Site Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Bid Primary Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	CAP Report Contact for Public Website	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	CEO - CMS Administrator Contact	CEO	Ms.	Brenier	Holly		2057579107					holly.brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/20/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	CEO - Senior Official for Contracting	CEO	Ms.	Brenier	Holly		2057579107					holly.brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/20/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Chief Financial Officer	CFO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Chief Operating Officer	Chief Operating Officer	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Chief Information Officer	VP, PMO & IT	Ms.	Watts	Tammy		2056037958					tammy.watts@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	01/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Chief Information Security Officer	VP, PMO & IT	Ms.	Watts	Tammy		2056037958					tammy.watts@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	01/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Complaints Tracking Contact	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Coordination of Benefits Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Corporate Mailing						2057579107				2059947028	Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	12/02/2022	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Customer Service Operations Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	DIR Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	DIR Contact (Secondary)	Controller	Mr.	Caton	Grady		2057579107					Grady.Caton@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Discount Program Payment Contact	Controller	Mr.	Caton	Grady		2057677930					Grady.Caton@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	03/05/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Emergency Part D Contact	CEO	Ms.	Brenier	Holly		2057579107					holly.brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/20/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Emergency Part D Contact (Secondary)	VP, Operations	Ms.	Gaines	Ann		2056590919					Ann.Gaines@acvcorp.com	3008 7th Avenue South	Suite 110	Birmingham	AL	35233	03/25/2025	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Encounter Data & Risk Adjustment Operations Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Enrollment Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	EOB Transfer Contact	CFO/COO	Ms.	Brenier	Holly		2057579107				8003756496	Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Financial Audit Contact	CFO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Financial Reporting Contact	CFO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Formulary Contact	Clinical Pharmacist	Mr.	Hayes	Jacob		2057900260					Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Formulary Contact (Secondary)	Formulary Team Lead	Ms.	Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	General Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Government Relations Contact	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	HIPAA Security Officer	VP, PMO & IT	Ms.	Watts	Tammy		2056037958					Tammy.Watts@acvcorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Hospice Contact	VP, Operations	Ms.	Gaines	Ann		2056590919					Ann.Gaines@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	03/25/2025	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Interoperability Contact	VP, PMO & IT	Ms.	Watts	Tammy		2056037958					tammy.watts@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	01/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	MA Appeals/Grievances Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	MA Claims Processing Contact for Public Website			Provider Services	Simpra Prv		8446374770					Providerinquiry@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	07/10/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Marketing Contact	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South	Suite 110	Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Medical Director	Chief Medical Director	Dr.	Hays	Clare		2058629595					clare.hays@acvcorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	02/24/2022	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 Seventh Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Medicare Coordinator	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist	Mr.	Hayes	Jacob		2057900260					Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Medication Therapy Management Contact	Clinical Pharmacist	Mr.	Hayes	Jacob		2057900260					Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	OffShore Subcontractor Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part C Application Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part C Reporting Contact	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Appeals	Supervisor, Grievance and Appeals	Mr.	LaCrosse	Justin						8442689791	Justin.LaCrosse@navitus.com	Navitus Health Solutions,	P.O. Box 1039	Appleton	WI	54912	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	9202214149				PPO - BBA		C	New York
H4091	Part D Appeals Contact (Secondary)	Supervisor, Grievances and Appeals	Ms.	Fritsche	Jacki						6082985881	Jacki.Fritsche@Navitus.com	361 Integrity Drive		Madison	WI	53717	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	6082985781				PPO - BBA		C	New York
H4091	Part D Application Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Benefits Contact	Clinical Pharmacist	Mr.	Hayes	Jacob		2057900260					Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Claims Submission Contact	Manager,Technical Operations	Mr.	Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization	Mr.	LeClair	Christophe						9202214676	Christopher.LeClair@Navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	9202214176				PPO - BBA		C	New York
H4091	Part D Exceptions Contact (Secondary)	Clinical Pharmacist	Mr.	Hayes	Jacob							Jacob.Hayes@acvcorp.com	3008 7th Avenue South	S	Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	2057900260				PPO - BBA		C	New York
H4091	Part D Price File Contact (Back-up)		Ms.	Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	361 Integrity Drive	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	Madison	WI	53717	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Price File Contact (Optional)	VP, Operations	Ms.	Gaines	Ann		2056590919					Ann.Gaines@acvcorp.com	3008 7th Avenue South	S	Birmingham	AL	35233	03/25/2025	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	04/03/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Quality Assurance Contact	Director of Quality	Ms.	Lumpkin	Karen		2057578993					Karen.Lumpkin@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Part D Reporting Contact	Clinical Pharmacist	Mr.	Hayes	Jacob		2057900260					Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Patient Safety Contact	Clinical Pharmacist	Mr.	Hayes	Jacob		2057900260					Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Payment Contact	CFO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Pharmacy Director	VP, Operations	Ms.	Gaines	Ann		2056590919					Ann.Gaines@acvcorp.com	3008 7th Avenue South	Suite 110	Birmingham	AL	35233	03/25/2025	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Pharmacy Network Management Contact	VP, Network Management	Ms.	Santos	Christina		6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	04/03/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist	Mr.	Hayes	Jacob		2057900260					Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts	Ms.	Nett	Danielle						9202214724	Danielle.Nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	8662703877	4224			PPO - BBA		C	New York
H4091	Pharmacy Technical Help Desk Contact (Secondary)	Clinical Pharmacist	Mr.	Hayes	Jacob							Jacob.Hayes@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	09/12/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active	2057900260				PPO - BBA		C	New York
H4091	Physician Incentive Contact	Chief Medical Officer	Dr.	Hays	Clare		2058629595					Clare.Hays@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	02/24/2022	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Plan Directory Contact for Public Website			Services	Member		8446374770					customerservice@simpra.com	PO Box 23607		Tampa	FL	33623	01/29/2025	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Plan to Plan Reconciliation Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Processor Contact	VP, Operations	Ms.	Gaines	Ann		2056590919					Ann.Gaines@acvcorp.com	Associated Care Ventures	3008 7th Avenue South	Birmingham	AL	35233	04/03/2024	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Quality Contact	Director, Quality	Ms.	Lumpkin	Karen		2057578993					Karen.Lumpkin@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Reconciliation Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Reconciliation Contact (Secondary)	Controller	Mr.	Caton	Grady		2057579107					Grady.Caton@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Recovery Audit Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	SNP Application Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	SNP State Contact	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Surveillance Contact	Chief Business Development Officer	Ms.	Hord	Stacey		2564906404					Stacey.Hord@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	System Contact	VP, PMO & IT	Ms.	Watts	Tammy		2056037958					tammy.watts@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Third Party Administrator (TPA) Liaison	CFO/COO	Ms.	Brenier	Holly		2057579107					Holly.Brenier@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	User Access Contact	Chief Compliance Officer	Ms.	Panaro	Celeste		8322783988					Celeste.Panaro@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Utilization Management Contact	Director, Utilization Management	Ms.	Mitchell	Koby		2057579031					Koby.Mitchell@ACVCorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4091	Utilization Review Contact	Director, Utilization Management	Ms.	Mitchell	Koby		2057579031					Koby.Mitchell@acvcorp.com	3008 7th Avenue South		Birmingham	AL	35233	06/12/2023	2026	SIMPRA ADVANTAGE, INC.	Local CCP	Simpra Advantage	Local PPO		Associated Care Ventures, Inc.	674	Yes	Active					PPO - BBA		C	New York
H4093	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4093	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Dallas
H4093	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Dallas
H4093	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Dallas
H4093	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H4093	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4093	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4093	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H4105	Automated TrOOP Balance Transfer Contact	Medical Management Coordinator		Loiselle	Amanda		4016544071				4016544660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	Backup User Access Contact	CEO		Kwiatkowski	Joan	L	4016544564				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Best Available Evidence Contact	CEO		Kwiatkowski	Joan	L	4016544564				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Bid Primary Contact	CFO	Mrs.	Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	CAP Report Contact for Public Website	CEO		Kwiatkowski	Joan	L	4016544564				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	CEO - CMS Administrator Contact	CEO	Mrs.	Kwiatkowski	Joan	L	4016545465				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	12/27/2021	2026	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	New York
H4105	CEO - Senior Official for Contracting	CEO	Mrs.	Kwiatkowski	Joan	L	4016545465				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	12/27/2021	2026	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	New York
H4105	Chief Financial Officer	CFO	Mrs.	Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Chief Operating Officer	CEO	Mrs.	Kwiatkowski	Joan	L	4016544564				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Chief Information Officer	Chief of Organizational Performance	Mrs.	Boucher	Liz		4016545255				4016544660	lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Chief Information Security Officer	Chief of Organizational Performance	Mrs.	Boucher	Liz		4016545255				4016544660	lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	CMS Casework Communication Contact	Chief of Organizational Performance	Mrs.	Boucher	Liz		4016545255				4016544660	lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Complaints Tracking Contact	CEO	Mrs.	Kwiatkowski	Joan	L	4016544564				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Contact for Fraud Investigations	CEO	Mrs.	Kwiatkowski	Joan	L	4016544564				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Coordination of Benefits Contact	Staff Accountant		Mukasa	Kevin		4016545140				4016544660	kmukasa@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Corporate Mailing						4014906566				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Customer Service Operations Contact	Chief of Growth		Girard	Maryellen		4016544072				4016544660	mgirard@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	DIR Contact	Medical Management Coordinator	Ms.	Loiselle	Amanda		4016544071				4016544660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/14/2025	2026	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	New York
H4105	DIR Contact (Secondary)	CFO		Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/14/2025	2026	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	New York
H4105	Discount Program Payment Contact	CFO		Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	Emergency Part D Contact	CEO		Kwiatkowski	Joan		4016545465					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Emergency Part D Contact (Secondary)	CFO		Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Encounter Data & Risk Adjustment Operations Contact	Medical Management Coordinator		Loiselle	Amanda		4016544071				4016544660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	Enrollment Contact	Staff Accountant		Mukasa	Kevin		4016545140				4014906537	kmukasa@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	EOB Transfer Contact	Staff Accountant		Mukasa	Kevin		4016545140				4016544660	kmukasa@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Financial Audit Contact	CFO	Mrs.	Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Financial Reporting Contact	CFO	Mrs.	Bernier	Corissa		4011654074				4016544660	cbernier@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Formulary Contact	Pharmacist		Dyer	Curtis		4016545254					cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2026	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	New York
H4105	Formulary Contact (Secondary)	Senior Director of Compliance & Quality		Walker	Mike		4016544075				4016544660	mwalker@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	01/09/2025	2026	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	New York
H4105	General Contact	CEO		Kwiatkowski	Joan		4016545465					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Government Relations Contact	CEO	Mrs.	Kwiatkowski	Joan	L	4016544564				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	HIPAA Privacy Officer	Compliance & Quality Manager	Mr.	Walker	Mike		4016544075				4016544660	mwalker@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	HIPAA Security Officer	Senior Director of Compliance & Quality		Walker	Mike		4016544075				4016544660	mwalker@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Interoperability Contact	CEO	Ms.	Kwiatkowski	Joan		4016544564					Jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	02/24/2022	2026	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	New York
H4105	MA Appeals/Grievances Contact	Chief of Organizational Performance		Boucher	Liz		4016545255					lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	MA Claims Processing Contact for Public Website	CFO		Bernier	Corissa		4016544074					cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Marketing Contact	Chief of Growth		Girard	Maryellen		4016544072				4016544660	mgirard@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Medical Director	Senior Director of Compliance & Quality		Walker	Mike		4016544075				4014906537	mwalker@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/09/2025	2026	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	New York
H4105	Medicare Compliance Officer	Chief of Organizational Performance	Mrs.	Boucher	Liz		4016545255				4016544660	lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Medicare Coordinator	CFO		Bernier	Corissa		4016544074					cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Medicare Part D Opioid Overutilization Contact	CEO		Kwiatkowski	Joan		4016544564					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	02/17/2022	2026	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	New York
H4105	Medication Therapy Management Contact	Pharmacist		Dyer	Curtis		4016545254					cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2026	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	New York
H4105	OffShore Subcontractor Contact	CEO		Kwiatkowski	Joan	L	4014906566				4014906537	jkwiatkowski@carelink-ri.com	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Online Enrollment Center Contact (Back-up)	CEO		Kwiatkowski	Joan		4016544564					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Online Enrollment Center Contact (Optional)	CFO		Bernier	Corissa		4016544074					cbernier@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Online Enrollment Center Contact (Primary)	Staff Accountant		Mukasa	Kevin		4016545140				4014906537	kmukasa@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Part C Application Contact	CEO		Kwiatkowski	Joan		4016544564					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Part D Appeals	Senior Director of Compliance & Quality		Walker	Mike							mwalker@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	4016544075				PACE - Nat		C	New York
H4105	Part D Appeals Contact (Secondary)	Pharmacist		Dyer	Curtis						4016544660	cdyer@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	08/29/2024	2026	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	4016545254				PACE - Nat		C	New York
H4105	Part D Application Contact	CEO		Kwiatkowski	Joan		4016545465					jkwiatkowski@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Part D Benefits Contact	Pharmacist		Dyer	Curtis		4016545254					cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2026	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	New York
H4105	Part D Claims Submission Contact	Medical Management Coordinator		Loiselle	Amanda		4016544071				4014906537	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	Part D Exceptions Contact	Medical Management Coordinator		Loiselle	Amanda						4016544660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	8777817223				PACE - Nat		C	New York
H4105	Part D Exceptions Contact (Secondary)	CEO		Kwiatkowski	Joan							jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	4016544564				PACE - Nat		C	New York
H4105	Part D Price File Contact (Back-up)	Medical Management Coordinator		Loiselle	Amanda		4016544071					aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	Part D Price File Contact (Optional)	CFO		Bernier	Corissa		4016544074					cbernier@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	Part D Price File Contact (Primary)	CEO		Kwiatkowski	Joan		4016544564					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Part D Quality Assurance Contact	Pharmacist		Dyer	Curtis		4016545254				4016544660	cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2026	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	New York
H4105	Part D Reporting Contact	CFO		Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Patient Safety Contact	Senior Director of Compliance & Quality		Walker	Mike		4016544075					mwalker@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Payment Contact	CEO		Kwiatkowski	Joan		4016545465				4016544660	jkwiatkowski@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Personal Health Record Contact	CEO		Kwiatkowski	Joan		4016544564					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Pharmacy Director	Pharmacist		Dyer	Curtis		4016545254					cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2026	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	New York
H4105	Pharmacy Network Management Contact	Contract Manager		Whitehead	Judy		4016544789					jwhitehead@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Pharmacy Network Management Contact (Secondary)	Pharmacist		Dyer	Curtis		4016545254					cdyer@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Pharmacy Technical Help Desk Contact	Pharmacist		Dyer	Curtis	L					4016544660	cdyer@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/25/2022	2026	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	4016545254				PACE - Nat		C	New York
H4105	Pharmacy Technical Help Desk Contact (Secondary)	Medical Management Coordinator		Loiselle	Amanda						4016544660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE		PACE Organization of Rhode Island	177	Yes	Active	8777817223				PACE - Nat		C	New York
H4105	PHR Beneficiary Contact																	11/23/2009	2026	PACE ORGANIZATION OF RHODE ISLAND	National PACE	PACE Organization Of Rhode Island	National PACE	Pace Organization of Rhode Island	PACE Organization of Rhode Island	177	Yes	Active	8777817223				PACE - Nat		C	New York
H4105	Plan Directory Contact for Public Website	CEO		Kwiatkowski	Joan		4016544564					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Plan to Plan Reconciliation Contact	Medical Management Coordinator		Loiselle	Amanda		4016544071				4016544660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	Processor Contact	Staff Accountant		Mukasa	Kevin		4016545140				4014906537	kmukasa@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Quality Contact	Chief of Organizational Performance		Boucher	Liz		4016545255					lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Reconciliation Contact	Medical Management Coordinator		Loiselle	Amanda		4016544071				4016544660	aloiselle@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/14/2025	2026	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	New York
H4105	Reconciliation Contact (Secondary)	CFO		Bernier	Corissa		4016544074					cbernier@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/14/2025	2026	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	New York
H4105	Recovery Audit Contact	CFO	Mrs.	Bernier	Corissa		4016544074				4016544660	cbernier@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	11/08/2024	2026	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	New York
H4105	Surveillance Contact	Chief of Organizational Performance		Boucher	Liz		4016545255					lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	System Contact	Chief of Organizational Performance		Boucher	Liz		4016545255					lboucher@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4105	Third Party Administrator (TPA) Liaison	Medical Management Coordinator		Loiselle	Amanda		4016544071				4016544660	aloiselle@pace-ri.org	10 Tripps Ln		Riverside	RI	02915	01/03/2025	2026	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	New York
H4105	User Access Contact	CEO		Kwiatkowski	Joan		4016544564					jkwiatkowski@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	11/08/2021	2026	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	New York
H4105	Utilization Management Contact	Senior Director of Compliance & Quality		Walker	Mike		4016544075					mwalker@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	01/09/2025	2026	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	New York
H4105	Utilization Review Contact	Chief of Clinical Services		Lupoli	Michelle		4016544122					mlupoli@pace-ri.org	10 Tripps Lane		Riverside	RI	02915	08/29/2024	2026	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	New York
H4118	Automated TrOOP Balance Transfer Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Backup User Access Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Best Available Evidence Contact	Executive Director		Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Bid Primary Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	CAP Report Contact for Public Website	Executive Director		Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	CEO - CMS Administrator Contact	Executive Director	Mrs	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	CEO - Senior Official for Contracting	Executive Director	Mrs	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Chief Financial Officer	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Chief Operating Officer	Executive Director	Mrs	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Chief Information Officer	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Chief Information Security Officer	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	CMS Casework Communication Contact	Executive Director	Mrs	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Complaints Tracking Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Contact for Fraud Investigations	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Coordination of Benefits Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Corporate Mailing						7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Customer Service Operations Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	DIR Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	DIR Contact (Secondary)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Discount Program Payment Contact	Director of Finance	Mrs.	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Emergency Part D Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Emergency Part D Contact (Secondary)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Encounter Data & Risk Adjustment Operations Contact	Director of Finance		Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2940 Ellsworth Road		Ypsilanti	MI	48197	10/21/2019	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Enrollment Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	EOB Transfer Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224			7342215124	jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	08/28/2017	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Financial Audit Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Financial Reporting Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Formulary Contact	Quality Director	MRS	Gearhart	Felicia		7345725777					fgearhart@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	03/10/2020	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Formulary Contact (Secondary)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	General Contact	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Government Relations Contact	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	HIPAA Privacy Officer	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	HIPAA Security Officer	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Interoperability Contact			Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth Road		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	MA Appeals/Grievances Contact	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	MA Claims Processing Contact for Public Website	Director of Finance	MRS	Dukes	Jaclyn		7345725777					jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Marketing Contact	Marketing Manager	MRS	Mann-Shanahan	Lindsay		7345725777					lmann-shanahan@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	03/10/2020	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Medical Director	Medical Director	MRS	Almeda	Marjorie		7345725777					malmeda@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	01/05/2021	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Medicare Compliance Officer	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	02/11/2019	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Medicare Coordinator	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Medicare Part D Opioid Overutilization Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	03/10/2020	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Medication Therapy Management Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	03/10/2020	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	OffShore Subcontractor Contact	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Online Enrollment Center Contact (Back-up)	Marketing Manager	MRS	Mann-Shanahan	Lindsay		7345725777					lmann-shanahan@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	03/10/2020	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Online Enrollment Center Contact (Optional)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Online Enrollment Center Contact (Primary)	Enrollment Director	MRS	Renfro	Heather		7345725777					hrenfro@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	02/19/2024	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part C Application Contact	Executive Director		Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth Road		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Appeals	Quality Director	Mrs	Gearhart	Felicia							fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	8554837223				PACE - Nat		C	Atlanta
H4118	Part D Appeals Contact (Secondary)	Finance Director	Mrs	Dukes	Jaclyn						7342215124	jdukes@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	01/05/2021	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	8554837223				PACE - Nat		C	Atlanta
H4118	Part D Application Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Benefits Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Claims Submission Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Exceptions Contact	Director of Finance	Mrs	Dukes	Jaclyn							jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	06/27/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	8554837223				PACE - Nat		C	Atlanta
H4118	Part D Exceptions Contact (Secondary)	Executive Director	MRS	Suntheimer	Mimi							msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	7345725777				PACE - Nat		C	Atlanta
H4118	Part D Price File Contact (Back-up)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Price File Contact (Optional)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Price File Contact (Primary)	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Quality Assurance Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Part D Reporting Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Patient Safety Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Payment Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Personal Health Record Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Pharmacy Director	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	03/10/2020	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Pharmacy Network Management Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Pharmacy Network Management Contact (Secondary)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Pharmacy Technical Help Desk Contact	Quality Director	Mrs	Gearhart	Felicia							fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	8554837223				PACE - Nat		C	Atlanta
H4118	Pharmacy Technical Help Desk Contact (Secondary)	Executive Director	MRS	Suntheimer	Mimi							msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active	7345725777				PACE - Nat		C	Atlanta
H4118	PHR Beneficiary Contact																	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE	Huron Valley PACE	Utd Methodist Retirement Communities of SE MI	558	Yes	Active	8554837223				PACE - Nat		C	Atlanta
H4118	Plan Directory Contact for Public Website	Marketing Manager	MRS	Mann-Shanahan	Lindsay		7345725777					lmann-shanahan@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	03/10/2020	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Plan to Plan Reconciliation Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Processor Contact	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Quality Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Reconciliation Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	05/02/2016	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Reconciliation Contact (Secondary)	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Recovery Audit Contact	Director of Finance	Mrs	Dukes	Jaclyn		7345725777	224				jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	08/28/2017	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Surveillance Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	System Contact	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Third Party Administrator (TPA) Liaison	Director of Finance	Mrs.	Dukes	Jaclyn		7348790325					jdukes@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	02/27/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	User Access Contact	Executive Director	MRS	Suntheimer	Mimi		7345725777					msuntheimer@hvpace.org	2940 Ellsworth		Ypsilanti	MI	48197	09/24/2025	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Utilization Management Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4118	Utilization Review Contact	Quality Director	Mrs	Gearhart	Felicia		7348790324					fgearhart@hvpace.org	2940 Ellsworth Rd		Ypsilanti	MI	48197	11/05/2018	2026	THE WASHTENAW PACE	National PACE	Huron Valley PACE	National PACE		Utd Methodist Retirement Communities of SE MI	558	Yes	Active					PACE - Nat		C	Atlanta
H4140	Agent/Broker Compensation Data Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D Program Manager		Rivera Aquino	Denisse		8582915269					partDCAT@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/07/2022	2026	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	Backup User Access Contact	CFO		Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	05/11/2022	2026	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		7865780959				7865780964	ghernandez@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	Bid Audit Contact	CFO		Garrote Torra	Ivonne		7865780954				7865780281	i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	10/07/2021	2026	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	Bid Primary Contact	CFO		Garrote Torra	Ivonne		7865780954				7865780281	i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	10/07/2021	2026	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	CAP Report Contact for Public Website	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Haushalter	Brandon		7865848345				7865780281	b.haus16@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/11/2023	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Haushalter	Brandon		7865848345				7865780281	b.haus16@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/11/2023	2026	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		7865780954				7865780282	i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2026	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 Operating Officer	Co-founder/Executive Director	Mr.	Perez	Martiniano	J	7865780946				7865780282	mperez@doctorshcp.com	2020 Ponce De Leon Bvd	PH 1	Coral Gables	FL	33134	10/11/2023	2026	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 Information Officer	Director of IT	Mr.	Miranda	Lazaro		7865780952				7865760298	lmiranda@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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 Information Security Officer	Director of IT	Mr.	Miranda	Lazaro		7865780952				7865760298	lmiranda@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	CMMI Model Point of Contact	Director of IT		Miranda	Lazaro		7865780952				7865760298	lmiranda@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	Manager, G&A		Gonzalez	Esther		7869803998					e.gonz23@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	12/02/2025	2026	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	Complaints Tracking Contact	Manager, G&A		Gonzalez	Esther		7869803998				7865780285	e.gonz23@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	12/02/2025	2026	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	Contact for Fraud Investigations	Sr. Director Operations		Gaviria	Nelson		7865848595					ngaviria@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	12/02/2025	2026	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		7865780954				7865780289	i.gtor03@doctorshcp.com	2020 Ponce De Leon Bvd	PH 1	Coral Gables	FL	33134	07/22/2022	2026	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	Corporate Mailing						7865780965				7865780290	receptionist@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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		7865780956				7865780283	jcurbelo@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	DIR Contact	CFO		Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2026	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	DIR Contact (Secondary)	Director Pharmacy		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	02/20/2024	2026	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	Discount Program Payment Contact	CFO		Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2026	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	Emergency Part D Contact	Director, Pharmacy		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	03/26/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Senior Director, IT		Miranda	Lazaro		7865780952					lmiranda@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/18/2019	2026	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	Enrollment Contact	Director of Enrollment		Hernandez	Gloria		7865780959				7865780964	ghernandez@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	EOB Transfer Contact	Co-founder/Executive Director		Perez	Martiniano		7865780946				7865780289	mperez@doctorshcp.com	2020 Ponce De Leon Bvd	PH 1	Coral Gables	FL	33134	10/11/2023	2026	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	Financial Audit Contact	CFO	Ms.	Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	10/07/2021	2026	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	Financial Reporting Contact	CFO		Garrote Torra	Ivonne		7865780954				7865780282	i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2026	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	Formulary Contact	Clinical Pharmacist Consultant		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	General Contact	CEO		Haushalter	Brandon		7865848345				7865780281	b.haus16@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/11/2023	2026	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		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	HIPAA Privacy Officer	Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	HIPAA Security Officer	Senior Director, IT		Miranda	Lazaro		7865780952					lmiranda@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	Director, Medical Management		Segrera	Cristina		7865780958					csegrera@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	03/26/2024	2026	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	Interoperability Contact	Director, IT		Miranda	Lazaro		7865780952					lmiranda@doctorshcp.com	2020 Ponce De Leon Blvd	PH-1	Coral Gables	FL	33134	12/21/2021	2026	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	MA Appeals/Grievances Contact	Director Member Services		Curbelo	Jenny		7865780956				7865780283	jcurbelo@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	MA Claims Processing Contact for Public Website	Co-founder/Executive Director		Perez	Martiniano		7865780946				7865780289	mperez@doctorshcp.com	2020 Ponce De Leon Bvd	PH 1	Coral Gables	FL	33134	10/11/2023	2026	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	Marketing Contact	Director Marketing and Sales		Delgado	Arlen		7865780957					adelgado@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	Medical Director	Chief Medical Officer	Dr.	Cabrera	Edward		7864536010					e.cabr02@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/27/2025	2026	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		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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 Coordinator	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist		Torres	Gerrado		7868663472					g.torr28@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	07/22/2022	2026	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	Medication Therapy Management Contact	Senior Director, Quality & HEDIS/Stars		Friedman	Stacey		7864253711					s.frie20@doctorshcp.com	2020 Ponce de Leon Blvd	Suite PH-1	Coral Gables	FL	33134	12/04/2024	2026	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	Online Enrollment Center Contact (Primary)	Director of Enrollment		Hernandez	Gloria		7865780959				7865780964	ghernandez@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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 C Application Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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 C Reporting Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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 Appeals	Grievance & Appeals		Xart	Jennifer						7865780293	jxart@doctorshcp.com	2020 Ponce De Leon Blvd.	PH 1	Coral Gables	FL	33134	01/04/2021	2026	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active	7865848594				HMO - Health Maintenance Organization		C	Atlanta
H4140	Part D Appeals Contact (Secondary)	Grievance & Appeals		Curbelo	Jenny						7865780293	jcurbelo@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/19/2021	2026	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active	7865780956				HMO - Health Maintenance Organization		C	Atlanta
H4140	Part D Application Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	07/22/2022	2026	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 Benefits Contact	Director, Pharmacy		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	03/26/2024	2026	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 Claims Submission Contact	Sub Medicare Operations		Rivera-Aquino	Denisse		8582915269					pde@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/02/2024	2026	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		Silveira	Silvia							ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	03/26/2024	2026	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active	7868663471				HMO - Health Maintenance Organization		C	Atlanta
H4140	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Torres	Gerardo							g.torr28@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	07/22/2022	2026	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active	7868663472				HMO - Health Maintenance Organization		C	Atlanta
H4140	Part D Price File Contact (Back-up)	Director, Pharmacy		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon	PH1	Coral Gables	FL	33134	03/26/2024	2026	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 Price File Contact (Primary)	Medicare Part D Program Manager		Keller	Shanon		8587907104					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/30/2021	2026	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 Quality Assurance Contact	Director, Pharmacy		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	07/18/2024	2026	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 Reporting Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349				7864724448	mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/25/2021	2026	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	Patient Safety Contact	Director, Pharmacy		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	07/18/2024	2026	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	Payment Contact	Chief Financial Officer	Ms	Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2026	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 Director	Director, Pharmacy		Silveira	Silvia		7868663471					ssilveira@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	03/26/2024	2026	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 Network Management Contact	Director, Pharmacy Network Administration		Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/07/2022	2026	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	2026	DOCTORS HEALTHCARE PLANS, INC.	Local CCP	Doctors HealthCare Plans, Inc.	HMO/HMOPOS		DOCTORS HEALTHCARE PLANS, INC.	691	Yes	Active	8009104730				HMO - Health Maintenance Organization		C	Atlanta
H4140	Plan Directory Contact for Public Website	VP Network Development		Atienza	Diego		7862982040					d.atie16@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	12/02/2025	2026	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	Plan to Plan Reconciliation Contact	CFO		Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	10/07/2021	2026	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	Processor Contact	MedImpact Senior Vice President		Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/01/2025	2026	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	Quality Contact			Griffin	Susan		7865780947					sgriffin@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	07/18/2024	2026	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	Reconciliation Contact	CFO		Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH1	Coral Gables	FL	33134	10/14/2021	2026	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	Recovery Audit Contact	CFO	Ms.	Garrote Torra	Ivonne		7865780954				7865780282	i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2026	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	SNP Application Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon	PH 1	Coral Gables	FL	33134	07/18/2024	2026	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	SNP State Contact	Vice President, Compliance Officer		Campuzano	Mayra		7865848349				7864724448	mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	Surveillance Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	System Contact	Director of IT		Miranda	Lazaro		7865780952				7865780298	lmiranda@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	02/22/2021	2026	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	Third Party Administrator (TPA) Liaison	CFO		Garrote Torra	Ivonne		7865780954					i.gtor03@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/07/2021	2026	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	User Access Contact	VP, Compliance Officer		Campuzano	Mayra		7865848349					mcampuzano@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	08/15/2019	2026	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	Utilization Management Contact	Chief Medical Officer	Dr.	Cabrera	Edward		7864536010					e.cabr02@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/27/2025	2026	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	Utilization Review Contact	Chief Medical Officer	Dr.	Cabrera	Edward		7864536010					e.cabr02@doctorshcp.com	2020 Ponce De Leon Blvd	PH 1	Coral Gables	FL	33134	10/27/2025	2026	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	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	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	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	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	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	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	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	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	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4141	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H4141	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4141	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H4141	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H4141	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H4141	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	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	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	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	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	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.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Backup User Access Contact	Executive Program Director	Mrs.	Duncan	Keeli		9184535554				9182070141	Keeli-duncan@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	04/07/2025	2026	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.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	Bid Primary Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	CAP Report Contact for Public Website	QI/Compliance Manager	Ms.	Walls	Kendra		9184535554				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	CEO - CMS Administrator Contact	Executive Program Director	Mrs	Duncan	Keeli		9184535554				9182070141	keeli-duncan@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	04/07/2025	2026	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	CEO - Senior Official for Contracting	Executive Program Director	Mrs.	Duncan	Keeli		9184535554				9182070141	keeli-duncan@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	04/07/2025	2026	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.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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 Operating Officer	Center Manager	Ms.	Roach	Lisa		9184535554	5832			9182070141	lisa-roach@cherokee.org	1387 W. 4th		Tahlequah	OK	74464	11/03/2025	2026	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 Information Officer	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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 Information Security Officer	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	Complaints Tracking Contact	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/21/2025	2026	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	Contact for Fraud Investigations	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Corporate Mailing						9184535554				9184314112	eldercare@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	03/03/2008	2026	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.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	DIR Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	DIR Contact (Secondary)	Payment Coordinator	Ms.	Yochum	Diana		9184586946				9182070141	diana-yochum@cherokee.org	1387 W. 4th Street		Tahlequah	OK	74464	03/13/2019	2026	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	Discount Program Payment Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Emergency Part D Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Emergency Part D Contact (Secondary)	Payment Coordinator		Yochum	Diana		9184535554	5614			9184314112	diana-yochum@cherokee.org	1387 W. 4th		Tahlequah	OK	74464	02/26/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Payment Coordinator		Yochum	Diana		9184586946				9182070141	diana-yochum@cherokee.org	1387 W. 4th Street		Tahlequah	OK	74464	10/28/2019	2026	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	Enrollment Contact	Payment Coordinator	Ms.	Yochum	Diana		9184586946				9182070141	diana-yochum@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	03/13/2019	2026	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	EOB Transfer Contact	Payment Coordinator	Ms.	Yochum	Diana		9184586946				9182070141	diana-yochum@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	03/13/2019	2026	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	Financial Audit Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Financial Reporting Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Formulary Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	General Contact	Executive Program Director	Mrs	Duncan	Keeli		9184535554				9182070141	keeli-duncan@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	04/07/2025	2026	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	Executive Program Director	Mrs	Duncan	Keeli		9184535554	7057			9182070141	keeli-duncan@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	04/07/2025	2026	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	HIPAA Privacy Officer	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	HIPAA Security Officer	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/22/2025	2026	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	Interoperability Contact	Executive Program Director	Mrs	Duncan	Keeli		9184585554				9182070141	keeli-duncan@cherokee.org	1387 W. 4th Street		Tahlequah	OK	74464	04/07/2025	2026	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	MA Appeals/Grievances Contact	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Marketing Contact	Marketing/Intake Manager	Mrs	Meredith	Janet		9184535554				9182070141	janet-meredith@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	Medical Director	Medical Director	Dr.	Loftin	Teresa		9184535554	5614			9182070141	teresa-loftin@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	11/03/2025	2026	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.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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 Coordinator	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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 Part D Opioid Overutilization Contact	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	Medication Therapy Management Contact	Medical Director	Dr.	Loftin	Teresa		9184535554	5614			9182070141	teresa-loftin@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	11/03/2025	2026	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 C Application Contact	Executive Program Director	Mrs	Duncan	Keeli		9184535554				9182070141	keeli-duncan@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	04/07/2025	2026	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 Appeals	Chief Financial Officer	Ms.	Echols	Ashley						9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active	9184535554	7057			PACE - Nat		C	Dallas
H4142	Part D Appeals Contact (Secondary)	QI/Compliance Manager		Walls	Kendra	A					9182070141	kendra-walls@cherokee.org	1387 W. 4th Street		Tahlequah	OK	74464	08/18/2025	2026	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active	9188220312				PACE - Nat		C	Dallas
H4142	Part D Application Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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 Benefits Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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 Claims Submission Contact	Payment Coordinator	Ms.	Yochum	Diana		9184586946				9182070141	diana-yochum@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	03/13/2019	2026	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.	Loftin	Teresa						9182070141	teresa-loftin@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	11/03/2025	2026	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active	8002560671	5554			PACE - Nat		C	Dallas
H4142	Part D Price File Contact (Back-up)	Payment Coordinator	Ms.	Yochum	Diana		9184586946				9182070141	diana-yochum@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	03/13/2019	2026	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 Price File Contact (Primary)	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	11/03/2025	2026	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 Quality Assurance Contact	QI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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 Reporting Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Patient Safety Contact	Center Manager	Ms.	Roach	Lisa		9184535554	5832			9182070141	lisa-roach@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	11/03/2025	2026	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	Payment Contact	Payment Coordinator	Ms.	Yochum	Diana		9184586946				9182070141	diana-yochum@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	03/13/2019	2026	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 Director	Chief Operating Officer		Kaiser	Chris		8662378217					MGreenhalgh@CareKinesis.com	Boomerxsolutions	5415 S. 125th East Avenue Suite 205	Tulsa	OK	74146	01/27/2025	2026	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 Network Management Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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 Network Management Contact (Secondary)	QI/Compliance Manager		Walls	Kendra		9184535554				9184314112	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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		Kaiser	Chris								Boomerxsolutions	5415 S. 125th E. Avenue Suite 205	Tulsa	OK	74146	01/27/2025	2026	CHEROKEE NATION COMPREHENSIVE CARE AGENCY	National PACE	Cherokee Elder Care	National PACE		Cherokee Nation Comprehensive Care Agency	358	Yes	Active	8662378217				PACE - Nat		C	Dallas
H4142	Plan Directory Contact for Public Website	Ex Director	Mrs	Duncan	Keeli		9184535554				9182070141	keeli-duncan@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	04/07/2025	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Processor Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Quality Contact	QAPI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	Reconciliation Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Recovery Audit Contact	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	Surveillance Contact	QAPI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	System Contact	Executive Program Director	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	01/22/2025	2026	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	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Ms.	Echols	Ashley		9184535554	7057			9182070141	ashley-echols@cherokee.org	1387 W 4th Street		Tahlequah	OK	74464	02/26/2024	2026	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	User Access Contact	QAPI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	Utilization Management Contact	Executive Program Director	Mrs	Duncan	Keeli		9184535554	7057			9182070141	keeli-duncan@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	04/07/2025	2026	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	Utilization Review Contact	QAPI/Compliance Manager	Ms.	Walls	Kendra		9188220312				9182070141	kendra-walls@cherokee.org	1387 W 4th St.		Tahlequah	OK	74464	08/18/2025	2026	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	Agent/Broker Compensation Data Contact	Director, Sales		Geyer	Rebecca		4014591343					rebecca.geyer@bcbsri.org	500 Exchange Street		Providence	RI	02903	11/25/2025	2026	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	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management		Bhesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/12/2025	2026	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	Backup User Access Contact	Medicare Compliance Officer	Ms.	Pennypacker	Regan		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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		Wisniewski	Ivona		4014591721				4014595089	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Bid Audit Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Bid Audit Site Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Bid Primary Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Pennypacker	Regan		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	8006373718	2100			HMO - Health Maintenance Organization		C	Boston
H4152	CEO - CMS Administrator Contact	CEO	Ms	Wofford	Martha		4014591200					martha.wofford@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/06/2025	2026	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	CEO - Senior Official for Contracting	CEO	Ms	Wofford	Martha		4014591200					martha.wofford@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/06/2025	2026	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	Interim CFO, VP Strategic Financial Management	Ms.	Soucy	Stacia		4014595304					stacia.soucy@bcbsri.org	500 Exchange Street		Providence	RI	02903	12/03/2025	2026	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 Operating Officer	SVP, Chief Operating Officer	Ms.	DeMoura	Tara		4014592308					tara.demoura@bcbsri.org	500 Exchange Street		Providance	RI	02903	08/08/2024	2026	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 Information Officer	Chief Information Officer	Mr.	Comella	David		4014591687					david.comella@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Information Security Officer	Managing Director, Information Security	Mr	Webster	Frederick		4014595728					fred.webster@bcbsri.org	500 Exchange Street		Providence	RI	02903	11/26/2024	2026	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	CMMI Model Point of Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Team Leader		Johnson	Shannon		4014592252				4014595668	shannon.johnson@bcbsri.org	500 Exchange St.		Providence	RI	02903	05/27/2025	2026	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	Complaints Tracking Contact	Team Leader		Johnson	Shannon		4014592252				4014595668	shannon.johnson@bcbsri.org	500 Exchange St.		Providence	RI	02903	05/27/2025	2026	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	Contact for Fraud Investigations	Director, Special Investigations Unit		Casilli	Brian		4014591727				4014591648	brian.casilli@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Mgr Project & Program Management		Bhesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/12/2025	2026	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	Corporate Mailing						4014592100					regan.pennypacker@bcbsri.org	500 Exchange Street		Providence	RI	02903	01/31/2025	2026	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		4014591721				4014595089	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	DIR Contact	Sr. Health Data Analyst		Simas	Heather		4014595286				4014591754	heather.simas@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	DIR Contact (Secondary)	Director, Actuarial Services		Eynatian	Chris		4014591741					chris.eynatian@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Discount Program Payment Contact	Team Leader Treasury Ops		Gulino	Samuel		4014595968					samuel.gulino@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Emergency Part D Contact	Director Pharmacy Operations		Sifakis	Gina		4017418686					gina.sifakis@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Emergency Part D Contact (Secondary)	Lead Medicare Part D Auditor		Higgins	Aimee		4016168583				4014591754	aimee.higgins@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Government Programs Revenue Officer		Rangarajan	Kiran		4014595247					kiran.rangarajan@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Enrollment Contact	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721					Ivona.Wisniewski@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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	EOB Transfer Contact	Mgr Project & Program Management		Bhesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	Financial Audit Contact	VP & Chief Actuary	Mr.	Mackintosh	Brian		4014591700					brian.mackintosh@bcbsri.org	500 Exchange Street		Providence	RI	02903	09/24/2025	2026	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	Financial Reporting Contact	Manager, Financial Operations		Bettencourt	Mike		4014595932				4014591875	mike.bettencourt@BCBSRI.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Formulary Contact	Director, Pharmacy Performance		Dunn	David		4014591409				4014591754	david.dunn@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/07/2025	2026	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	General Contact	Medicare Compliance Officer	Ms.	Pennypacker	Regan		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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		4014591103					christina.pitney@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	HIPAA Privacy Officer	SVP and General Counsel		McLean	Kristen		4014591383					kristen.mclean@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	HIPAA Security Officer	Managing Director of Information Security		Webster	Fred		4014595728					fred.webster@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Lead, Outsourced Medicare Operations		Storti	Jane		4018378818					jane.storti@bcbsri.org	500 Exchange St.		Providence	RI	02903	08/08/2024	2026	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	Interoperability Contact	Director, Enterprise Analytics		Pant	Lokesh		6123003095					lokesh.pant@bcbsri.org	500 Exchange St.		Providence	RI	02903	08/08/2024	2026	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	MA Appeals/Grievances Contact	Team Leader		Johnson	Shannon		4014592252				4014595668	shannon.johnson@bcbsri.org	500 Exchange St.		Providence	RI	02903	05/27/2025	2026	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	MA Claims Processing Contact for Public Website	Manager Claims Operations		DeLuca	Melissa		4012153989					Melissa.DeLuca@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/20/2025	2026	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	Marketing Contact	Managing Director, Marketing & Communications		Battista	Stephanie		4014592595					stephanie.battista@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/13/2025	2026	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	Medical Director	Senior Medical Director	Dr.	Pinkes	Victor		4014592054					victor.pinkes@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/13/2024	2026	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		4017430003				4014591598	mco@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Coordinator	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Part D Opioid Overutilization Contact	Supervisor Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	11/26/2024	2026	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	Medication Therapy Management Contact	Director Pharmacy Performance		Dunn	David		4014591409				4014591754	David.Dunn@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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	OffShore Subcontractor Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690				4014591598	elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Online Enrollment Center Contact (Back-up)	Lead, Outsourced Medicare Operations		Storti	Jane		4014595588				4014595649	jane.storti@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Online Enrollment Center Contact (Primary)	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721				4014595649	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 C Application Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 C Reporting Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690					elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/12/2025	2026	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 Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8006936651				HMO - Health Maintenance Organization		C	Boston
H4152	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/12/2025	2026	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	8006936651				HMO - Health Maintenance Organization		C	Boston
H4152	Part D Application Contact	Managing Director, Medicare Product		Marfeo	Jessica		4014592321				4014591754	Jessica.Marfeo@bcbsri.org	500 Exchange Street		Providence	RI	02903	02/10/2025	2026	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 Benefits Contact	Senior Director Benefits Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	Prime Therapeutics	1440 Northland Drive	Mendota Heights	MN	55120	03/12/2025	2026	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 Claims Submission Contact	Functional Business Consultant- Government Program		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	08/08/2024	2026	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 Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8006936651				HMO - Health Maintenance Organization		C	Boston
H4152	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8006936651				HMO - Health Maintenance Organization		C	Boston
H4152	Part D Price File Contact (Back-up)	Price File Analyst Sr.		Trudeau	Ashley		6127771338					ashley.trudeau@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	08/08/2024	2026	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 Price File Contact (Optional)	Network Pricing Data Analyst		Tastad	Emily		6518085779					emily.tastad@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Rd	Eagan	MN	55121	08/08/2024	2026	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 Price File Contact (Primary)	Director Pharmacy Performance		Dunn	David		4014591409					david.dunn@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Quality Assurance Contact	Lead Medicare Part D Auditor		Higgins	Aimee		4014595555					aimee.higgins@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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 Reporting Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690					elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Patient Safety Contact	Director Pharmacy Performance		Dunn	David		4014591409				4014591754	david.dunn@bcbsri.org	500 Exchange St		Providence	RI	02903	08/08/2024	2026	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	Payment Contact	Sr. Financial Analyst		Souza	Cheryl		4014592749					cheryl.souza@bcbsri.org	500 Exchange Street		Providence	RI	02903	03/10/2025	2026	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 Director	Director Pharmacy Operations		Sifakis	Gina		4014595704					gina.sifakis@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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 Network Management Contact	VP, Network Management		Conlin	Marci		6127772842				8778236373	Marci.Conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	08/08/2024	2026	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 Network Management Contact (Secondary)	Senior Director Network Client Services		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	08/08/2024	2026	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	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8554571207				HMO - Health Maintenance Organization		C	Boston
H4152	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	03/12/2025	2026	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	8554571207				HMO - Health Maintenance Organization		C	Boston
H4152	Plan Directory Contact for Public Website	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721					Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Health Data Analyst		Simas	Heather		4014595286				4014591198	heather.simas@bcbsri.org	PO Box 1057		Providence	RI	02901	08/08/2024	2026	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	Processor Contact	Director PBM Operations		Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	08/08/2024	2026	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	Quality Contact	Director, Quality and Stars		Mitchell	Catherine		4014592644					Catherine.Mitchell@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Reconciliation Contact	Sr. Health Data Analyst		Simas	Heather		4014595286				4014591754	heather.simas@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Reconciliation Contact (Secondary)	Director, Actuarial Services		Eynatian	Chris		4014591741					chris.eynatian@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Recovery Audit Contact	SVP Government Programs	Ms.	Pitney	Christina		4014591103				4014591598	christina.pitney@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	SNP Application Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	SNP State Contact	Managing Director Duals		Moran	Leanna		4014591331					leanna.moran@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Surveillance Contact	VP, Medicare		Menard	Michael		4014591979					michael.menard@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	System Contact	Mng Dir Operations - Medicare Segment		Wisniewski	Ivona		4014591721				4014595649	Ivona.Wisniewski@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Third Party Administrator (TPA) Liaison	Sr. Health Data Analyst		Simas	Heather		4014595286					heather.simas@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	User Access Contact	Lead Compliance Analyst		Giacomini	Elizabeth		4017490690				4014591598	elizabeth.giacomini@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Utilization Management Contact	Managing Director Utilization Management		Labbe	Karen		4014591796				4014595072	Karen.Labbe@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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	Utilization Review Contact	Managing Director Utilization Management		Labbe	Karen		4014591796				4014595072	Karen.Labbe@bcbsri.org	500 Exchange Street		Providence	RI	02903	08/08/2024	2026	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
H4158	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	09/29/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504433				HMO - Health Maintenance Organization		C	Dallas
H4158	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504433				HMO - Health Maintenance Organization		C	Dallas
H4158	PHR Beneficiary Contact																	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Dallas
H4158	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4158	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	BUCKEYE COMMUNITY HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4161	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4161	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4161	PHR Beneficiary Contact																	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H4161	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	01/10/2022	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4161	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross Partnership Plan	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Best Available Evidence Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	CAP Report Contact for Public Website	Compliance Officer		Locke	Kitty		6158902020	1664				compliance@nhcadvantageplan.com	100 East Vine Street		Murfreesboro	TN	37130	09/28/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	CEO - CMS Administrator Contact		Mr.	Ussery	Michael		6158902020					mussery@nhccare.com	100 E. Vine St.		Murfreesboro	TN	37130	02/04/2019	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	CEO - Senior Official for Contracting	CEO	Mr.	Ussery	Michael		6158902020					mussery@nhccare.com	100 E. Vine St.		Murfreesboro	TN	37130	04/02/2018	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Chief Financial Officer	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/18/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Chief Operating Officer	Chief Operating Officer	Mr.	Ussery	Mike		6158902020					mussery@nhccare.com	100 East Vine Street		Murfreesboro	TN	37130	06/06/2024	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Chief Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Contact for Fraud Investigations	Compliance Officer		Locke	Kitty		6158902020	1664				compliance@nhcadvantageplan.com	100 East Vine Street		Murfreesboro	TN	37130	09/28/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Coordination of Benefits Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Corporate Mailing						8448546886				8336102390	customerservice@nhcadvantageplan.com	P.O. Box 5849		Glen Allen	VA	230585849	12/15/2021	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Discount Program Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/18/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	EOB Transfer Contact			Lowry	Kristy		8448546886				8336102390	customerservice@nhcadvantageplan.com	P.O. Box 5849		Glen Allen	VA	23058	12/15/2021	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Financial Audit Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/18/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Financial Reporting Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/18/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	12/31/2019	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	General Contact			Hopkins	Robyn		9136535921					robyn.hopkins@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	HIPAA Privacy Officer	Chief Compliance Officer and HIPAA Privacy Officer	Ms.	Crowe	Melanie		4049330409					melanie.crowe@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	HIPAA Security Officer	Chief Information Security Officer	Mr	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Marketing Contact	Marketing Director		Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Medical Director	VP Medical Affairs		Dahlgren	Andrew		8042968288					Andrew.Dahlgren@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Medicare Compliance Officer	Compliance Officer	Ms.	Locke	Kitty		6158902020	1664				compliance@nhcadvantageplan.com	100 East Vine Street		Murfreesboro	TN	37130	09/28/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Medicare Coordinator	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Appeals	Supervisor, Grievance and Appeals		LaCrosse	Justin						8442689791	Justin.LaCrosse@navitus.com	Navitus Health Solutions,	P.O. Box 1039	Appleton	WI	54912	01/06/2021	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	9202214149				HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	04/09/2024	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	12/15/2021	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	04/09/2024	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/19/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Pharmacy Network Management Contact			Robinson	Jan		6087291688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H4172	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H4172	Physician Incentive Contact			Hopkins	Robyn		9136535921					robyn.hopkins@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Plan Directory Contact for Public Website			Locke	Kitty		6158902020	1664				compliance@nhcadvantageplan.com	100 East Vine Street		Murfreesboro	TN	37130	09/28/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/19/2024	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/06/2017	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Reconciliation Contact (Secondary)	CFO	Ms.	Martin	Rachel		7755448314					rachel.martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/19/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Recovery Audit Contact	Compliance Officer	Mrs.	Locke	Kitty		6158902020	1664				compliance@nhcadvantageplan.com	100 East Vine Street		Murfreesboro	TN	37130	09/28/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Surveillance Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	User Access Contact	Compliance Officer		Locke	Kitty		6158902020	1664				compliance@nhcadvantageplan.com	10900 Nuckols Rd.		Glen Allen	TN	37130	09/28/2023	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4172	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	NHC ADVANTAGE, LLC	Local CCP	NHC Advantage	HMO/HMOPOS		Missouri Healthcare Advisors, LLC	638	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4185	Automated TrOOP Balance Transfer Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Backup User Access Contact	Director of IT		Lomeli	Marina		4422867820					marinal@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	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		4422868409					jims@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Bid Primary Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	CAP Report Contact for Public Website	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	8446427223				PACE - Nat		C	San Francisco
H4185	CEO - CMS Administrator Contact	Chief Executive Officer	Dr.	Patel	Rakesh		7605208375					rakeshp@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	CEO - Senior Official for Contracting	Chief Executive Officer	Dr.	Patel	Rakesh		7605208375					rakeshp@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	05/07/2025	2026	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		4422868196					lisad@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Chief Operating Officer	Chief Operating Officer	Mr.	Nunez	Alejandro		4422868202					Alejandro.Nunez@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Chief Information Officer	Director of IT	Ms	Lomeli	Marina		4422867820					marinal@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Chief Information Security Officer	Director of IT	Ms	Lomeli	Marina		4422867820					marinal@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	CMS Casework Communication Contact	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Complaints Tracking Contact	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	03/19/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Contact for Fraud Investigations	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	03/19/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Coordination of Benefits Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Corporate Mailing						7605208200					astrid.forbito@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Customer Service Operations Contact	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	DIR Contact	Chief Financial Officer		Daigle	Lisa		4422868196					lisad@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	DIR Contact (Secondary)	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Discount Program Payment Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Emergency Part D Contact	Clinical Pharmacist		Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Emergency Part D Contact (Secondary)	Clinical Pharmacist		Hughes	Michelle		4422868542					Michelle.Hughes@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Encounter Data & Risk Adjustment Operations Contact	PACE Finance Director	Ms	Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Enrollment Contact	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	EOB Transfer Contact	PACE Finance Director		Grant	Christa		4422572082				7607412782	christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Financial Audit Contact	PACE Finance Director	Ms	Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Financial Reporting Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Formulary Contact	Director of Pharmacy Operations	Ms	Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Formulary Contact (Secondary)	Clinical Pharmacist		Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	General Contact	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	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		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	HIPAA Privacy Officer	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	03/19/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	HIPAA Security Officer	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	05/07/2025	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Interoperability Contact	Chief Operating Officer	Mr.	Nunez	Alejandro		4422868202					Alejandro.Nunez@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	MA Appeals/Grievances Contact	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	MA Claims Processing Contact for Public Website	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Marketing Contact	VP of Growth		Ramirez	Johann		4422868532					johann.ramirez@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	05/07/2025	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Medical Director	Chief Medical Officer	Dr.	Schultz	James		8338674642					jims@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	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	Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Medicare Coordinator	PACE Finance Director	Ms	Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Medication Therapy Management Contact	Clinical Pharmacist		Hughes	Michelle		4422868542					Michelle.Hughes@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Online Enrollment Center Contact (Back-up)	Outreach & Enrollment Supervisor		Tejeda	Susana		8446427223					susana.tejeda@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Online Enrollment Center Contact (Primary)	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	02/23/2023	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part C Application Contact	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Appeals	Clinical Pharmacist		Maynard	Brittany							brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	4422868535				PACE - Nat		C	San Francisco
H4185	Part D Appeals Contact (Secondary)	Clinical Pharmacist		Hughes	Michelle							Michelle.Hughes@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	8338674642				PACE - Nat		C	San Francisco
H4185	Part D Application Contact	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Benefits Contact	Clinical Pharmacist		Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Claims Submission Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Exceptions Contact	Clinical Pharmacist		Maynard	Brittany							brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	4422868535				PACE - Nat		C	San Francisco
H4185	Part D Price File Contact (Back-up)	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Price File Contact (Primary)	Clinical Pharmacist		Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Quality Assurance Contact	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Part D Reporting Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Patient Safety Contact	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Payment Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Personal Health Record Contact	PACE Compliance Officer		Thacker	Cherry		8446427223					cherry.thacker@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Pharmacy Director	Director of Pharmacy Services	Ms	Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Pharmacy Network Management Contact	Clinical Pharmacist		Maynard	Brittany		4422868535					brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	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	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	4422868542				PACE - Nat		C	San Francisco
H4185	Pharmacy Technical Help Desk Contact (Secondary)	Clinical Pharmacist		Maynard	Brittany							brittany.maynard@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active	4422868535				PACE - Nat		C	San Francisco
H4185	Plan Directory Contact for Public Website	PACE Program Director		Forbito	Astrid		9515303341					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Plan to Plan Reconciliation Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Processor Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Quality Contact	Director Quality and Population Health		Hughes	Michelle		4422868542					michelle.hughes@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Reconciliation Contact	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Recovery Audit Contact	PACE Finance Director	Ms	Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Surveillance Contact	Director of Facilities		DeLeon	Mike		4422572959					mike.deleon@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	System Contact	Director of IT		Lomeli	Marina		4422867820					marinal@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Third Party Administrator (TPA) Liaison	PACE Finance Director		Grant	Christa		4422572082					christa.grant@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	User Access Contact	Director of IT		Lomeli	Marina		4422867820					marinal@nhcare.org	215 S. Hickory St.		Escondido	CA	92025	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Utilization Management Contact	PACE Program Director		Forbito	Astrid		8446427223					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4185	Utilization Review Contact	PACE Program Director		Forbito	Astrid		8446427223					astrid.forbito@nhcare.org	4371 Latham Street		Riverside	CA	92501	09/25/2024	2026	NEIGHBORHOOD HEALTHCARE	National PACE	Neighborhood Healthcare PACE	National PACE		Neighborhood HealthCare	777	Yes	Active					PACE - Nat		C	San Francisco
H4193	Agent/Broker Compensation Data Contact	Regulatory Submission Specialist	Mr.	Merrick	Nick		3306910252					MACompliance@CareSource.com	230 North Main St		Dayton	OH	45402	06/17/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Backup User Access Contact	Regulatory Submission Specialist	Mr.	Merrick	Nick		3306910252					MACompliance@CareSource.com	230 North Main St		Dayton	OH	45402	06/17/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Best Available Evidence Contact	Team Lead, Enrollment Operations	Ms.	Davidson	Amber		9376090157	3437				amber.davidson@caresource.com	230 N. Main St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Bid Audit Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wesley.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Bid Audit Site Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wesley.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Bid Primary Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wesley.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	CAP Report Contact for Public Website	Sr. Manager, Compliance	Ms.	Nettles	Kylie		9375313338					margaux.frazee@caresource.com	230 N Main St		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	CEO - CMS Administrator Contact	President and CEO	Ms.	Anderson	Margaret		2484431025					manders9@hap.org	1414 E Maple		Troy	MI	48202	06/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	CEO - Senior Official for Contracting	SVP Chief Financial Offier	Ms.	Hausenfluck	Merrill		2487763530					mhausen1@hap.org	1414 E Maple		Troy	MI	48202	06/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Chief Financial Officer	SVP, Chief Financial Officer	Mr.	Hausenfluck	Merrill		2487763530					mhausen1@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Chief Operating Officer	(Interim) Chief Operating Officer	Mr.	Davidi	Isaac		9372715922					isaac.davidi@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Chief Information Officer	Chief Information Officer	Ms.	Valencia	Devon		9375312552					devon.valencia@caresource.com	PO Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Chief Information Security Officer	Vice President, Information Security and Privacy	Ms.	Heckler	Lisa		9375313895	3895				Lisa.Heckler@caresource.com	230 N. Main St.		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	CMMI Model Point of Contact	Product Management Specialist	Mr.	Blankenship	Aaron		9375313338					aaron.blankenship@caresource.com	230 North Main Street		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	CMS Casework Communication Contact	Manager, Grievance & Appeal	Ms.	Diaz	Marissa		9372243300	2604			9374250833	Marissa.Diaz@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Complaints Tracking Contact	Manager, Grievance & Appeal	Ms.	Diaz	Marissa		9372243300	2604			9374250833	Marissa.Diaz@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Contact for Fraud Investigations	Program Integrity Analyst	Ms.	Johnson	Alexis	N	9372243300	2870			9373963876	SIUprogramintegrity@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Coordination of Benefits Contact	Senior Manager, Enrollment Operations	Mr.	Spivey	Michael		9375313682					COBInquiry@caresource.com	230 N. Main St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Corporate Mailing						9372243300	3338			9374870610	Margaux.Frazee@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Customer Service Operations Contact	Director, Customer Care	Mr.	McDade	Sean		9375313565					sean.mcdade@caresource.com	P.O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	DIR Contact	VP, Actuarial Science		Farmer	Nikki		9372863350					nikki.farmer@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	DIR Contact (Secondary)	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wesley.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Discount Program Payment Contact	Director, Health Plan Accounting	Ms.	Dobrovolschi	Natalia		3138069071					natalia.dobrovolschi@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Emergency Part D Contact	Director, Pharmacy Operations	Ms.	Peery	Lorraine		3137061016					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Emergency Part D Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Employer Waiver Contact	Director, Integrated Care	Ms.	Meyer	Cheryl		9378182992					cheryl.meyer@caresource.com	140 North Jefferson St.		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Encounter Data & Risk Adjustment Operations Contact	Senior Manager, Claims Encounters	Mr.	Shakruwala	Mustafa		8133609207					Mustafa.Shakruwala@CareSource.com	220 E. Monument Ave.		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Enrollment Contact	Manager, Enrollment Operations	Mr.	Weber	Brett		9374748938					brett.weber@caresource.com	230 N Main St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	EOB Transfer Contact	Director, Pharmacy Operations	Ms.	Peery	Lorraine		3137061016				9374870359	rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Financial Audit Contact	Director, External Regulatory Audit Management	Ms.	Hoben	Erin		9375313338					erin.hoben@caresource.com	230 N. Main Street		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Financial Reporting Contact	Chief Financial Officer	Mr.	Smart	Lawrence		9372243300	3310				lawrence.smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Formulary Contact	Pharmacist, Formulary Strategy Management	Mr.	Bogner	Craig		9374874026					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Formulary Contact (Secondary)	Coordinator, Pharmacy Benefits		Yaldo	Traci		3136648607					tyaldo@hap.org	2850 West Grand Blvd		Detroit	MI	48202	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	General Contact	Regulatory Manager	Ms.	Tuttle	Amanda		6143099234					Compliance.MI@CareSource.com	230 North Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Government Relations Contact	Sr. Manager, Compliance	Ms.	Nettles	Kylie		9375313338					margaux.frazee@caresource.com	230 North Main Street		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	HIPAA Privacy Officer	Dir, Privacy	Ms.	Fogler	Anne		9375312728					Anne.Fogler@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	HIPAA Security Officer	VP, Information Security and Privacy Officer	Ms.	Heckler	Lisa		9375313895					lisa.heckler@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Hospice Contact	Team Lead, Enrollment Operations	Ms.	Davidson	Amber		9376090157	3437				amber.davidson@caresource.com	230 N. Main St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Interoperability Contact	AVP, Enterprise Architecture		Hanley	Michael		8033721957					michael.hanley@caresource.com	230 N Main St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	MA Appeals/Grievances Contact	Manager, Grievance & Appeal	Ms.	Diaz	Marissa		9372243300	2604			9374250833	Marissa.Diaz@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	MA Claims Processing Contact for Public Website	VP of Claims & Configuration	Ms.	Hans	Holly		9375312750				9374871596	holly.hans@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Marketing Contact	Director, Community Marketing	Mr.	Tischer	Chip		2487095939					charles.tischer@caresource.com	3031 W Grand Blvd.		Detroit	MI	48202	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Medical Director	Medical Director	Dr.	Billis	Lori		3133486662					lori.billis@caresource.com	3031 W Grand Blvd.		Detroit	MI	48202	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Medicare Compliance Officer	Director	Mr.	Randle	Johnathan		5123507810					jrandle4@hap.org	1414 E Maple		Troy	MI	48303	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Medicare Coordinator	Sr. Manager, Compliance	Ms.	Nettles	Kylie		9375313338					OHCompliance@CareSource.com	230 North Main Street		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Operations	Ms.	Rattan	Sangeet		9375911634				9373963605	rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Medication Therapy Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	OffShore Subcontractor Contact	Sr. Manager, Compliance	Ms.	Nettles	Kylie		9375313338					OHCompliance@CareSource.com	230 North Main Street		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Operations	Mr.	Weber	Brett		9374748938					brett.weber@caresource.com	230 N Main St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Online Enrollment Center Contact (Optional)	Director, Enrollment		Castro	Armando		9375312291					Armando.Castro@caresource.com	230 North Main Street		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Online Enrollment Center Contact (Primary)	Team Lead, Enrollment Operations	Ms.	Davidson	Amber		9376090157	3437				amber.davidson@caresource.com	230 N. Main St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part C Application Contact	Director, Government Programs Compliance	Mr.	Randle	Johnathan		5123507810					jrandle4@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	04/17/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part C Reporting Contact	Sr. Manager, Compliance	Ms.	Nettles	Kylie		9375313338					margaux.frazee@caresource.com	230 North Main Street		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian							brian_schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	6143363326				HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Appeals Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol							rxcompliancerequest@caresource.com	140 N. Jefferson St.		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	9378187479				HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Application Contact	Director, Government Programs Compliance	Mr.	Randle	Johnathan		5123507810					jrandle4@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	04/17/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Benefits Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Exceptions Contact	Director, Pharmacy Operations	Mr.	Rattan	Sangeet							rxcompliancerequest@caresource.com	140 North Jefferson St.		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	9375911634				HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Rattan	Sangeet							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	9375911634				HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Price File Contact (Optional)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Quality Assurance Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferon St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Part D Reporting Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Patient Safety Contact	Pharmacist, Formulary Strategy Management	Mr.	Bogner	Craig		9374874026					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Payment Contact	Director, Health Plan Accounting	Ms.	Dobrovolschi	Natalia		3138069071					natalia.dobrovolschi@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Personal Health Record Contact	Vice President, Information Security and Privacy	Ms.	Heckler	Lisa		9375313895	3895				Lisa.Heckler@caresource.com	230 N. Main St.		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Pharmacy Director	Director, Pharmacy Operations	Ms.	Peery	Lorraine		3137061016					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Pharmacy Network Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Pharmacy Network Management Contact (Secondary)	Pharmacy Specialist		Webb	Marcia		3136648860					mwebb2@hap.org	2850 W. Grand Blvd.		Detroit	MI	48202	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	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	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H4193	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active	9378187479				HMO - Health Maintenance Organization		C	Chicago
H4193	PHR Beneficiary Contact																	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS	Health Alliance Plan of Michigan	Henry Ford Health System	122	Yes	Active	8008011770				HMO - Health Maintenance Organization		C	Chicago
H4193	Physician Incentive Contact	Director, Government Programs Compliance	Mr	Randle	Johnathan		5123507810					jrandle4@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Plan Directory Contact for Public Website	Director, Provider Information Management	Ms.	Le	San		9375312060					bobby.pace@caresource.com	P. O. Box 8378		Dayton	OH	45401	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Plan to Plan Reconciliation Contact	Director, Health Plan Accounting	Ms.	Dobrovolschi	Natalia		3138069071					CareSourceP2P@CareSource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Processor Contact	VP, Claims & Configuration	Ms.	Hans	Holly		9372243300	12750				holly.hans@caresource.com	PO Box 8378		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Quality Contact	Director, Quality	Ms.	Meyer	Cheryl	L	9378182993					cheryl.meyer@CareSource.com	140 North Jefferson St.		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Reconciliation Contact	Director, Health Plan Accounting	Ms.	Dobrovolschi	Natalia		3138069071					natalia.dobrovolschi@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Reconciliation Contact (Secondary)	AVP, Accounting	Ms.	Ainslie	Rachel		9472336771					rachel.ainslie@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Recovery Audit Contact	VP of Claims & Configuration	Ms.	Hans	Holly		9375312750					holly.hans@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	SNP Application Contact	Director, Government Programs Compliance	Mr.	Randle	Johnathan		5123507810					jrandle4@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	04/17/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	SNP State Contact	Director, Medicaid		Davis	Nancy		2484438816					ndavis@hap.org	2850 W. Grand Blvd		Detroit	MI	48202	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Surveillance Contact	Regulatory Manager	Ms.	Tuttle	Amanda		6143099234					Compliance.MI@CareSource.com	230 North Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	System Contact	Chief Information Officer	Ms.	Valencia	Devon		9375312552					devon.valencia@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Third Party Administrator (TPA) Liaison	Director, Health Plan Accounting	Ms.	Dobrovolschi	Natalia		3138069071					natalia.dobrovolschi@caresource.com	230 N. Main Street		Dayton	OH	45402	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	User Access Contact	Sr. Manager, Compliance	Ms.	Nettles	Kylie		9375313338					margaux.frazee@caresource.com	230 North Main Street		Dayton	OH	45402	02/12/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Utilization Management Contact	Director, Utilization Management	Ms.	O'Connor	Charity		3055630492					charity.oconnor@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4193	Utilization Review Contact	Director, Clinical Operations		Honig	Deronda		2162180296					Deronda.Honig@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/11/2025	2026	HAP CARESOURCE	Local CCP	HAP CareSource MI Coordinated Health	HMO/HMOPOS		Henry Ford Health System	122	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4203	Automated TrOOP Balance Transfer Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Backup User Access Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Bid Primary Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	CAP Report Contact for Public Website	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	CEO - CMS Administrator Contact	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	CEO - Senior Official for Contracting	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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	Director	Mrs.	Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Chief Operating Officer	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Chief Information Officer	Director	Mrs.	Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Chief Information Security Officer	Director	Mrs.	Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	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		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Complaints Tracking Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Contact for Fraud Investigations	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Corporate Mailing						8645221966				8647977880	nicholas.weaver@prismahealth.org	32 Centennial Way		Greenville	SC	29605	09/30/2025	2026	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	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	DIR Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Discount Program Payment Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Emergency Part D Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Encounter Data & Risk Adjustment Operations Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Enrollment Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	EOB Transfer Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Financial Audit Contact	Director	Mrs.	Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Financial Reporting Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Formulary Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	General Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	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		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	HIPAA Privacy Officer	Corporate Compliance Officer		Pietras	Scott		8647977712					scott.pietras@prismahealth.org	300 East McBee Avenue	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	HIPAA Security Officer	Corporate Compliance Officer		Pietras	Scott		8647977712					scott.pietras@prismahealth.org	300 East McBee Avenue	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Interoperability Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	MA Appeals/Grievances Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	MA Claims Processing Contact for Public Website	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Marketing Contact	Manager - Outreach/Intake RN		Kitchens	Dan		8645221960				8645221955	dan.kitchens@prismahealth.org	32 Centennial Way		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Medical Director	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	07/08/2024	2026	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		8647977712					scott.pietras@prismahealth.org	300 E. McBee Ave	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Medicare Coordinator	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Medicare Part D Opioid Overutilization Contact	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Medication Therapy Management Contact	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part C Application Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part D Appeals	Director		Burnette	Alison						8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active	8034344421				PACE - Nat		C	Atlanta
H4203	Part D Application Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part D Benefits Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part D Claims Submission Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	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	Director, Pharmacy Services		Ranck	Steve							steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active	8644551325				PACE - Nat		C	Atlanta
H4203	Part D Price File Contact (Back-up)	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part D Price File Contact (Primary)	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part D Quality Assurance Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Part D Reporting Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Patient Safety Contact	Medical Director		Theriot Roley	Laurie		8645221950				8645221955	laurie.theriot@prismahealth.org	32 Centennial Drive		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Payment Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Pharmacy Director	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Pharmacy Network Management Contact	Director, Pharmacy Services		Ranck	Steve		8644551325				8644558247	steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	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	Director, Pharmacy Services		Ranck	Steve							steve.ranck@prismahealth.org	701 Grove Road		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active	8644551325				PACE - Nat		C	Atlanta
H4203	Plan Directory Contact for Public Website	Manager - Outreach/Intake RN		Kitchens	Dan		8645221960				8645221955	dan.kitchens@prismahealth.org	32 Centennial Way		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Plan to Plan Reconciliation Contact	Director of Operations		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Processor Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Quality Contact	Director, Quality		Mattison	Amy		8644329189					amy.mattison@prismahealth.org	300 East McBee Avenue	Suite 400	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Reconciliation Contact	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Recovery Audit Contact	Director	Ms.	Burnette	Alison		8034344421					alison.burnette@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Surveillance Contact	Manager - Outreach/Intake RN		Kitchens	Dan		8645221960				8645221955	dan.kitchens@prismahealth.org	32 Centennial Way		Greenville	SC	29605	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	System Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Third Party Administrator (TPA) Liaison	Director		Burnette	Ali		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street		Columbia	SC	29201	01/17/2025	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	User Access Contact	Corporate Compliance Officer		Pietras	Scott		8647977712					scott.pietras@prismahealth.org	300 E. Mcbee Ave.	Suite 302	Greenville	SC	29601	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Utilization Management Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4203	Utilization Review Contact	Director		Burnette	Alison		8034344421				8034343773	alison.burnette2@prismahealth.org	1308 Laurel Street	2nd Floor	Columbia	SC	29201	07/08/2024	2026	PRISMA HEALTH-MIDLANDS	National PACE	Prisma Health SeniorCare PACE-Midlands	National PACE		Prisma Health	739	Yes	Active					PACE - Nat		C	Atlanta
H4213	Agent/Broker Compensation Data Contact	Manager, Individual Sales Agent		Creasman	Matthew		5013993923					mdcreasman@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Automated TrOOP Balance Transfer Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Backup User Access Contact	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Best Available Evidence Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Bid Audit Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Bid Audit Site Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Bid Primary Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	CAP Report Contact for Public Website	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	CEO - CMS Administrator Contact	VP Government Programs & Enterprise Analytics	Mr.	Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	12/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	CEO - Senior Official for Contracting	CEO	Mr.	Barnett	Curtis		5013782007					cebarnett@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Chief Financial Officer	CFO	Mr.	Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Chief Operating Officer	Executive VP, Chief Operating Officer	Mr.	Dillard	Gray		5013782436					gddillard@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Chief Information Officer	VP Infrastructure & Operations	Mr.	Martin	David		5012940910					dbmartin@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/16/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Chief Information Security Officer	Chief Security Officer	Mr.	Shirley	Devin		5016880747					dmshirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	CMS Casework Communication Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Complaints Tracking Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Contact for Fraud Investigations	Director, Performance Mgt. & Investigations		Gunter	Debbie		5013786610					dsgunter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Coordination of Benefits Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Corporate Mailing						5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Customer Service Operations Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	DIR Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines St		Little Rock	AR	72201	12/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	DIR Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Discount Program Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Emergency Part D Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Emergency Part D Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/03/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Encounter Data & Risk Adjustment Operations Contact	Director Risk Adjustment		Dotson	Adonica		5012941964					andotson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/01/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Enrollment Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	EOB Transfer Contact	Account Manager		Ellinger	David		4802408415				4803146066	David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Financial Audit Contact	Medicare Compliance Manager	Mr	Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Financial Reporting Contact	Director, Financial Reporting & Payroll		Russell	Holly		5013993954					hkrussell@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Formulary Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Formulary Contact (Secondary)	Clinical Advisor		Seto	Kim		6193460146					Kim.Seto@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/01/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	General Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		5013782103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	HIPAA Privacy Officer	Chief Privacy Officer		Gardner	Anne		5013932994					aegardner@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	HIPAA Security Officer	Physical Security/Chief Security Officer		Shirley	Devin		5016880747					DMShirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/11/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		5013783743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Interoperability Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	MA Appeals/Grievances Contact	Supervisor, Medicare Member Services		Taylor	Alicia		5013783743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	MA Claims Processing Contact for Public Website	Manager, Medicare Claims Operations		Pilkington Ross	Amanda		5013013452					ampilkington@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Marketing Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Medical Director	Associate Medical Director	Dr.	Becker	Thomas		5013964196					tebecker@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Medicare Compliance Officer	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/05/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Medicare Coordinator	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Medicare Part D Opioid Overutilization Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Medication Therapy Management Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	OffShore Subcontractor Contact	Director, Medicare Operations		Bradford	Wanda		5013782387					wlbradford@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/20/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Online Enrollment Center Contact (Back-up)	Supervisor, Medicare Operations		Kaiser	Ashley		5012941625					aekaiser@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part C Application Contact	Manager Medicare Advantage Product Development		Pepper	Chad		5012941697					wcpepper@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part C Reporting Contact	Director, Medicare Operations		Bradford	Wanda		5013782387					wlbradford@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/20/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part D Appeals	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				PFFS - Private Fee for Service		C	New York
H4213	Part D Appeals Contact (Secondary)	Senior Counsel, Appeals		Phillips	Ashleigh						5013783366	adphillips@arkbluecross.com	PO Box 2181	Attn: Legal Appeals	Little Rock	AR	72203	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	5013782025				PFFS - Private Fee for Service		C	New York
H4213	Part D Application Contact	Manager Medicare Advantage Product Development		Pepper	Chad		5012941697					wcpepper@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part D Benefits Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part D Claims Submission Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part D Exceptions Contact	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				PFFS - Private Fee for Service		C	New York
H4213	Part D Exceptions Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza							mbegovic@arkbluecross.com	601 S Gaines St.		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	5013932813				PFFS - Private Fee for Service		C	New York
H4213	Part D Price File Contact (Back-up)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part D Price File Contact (Primary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part D Quality Assurance Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Part D Reporting Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Patient Safety Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	PFFS Terms and Conditions of Payment Contact for Public Website			Bradford	Geraldan		5013783120					GRBRADFORD@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/24/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Pharmacy Director	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Pharmacy Network Management Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Pharmacy Network Management Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Pharmacy Technical Help Desk Contact			Customer Service	CVS								9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/10/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	8442805833				PFFS - Private Fee for Service		C	New York
H4213	Pharmacy Technical Help Desk Contact (Secondary)	CVS Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				PFFS - Private Fee for Service		C	New York
H4213	Plan Directory Contact for Public Website			Service	Customer		8442014934					MediPakAdvRx@arkbluecross.com	P O Box 3648		Little Rock	AR	72203	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		5012942491				5013783258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Processor Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Quality Contact	Director, Clinical Quality & HEDIS		Mattson	Sarah		5012943643					spmattson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Reconciliation Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines St		Little Rock	AR	72201	12/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Reconciliation Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Recovery Audit Contact	Financial Analyst	Ms.	Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Surveillance Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	System Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Third Party Administrator (TPA) Liaison	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	User Access Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Utilization Management Contact	Director, Health Management		Seleski-Lopez	Verna		5013409235					vlseleskilopez@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4213	Utilization Review Contact	Associate Medical Director	Dr.	Becker	Thomas		5013964196					tebecker@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PFFS	Arkansas Blue Medicare	PFFS		USAble Mutual Insurance Company	421	Yes	Active					PFFS - Private Fee for Service		C	New York
H4217	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Best Available Evidence Contact	VPO	Ms	Runyon	Bobbi		8129905800					brunyon@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	CAP Report Contact for Public Website	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923501	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	2675751196				PACE - Nat		C	New York
H4217	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	CMS Casework Communication Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Customer Service Operations Contact	Compliance Director	Mr	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Formulary Contact	Chief Medical Officer	Mr	Meyers	Glenn		6406501565					gmeyers@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	General Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation	Mr	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Medical Director	Chief Medical Officer	Dr.	Meyers	Glenn		7325923400					gmeyers@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Medicare Coordinator	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Medicare Part D Opioid Overutilization Contact	Director of Compliance		Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Medication Therapy Management Contact	Chief Medical Officer	Mr	Meyers	Glenn		9548395000				7325923500	gmeyers@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	OffShore Subcontractor Contact	CFO	Mrs	Prentis	Kristin		7328063224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Online Enrollment Center Contact (Back-up)	CEO	Mrs	Austin	Mary		2156098714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Online Enrollment Center Contact (Primary)	CEO	Mrs	Austin	Mary		2156098714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part D Appeals	Compliance & HIS Coordinator		Cooper	Wanda						8563710276	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	2675751196				PACE - Nat		C	New York
H4217	Part D Appeals Contact (Secondary)	Chief Health Plan Operations	Mr.	Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7328063224				PACE - Nat		C	New York
H4217	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part D Exceptions Contact	Chief Medical Officer	Mr	Meyers	Glenn							gmeyers@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	9548395000				PACE - Nat		C	New York
H4217	Part D Exceptions Contact (Secondary)	Chief Medical Officer	Mr	Meyers	Glenn							gmeyers@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	9548395000				PACE - Nat		C	New York
H4217	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part D Quality Assurance Contact	Director of Compliance	Ms	Santilli	Lisa		8563710276					Lisa.Santilli@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Patient Safety Contact	Chief Medical Officer	Dr	Meyers	Glenn		9548395000					gmeyers@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Pharmacy Director	Chief Medical Officer	Mr	Meyers	Glenn		9548395000					gmeyers@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	8558012653				PACE - Nat		C	New York
H4217	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	8558012653				PACE - Nat		C	New York
H4217	PHR Beneficiary Contact																	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE	Beacon of Life SC	Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7325923400				PACE - Nat		C	New York
H4217	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Plan to Plan Reconciliation Contact	Financial Specialist	Mr	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Quality Contact	Director of Compliance	Ms	Santilli	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Surveillance Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	User Access Contact	Business Administrator	Ms	Ray	Jennifer		7326643786					jray@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4217	Utilization Review Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	09/11/2025	2026	HILLSBOROUGH PACE, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H4227	Agent/Broker Compensation Data Contact	National Director Retail Sales	Mr.	Javor	Chris		2159378396					cjavor@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Automated TrOOP Balance Transfer Contact	Business Systems Analyst	Ms.	Murray	Karla		2672985899					kdmurray@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Backup User Access Contact	Medicare Compliance Sr Operations Analyst	Ms	Morris	Gail		2158635141					gpmorris@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Bid Audit Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Bid Audit Site Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Bid Primary Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	05/07/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	CEO - CMS Administrator Contact	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	CEO - Senior Official for Contracting	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Chief Operating Officer	President, Medicare Markets	Mr.	McDade	Chris		5704179770					cmcdad@amerihealthcaritas.com	AmeriHealth Caritas Families of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Chief Information Officer	Exec. Vice President, Chief Information Officer	Mr.	Dickson	Fred		2158636570					fdickson@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	CMS Casework Communication Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Complaints Tracking Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Contact for Fraud Investigations	Director, SIU	Mr.	McCall	Trevor		4844971241					tmccall2@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Coordination of Benefits Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Corporate Mailing						2159378725					KGrimmett@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive, 1st Floor	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		2672981794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	DIR Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/07/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	DIR Contact (Secondary)	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2824045991					AKindred@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Discount Program Payment Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Electronic Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Emergency Part D Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Emergency Part D Contact (Secondary)	VP, Corporate Pharmacy		Cherian	Sheena		2158635768					scherian@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	2002 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare ACA and Risk Adjustment	Mr.	Greer	Kevin		2159378761					kgreer@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Enrollment Contact	Manager, Enrollment Operations	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	EOB Transfer Contact	VP, Medicare Claims	Mr.	Boyer	Joseph		2158636668				2159375321	jboyer@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Financial Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					ak16850@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Financial Reporting Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Formulary Contact	Director, Formulary Management,	Ms.	Megargell	Lauren		2159374135					lmegargell@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	General Contact	VP, Medicare Strategy & Execution	Mr.	Sukhu	Chistopher		4844233175					csukhu@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Government Relations Contact	VP, Government Relations, External Affairs	Mr.	Cozzo	Steven		2159378236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	HIPAA Privacy Officer	Director Privacy	Ms.	Desipio	Nicole		4844971132					ndesipio@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Hospice Contact	Dir.  Medicare Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Interoperability Contact	Director, Medicare Performance Management		Kindred	Amanda		2484045991					akindred@amerihealthcaritas.com	4000 Town Center	Suite 1300	Southfield	MI	48075	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	MA Appeals/Grievances Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	MA Claims Processing Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Marketing Contact	Medicare Compliance Sr Operations Analyst	Ms.	Morris	Gail	P	2158635141					gpmorris@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Medical Director	Chief Medical Officer, Population Health	Dr.	Wright	Julia		2159378000					jwright6@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Medicare Coordinator	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	05/07/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Medication Therapy Management Contact	Director, Clinical Outcomes & Therapeutic Optimiz	Ms.	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	OffShore Subcontractor Contact	Esquire	Ms.	Sitner	Roni		8602149125					rsitner@ameriheathcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Online Enrollment Center Contact (Primary)	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part C Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part C Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Appeals	Director,  Medicare Appeals and Grievances	Ms.	Lopez	Yismell							yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158635677				HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Appeals Contact (Secondary)	Manager, Medicare Appeals & Grievance	Ms.	Smith-Cooks	Tiarra							tsmithcooks@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2151112917				HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Benefits Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Claims Submission Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Prior Authorization	Mr.	McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens drive	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Price File Contact (Back-up)	Medicare Part D program Analyst	Ms.	Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	00909	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Price File Contact (Optional)	Medicare Part D Program Analyst	Ms	Wiehe	Heather		4127156363					heather.weihe@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Price File Contact (Primary)	Medicare Part D Program Anaylst	Ms.	West	Ariel		3133781225					Ariel.West@abarcahealth.com	PerformRx	1606 Ave Ponce de Leon	San Juan	PR	00909	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Part D Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Patient Safety Contact	Director,Clinical Outcomes &Therap Optimization	Ms	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Payment Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Personal Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Pharmacy Director	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Pharmacy Network Management Contact	President, Network Strategy	Mr	Sullivan	Tim		6303303638					tssullivan@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	06/27/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Pharmacy Network Management Contact (Secondary)	Network Operations Analyst	Mr.	Kramerov	Allen		2159374120					akramerov@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Pharmacy Technical Help Desk Contact	Manager, Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H4227	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H4227	PHR Beneficiary Contact																	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS	AmeriHealth Caritas	Independence Health Group, Inc.	609	Yes	Active	2672985710				HMO - Health Maintenance Organization		C	Chicago
H4227	Physician Incentive Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Plan Directory Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Plan to Plan Reconciliation Contact	Director, Finance	Ms	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	P.O. 7137	London	KY	40742	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Processor Contact	Director of Clincal Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerFormrx	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Quality Contact	Director, Quality Management	Ms.	Popiolek	Rose		6107234450					rpopiolek@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Reconciliation Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Reconciliation Contact (Secondary)	Manager, Medicare Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Recovery Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	SNP Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	SNP State Contact	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Surveillance Contact	Director, Retail Sales Operations	Ms.	Bech	Mary		4146875533					mbech@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	System Contact	Manager, Medicare IS	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Third Party Administrator (TPA) Liaison	Manager, MCR Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/06/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	User Access Contact	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Utilization Management Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4227	Utilization Review Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	VISTA HEALTH PLAN, INC.	Local CCP	VISTA Health Plan Inc.	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4232	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8555210627				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmsHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	01/18/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8555210627				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	ChrisC		8555210627				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Ste 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Coordinator	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	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	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	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	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H4232	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H4232	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H4232	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H4232	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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 Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	2026	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8336746196				HMO - Health Maintenance Organization		C	Dallas
H4232	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn						4056015627	lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	06/25/2021	2026	AMERICAN HEALTH PLAN OF UT, INC.	Local CCP	American Health Advantage of Utah	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8555210627				HMO - Health Maintenance Organization		C	Dallas
H4232	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8555210627				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	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	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	SNP State Contact	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		7048740604				7048341998	awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Backup User Access Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Bid Primary Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	CAP Report Contact for Public Website	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	CEO - CMS Administrator Contact	Executive Director	Ms	Kenzig	Cathy		7048740600					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	CEO - Senior Official for Contracting	Executive Director	CEO	Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	CFO	CFO	Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	04/11/2025	2026	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 Operating Officer	Executive Director	COO	Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Information Officer	Director of Quality & Corporate Compliance	Ms	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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 Information Security Officer	Compliance & Quality Director	CIO	Alexander	Lydia		7048740639					lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	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		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Complaints Tracking Contact	Director of Finance and Administration	CFO	Witt	Anne		7048740604					awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Contact for Fraud Investigations	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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		7048740604					awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Corporate Mailing						7048740600				7048743307	ckenzig@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	DIR Contact	CFO		Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Discount Program Payment Contact	CFO	CFO	Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	05/29/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Emergency Part D Contact	Executive Director		Kenzig	Cathy		7048740600					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Emergency Part D Contact (Secondary)	Director of Finance and Administration		Crerar	Vanessa		7048740621					vcrerar@seniortlc.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Encounter Data & Risk Adjustment Operations Contact	Compliance & Quality Director		Alexander	Lydia		7048740639					lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Enrollment Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	EOB Transfer Contact	Executive Director		Kenzig	Cathy		7048740603				7048667732	ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Financial Audit Contact	Health Plan Data Specialist	Mr.	Powell	Greg		7048873898					gpowell@seniortlc.org	1875 Remount Rd.		Gastonia	NC	28054	04/17/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Financial Reporting Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Formulary Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	General Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	HIPAA Privacy Officer	Director Corporate Compliance		Alexander	Lydia		7048740600					lyalexander@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	HIPAA Security Officer	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Interoperability Contact			Kenzig	Catherine		7048740603					ckenzig@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	MA Appeals/Grievances Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	MA Claims Processing Contact for Public Website	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Marketing Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Medical Director	Medical Director	Dr	Clark	Alan		7048740619				7048743307	aclark@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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		7048740639					lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	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 Coordinator	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Medication Therapy Management Contact	Medical Director	Dr	Clark	Alan		7048740619				7048743307	aclark@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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 C Application Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Appeals	Quality Coordinator	Ms	Alexander	Lydia						7048740600	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active	8553277852				PACE - Nat		C	Atlanta
H4235	Part D Appeals Contact (Secondary)			Alexander	Lydia						7048341998	lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active	8553277852				PACE - Nat		C	Atlanta
H4235	Part D Application Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Benefits Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Claims Submission Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active	8553277852				PACE - Nat		C	Atlanta
H4235	Part D Exceptions Contact (Secondary)	Health Data Specialist		Powell	Greg							gpowell@seniortlc.org	6133 The Plaza		Charlotte	NC	28215	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active	7048873857				PACE - Nat		C	Atlanta
H4235	Part D Price File Contact (Back-up)	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Price File Contact (Primary)	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Quality Assurance Contact	Quality Coordinator	Ms	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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 Reporting Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Patient Safety Contact	Medical Director	Dr	Crerar	Vanessa		7048740600				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/17/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Payment Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Personal Health Record Contact	Finance Director		Alexander	Lydia		7048740639					lyalexander@seniortlc.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Director	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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 Network Management Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Network Management Contact (Secondary)	Program Director	Ms.	Kenzig	Cathy		7048873869				7048873844	ckenzig@seniortlc.org	6133 The Plaza		Charlotte	NC	28215	04/11/2025	2026	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	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active	8882987770				PACE - Nat		C	Atlanta
H4235	Plan Directory Contact for Public Website	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Plan to Plan Reconciliation Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Processor Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Quality Contact	Quality Coordinator	Ms	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Reconciliation Contact	CFO		Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Recovery Audit Contact	Finance Director	MS	Witt	Anne		7048740600				7048743307	awitt@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Surveillance Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	System Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Third Party Administrator (TPA) Liaison	Director fo Administration and Finance	CIO	Witt	Anne		7048740600				7048654785	awitt@seniortlc.org	1875 Remount Raod		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	User Access Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Utilization Management Contact	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4235	Utilization Review Contact	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	SENIOR TOTAL LIFE CARE, INC.	National PACE	Senior Total Life Care	National PACE		CaroMont Health, Inc.	556	Yes	Active					PACE - Nat		C	Atlanta
H4239	Automated TrOOP Balance Transfer Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Backup User Access Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Best Available Evidence Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Bid Primary Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	CAP Report Contact for Public Website	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	CEO - CMS Administrator Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	CEO - Senior Official for Contracting	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Chief Financial Officer	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Chief Operating Officer	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Chief Information Officer	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Chief Information Security Officer	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	CMS Casework Communication Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Complaints Tracking Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Contact for Fraud Investigations	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Coordination of Benefits Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Corporate Mailing						8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Customer Service Operations Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	DIR Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Discount Program Payment Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Emergency Part D Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Encounter Data & Risk Adjustment Operations Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Enrollment Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	EOB Transfer Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Financial Audit Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Financial Reporting Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Formulary Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	General Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Government Relations Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	HIPAA Privacy Officer	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	HIPAA Security Officer	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Interoperability Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	MA Appeals/Grievances Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	MA Claims Processing Contact for Public Website	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Marketing Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Medical Director	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Medicare Compliance Officer	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Medicare Coordinator	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Medicare Part D Opioid Overutilization Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Medication Therapy Management Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd, Suite 140		Columbia	SC	29209	02/04/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part D Appeals	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N						ayip@chccc.org	150 Tejas PL		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending	8035988588				PACE - Nat		C	San Francisco
H4239	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd, Suite 140		Columbia	SC	29209	02/04/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part D Benefits Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part D Claims Submission Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part D Exceptions Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N						ayip@chccc.org	150 Tejas PL		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending	8035988588				PACE - Nat		C	San Francisco
H4239	Part D Price File Contact (Back-up)	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part D Price File Contact (Primary)	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part D Quality Assurance Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Part D Reporting Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Patient Safety Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Payment Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Pharmacy Director	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Pharmacy Network Management Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Pharmacy Technical Help Desk Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N						ayip@chccc.org	150 Tejas PL		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending	8035988588				PACE - Nat		C	San Francisco
H4239	Plan Directory Contact for Public Website	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Plan to Plan Reconciliation Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Processor Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Quality Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Reconciliation Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588					terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Recovery Audit Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Surveillance Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	System Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Third Party Administrator (TPA) Liaison	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	User Access Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Utilization Management Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4239	Utilization Review Contact	Chief PACE and Senior Services Officer	Mrs	Carr	Terrilyn	N	8055988588				8053463934	terrilyn.carr@chccc.org	2050 S. Blosser Rd		Santa Maria	CA	93458	07/24/2025	2026	COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.	National PACE	Central Coast PACE	National PACE		Community Health Centers of the Central Coast	882	Yes	Pending					PACE - Nat		C	San Francisco
H4253	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Best Available Evidence Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	CAP Report Contact for Public Website	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooperi@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	CMS Casework Communication Contact	Director of Compliance		Cooper	Wanda		2675751196				7325923500	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Customer Service Operations Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Discount Program Payment Contact	Chief of Health Plan Operations	Ms.	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/01/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Formulary Contact	Medical Director		Partlow	Jennie		6406501565					jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923500	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	General Contact	Executive Director	Mr	Sprockett	Stephen		5082502267					Ssprockett@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	09/11/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation		Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Medical Director	Medical Director	Dr.	Fornadel	Brian		7325923400					bfornadol@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Medicare Coordinator	Finance Specialist	Ms	Partlow	Jennie		5082502267					jpartlow@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	09/11/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Medicare Part D Opioid Overutilization Contact	Director of Compliance		Cooper	Wanda		2675751196					Wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Medication Therapy Management Contact	Medical Director	Dr.	Fornadel	Brian		9548395000				7325923500	bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part D Appeals	Director of Compliance		Cooper	Wanda						2675751196	wcoooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending	7325923407				PACE - Nat		C	New York
H4253	Part D Appeals Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending	7328063224				PACE - Nat		C	New York
H4253	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part D Exceptions Contact	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending	9548395000				PACE - Nat		C	New York
H4253	Part D Exceptions Contact (Secondary)	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending	9548395000				PACE - Nat		C	New York
H4253	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part D Quality Assurance Contact	Director of Compliance	Ms	Coooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Patient Safety Contact	Finance Specialist		Partlow	Jennie		9548395000					jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Pharmacy Director	Medical Director	Dr.	Fornadel	Brian		9548395000					bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending	8558012653				PACE - Nat		C	New York
H4253	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending	8558012653				PACE - Nat		C	New York
H4253	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Plan to Plan Reconciliation Contact	Financial Specialist		Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Surveillance Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Third Party Administrator (TPA) Liaison	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/01/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	User Access Contact	Business Administrator		Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4253	Utilization Review Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE LUCAS, LLC	National PACE	Acutecare PACE Lucas, LLC	National PACE		Beacon Care Ventures, LLC d/b/a BoldAge PACE	845	Yes	Pending					PACE - Nat		C	New York
H4256	Automated TrOOP Balance Transfer Contact	FinanceDirector	Mr.	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	03/15/2021	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Backup User Access Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Best Available Evidence Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Bid Primary Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	CAP Report Contact for Public Website	Community Outreach Director	Ms	Wells	Lori		2312523821				2312523750	lwells@pacenorth.org	2325 Garfield Rd., N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active	2312523821				PACE - Nat		C	Kansas City
H4256	CEO - CMS Administrator Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	CEO - Senior Official for Contracting	Executive Director	Ms	Farkas	Nicole		2312523814					nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Chief Financial Officer	Financial Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Chief Operating Officer	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	12/20/2022	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Chief Information Officer	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Chief Information Security Officer	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	CMS Casework Communication Contact	Center Manager		Baldwin	David		2312523801				2312523750	dbaldwin@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	04/30/2025	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Complaints Tracking Contact	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Contact for Fraud Investigations	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Coordination of Benefits Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Corporate Mailing						2312523814					nfarkas@pacenorth.org	2325 Garfield Rd. N.		Traverse City	MI	49686	12/20/2022	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Customer Service Operations Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	DIR Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield Rd		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Discount Program Payment Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Emergency Part D Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Encounter Data & Risk Adjustment Operations Contact	Finance Director	Mr.	Jacobs	John		2312523816					jjacobs@pacenorth.org	2325 Garfield Road North		Traverse City	MI	49686	04/15/2020	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Enrollment Contact	Community Outreach Director	Ms	Wells	Lori		2312523821				2312523750	lwells@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	EOB Transfer Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Financial Audit Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Financial Reporting Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Formulary Contact	Medical Director	Dr.	Wilborn	Jerry		2312522767				2312523750	jwilborn@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	General Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Government Relations Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	12/20/2022	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	HIPAA Privacy Officer	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	HIPAA Security Officer	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Interoperability Contact	Finance Director	Mr	Jacobs	John		2312523816					jjacobs@pacenorth.org	2325 N Garfield Rd		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	MA Appeals/Grievances Contact	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	MA Claims Processing Contact for Public Website	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Marketing Contact	Community Outreach Director	Ms	Wells	Lori		2312523821				2312523750	lwells@pacenorth.org	2325 Garfield Rd., N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Medical Director	Medical Director	Dr	Wilborn	Jerry		2312522767					jwilborn@pacenorth.org	2325 Garfield Rd. N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Medicare Compliance Officer	Quality Assurance Director	Ms.	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Medicare Coordinator	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr	Wilborn	Jerry		2312522767				2312523750	jwilborn@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Medication Therapy Management Contact	Medical Director	Dr	Wilborn	Jerry		2312522767				2312523750	jwilborn@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Online Enrollment Center Contact (Primary)	Community Outreach Director	Ms.	Wells	Lori		2312523821				2312523750	lwells@pacenorth.org	2325 Garfield Rd., N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part C Application Contact	Finance Director	Mr	Jacobs	John		2312523816					jjacobs@pacenorth.org	2325 Garfield Rd. N.		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part D Appeals	Quality Assurance Director	Ms	Reardon	Michelle						2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active	2312523819				PACE - Nat		C	Kansas City
H4256	Part D Appeals Contact (Secondary)	Finance Director	Mr.	Jacobs	John						2312523750	jjacobs@pacenorth.org	2325 Garfield Road North		Traverse City	MI	49686	12/30/2020	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active	2312523816				PACE - Nat		C	Kansas City
H4256	Part D Application Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part D Benefits Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part D Claims Submission Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part D Exceptions Contact	Finance Director	Mr	Jacobs	John						2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active	2312523816				PACE - Nat		C	Kansas City
H4256	Part D Price File Contact (Back-up)	Finance Director	Mr	Jacobs	John		2312523816					jjacobs@pacenorth.org	2325 Garfield Rd. N.		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part D Price File Contact (Primary)	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part D Quality Assurance Contact	Quality Assurance Director	Ms.	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield rd		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Part D Reporting Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Patient Safety Contact	Medical Director	Dr.	Wilborn	Jerry		2312522767				2312523750	jwilborn@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Payment Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Personal Health Record Contact	Medical Records		Sullivan	Kristin		2312523822				2312523750	ksullivan@pacenorth.org	1652 Keane Drive		Traverse City	MI	49686	04/30/2025	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Pharmacy Director	Medical Director	Dr.	Wilborn	Jerry		2312521767				2312523750	jwilborn@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Pharmacy Network Management Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Pharmacy Technical Help Desk Contact	Executive Director	Ms	Jacobs	John						2312523750	jjacobs@pacenorth.org	2325 N Garfield Rd		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active	2312523816				PACE - Nat		C	Kansas City
H4256	PHR Beneficiary Contact																	04/15/2020	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE	PACE North	PACE North	721	Yes	Active	8334102086				PACE - Nat		C	Kansas City
H4256	Plan Directory Contact for Public Website	Community Outreach Director	Ms	Wells	Lori		2312523821				2312523750	lwells@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Plan to Plan Reconciliation Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Processor Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Quality Contact	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield rd		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Reconciliation Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Recovery Audit Contact	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Surveillance Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	System Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Third Party Administrator (TPA) Liaison	Finance Director	Mr	Jacobs	John		2312523816				2312523750	jjacobs@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	05/21/2019	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	User Access Contact	Executive Director	Ms	Farkas	Nicole		2312523814				2312523750	nfarkas@pacenorth.org	2325 Garfield Road, N.		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Utilization Management Contact	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4256	Utilization Review Contact	Quality Assurance Director	Ms	Reardon	Michelle		2312523819				2312523750	mreardon@pacenorth.org	2325 N Garfield RD		Traverse City	MI	49686	02/23/2024	2026	PACE NORTH, INC.	National PACE	PACE North	National PACE		PACE North	721	Yes	Active					PACE - Nat		C	Kansas City
H4279	Agent/Broker Compensation Data Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Backup User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		8006068648					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/17/2023	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Bid Audit Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Bid Audit Site Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Bid Primary Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	CAP Report Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	CEO - CMS Administrator Contact	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	CEO - Senior Official for Contracting	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		4124545559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Chief Operating Officer	Chief Operating Officer	Ms.	Jenkins	Mary Beth	L	4124547764					jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	12/09/2015	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Chief Information Officer	Chief Information Officer	Mr.	McCallister	Ed		4124547711					mccallisterew@upmc.edu	USX Tower, 60th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Chief Information Security Officer	Vice President, ISD	Mr	Haas	Scott		4124546162					haassm@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Complaints Tracking Contact	Sr. Manager, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	03/17/2023	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Contact for Fraud Investigations	Sr. Director Fraud & Abuse		Workman	Craig		4124545524					workmanc@upmc.edu	USX Tower, 47th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Corporate Mailing						4124547500					upmchp@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		8006068648					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/17/2023	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	DIR Contact	Director, Pharmacy Finance		Bovier	Jacqueline		4124547584					bovierjd@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/18/2015	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	DIR Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Discount Program Payment Contact	Business Analyst III		Michalski	Jeff		4124545715				4124542110	michalskij@upmc.edu	USX Tower, 21st Floor	600 Grant Street	Pittsburgh	PA	15219	11/18/2024	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Emergency Part D Contact	Vice President, Customer Engagement & Enrollment		Palmerine	Anne		4129777828					palmerineac3@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Emergency Part D Contact (Secondary)	AVP, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	12/27/2023	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Encounter Data & Risk Adjustment Operations Contact	Director, Government Revenue		Plank	Tim		4124547747					planktm@upmc.edu	USX Tower, 36th Floor	600 Grant Street	Pittsburgh	PA	15219	10/28/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Enrollment Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	EOB Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Financial Audit Contact	AVP, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	08/14/2020	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Financial Reporting Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Formulary Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Formulary Contact (Secondary)	Manager, Clinical Pharmacy Medicare	Ms.	Ryan	Maggie		4124547086					ryanm7@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	05/13/2025	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	General Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	HIPAA Security Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		4124548589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Interoperability Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	02/16/2022	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	MA Appeals/Grievances Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	MA Claims Processing Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Marketing Contact	Director, Medicare Marketing		McVey	Alicia		4124545525					mcveyal@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	08/03/2017	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Medical Director	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Medicare Coordinator	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Medicare Part D Opioid Overutilization Contact	Sr. Manager, Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Medication Therapy Management Contact	Sr. Manager Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Online Enrollment Center Contact (Back-up)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Online Enrollment Center Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Online Enrollment Center Contact (Primary)	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part C Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part C Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Appeals	Manager, C&G		Richards	Rebecca						4124547920	richardsr3@upmc.edu	USX Tower, 42nd Floor	600 Grant Street	Pittsburgh	PA	15219	02/25/2021	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	4124540116				HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Appeals Contact (Secondary)	Manager, Pharmacy Compliance		Chaussinand	Matt							chaussinandm@upmc.edu	600 Grant St., USX, 12th Floor		Pittsburgh	PA	15219	02/25/2021	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	4124545914				HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Benefits Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions		Dovico	Rosario		2012696398					rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	04/23/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	8003964139				HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Price File Contact (Back-up)	Sr. Manager, Government Programs		Dolfi	Amanda		6147613606					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	03/12/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Price File Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Price File Contact (Primary)	Director, Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107th St. #11202		Overland Park	KS	66207	07/28/2020	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Quality Assurance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Part D Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Patient Safety Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Payment Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Personal Health Record Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Pharmacy Director	Sr. Director, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H4279	PHR Beneficiary Contact																	05/17/2011	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS	MyHealth	UPMC Health System	249	Yes	Active	4128032065				HMO - Health Maintenance Organization		C	Dallas
H4279	Physician Incentive Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Plan Directory Contact for Public Website			Marketing	Medicare		8773813765					upmchp@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		4124545715				4124542110	medicarereporting@upmc.edu	US Steel Tower, 600 Grant Street, 9th Floor	c/o UPMC Health Plan Attn: Aunika Hall P2P - 09-257	Pittsburgh	PA	15219	03/17/2025	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Processor Contact	Sr Director - Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Quality Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Reconciliation Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Reconciliation Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Recovery Audit Contact	Sr. Director, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	SNP Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	SNP State Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Surveillance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	System Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Third Party Administrator (TPA) Liaison	Business Analyst III		Michalski	Jeff		4124545715				4124542110	michalskij@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	11/18/2024	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Utilization Management Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4279	Utilization Review Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC FOR YOU, INC	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4286	Agent/Broker Compensation Data Contact	CEO		Hernandez	Henry		3056315855				3056463226	henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Automated TrOOP Balance Transfer Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Backup User Access Contact	CEO		Hernandez	Henry		3056315855				3056463326	henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Best Available Evidence Contact	CEO		Hernandez	Henry		3056315855				3057182860	henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Bid Audit Contact	SVP & CFO		Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Bid Audit Site Contact	SVP & CFO		Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Bid Primary Contact	SVP & CFO		Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	CAP Report Contact for Public Website	VP & CIO		Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	CEO - CMS Administrator Contact	CEO	Mr.	Hernandez	Henry		3059860290					Henry.Hernandez@leonhealth.com	8600 NW 41 St	Suite 210	Miami	FL	33166	12/23/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	CEO - Senior Official for Contracting	CEO	Mr.	Hernandez	Henry		3056315855					Henry.Hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Chief Financial Officer	SVP & CFO	Ms.	Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Chief Operating Officer	COO	Mr.	Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	05/17/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Chief Information Officer	VP & CIO	Mr.	Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Chief Information Security Officer	VP & CIO	Mr.	Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	CMMI Model Point of Contact	CEO	Mr.	Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Yzquierdo	Milagros		3056315855					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	06/16/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Complaints Tracking Contact	Chief Compliance Officer	Ms.	Yzquierdo	Milagros		3056315855					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	06/16/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Contact for Fraud Investigations	CCO		Yzquierdo	milagros		3054963156					milagros.yzquierdo@leonhealth.com	8600 NW 41 St	false	Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Coordination of Benefits Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Corporate Mailing						3055415366					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	08/28/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Customer Service Operations Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	DIR Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	DIR Contact (Secondary)	SVP & CFO		Pardo	Ann Mary		3056315064					annmary.pardo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	02/19/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Discount Program Payment Contact	SVP & CFO		Pardo	Ann Mary		3056315064					annmary.pardo@leonhealth.com	8600 NW 41 St	Suite 210	Doral	FL	33166	03/01/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Electronic Health Record Contact	VP & CIO		Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Emergency Part D Contact	CEO		Hernandez	Henry		3059860290					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	12/23/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Emergency Part D Contact (Secondary)	CCO	Mrs.	Yzquierdo	Milagros		3054963156					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Employer Waiver Contact	CEO	Mr.	Hernandez	Henry		3056315855					Henry.Hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Encounter Data & Risk Adjustment Operations Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Enrollment Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	EOB Transfer Contact	CEO		Hernandez	Henry		3056315855				3056463226	henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Financial Audit Contact	SVP & CFO	Ms.	Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Financial Reporting Contact	SVP & CFO		Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Formulary Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Formulary Contact (Secondary)	CCO	Mrs.	Yzquierdo	Milagros		3054963156					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	General Contact	CEO	Mr.	Hernandez	Henry		3056315855					Henry.Hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Government Relations Contact	CEO	Mr.	Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Yzquierdo	Milagros		3056315855					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	06/16/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	HIPAA Security Officer	VP & CIO		Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	05/17/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Hospice Contact	SVP & CMO		Mas	Rafael		3056425366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Interoperability Contact	CEO		Hernandez	Henry		3059860290					Henry.Hernandez@leonhealth.com	8600 NW 41st St Ste 210		Doral	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	MA Appeals/Grievances Contact	Chief Compliance Officer	Ms.	Yzquierdo	Milagros		3056315855					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	06/16/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	MA Claims Processing Contact for Public Website	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Marketing Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Medical Director	SVP & CMO		Mas	Rafael		3056425366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Yzquierdo	Milagros		3054963156					milagros.yzquierdo@leonhealth.com	8600 NW 41 Street		Miami	FL	33166	04/20/2023	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Medicare Coordinator	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Medicare Part D Opioid Overutilization Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Medication Therapy Management Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	OffShore Subcontractor Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Online Enrollment Center Contact (Back-up)	VP of Operations	Mr.	Tiffer	Giancarlo		3052138593					Giancarlo.Tiffer@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Online Enrollment Center Contact (Optional)	CCO		Yzquierdo	Milagros		3054963156					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Online Enrollment Center Contact (Primary)	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part C Application Contact	CEO	Mr.	Hernandez	Henry		3056315855					Henry.Hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part C Reporting Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Appeals	CEO		Hernandez	Henry						3056463226	henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active	8333765366				HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Application Contact	CEO		Hernandez	Henry		3056315855					Henry.Hernandez@leonhealth.com	8600 NW 41 Street		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Benefits Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Claims Submission Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Exceptions Contact	CEO		Hernandez	Henry						3056463226	henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active	8333765366				HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Price File Contact (Back-up)	Compliance Officer	Mrs.	Yzquierdo	Milagros		3054963156					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	10/11/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Price File Contact (Optional)	PBM		Medimpact	Medimpact		8007882949					PlanFinderCommunications@medimpact.com	10181 Scripps Gateway Ct.		San Diego,	CA	92131	10/11/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Price File Contact (Primary)	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Quality Assurance Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Part D Reporting Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Patient Safety Contact	SVP & CMO		Mas	Rafael		3056425366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Payment Contact	SVP & CFO		Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Personal Health Record Contact	VP & CIO	Mr.	Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Pharmacy Director	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Pharmacy Network Management Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Pharmacy Network Management Contact (Secondary)	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Pharmacy Technical Help Desk Contact	Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway CT		San Diego	CA	92131	11/15/2023	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active	8006817504				HMO - Health Maintenance Organization		C	Atlanta
H4286	Pharmacy Technical Help Desk Contact (Secondary)	CEO		Hernandez	Henry						3056463226	henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active	8006817504				HMO - Health Maintenance Organization		C	Atlanta
H4286	PHR Beneficiary Contact																	02/12/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS	Leon Health Plans	LMC Family Holdings, LLC	771	Yes	Active	8333765366				HMO - Health Maintenance Organization		C	Atlanta
H4286	Physician Incentive Contact	SVP & CMO		Mas	Rafael		3056425366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Plan Directory Contact for Public Website	VP & CIO	Mr.	Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Plan to Plan Reconciliation Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Processor Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Quality Contact	SVP & CMO		Mas	Rafael		3056425366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Reconciliation Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Reconciliation Contact (Secondary)	CFO &SVP		Pardo	Ann Mary		3056315064					annmary.pardo@leonhealth.com	8600 NW 41 Street		Miami	FL	33166	03/07/2023	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Recovery Audit Contact	SVP & CFO	Ms.	Pardo	Ann Mary		3056315064					annmary.pardo@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	01/26/2022	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	SNP Application Contact	CEO	Mr.	Hernandez	Henry		3056315855					Henry.Hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	SNP State Contact	CEO	Mr.	her	Henry		3056315855					Henry.Hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	01/15/2025	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Surveillance Contact	Chief Compliance Officer	Ms.	Yzquierdo	Milagros		3056315855					milagros.yzquierdo@leonhealth.com	8600 NW 41 St		Miami	FL	33166	06/16/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	System Contact	VP & CIO	Mr.	Gomez	Marcus		3056442156					marcus.gomez@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Third Party Administrator (TPA) Liaison	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St,		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	User Access Contact	CEO		Hernandez	Henry		3056315855					henry.hernandez@leonhealth.com	8600 NW 41 St		Miami	FL	33166	07/29/2024	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Utilization Management Contact	SVP & CMO		Mas	Rafael		3056425366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4286	Utilization Review Contact	SVP & CMO		Mas	Rafael		3056425366					rafael.mas@leonmedicalcenters.com	8600 NW 41 St		Miami	FL	33166	02/05/2021	2026	LEON HEALTH, INC.	Local CCP	Leon Health, Inc.	HMO/HMOPOS		LMC Family Holdings, LLC	771	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4305	Automated TrOOP Balance Transfer Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Backup User Access Contact	Program Integrity Manager		Rowe	Shellei		8702077485				8702070550	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/22/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Best Available Evidence Contact	Executive Director		Whitehead	Chad		8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews		Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Bid Primary Contact	Accountant		Domino	DeAnna		8702077526				8702070527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	CAP Report Contact for Public Website	Executive Director		Whitehead	Chad	R	8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	CEO - CMS Administrator Contact	Executive Director	Mr.	Whitehead	Chad	R	8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	CEO - Senior Official for Contracting	Executive Director	Mr.	Whitehead	Chad	R	8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Chief Financial Officer	Accountant	Mrs.	Domino	DeAnna	J	8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Chief Operating Officer	Operations Manager	Mr.	Combs	Terry		8702077530				8702070527	tcombs@sbrmc.org	505  E Matthews Avenue	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Chief Information Officer	Executive Director	Mr.	Whitehead	Chad		8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Chief Information Security Officer	IT Security Mgr - SB	Ms	Stoneman	Marta		8702077181				8702076503	mwstoneman@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	CMS Casework Communication Contact	Program Integrity Manager		Rowe	Shellei		8702077485				8702070550	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/22/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Complaints Tracking Contact	Operations Manager		Combs	Terry		8702077530				8702070527	tcombs@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Contact for Fraud Investigations	VP Corp Compliance/Audit - SB		Shipman	Daya		8702074422				8709302854	dshipman@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Coordination of Benefits Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Corporate Mailing						8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Customer Service Operations Contact	Center Manager		Hayes	Tina		8702077503				8702070527	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	06/13/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	DIR Contact	Accountant		Domino	DeAnna	J	8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/22/2022	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Discount Program Payment Contact	Accountant		Domino	DeAnna		8702077526				8702070527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Emergency Part D Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Emergency Part D Contact (Secondary)	Operations Manager		Combs	Terry		8702077530					tcombs@sbrmc.org	505 E. Matthews Avenue		Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Encounter Data & Risk Adjustment Operations Contact	Accountant		Domino	DeAnna		8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews		Jonesboro	AR	72401	02/20/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Enrollment Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	EOB Transfer Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070527	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Financial Audit Contact	Accountant	Mrs	Domino	DeAnna		8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	08/23/2022	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Financial Reporting Contact	Accountant		Domino	DeAnna		8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	08/23/2022	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Formulary Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	General Contact	Executive Director		Whitehead	Chad		8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Government Relations Contact	Executive Director		Whitehead	Chad		8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	HIPAA Privacy Officer	VP Corp Compliance/Audit - SB		Shipman	Daya		8702074422				8709302854	dshipman@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	HIPAA Security Officer	IT Security Mgr - SB	Ms	Stoneman	Marta		8702077181				8702076503	mwstoneman@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Interoperability Contact	Operations Manager		Combs	Terry		8702077530				8702070527	tcombs@sbrmc.org	505 E. Matthews		Jonesboro	AR	72401	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	MA Appeals/Grievances Contact	Program Integrity Manager		Rowe	Shellei		8702077485				8702070550	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/22/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	MA Claims Processing Contact for Public Website	Accountant		Domino	DeAnna		8702077526				8702070527	lsummitt@sbrmc.org	505 E Mattews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Marketing Contact	Executive Director		Whitehead	Chad		8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Medical Director	Medical Director		Murrey	James		8702077511				8702070530	jmurrey2@sbrmc.org	505 E Matthews Avenue	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Medicare Compliance Officer	Program Integrity Manager	Mrs.	Rowe	Shellei		8702077485				8702070550	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Medicare Coordinator	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Medicare Part D Opioid Overutilization Contact	Center Manager		Hayes	Tina		8702077503				8702070527	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	07/28/2022	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Medication Therapy Management Contact	Center Manager		Hayes	Tina		8702077503				8702070527	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Online Enrollment Center Contact (Primary)	Accountant		Domino	DeAnna		8702077526				8702070527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part C Application Contact	Operations Manager		Combs	Terry		8702077530				8702070527	tcombs@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part D Appeals	Finance and Part D Specialist		Tibbs	Amanda						8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active	8552077502				PACE - Nat		C	New York
H4305	Part D Application Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part D Benefits Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part D Claims Submission Contact	Accountant		Domino	DeAnna		8702077526				8702070527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part D Exceptions Contact	Finance and Part D Specialist		Tibbs	Amanda						8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active	8552077502				PACE - Nat		C	New York
H4305	Part D Exceptions Contact (Secondary)	Operations Manager		Combs	Terry						8702070571	tcombs@sbrmc.org	505 E. Matthews Avenue		Jonesboro	AR	72450	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active	8702077530				PACE - Nat		C	New York
H4305	Part D Price File Contact (Back-up)	Accountant		Domino	DeAnna		8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	08/23/2022	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part D Price File Contact (Primary)	Medicare Part D Manager		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/15/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part D Quality Assurance Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Part D Reporting Contact	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070571	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Patient Safety Contact	Program Integrity Manager		Rowe	Shellei		8702077485				8702070550	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/22/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Payment Contact	Accountant		Domino	DeAnna	J	8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/22/2022	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Pharmacy Director	Medical Director	Dr	Murrey	James		8702077505				8702070527	bmcdaniel@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Pharmacy Network Management Contact	Center Manager		Hayes	Tina		8702077503				8702070571	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	07/28/2022	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Pharmacy Network Management Contact (Secondary)	Executive Director		Whitehead	Chad		8702077530				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/21/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Pharmacy Technical Help Desk Contact	Finance and Part D Specialist		Tibbs	Amanda						8702070502	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active	8552077526				PACE - Nat		C	New York
H4305	Pharmacy Technical Help Desk Contact (Secondary)	Operations Manager		Combs	Terry							tcombs@sbrmc.org	505 E. Matthews Avenue		Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active	8702077530				PACE - Nat		C	New York
H4305	Plan Directory Contact for Public Website	Executive Director		Whitehead	Chad		8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Plan to Plan Reconciliation Contact	Accountant		Domino	DeAnna		8702077526				8702070527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Processor Contact	Accountant		Domino	DeAnna		8702077526				8702070527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Quality Contact	Program Integrity Manager		Rowe	Shellei		8702077485				8702070550	srowe@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/22/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Reconciliation Contact	Accountant		Domino	DeAnna		8702077526				8702070571	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Reconciliation Contact (Secondary)	Finance and Part D Specialist		Tibbs	Amanda		8702077502				8702070527	amoon@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	02/23/2024	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Recovery Audit Contact	Asst Controller Corporate - SB	Mrs.	Domino	DeAnna		8702074969				8709721749	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	01/10/2020	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Surveillance Contact	Executive Director		Whitehead	Chad	R	8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72450	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	System Contact	Executive Director		Whitehead	Chad	R	8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Third Party Administrator (TPA) Liaison	Accountant		Domino	DeAnna		8702077526				8702070527	ddomino@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/16/2025	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	User Access Contact	Executive Director		Whitehead	Chad		8702077505				8702070527	crwhitehead@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	05/02/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Utilization Management Contact	Center Manager		Hayes	Tina		8702077503				8702070527	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	04/18/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4305	Utilization Review Contact	Center Manager		Hayes	Tina		8702077503				8702070527	trhayes@sbrmc.org	505 E Matthews	505 E Matthews Avenue	Jonesboro	AR	72401	04/18/2023	2026	TOTAL LIFE HEALTHCARE	National PACE	Total Life Healthcare	National PACE		St. Bernard's Healthcare	353	Yes	Active					PACE - Nat		C	New York
H4326	Automated TrOOP Balance Transfer Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8289944298	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Backup User Access Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8289944298	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Best Available Evidence Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Bid Primary Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/11/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	CAP Report Contact for Public Website	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active	8284683980				PACE - Nat		C	Atlanta
H4326	CEO - CMS Administrator Contact	Executive Director	Mrs.	Kenzig	Cathy		7048740600					ckenzig@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	02/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	CEO - Senior Official for Contracting	Executive Director	Mrs.	Kenzig	Cathy		7048740600					ckenzig@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	02/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Chief Financial Officer	Finance Specialist	Mrs.	Martin	Ambra		8284683013				8289944298	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/11/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Chief Operating Officer	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Chief Information Officer	Director of Quality & Corporate Compliance	Mrs.	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	02/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Chief Information Security Officer	Director of Quality & Corporate Compliance	Mrs.	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	02/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	CMS Casework Communication Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Complaints Tracking Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Contact for Fraud Investigations	Quality Coordinator	Mrs.	Smith	Miriam		8284683019				8284642845	mismith@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Coordination of Benefits Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8289944298	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/11/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Corporate Mailing						8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Customer Service Operations Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	DIR Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8289944298	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/11/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Discount Program Payment Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/11/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Emergency Part D Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8289944298	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/11/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Encounter Data & Risk Adjustment Operations Contact	Finance Specialist	Ms.	Martin	Ambra		8284683980	23013			8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Enrollment Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	EOB Transfer Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Financial Audit Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Financial Reporting Contact	Finance Specialist	Ms.	Martin	Ambra		8284683980	23013			8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Formulary Contact		Ms.	Krall	Megan		7158522049					mkrall@pharmastar.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/07/2024	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	General Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Government Relations Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	HIPAA Privacy Officer	Director of Quality & Corporate Compliance	Mrs.	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	02/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	HIPAA Security Officer	Director of Quality & Corporate Compliance	Mrs.	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Interoperability Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	MA Appeals/Grievances Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	MA Claims Processing Contact for Public Website	Finance Specialist	Mrs.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Marketing Contact	Director of Community Education & Intake	Mrs.	Justus	Amanda		8284683003				8289944298	ajustus@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Medical Director	Medical Director	Dr.	Crerar	Vanessa		7048740600	15393				vcrerar@seniortlc.org	1875 Remount Rd		Gastonia	NC	28054	07/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Medicare Compliance Officer	Director of Quality & Corporate Compliance	Mrs.	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	02/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Medicare Coordinator	Finance Specialist	Mrs.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Medicare Part D Opioid Overutilization Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Medication Therapy Management Contact	Medical Director	Dr.	Crerar	Vanessa		7048740600	15393				vcrerar@seniortlc.org	1875 Remount Rd		Gastonia	NC	28054	07/10/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part C Application Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Appeals	Program Director	Mrs.	Jones	Emily						8284642845	ejones@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active	8284683980				PACE - Nat		C	Atlanta
H4326	Part D Appeals Contact (Secondary)	Finance Specialist	Ms.	Martin	Ambra						8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active	8284683013				PACE - Nat		C	Atlanta
H4326	Part D Application Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Benefits Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Claims Submission Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Exceptions Contact	Program Director	Mrs.	Jones	Emily						8284642845	ejones@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active	8284683980				PACE - Nat		C	Atlanta
H4326	Part D Price File Contact (Back-up)	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Price File Contact (Primary)		Ms.	Krall	Megan		7158522049					mkrall@pharmastar.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/07/2024	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Quality Assurance Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Part D Reporting Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Patient Safety Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Payment Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Personal Health Record Contact	Medical Records	Mrs.	Bowman	Elizabeth		8284683980	5310			8284642845	ebowman@pace-at-home.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	08/13/2020	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Pharmacy Director	PharmD, BCGP, CMWA Clinical Pharmacist	Ms.	Weindel	Nicolette		8889742763	9982				nweindel@carekinesis.com	228 Strawbridge Drive		Moorestown	NJ	08057	05/10/2024	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Pharmacy Network Management Contact		Ms.	Slowiak	Andrea		7158522983					aslowiak@pharmastarpbm.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	03/07/2016	2026	PACE @ HOME, INC.	National PACE	Senior TLC	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	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active	6096701034				PACE - Nat		C	Atlanta
H4326	PHR Beneficiary Contact																	02/18/2021	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE	PACE at Home	PACE @ Home	459	Yes	Active	8284683980				PACE - Nat		C	Atlanta
H4326	Plan Directory Contact for Public Website	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Plan to Plan Reconciliation Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Processor Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Quality Contact	Director of Quality & Corporate Compliance	Mrs.	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Reconciliation Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Recovery Audit Contact	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Surveillance Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	System Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	10/13/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Third Party Administrator (TPA) Liaison	Finance Specialist	Ms.	Martin	Ambra		8284683013				8284642845	amartin@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	07/21/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	User Access Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Utilization Management Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4326	Utilization Review Contact	Executive Program Director	Mrs.	Jones	Emily		8284683980				8284642845	ejones@seniortlc.org	1915 Fairgrove Church Rd. SE		Newton	NC	28658	11/25/2025	2026	PACE @ HOME, INC.	National PACE	Senior TLC	National PACE		PACE @ Home	459	Yes	Active					PACE - Nat		C	Atlanta
H4329	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Best Available Evidence Contact	Manager, Enrollment		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Chief Financial Officer	Chief Financial Officer	Ms.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Government Relations Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H4329	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H4329	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4329	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4346	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	04/07/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4346	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4346	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4346	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4346	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4346	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4346	PHR Beneficiary Contact																	12/28/2017	2026	HMO COLORADO, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H4346	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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
H4348	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H4348	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Atlanta
H4348	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H4348	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H4348	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Atlanta
H4348	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H4348	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Atlanta
H4348	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4348	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KANSAS	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4371	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H4371	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	Atlanta
H4371	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4371	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	SENIOR WHOLE HEALTH, LLC	Local CCP	Molina Healthcare	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4393	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Services		Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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	Backup User Access Contact	Chief Information Officer	Ms.	Amoroso	Mitze		6465053860					mamoroso@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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	SVP, Business Development		Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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	Bid Primary Contact	Chief Financial Officer	Ms.	Covone	Annmarie		6466334702					acovone@archcare.org	205 Lexington Ave.	2nd Floor	New York	NY	10016	03/31/2011	2026	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	CAP Report Contact for Public Website	SVP, Business Development		Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	LaRue	Scott		6462856858					slarue@archcare.org	205 Lexington Ave.	3rd Floor	New York	NY	10016	12/23/2014	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	LaRue	Scott		6464754868					slarue@chcsnet.org	205 Lexington Ave.	2nd Floor	New York	NY	10016	11/04/2016	2026	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		6466334702					acovone@chcsnet.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	11/04/2016	2026	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 Operating Officer	SVP, Business Development	Mr.	Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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 Information Officer	VP Information Technology	Ms.	Amoroso	Mitze		6465053860				6463695679	mamoroso@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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 Information Security Officer	VP Information Technology	Ms.	Amoroso	Mitze		6465053860				6463695679	mamoroso@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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	SVP, Business Development		Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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	Complaints Tracking Contact	VP Business Operations and Regulatory Oversight	Ms.	Johnston	Stacey		3322277901					sjohnston@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	09/02/2025	2026	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	Contact for Fraud Investigations	VP, Business Operations and Regulatory Affairs	Ms.	Johnston	Stacey		3322277901					sjohnston@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	09/25/2025	2026	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	Clinical Director		Gloskin	Ellen		9143263111					egloskin@archcare.org	115 Broadway		Dobbs Ferry	NY	10522	12/01/2023	2026	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	Corporate Mailing						6466334738					ddunbar@archcare.org	Derek Dunbar	205 Lexington Avenue, 3rd Floor	New York	NY	10016	12/26/2023	2026	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		4405424056					rachelswanger@caremark.com	CVS Caremark Part D Services, LCC.	29100 Aurora Road	Solon	OH	44139	08/20/2020	2026	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	DIR Contact	Financial Analyst		Chan-Vinueza	Carol		6466334761				6462335745	cchan-vinueza@archcare.org	205 Lexington Avenue, 2nd Floor		New York	NY	10016	02/16/2024	2026	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	DIR Contact (Secondary)	CFO	Ms	Covone	Annmarie		6466334702				6466334701	acovone@archcare.org	205 Lexington Ave.	2nd Floor	New York	NY	10016	02/16/2024	2026	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	Discount Program Payment Contact	Senior Director, Finance		Traina	Marc		6466334732					mtraina@archcare.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	03/20/2020	2026	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	Emergency Part D Contact	AVP Clinical Services		Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	12/26/2023	2026	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	Emergency Part D Contact (Secondary)	Clinical Director		Gloskin	Ellen		9143263111					egloskin@archcare.org	115 Broadway		Dobbs Ferry	NY	10522	12/01/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP, Managed Care Operations		Fama	Victor		6465847984					vfama@archcare.org	205 Lexington Ave	2nd Floor	New York	NY	10016	11/27/2023	2026	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	Enrollment Contact	Director of Intake and Enrollment	Ms.	Kim-Smith	Jin		6468995328					jksmith@archcare.org	115 East Stevens Avenue		Valhalla	NY	10595	12/01/2023	2026	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	EOB Transfer Contact	Director of Intake and Enrollment	Ms.	Kim-Smith	Jin		6468995328				6463047131	jksmith@archcare.org	115 East Stevens Avenue		Valhalla	NY	10595	12/01/2023	2026	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	Financial Audit Contact	Chief Financial Officer	Ms.	Covone	Annmarie		6466334702					acovone@archcare.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	03/25/2011	2026	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	Financial Reporting Contact	Chief Financial Officer	Ms.	Covone	Annmarie		6466334702					acovone@chcsnet.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	11/04/2016	2026	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	Formulary Contact	Director, Pharmacy Services	Mr.	Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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	General Contact	SVP, Business Development		Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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	SVP, Business Development		Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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	HIPAA Privacy Officer	VP, Business Operations and Regulatory Affairs	Ms.	Johnston	Stacey		3322277901					sjohnston@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	09/25/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Amoroso	Mitze		6465053860					mamoroso@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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	Interoperability Contact	Director of Non-Clinical Applications		Brown	Antonette		6462535650					atbrown@archcare.org	205 Lexington Avenue, 8th Floor	8th Floor	New York	NY	10016	09/21/2023	2026	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	MA Appeals/Grievances Contact	Director of Quality Management		Vega-Stevens	Carmen		6462897715					cvstevens@archcare.org	1432 5th Ave		New York	NY	10032	12/26/2023	2026	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	MA Claims Processing Contact for Public Website	VP, Managed Care Operations		Fama	Victor		6465847984					vfama@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	01/07/2025	2026	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	Marketing Contact	Director of Marketing & Communications		Matta	Christine		6466334744					cmatta@archcare.org	205 Lexington Avenue	8th Floor	New York	NY	10016	09/21/2023	2026	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	Medical Director	Medical Director	Dr.	Chan-Ting	Rengena		9177346410					rchanting@archcare.org	205 Lexington Avenue	3rd Floor	New York	NY	10016	09/02/2025	2026	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	VP, Business Operations and Regulatory Affairs	Ms.	Johnston	Stacey		3323377901					sjohnston@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	09/25/2025	2026	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 Coordinator	SVP, Business Development		Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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 Part D Opioid Overutilization Contact	Director, Pharmacy Services		Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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	Medication Therapy Management Contact	Medical Director	Dr.	Chan-Ting	Rengena		9177346410					rchanting@archcare.org	205 Lexington Avenue	3rd Floor	New York	NY	10016	09/02/2025	2026	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	Online Enrollment Center Contact (Primary)	Director of Intake and Enrollment	Ms.	Kim-Smith	Jin		6468995328					jksmith@archcare.org	115 East Stevens Avenue		Valhalla	NY	10595	12/01/2023	2026	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 C Application Contact	Medical Director	Dr.	Chan-Ting	Rengena		9177346410					rchanting@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	09/02/2025	2026	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 Appeals	Director Pharmacy Services		Krupar	Roman	S						rkrupar@archcare.org	205 Lexington Avenue		New York	NY	10016	01/09/2021	2026	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active	9174845060				PACE - Nat		C	New York
H4393	Part D Application Contact	Chief Financial Officer	Ms.	Covone	Annmarie		6466334702					acovone@archcare.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	02/27/2013	2026	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 Benefits Contact	Director, Pharmacy Services		Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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 Claims Submission Contact	Director, Pharmacy Services	Mr.	Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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	2026	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active	4405425770				PACE - Nat		C	New York
H4393	Part D Exceptions Contact (Secondary)	Director, Pharmacy Services		Krupar	Roman							rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active	9174845060				PACE - Nat		C	New York
H4393	Part D Price File Contact (Back-up)	Senior Analyst, Medicare Operations		Nichols	Kristy		4806147768					kristy.nichols@caremark.com	CVS Caremark Part D Services, LCC.	9501 E Shea Boulevard	Scottsdale	AZ	85260	07/03/2013	2026	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 Price File Contact (Primary)	Chief Financial Officer	Ms.	Covone	Annmarie		6466334702					acovone@chcsnet.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	11/04/2016	2026	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 Quality Assurance Contact	Director, Pharmacy Services	Mr.	Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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 Reporting Contact	CFO	Ms	Covone	Annmarie		6466334702					acovone@archcare.org	205 Lexington Avenue		New York	NY	10016	11/09/2011	2026	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	Patient Safety Contact	Medical Director	Dr.	Chan-Ting	Rengena		9117734641					rchanting@archcare.org	205 Lexington Avenue	3rd Floor	New York	NY	10016	09/02/2025	2026	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	Payment Contact	Chief Financial Officer	Ms.	Covone	Annmarie		6466334702					acovone@chcsnet.org	205 Lexington Avenue	2nd Floor	New York	NY	10016	11/04/2016	2026	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	Personal Health Record Contact	SVP, Human Resources		Maijala	Jake		6466334422					jmaijala@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	09/02/2025	2026	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 Director	Director, Pharmacy Services	Mr.	Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue, 8th Floor		New York	NY	10016	02/06/2019	2026	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 Network Management Contact	Director, Network Systems & Standards		Tressler	Damon		4803914702				4803146023	damon.tressler@caremark.com	CVS Caremark Part D Services, LCC.	9501 E Shea Blvd., MC080	Scottsdale	AZ	85260	01/19/2016	2026	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 Network Management Contact (Secondary)	Medical Director	Dr.	Chan-Ting	Rengena		9177346410					rchanting@archcare.org	205 Lexington Avenue	3rd Floor	New York	NY	10016	09/02/2025	2026	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						8666934620	Mike.Palmieri@caremark.com	CVS Caremark Part D Services, LCC.	2401 Cherahala Blvd., MC650	Knoxville	TN	37932	11/23/2021	2026	CATHOLIC MANAGED LONG TERM CARE, INC.	National PACE	ArchCare Senior Life	National PACE		Catholic Health Care System	317	Yes	Active	8666934620				PACE - Nat		C	New York
H4393	Plan Directory Contact for Public Website			Senior Life	ArchCare		8662639083					providerrelations@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	10/30/2025	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Covone	Annmarie		6466334702					acovone@archcare.org	205 Lexington Ave.	2nd Floor	New York	NY	10016	11/04/2016	2026	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	Processor Contact	Vice President, Medicare Program Services		Merlino	Melanie		4802152151				4803146881	Melanie.Merlino@caremark.com	CVS Caremark Part D Services, LCC.	9501 E Shea Blvd.	Scottsdale	AZ	85260	01/19/2016	2026	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	Quality Contact	Director of Quality Management		Vega-Stevens	Carmen		6462897715					cvstevens@archcare.org	1432 5th Ave		New York	NY	10032	12/26/2023	2026	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	Reconciliation Contact	CFO	Ms.	Covone	Annmarie		6466334702					acovone@archcare.org	205 Lexington Avenue		New York	NY	10016	10/18/2010	2026	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	Reconciliation Contact (Secondary)	Senior Director, Finance		Johnson	Timothy		6466334737					tjohnson1@archcare.org	205 Lexington Avenue, 2nd Fl	Archcare Advantage - Finance	New York	NY	10016	04/26/2022	2026	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	Recovery Audit Contact	Financial Analyst	Ms.	Chan	Carol		6466334761				6462335745	cchan@archcare.org	205 Lexington Avenue, 2nd Floor	Archcare Advantage - Finance	New York	NY	10016	11/04/2016	2026	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	Surveillance Contact	SVP, Business Development		Dunbar	Derek		6466334738					ddunbar@archcare.org	205 Lexington Avenue, 3rd Floor		New York	NY	10016	12/26/2023	2026	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	System Contact	Director of Non-Clinical Operations		Brown	Antonette		6462535650					atbrown@archcare.org	205 Lexington Avenue, 8th Floor	8th Floor	New York	NY	10016	11/27/2023	2026	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	Third Party Administrator (TPA) Liaison	VP, Managed Care Operations		Fama	Victor		6465847984					vfama@archcare.org	205 Lexington Avenue, 2nd Floor		New York	NY	10016	11/27/2023	2026	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	User Access Contact	Director of Non-Clinical Applications		Brown	Antonette		6462535650					atbrown@archcare.org	205 Lexington Avenue, 8th Floor	8th Floor	New York	NY	10016	09/21/2023	2026	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	Utilization Management Contact	Director, Pharmacy Services		Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue	8th Floor	New York	NY	10016	09/02/2025	2026	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	Utilization Review Contact	Director, Pharmacy Services		Krupar	Roman		9174845060					rkrupar@archcare.org	205 Lexington Avenue	8th Floor	New York	NY	10016	09/02/2025	2026	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	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Backup User Access Contact	Executive Director	Ms.	Herring	Beth		4234959104					bherring@ascension.org	425 Cumberland Street		Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Best Available Evidence Contact	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Bid Primary Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	CAP Report Contact for Public Website	Director of Compliance		Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	CEO - CMS Administrator Contact	Executive Director	Ms.	Herring	Beth		4234959118				4236226048	bherring@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	CEO - Senior Official for Contracting	Executive Director	Ms.	Herring	Beth		4234959118				4236226048	bherring@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Chief Financial Officer	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Chief Operating Officer	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Chief Information Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	2622 W Central #100		Wichita	KS	67203	04/04/2022	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Chief Information Security Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	2622 W Central #100		Wichita	KS	67203	04/04/2022	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	CMS Casework Communication Contact	Compliance director	Ms	Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Complaints Tracking Contact	QI Director		Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@acesnion.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Contact for Fraud Investigations	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Coordination of Benefits Contact	Finance Director	Mr.	Webster	Ty		3142702497				3169465106	ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Corporate Mailing						4236980802				4236226048	vguertin@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Customer Service Operations Contact	Site Director	Ms	Busby	Elouise		4234959104				4234959145	elouise.busby@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	DIR Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	DIR Contact (Secondary)	Senior Director of Clinical Services PACE	Ms.	Goetzinger	Jill		7725215733				4236226048	jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Discount Program Payment Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Emergency Part D Contact	Director of Pharmacy		McDonough	Leah		4234959203				4236226048	lmcdonough@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	04/02/2018	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Emergency Part D Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Encounter Data & Risk Adjustment Operations Contact	Finance Director	Mr.	Webster	Ty		3142702497				3169465106	ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Enrollment Contact	Accounting	Ms.	Sanders	Rebecca		8016880282					rebecca.sanders2@ascension.org	250 East 10th Street		Chattanooga	TN	37402	04/11/2023	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	EOB Transfer Contact	Finance Director	Mr.	Webster	Ty		3142702497				3169465106	ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Financial Audit Contact	Finance Dirctor	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Financial Reporting Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Formulary Contact	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Formulary Contact (Secondary)	Pharmacy Director	Ms.	McDonough	Leah		4234953203					lmcdonough@ascension.org	425 Cumberland Street #110		Chattanooga	TN	37404	05/12/2021	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	General Contact	Executive Director	Ms	Herring	Beth		4234959118				4236226048	bherring@ascnsion.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Government Relations Contact	QI Director	Ms	Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascesnion.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	HIPAA Privacy Officer	Dir.Clinical Services	Ms	Chesnutt	Jacquelyn		4234951991				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	HIPAA Security Officer	Dir.Quality	Ms	Chesnutt	Jacquelyn		4234959119				4236226048	jacqulyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Interoperability Contact	Executive Director		Herring	Beth		4234959118				4236226048	bherring@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	MA Appeals/Grievances Contact	QI Director		Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	MA Claims Processing Contact for Public Website	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Marketing Contact	Marketing Director	Ms.	Thompson	Sierra		4236980802					sierra.thompson@ascension.org	425 Cumberland Street		Chattanooga	TN	37404	01/24/2023	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Medical Director	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Medicare Compliance Officer	Compliance Director	Ms	Chesnutt	Jacquelyn		4234959119				4236971752	jacquelyn.chesnutt@ascesnion.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Medicare Coordinator	Dir Compliance	Ms	Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Medication Therapy Management Contact	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part C Application Contact	Executive Director	Ms.	Herring	Beth		4234959118				4236226048	bherring@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Appeals	Pharmacy Director		McDonough	Leah						4234959213	lmcdonough@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	02/18/2022	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active	4234959203				PACE - Nat		C	Atlanta
H4402	Part D Application Contact	Executive Director	Ms.	Herring	Beth		4234959118					bherring@ascension.org	425 Cumberland Street		Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Benefits Contact	Pharmacy Director		McDonough	Leah		4234959203				4236226048	lmcdonough@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	06/22/2021	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Claims Submission Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Exceptions Contact	Finance Director	Mr.	Webster	Ty						4236226048	ty.webster@ascension.org	250 East 10th Street		Chattanooga	TN	37402	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active	8004418883				PACE - Nat		C	Atlanta
H4402	Part D Exceptions Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff							jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active	8008814443				PACE - Nat		C	Atlanta
H4402	Part D Price File Contact (Back-up)	Director of Pharmacy		McDonough	Leah		4234959203				4236226048	lmcdonough@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	04/02/2018	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Price File Contact (Primary)	Executive Director	Ms.	Herring	Beth		4234959118				4236226048	bherring@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Quality Assurance Contact	QI Director		Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Part D Reporting Contact	Finance  Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Patient Safety Contact	QI Director		Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Payment Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Personal Health Record Contact	Director of Health Information		Stanley	Elizabeth	M	4236980802	117				elizabeth.stanley@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Pharmacy Director	Director of Pharmacy		McDonough	Leah		4234959203				4236226048	lmcdonough@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	04/02/2018	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Pharmacy Network Management Contact	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Pharmacy Technical Help Desk Contact	Director of Pharmacy		McDonough	Leah						4236226048	lmcdonough@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	04/02/2018	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active	8004418883				PACE - Nat		C	Atlanta
H4402	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacist-PharmD		Hankins	Sherry						4236226048	shankins@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	04/02/2018	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active	4236980802	203			PACE - Nat		C	Atlanta
H4402	PHR Beneficiary Contact																	06/07/2011	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE	Alexian Brothers Community Services	Ascension Health Alliance	708	Yes	Active	8004418883				PACE - Nat		C	Atlanta
H4402	Plan Directory Contact for Public Website	Marketing Director	Ms.	Thompson	Sierra		4236980802					sierra.thompson@ascension.org	425 Cumberland Street		Chattanooga	TN	37404	01/24/2023	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Plan to Plan Reconciliation Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Processor Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Quality Contact	QI Director		Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Reconciliation Contact	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Reconciliation Contact (Secondary)	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Recovery Audit Contact	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Surveillance Contact	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	System Contact	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Third Party Administrator (TPA) Liaison	Finance Director	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	User Access Contact	Quality Director	Ms	Chesnutt	Jacquelyn		4234959119				4236226048	jacquelyn.chesnutt@ascension.org	425 Cumberland Street	Suite 110	Chattanooga	TN	37404	09/29/2025	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Utilization Management Contact	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4402	Utilization Review Contact	Medical Director	Dr.	Birch	Lorna		4236980802	1080188			4236226048	lbirch@ascension.org	425 Cumberland Street	Suite 110	Chattanoga	TN	37404	09/04/2020	2026	ALEXIAN BROTHERS COMMUNITY SERVICES	National PACE	Ascension Living Alexian PACE	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H4407	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	07/03/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H4407	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H4407	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H4407	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H4407	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H4407	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H4407	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4407	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4439	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4439	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4439	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H4444	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4444	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF INDIANA	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4445	Automated TrOOP Balance Transfer Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Backup User Access Contact			Durbin	Patrick		8446642248					pdurbin@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Best Available Evidence Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Bid Primary Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	CAP Report Contact for Public Website			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	CEO - CMS Administrator Contact		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	CEO - Senior Official for Contracting		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Chief Financial Officer		Mr.	Fuentes	Robert		8446642248					rfuentes@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Chief Operating Officer		Ms.	Funk	Jennie		8446642248					jfunk@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Chief Information Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Chief Information Security Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	CMS Casework Communication Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Complaints Tracking Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Contact for Fraud Investigations			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Coordination of Benefits Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Corporate Mailing						8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Customer Service Operations Contact			Guel-Valenzuela	Sophia		3106275500					sguel-valenzuela@habitathealth.com	1005 East Rosecrans Avenue		Compton	CA	90221	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	DIR Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Discount Program Payment Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Emergency Part D Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Encounter Data & Risk Adjustment Operations Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Enrollment Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	EOB Transfer Contact			Siler	Sarah		8556592670				9165144953	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Financial Audit Contact	Sr. Dir, Health Plan	Mrs.	Siler	Sarah		8446642248				9167372990	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Financial Reporting Contact			Ryan	Chandler		8446642248					cryan@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Formulary Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	General Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Government Relations Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	HIPAA Privacy Officer			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	HIPAA Security Officer			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Interoperability Contact			Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	MA Appeals/Grievances Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	MA Claims Processing Contact for Public Website			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Marketing Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Medical Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Medicare Compliance Officer		Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Medicare Coordinator	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Medicare Part D Opioid Overutilization Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Medication Therapy Management Contact	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part C Application Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part D Appeals		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8446642248				PACE - Nat		C	San Francisco
H4445	Part D Application Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part D Benefits Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part D Claims Submission Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part D Exceptions Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8556592670				PACE - Nat		C	San Francisco
H4445	Part D Price File Contact (Back-up)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part D Price File Contact (Primary)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part D Quality Assurance Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Part D Reporting Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Patient Safety Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Payment Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Pharmacy Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Pharmacy Network Management Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Pharmacy Technical Help Desk Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8556592670				PACE - Nat		C	San Francisco
H4445	Plan Directory Contact for Public Website			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Plan to Plan Reconciliation Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Processor Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Quality Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Reconciliation Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Recovery Audit Contact	VP, Compliance	Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Surveillance Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	System Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Third Party Administrator (TPA) Liaison			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	User Access Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Utilization Management Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4445	Utilization Review Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SOUTH LOS ANGELES, LLC	National PACE	Habitat Health South Los Angeles	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H4461	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H4461	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H4461	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4461	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	CARITEN HEALTH PLAN INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4471	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		5136497052				8884581406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/10/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4471	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4471	PHR Beneficiary Contact																	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H4471	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/06/2023	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4471	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	Local CCP	Anthem Blue Cross	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4473	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H4473	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Atlanta
H4473	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H4473	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H4473	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Atlanta
H4473	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H4473	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Atlanta
H4473	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4473	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H4490	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8442287934				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	01/18/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8442287934				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8442287934				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Ste 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Coordinator	Executive Director	Ms.	Kukuljan	Shiloh		3143549940				8442805360	skukuljan@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	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	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	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	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H4490	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H4490	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H4490	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H4490	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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 Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	2026	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8335026757				HMO - Health Maintenance Organization		C	Dallas
H4490	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Technician		Sanchez	Lynn						6157610920	lsanchez@amhealthplans.com	909 S Meridian Avenue	Ste 425	Oklahoma City	OK	73108	06/25/2021	2026	AMERICAN HEALTH PLAN OF MISSOURI, INC.	Local CCP	American Health Advantage of Missouri	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8442287934				HMO - Health Maintenance Organization		C	Dallas
H4490	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8442287934				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	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	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	SNP State Contact	Executive Director	Ms.	Kukuljan	Shiloh		3143549940				8442805360	skukuljan@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Agent/Broker Compensation Data Contact	Dir, Administrative Expense Management		Fiala	Ladimir		2166877820					ladimir.fiala@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Automated TrOOP Balance Transfer Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Backup User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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		2166876585					BAEdocs@medmutual.com	100 American Road		Cleveland	OH	44144	04/03/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Bid Audit Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Bid Audit Site Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Bid Primary Contact	Lead Medicare Products Analyst		Kotecki	Bradley		2166872762					bradley.kotecki@medmutual.com	100 American Road		Cleveland	OH	44144	06/09/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	CAP Report Contact for Public Website	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	CEO - CMS Administrator Contact	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	01/24/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	CEO - Senior Official for Contracting	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	01/24/2025	2026	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	VP, Chief Financial Officer	Mr.	McNutt	Jim		2166877006					james.mcnutt@medmutual.com	100 American Road		Cleveland	OH	44144	01/24/2025	2026	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 Operating Officer	EVP, President of Paramount Health	Ms.	Johnston	Lori		2166877000					lori.johnston@medmutual.com	100 American Road		Cleveland	OH	44144	02/06/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	04/03/2023	2026	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 Information Security Officer	Chief Data & Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	04/03/2023	2026	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	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	04/03/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Complaints Tracking Contact	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	04/03/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Contact for Fraud Investigations	Manager, Financial Investigations		Jorz	Nicholas		2166877433					nicholas.jorz@medmutual.com	100 American Road		Cleveland	OH	44144	06/20/2024	2026	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	Manager, COB and Workers Comp		Njaim	Stephanie		4194737733					Stephanie.Njaim@medmutual.com	100 American Road		Cleveland	OH	44144	09/15/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Corporate Mailing						2166877000					Victoria.Kressler@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	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	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	DIR Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	09/15/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	DIR Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	09/14/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Discount Program Payment Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					michelle.stepic@medmutual.com	100 American Road		Cleveland	OH	44144	09/15/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Electronic Health Record Contact	Manager, Compliance		Dean	Herbert		2166877000					herbert.dean@medmutual.com	100 American Road		Cleveland	OH	44144	11/15/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Emergency Part D Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Employer Waiver Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment Information Services		Shaner	Donald		2166877159					Donald.Shaner@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Enrollment Contact	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	EOB Transfer Contact	Sr. Project Manager		Rush	Jamie		5132347613	617613			2166877675	ESITrOOPTransfer@express-scripts.com	8990 Duke Drive		Mason	OH	45040	12/14/2016	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Financial Audit Contact	Lead Financial Analyst	Ms.	Lohrke	Maureen		2162933190					maureen.lohrke@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Financial Reporting Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					cory.hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Formulary Contact	Clinical Pharmacist		Ivec	Carl		2166876017					Carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	08/26/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Formulary Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katherine		2166877344					Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	General Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	HIPAA Privacy Officer	Chief Compliance and Privacy Officer		Fichter	Lynn		2166872617					Lynn.Fichter@medmutual.com	100 American Road		Cleveland	OH	44144	06/20/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	HIPAA Security Officer	EVP, Chief Data and Information Officer		Donovan	Chris		4408786450					Chris.Donovan@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	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	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Interoperability Contact	Manager, EDI Compliance		Huebler	Kathleen		4408785420					kathleen.huebler@medmutual.com	100 American Road		Cleveland	OH	44144	11/15/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	MA Appeals/Grievances Contact	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	MA Claims Processing Contact for Public Website	Director, Claims Operations		Rittner	Kim		2166874377					kim.rittner@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Marketing Contact	Director, Acquisition Marketing Govermnt Prgms		Schultz	Melissa		2166877000					Melissa.Schultz@medmutual.com	100 American Road		Cleveland	OH	44144	01/24/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Medical Director	VP, Sr. Medical Officer	Dr.	Bialecki-Haase	Dee		2166877000					dee.bialeckihaase@medmutual.com	100 American Road		Cleveland	OH	44144	11/15/2024	2026	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	Medicare Compliance Officer	Ms.	Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Coordinator	Lead Compliance Analyst		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44115	01/21/2025	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist		Ivec	Carl		2166876017					carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Medication Therapy Management Contact	Clinical Pharmacist		Ivec	Carl		2166876017					carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	04/03/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	OffShore Subcontractor Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Online Enrollment Center Contact (Back-up)	Manager, Member Services & System Administration		Bartholomai	Diane		2166877357					Diane.Bartholomai@medmutual.com	100 American Road		Cleveland	OH	44144	09/15/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Online Enrollment Center Contact (Optional)	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Online Enrollment Center Contact (Primary)	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	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 C Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 C Reporting Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Appeals	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/14/2016	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	8003443405	733326			PPO - BBA		C	Chicago
H4497	Part D Appeals Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				PPO - BBA		C	Chicago
H4497	Part D Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Benefits Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Claims Submission Contact	Director   Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive.		Franklin Lakes	NJ	07417	05/19/2021	2026	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	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	6143363326				PPO - BBA		C	Chicago
H4497	Part D Exceptions Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katherine							Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				PPO - BBA		C	Chicago
H4497	Part D Price File Contact (Back-up)	Director, Pharmacy - Medicare and Information		Goff	Katherine		2166877344					Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	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 Price File Contact (Optional)	Sr. Manager Government Programs		Dolfi	Amanda		6147613606				2166872623	amanda_dolfi@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/14/2016	2026	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 Price File Contact (Primary)			Westrum	Joshua		4807363132	433132				Medicarewebsitefiles@express-scripts.com	7909 S. Hardy Dr.	#106	Tempe	AZ	85284	12/14/2016	2026	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 Quality Assurance Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Reporting Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Patient Safety Contact	VP, Pharmacy		Blagojevic	Marko		2166876239					Marko.Blagojevic@medmutual.com	100 American Road		Cleveland	OH	44144	01/25/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Payment Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					Cory.Hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	09/15/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Personal Health Record Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Director	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Network Management Contact			Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	02/02/2015	2026	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 Network Management Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	8009221557				PPO - BBA		C	Chicago
H4497	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				PPO - BBA		C	Chicago
H4497	Physician Incentive Contact	Mgr, Clinical Quality Improvement		Brooks	Melissa		4408784163					melissa.brooks@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Plan Directory Contact for Public Website	Dir, Operations Technology Transformation		Palace	Ted		2166872807					ted.palace@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Plan to Plan Reconciliation Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road	MZ: 02-3B-5320	Cleveland	OH	44144	10/02/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Processor Contact	Sr. Director, Government Programs Medicare		Gibson	Sharon		8057779130					SGGibson@express-scripts.com	One Express Way		St. Louis	MO	63121	11/28/2016	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Quality Contact	Director, Clinical Quality Improvement		Sullivan	Suzanne		4408786481					suzanne.sullivan@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Reconciliation Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	09/14/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Reconciliation Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	09/14/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Recovery Audit Contact	VP, Health Plan Payment Integrity	Mr.	Palace	Ted		2166872807					Ted.Palace@medmutual.com	100 American Road		Cleveland	OH	44144	01/25/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Surveillance Contact	Director, Individual Sales and Compliance		Coyne	Jaime		2166872676					MASalesCompliance@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	System Contact	VP, Chief Technology Officer		Stein	Matt		4408786460					matt.stein@medmutual.com	100 American Road		Cleveland	OH	44144	05/12/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Third Party Administrator (TPA) Liaison	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	09/15/2023	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Utilization Management Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/20/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4497	Utilization Review Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/20/2024	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H4499	Agent/Broker Compensation Data Contact	Sr. Director, Consumer Products & Sales		McVey	Kathy		7574181231					kemcvey@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Benefits		Strickland	Brandi		7572528193				7579625575	RxBenefits@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Backup User Access Contact	Compliance Consultant		Harvey	Kimberly		8046134890	20178				kdharvey@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Best Available Evidence Contact	Director Enrollment & Disenrollment		Brown	Sheila		7572528015				7576925575	sxbrown29@sentara.com	4456 Corporation Lane	Suite 210	Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Bid Audit Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Bid Audit Site Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Bid Primary Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	CAP Report Contact for Public Website	Medicare Contract Administrator		MEDICARE	SENTARA		7576876160				7575527116	jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	03/04/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8009276048				HMO - Health Maintenance Organization		C	Dallas
H4499	CEO - CMS Administrator Contact	VP, Government Programs	Mr	Whitehead	Steve		7579832538					srwhiteh@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	CEO - Senior Official for Contracting	VP, Government Programs	Mr	Whitehead	Steve		7579832538					srwhiteh@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Chief Financial Officer	SVP & CFO	Ms.	Campbell	Sharilyn		2068980702					sxcamp11@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Chief Operating Officer	VP, Government Programs	Mr	Whitehead	Steve		7579832538					srwhiteh@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Chief Information Officer	VP Information Systems	Mr	Schrecengost	Jeff		7575803501					JRSCHREC@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Siddiqui	Zishan		7572520015				7579638689	zasiddiq@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	CMS Casework Communication Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Complaints Tracking Contact	Manager, Regulatory Compliance		Jones	Uyvonka		8043398376					UXJONES@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	03/04/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Contact for Fraud Investigations	Director , Program Integrity/SIU		Abenante	Carrie		7576876405					clabenan@sentara.com	1330 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Coordination of Benefits Contact	Sr. Compliance Consultant	Ms	Godette	Maricelis		8048195151					mxcintro@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Corporate Mailing						5704920915				7575527116	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Customer Service Operations Contact	Sr. Director, Customer Services		Bain	Shenna		8133348871				7575527116	sxlucasb@sentara.com	10800 Nuckols Road		Glen Allen	VA	23060	02/11/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	DIR Contact	Director Pharmacy Performance		Hartzell	Lindsay		8048195179				7579625575	lxhartze@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	DIR Contact (Secondary)	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Discount Program Payment Contact	Director Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Emergency Part D Contact	Clinical Pharmacist		Rasnick	Dorothy		7579834243				7579625575	dxrasnic@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Emergency Part D Contact (Secondary)	Manager Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Employer Waiver Contact	Director Government Programs - Medicare		Hoffman	Daniel		7579832540				7575527396	dehoffma@sentara.com	4417 Corporation Lane		Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Encounter Data & Risk Adjustment Operations Contact	Director, Actuary		Ratzlaff	Dean		7576876018					daratzla@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Enrollment Contact	Director, Enrollment		Brown	Sheila		7572528015					sxbrown29@sentara.com	4456 Corporation Lane		Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	EOB Transfer Contact	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625576	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Financial Audit Contact	Director, Medicare Compliance	Ms.	Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Financial Reporting Contact	VP & Controller		Snyder	Jeff		7572528023				7572528030	jcsnyder@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Formulary Contact	Clinical Pharmacist		Rasnick	Dorothy		7579834243				7579625575	dxrasnic@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Formulary Contact (Secondary)	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	General Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Government Relations Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	HIPAA Privacy Officer	Director, Compliance	Ms.	Dajon	Sharon	M	7575527485				7575527116	smdajon@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Siddiqui	Zishan		7572520015				7579638689	zasiddiq@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Hospice Contact	Director Pharmacy Ops & Compliance		May	Crystal		8666037514				7579625575	ccmay2@sentara.com	10800 Nuckols		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Interoperability Contact	VP, Information Systems		Brown	Marty		3056710216					Marty.brown@avmed.org	3470 NW 82nd St.		Doral	FL	33122	02/11/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	MA Appeals/Grievances Contact	Director Appeals & Grievance		Byrd	Natasha		8048195151				7576876232	nxbyrd@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	MA Claims Processing Contact for Public Website	Director Ops Support		Rodriguez	Joseph		7579834333				7572528030	jxrodr10@sentara.com	10800 Nuckols Rd		Glen Allen	VA	23060	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Marketing Contact	Government Programs Director of Marketing and Comm		Morey	Fallon		7176140606					fnmorey@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Medical Director	CMO Health Plan	Dr.	Greifer	Kristyn		6782748402				7572267944	KXGREIFE@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Medicare Compliance Officer	Director, Medicare Compliance	Ms.	Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Medicare Coordinator	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Papcun	Richard		8043013903				7579625575	RFPAPCU1@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Medication Therapy Management Contact	Clinical Pharmacist		Rasnick	Dorothy		8043013903				7579625575	DXRASNIC@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	06/19/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Erie	James		8048195151					jxerie@sentara.com	4456 Corporate Lane		Virginia Beach	VA	23462	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Online Enrollment Center Contact (Optional)	Sr. Business Analyst, Medicare		Ashar	Satish		8048195151	302				sdashar@sentara.com	4456 Corporate Lane		Virginia Beach	VA	23462	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Online Enrollment Center Contact (Primary)	Director, Enrollment		Brown	Sheila		7572528015					sxbrown29@sentara.com	4456 Corporation Lane		Virginia Beach	VA	23462	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part C Application Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part C Reporting Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Appeals	Clinical Pharmacist		Rasnick	Dorothy						7579625576	dxrasnic@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	7579834243				HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Appeals Contact (Secondary)	Manager Pharmacy Compliance		Allen	Emily						7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8048144500				HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Application Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Benefits Contact	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Claims Submission Contact	Manager, Pharmacy Benefits		Strickland	Brandi		7572528193				7579625575	RxBenefits@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Exceptions Contact	Clinical Pharmacist		Rasnick	Dorothy						7579625576	dxrasnic@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	7579834243				HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Exceptions Contact (Secondary)	Manager Pharmacy Compliance		Allen	Emily						7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8048144500				HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Price File Contact (Back-up)	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Price File Contact (Optional)	Director Pharmacy Performance		Hartzell	Lindsay		8048195179				7579625575	lxhartze@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Price File Contact (Primary)	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Quality Assurance Contact	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Part D Reporting Contact	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7576925576	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Patient Safety Contact	Clinical Pharmacist		Rasnick	Dorothy		7579834243				7579625575	dxrasnic@sentara.com	1300 Sentara Park	Suite 210	Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Payment Contact	Director, Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Pharmacy Director	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Pharmacy Network Management Contact	VP, Pharmacy		Daw	Jessica		7572528181				7579625575	jrdaw@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Compliance		Allen	Emily		8048144500				7579625575	RxCompliance@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	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	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H4499	Physician Incentive Contact	VP Network Management & Value Based Care		Krebbs	Robert		8045728832				7575527576	rlkrebbs@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Plan Directory Contact for Public Website	Member Services		MEMBER SERVICES	OPTIMA		8009276048					members@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/11/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Plan to Plan Reconciliation Contact	Director Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Processor Contact	Director Ops Support		Rodriguez	Joseph		7579834333				7572528030	jxrodr10@sentara.com	10800 Nuckols Rd		Glen Allen	VA	23060	08/12/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Quality Contact	Director Quality Improvement		Taylor	Tonya		8046136524					tptaylor@sentara.com	10800 Nuckols Rd.		Glen Allen	VA	23060	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Reconciliation Contact	Director, Accounting Operations	Ms.	Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Reconciliation Contact (Secondary)	Manager Actuarial Support		Wimalendran	Shane		7575528944					uxwimale@sentara.com	1330 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Recovery Audit Contact	Director, Accounting Operations	Ms.	Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	SNP Application Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	SNP State Contact	Director Government Programs - Medicare		Hoffman	Daniel		5704920915				7575527396	dehoffma@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Surveillance Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	System Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Third Party Administrator (TPA) Liaison	Director Accounting Operations		Duncan	April		7572528055				7572528039	acmorgan@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	User Access Contact	Director Medicare Compliance		Green	Janet		8133682227					jlgree13@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Utilization Management Contact	Director Utilization Management		Barber-Euresti	Jessica		8045862351				7575527108	jxbarber@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4499	Utilization Review Contact	Director Utilization Management		Barber-Euresti	Jessica		8045862351					jxbarber@sentara.com	1300 Sentara Park		Virginia Beach	VA	23464	02/10/2025	2026	SENTARA HEALTH PLANS	Local CCP	Sentara Medicare	HMO/HMOPOS		Sentara Health Care (SHC)	345	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4506	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H4506	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H4506	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H4506	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H4506	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4506	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4506	PHR Beneficiary Contact																	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H4506	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4506	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	SELECTCARE OF TEXAS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4513	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	07/03/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H4513	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H4513	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H4513	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H4513	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H4513	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H4513	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4513	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4514	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H4514	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4514	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4514	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H4514	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4514	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4517	Automated TrOOP Balance Transfer Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Backup User Access Contact	Executive Director		Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Best Available Evidence Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Bid Primary Contact	Executive Director		Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	CAP Report Contact for Public Website	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	CEO - CMS Administrator Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	CEO - Senior Official for Contracting	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Chief Financial Officer	Director of Finance	Mrs	Houck	Jamie		8063745516				8063739446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	11/05/2020	2026	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	Atlanta
H4517	Chief Operating Officer	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Chief Information Officer	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Chief Information Security Officer	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	CMS Casework Communication Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Complaints Tracking Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Contact for Fraud Investigations	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Coordination of Benefits Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Corporate Mailing						8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	09/08/2020	2026	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	Atlanta
H4517	Customer Service Operations Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	DIR Contact	Director of Finance	Mrs	Houck	Jamie		8063745516				8063739446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	02/24/2021	2026	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	Atlanta
H4517	DIR Contact (Secondary)	Executive Director	Mrs	Hurt	Kristen	R	8063745516					krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	02/24/2021	2026	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	Atlanta
H4517	Discount Program Payment Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Emergency Part D Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Emergency Part D Contact (Secondary)	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Encounter Data & Risk Adjustment Operations Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Enrollment Contact	Master Social Worker		Gaitan	Ruby		8063745516				8063739446	ruby@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	05/06/2015	2026	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	Atlanta
H4517	EOB Transfer Contact	Director of Finance		Houck	Jamie		8063745516				8063739446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Financial Audit Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Financial Reporting Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Formulary Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	General Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Government Relations Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	HIPAA Privacy Officer	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	HIPAA Security Officer	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Interoperability Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	04/26/2022	2026	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	Atlanta
H4517	MA Appeals/Grievances Contact	Compliance Coordinator	Ms	Gross	Stephanie		8063745516				8063739446	stephanie@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	07/22/2021	2026	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	Atlanta
H4517	MA Claims Processing Contact for Public Website	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Marketing Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Medical Director	Medical Director		Rankin	Ron		8063745516				8063734769	ron@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	05/05/2010	2026	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	Atlanta
H4517	Medicare Compliance Officer	Compliance Coordinator	Ms	Gross	Stephanie		8063745516				8063739446	stephanie@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	07/22/2021	2026	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	Atlanta
H4517	Medicare Coordinator	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Medicare Part D Opioid Overutilization Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	04/26/2022	2026	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	Atlanta
H4517	Medication Therapy Management Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Part C Application Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Part D Appeals	Executive Director		Hurt	Kristen	R					8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	8882996401				PACE - Nat		C	Atlanta
H4517	Part D Appeals Contact (Secondary)	Director of Finance		Houck	Jamie						8063739446	jamieh@janwerneradultdaycare.org	3108 S. Fillmore		Amarillo	TX	79110	01/04/2021	2026	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	8882996401				PACE - Nat		C	Atlanta
H4517	Part D Application Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Part D Benefits Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Part D Claims Submission Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Part D Exceptions Contact	Finance Director	Ms	Houck	Jamie						8063739446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	03/20/2020	2026	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	8883748400				PACE - Nat		C	Atlanta
H4517	Part D Price File Contact (Back-up)	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Part D Price File Contact (Primary)	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Part D Quality Assurance Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Part D Reporting Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Patient Safety Contact	Director of Clinical Services		Ozzello	Serenity		8063745516				8063734769	Serenity@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	04/14/2025	2026	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	Atlanta
H4517	Payment Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Pharmacy Director	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Pharmacy Network Management Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Pharmacy Technical Help Desk Contact	Director of Finance	Ms	Houck	Jamie						8063739446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	03/20/2020	2026	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	8882996401				PACE - Nat		C	Atlanta
H4517	Plan Directory Contact for Public Website	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Plan to Plan Reconciliation Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Processor Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Quality Contact	Executive Director		Hurt	Kristen		8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Reconciliation Contact	Director of Finance	Mrs	Houck	Jamie		8063745516				8063739446	jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	02/24/2021	2026	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	Atlanta
H4517	Reconciliation Contact (Secondary)	Executive Director	Mrs	Hurt	Kristen	R	8063745516					krissy@janwerneradultdaycare.org	3108 S. Fillmore		Amarillo	TX	79110	02/24/2021	2026	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	Atlanta
H4517	Recovery Audit Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	Surveillance Contact	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	System Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Third Party Administrator (TPA) Liaison	Executive Director	Mrs	Hurt	Kristen	R	8063745516				8063739446	krissy@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	79110	09/08/2020	2026	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	Atlanta
H4517	User Access Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Utilization Management Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4517	Utilization Review Contact	Director of Finance		Houck	Jamie		8063745516					jamieh@janwerneradultdaycare.org	3108 S Fillmore		Amarillo	TX	791101026	03/20/2020	2026	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	Atlanta
H4518	Automated TrOOP Balance Transfer Contact	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Backup User Access Contact	EHR Project Manager		Caracosa	Luis		9155623444	2410				lcaracosa@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Best Available Evidence Contact	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Bid Primary Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	CAP Report Contact for Public Website	Director of Process Improvement	Mr	Alvarado	Efren	A	9155623444	1606			9158758851	efren.alvarado@bienvivir.org	2300 McKinley		El Paso	TX	79930	07/15/2022	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Castillo	Rosemary		9155623444	2800				CEO@bienvivir.org	2300 McKinley		El Paso	TX	79930	09/18/2017	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	CEO - Senior Official for Contracting	Chief Executive Officer	Ms	Castillo	Rosemary		9155623444	2800				CEO@bienvivir.org	2300 McKinley		El Paso	TX	79930	09/18/2017	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Chief Financial Officer	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	08/13/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Chief Operating Officer	VP of Center Operations	MR	Baca	James		9155623444	2240				jbaca@bienvivir.org	2300 McKinley		El Paso	TX	79930	10/30/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Chief Information Officer	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 McKinley		El Paso	TX	79930	08/13/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Chief Information Security Officer		Mr	Caracosa	Luis		9155623444	2410				lcaracosa@bienvivir.org	2300 McKinley		El Paso	TX	79930	02/12/2016	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	CMS Casework Communication Contact	QI Manager	Ms.	Alvarado	Karla	L	9155623444	1603				karla.alvarado@bienvivir.org	2300 McKinley		El Paso	TX	79930	07/15/2022	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Complaints Tracking Contact	QI Manager	Ms.	Alvarado	Karla	L	9155623444	1603			9158758851	karla.alvarado@bienvivir.org	2300 McKinley		El Paso	TX	79930	07/15/2022	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Contact for Fraud Investigations	Compliance Officer	Mr	Barrera	Antonio		9155623444	1703				antonio.barrera@bienvivir.org	2300 McKinley		El Paso	TX	79930	02/23/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Coordination of Benefits Contact	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Corporate Mailing						9155623444	2800				analisa.flores@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Customer Service Operations Contact	VP of Center Operations	MR	Baca	James		9155623444	2240				jbaca@bienvivir.org	2300 McKinley		El Paso	TX	79930	10/30/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	DIR Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	03/21/2018	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	DIR Contact (Secondary)	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley Ave		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Discount Program Payment Contact	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 Mckinley		El Paso	TX	79930	10/02/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Emergency Part D Contact	Director of Pharmacy		Orona	Robert		9155623444	1801				rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Emergency Part D Contact (Secondary)	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Encounter Data & Risk Adjustment Operations Contact	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Enrollment Contact	Accounting Supervisor		Garcia	Irene		9155623444	2370				igarcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	05/23/2016	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	EOB Transfer Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101			9158758850	luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Financial Audit Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	08/13/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Financial Reporting Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	08/13/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Formulary Contact	Director of Pharmacy		Orona	Robert		9155623444	1801				rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	General Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Government Relations Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	HIPAA Privacy Officer	Compliance Officer	Mr	Barrera	Antonio		9155623444	1703				antonio.barrera@bienvivir.org	2300 McKinley		El Paso	TX	79930	02/23/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	HIPAA Security Officer	EHR Project Manager		Caracosa	Luis		9155623444	2410				lcaracosa@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Interoperability Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	03/16/2022	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	MA Appeals/Grievances Contact	QI and UM Director	Ms.	Alvarado	Karla	L	9155623444	1603			9158758851	karla.alvarado@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	MA Claims Processing Contact for Public Website	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Marketing Contact	Growth Director		Salinas	Michelle		9155623444	1315				michelle.salinas@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Medical Director	Medical Director	Dr.	Read	Hilary		9155623444	2800				Hilary.Read@bienvivir.org	2300 McKinley		El Paso	TX	79930	09/24/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Medicare Compliance Officer	Compliance Officer	Mr	Barrera	Antonio		9155623444	1703				antonio.barrera@bienvivir.org	2300 McKinley		El Paso	TX	79930	02/23/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Medicare Coordinator	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Orona	Robert		9155623444	1801				rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	11/20/2018	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Medication Therapy Management Contact	Chief Executive Officer	Ms	Castillo	Rosemary		9155623444	2800				CEO@bienvivir.org	2300 McKinley		El Paso	TX	79930	12/17/2019	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part C Application Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part D Appeals	VP of Finance	Mr	Ortiz	Luis							luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active	9155623444	2101			PACE - Nat		C	Atlanta
H4518	Part D Appeals Contact (Secondary)	PACE Center Director		Olivas	Naomi							naomi.olivas@bienvivir.org	2300 McKinley Ave		El Paso	TX	79930	01/06/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active	9155623444	2470			PACE - Nat		C	Atlanta
H4518	Part D Application Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part D Benefits Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part D Claims Submission Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part D Exceptions Contact	Director of Pharmacy		Orona	Robert							rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	10/30/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active	9155623444	1801			PACE - Nat		C	Atlanta
H4518	Part D Price File Contact (Back-up)	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part D Price File Contact (Primary)	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part D Quality Assurance Contact	QI Manager	Ms.	Alvarado	Karla	L	9155623444	1603			9158758851	karla.alvarado@bienvivir.org	2300 McKinley		El Paso	TX	79930	07/15/2022	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Part D Reporting Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	02/25/2021	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Patient Safety Contact	Chief Executive Officer	Ms	Castillo	Rosemary		9155623444	2800				CEO@bienvivir.org	2300 McKinley		El Paso	TX	79930	12/17/2019	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Payment Contact	Accounts Payable Manager		Garcia	Irene		9155623444	2370				irene.garcia@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Pharmacy Director	Director of Pharmacy		Orona	Robert		9155623444	1801				rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Pharmacy Network Management Contact	Director of Pharmacy		Orona	Robert		9155623444	1801				rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Pharmacy Technical Help Desk Contact	Director of Pharmacy		Orona	Robert							rorona@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/24/2012	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active	9155623444	1801			PACE - Nat		C	Atlanta
H4518	Pharmacy Technical Help Desk Contact (Secondary)	Chief Executive Officer	Ms	Castillo	Rosemary							CEO@bienvivir.org	2300 McKinley		El Paso	TX	79930	12/17/2019	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active	9155623444				PACE - Nat		C	Atlanta
H4518	Plan Directory Contact for Public Website	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Plan to Plan Reconciliation Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Processor Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Quality Contact	QI and UM Director	Ms.	Alvarado	Karla	L	9155623444	1603			9158758851	karla.alvarado@bienvivir.org	2300 McKinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Reconciliation Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	03/21/2018	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Recovery Audit Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Surveillance Contact	VP of Center Operations	Mr	Baca	James		9155623444	2240			9158758841	james.baca@bienvivir.org	2300 McKinley		El Paso	TX	79930	09/24/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	System Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Third Party Administrator (TPA) Liaison	Controller	Ms.	Carrasco	Julia		9155623444	2340				julia.carrasco@bienvivir.org	2300 Mckinley		El Paso	TX	79930	10/02/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	User Access Contact	VP of Finance	Mr	Ortiz	Luis		9155623444	2101				luis.ortiz@bienvivir.org	2300 Mckinley		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Utilization Management Contact	QI and UM Director	Ms	Alvarado	Karla		9155623444	2216				karla.alvarado@bienvivir.org	2300 McKinley street		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4518	Utilization Review Contact	QI and UM Director	Ms	Alvarado	Karla		9155623444	2216				karla.alvarado@bienvivir.org	2300 McKinley street		El Paso	TX	79930	04/23/2025	2026	BIENVIVIR SENIOR HEALTH SERVICES	National PACE	Bienvivir Senior Health Services	National PACE		Bienvivir Senior Health Services	23	Yes	Active					PACE - Nat		C	Atlanta
H4523	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H4523	PHR Beneficiary Contact																	11/15/2012	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H4523	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4523	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (TX)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4527	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H4527	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4527	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4527	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H4527	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4527	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4537	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H4537	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H4537	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H4537	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H4537	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H4537	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H4537	PHR Beneficiary Contact																	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H4537	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4537	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/20/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF OKLAHOMA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H4538	Automated TrOOP Balance Transfer Contact		Ms	Lan	Alice		6262631263					cms-troop-balance-transfer@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Backup User Access Contact		Ms	Lan	Alice		6262631263					cms-backup-user-access@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Best Available Evidence Contact		Ms.	Sandoval	Patricia		6262631263					cms-best-available-evidence@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Bid Primary Contact		Ms	Lan	Alice		6262631263					cms-bid-primary@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	CAP Report Contact for Public Website		Ms.	Sandoval	Patricia		6262631263					cms-cap-report-for-public-website@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	CEO - CMS Administrator Contact		Mr.	Su	Xing		6262631263					cms-ceo-cms-administrator@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	CEO - Senior Official for Contracting		Mr.	Su	Xing		6262631263					cms-ceo-senior-contracting@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Chief Financial Officer		Mr.	Su	Xing		6262631263					cms-cfo@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Chief Operating Officer		Ms	Lan	Alice		6262631263					cms-coo@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Chief Information Officer		Mr.	Su	Yang		6262631263					cms-cio@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Chief Information Security Officer		Mr.	Su	Yang		6262631263					cms-ciso@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	CMS Casework Communication Contact		Ms	Lan	Alice		6262631263					cms-casework-communication@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Complaints Tracking Contact		Ms.	Sandoval	Patricia		6262631263					cms-complaints-tracking@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Contact for Fraud Investigations		Ms.	Sandoval	Patricia		6262631263					cms-fraud-investigations@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Coordination of Benefits Contact		Ms.	Sandoval	Patricia		6262631263					cms-coordination-of-benefits@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Corporate Mailing		Mr.	Su	Xing		6262631263					cms-corporate-mailing@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Customer Service Operations Contact		Ms.	Sandoval	Patricia		6262631263					cms-customer-service-operations@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	DIR Contact		Ms	Lan	Alice		6262631263					cms-dir@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Discount Program Payment Contact		Mr.	Gallese	Paul		6265630588					cms-cgdp-payment@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	08/28/2023	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Emergency Part D Contact		Ms	Lan	Alice		6262631263					cms-emergency-part-d@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Encounter Data & Risk Adjustment Operations Contact		Ms	Lan	Alice		6262631263					cms-encounter-data-risk-adjustment@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Enrollment Contact		Ms	Lan	Alice		6262631263					cms-enrollment@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	EOB Transfer Contact		Ms	Lan	Alice		6262631263				6266041062	cms-eob-transfer@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Financial Audit Contact	Co-Founder	Mr.	Su	Xing		6262631263					cms-financial-audit@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Financial Reporting Contact		Mr.	Su	Xing		6262631263					cms-financial-reporting@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Formulary Contact		Ms	Lan	Alice		6262631263					cms-formulary@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	General Contact		Mr.	Su	Xing		6262631263					cms-general@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Government Relations Contact		Ms	Lan	Alice		6262631263					cms-government-relations@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	HIPAA Privacy Officer		Mr.	Su	Yang		6262631263					cms-hipaa-privacy-officer@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	HIPAA Security Officer		Mr.	Su	Yang		6262631263					cms-hipaa-security-officer@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Interoperability Contact		Mr.	Su	Yang		6262631263					cms-interoperability@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	MA Appeals/Grievances Contact		Ms.	Sandoval	Patricia		6262631263					cms-ma-appeals-grievances@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	MA Claims Processing Contact for Public Website		Ms.	Sandoval	Patricia		6262631263					cms-ma-claims-processing-contact@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Marketing Contact		Ms	Lan	Alice		6262631263					cms-marketing@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Medical Director		Ms	Lan	Alice		6262631263					cms-medical-director@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Medicare Compliance Officer		Ms	Sandoval	Patricia		6262631263					patricia.sandoval@seensgv.com	548 Market St	PMB 76247	San Francisco	CA	94104	01/21/2025	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Medicare Coordinator		Ms.	Sandoval	Patricia		6262631263					cms-medicare-coordinator@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Medicare Part D Opioid Overutilization Contact		Ms	Lan	Alice		6262631263					cms-part-d-opioid-overutilization@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Medication Therapy Management Contact		Ms	Lan	Alice		6262631263					cms-medication-therapy-management@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part C Application Contact		Ms	Lan	Alice		6262631263					cms-part-c-application@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part D Appeals		Ms.	Sandoval	Patricia		6262631263					cms-part-d-appeals@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active	6262631263				PACE - Nat		C	San Francisco
H4538	Part D Application Contact		Ms	Lan	Alice		6262631263					cms-part-d-application@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part D Benefits Contact		Ms	Lan	Alice		6262631263					cms-part-d-benefits@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part D Claims Submission Contact		Ms	Lan	Alice		6262631263					cms-part-d-claims-submission@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part D Exceptions Contact		Ms	Lan	Alice		6262631263					cms-part-d-exceptions@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active	6262631263				PACE - Nat		C	San Francisco
H4538	Part D Price File Contact (Back-up)		Mr.	Su	Xing		6262631263					cms-part-d-price-file-back-up@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part D Price File Contact (Primary)		Ms	Lan	Alice		6262631263					cms-part-d-price-file-primary@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part D Quality Assurance Contact		Ms.	Sandoval	Patricia		6262631263					cms-part-d-quality-assurance@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Part D Reporting Contact		Ms	Lan	Alice		6262631263					cms-part-d-reporting@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Patient Safety Contact		Ms.	Sandoval	Patricia		6262631263					cms-patient-safety@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Payment Contact		Ms	Lan	Alice		6262631263					cms-payment@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Pharmacy Director		Ms	Lan	Alice		6262631263					cms-pharmacy-director@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Pharmacy Network Management Contact		Ms	Lan	Alice		6262631263					cms-pharmacy-network-management@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Pharmacy Technical Help Desk Contact		Ms	Lan	Alice		6262631263					cms-pharmacy-technical-help-desk@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active	6262631263				PACE - Nat		C	San Francisco
H4538	Plan Directory Contact for Public Website		Ms.	Sandoval	Patricia		6262631263					cms-plan-directory-contact@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Plan to Plan Reconciliation Contact		Ms	Lan	Alice		6262631263					cms-plan-to-plan-reconciliation@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Processor Contact		Ms	Lan	Alice		6262631263					cms-processor@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Quality Contact		Ms.	Sandoval	Patricia		6262631263					cms-quality@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Reconciliation Contact		Ms	Lan	Alice		6262631263					cms-reconciliation@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Recovery Audit Contact	Co-Founder	Mr.	Su	Xing		6262631263					cms-recovery-audit@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Surveillance Contact		Ms.	Sandoval	Patricia		6262631263					cms-surveillance@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	System Contact		Mr.	Su	Yang		6262631263					cms-system@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Third Party Administrator (TPA) Liaison		Ms	Lan	Alice		6262631263					cms-tpa-liaison@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	User Access Contact		Mr.	Su	Yang		6262631263					cms-user-access@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Utilization Management Contact		Ms.	Sandoval	Patricia		6262631263					cms-utilization-management@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4538	Utilization Review Contact		Ms.	Sandoval	Patricia		6262631263					cms-utilization-review@seenhealth.org	548 Market St	PMB 76247	San Francisco	CA	94104	10/01/2024	2026	SEEN HEALTH SAN GABRIEL VALLEY, LLC	National PACE	Seen Health San Gabriel Valley, LLC	National PACE		Seen Health San Gabriel Valley, LLC	857	Yes	Active					PACE - Nat		C	San Francisco
H4544	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H4544	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H4544	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H4544	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H4544	Plan Directory Contact for Public Website			Customer Service	UHC		8773691907					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	680 Blair Mill Road		Horsham	PA	19044	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4544	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/07/2025	2026	PEOPLES HEALTH, INC.	Local CCP	Peoples Health	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H4545	Automated TrOOP Balance Transfer Contact	Operation Support Manager	Mrs	Lee	Erin		3239299043				2137572083	elee@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	07/30/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Backup User Access Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	07/30/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Best Available Evidence Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Bid Primary Contact	Center Director	Mr.	Jacob	Jeffin	M	3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	07/30/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	CAP Report Contact for Public Website	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	CEO - CMS Administrator Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	CEO - Senior Official for Contracting	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Chief Financial Officer	CFO	Mr.	Joshi	Soham		9739792374				2137572083	sjoshi@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	09/09/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Chief Operating Officer	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	09/09/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Chief Information Officer	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Chief Information Security Officer	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	CMS Casework Communication Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Complaints Tracking Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Contact for Fraud Investigations	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Coordination of Benefits Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Corporate Mailing						3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Customer Service Operations Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	DIR Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Discount Program Payment Contact	Finance Director	Mr.	Joshi	Soham		9739792374				2137572083	sjoshi@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	12/05/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Emergency Part D Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Encounter Data & Risk Adjustment Operations Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Enrollment Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	EOB Transfer Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Financial Audit Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Financial Reporting Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Formulary Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	General Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Government Relations Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	HIPAA Privacy Officer	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	HIPAA Security Officer	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Interoperability Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	MA Appeals/Grievances Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	MA Claims Processing Contact for Public Website	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Marketing Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Medical Director	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Medicare Compliance Officer	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Medicare Coordinator	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Medication Therapy Management Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part C Application Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	329 S. Mansfield Avenue		Los Angeles	CA	90036	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part D Appeals	Chief Medical Officer	Mr.	Rheem	Justin						2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active	8183267166				PACE - Nat		C	San Francisco
H4545	Part D Application Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	329 S. Mansfield Avenue		Los Angeles	CA	90036	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part D Benefits Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part D Claims Submission Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part D Exceptions Contact	Chief Medical Officer	Mr.	Rheem	Justin						2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active	8183267166				PACE - Nat		C	San Francisco
H4545	Part D Price File Contact (Back-up)	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part D Price File Contact (Primary)	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part D Quality Assurance Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Part D Reporting Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Patient Safety Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Payment Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Pharmacy Director	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Pharmacy Network Management Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Pharmacy Technical Help Desk Contact	Chief Medical Officer		Rheem	Justin						2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active	8183267166				PACE - Nat		C	San Francisco
H4545	Plan Directory Contact for Public Website	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Plan to Plan Reconciliation Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Processor Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Quality Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Reconciliation Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2136747414	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Recovery Audit Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Surveillance Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	System Contact	CEO	Mr.	Hahn	Ray		3104351351				2137572083	rhahn@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Third Party Administrator (TPA) Liaison	Finance Director	Mr.	Joshi	Soham		9739792374				2137572083	sjoshi@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	12/05/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	User Access Contact	Center Director	Mr.	Jacob	Jeffin		3107097894				2137572083	jjacob@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Utilization Management Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4545	Utilization Review Contact	Chief Medical Officer	Mr.	Rheem	Justin		8183267166				2137572083	jrheem@k-day.com	303 S Union Avenue		Los Angeles	CA	90057	02/24/2025	2026	K-DAY, INC.	National PACE	K-Day PACE	National PACE		K-DAY INC	851	Yes	Active					PACE - Nat		C	San Francisco
H4556	Backup User Access Contact	CFO	Ms.	Ross	Tracy		2547731330	307			2547747652	tracyr@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	CAP Report Contact for Public Website	Medicare Coordinator	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	CEO - CMS Administrator Contact	CEO/Administrator	Ms.	Cumby	Shelly		2547731330	306			2547748029	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	08/16/2016	2026	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	CEO - Senior Official for Contracting	CEO/Administrator	Ms.	Cumby	Shelly		2547731330	306			2547748029	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	08/16/2016	2026	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	Chief Financial Officer	CFO	Mrs.	Ross	Tracy		2547731330	307			2547748029	tracyr@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	01/30/2019	2026	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.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Complaints Tracking Contact		Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Contact for Fraud Investigations		Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Corporate Mailing						2547731330				2547748029	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	08/16/2016	2026	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	Cost Report Contact	CFO	Mrs.	Ross	Tracy		2547731330	307			2547748029	tracyr@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	01/30/2019	2026	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	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	CFO		Ross	Tracy		2547731330	307			2547748029	tracyr@carehealthplan.com	PO Box 6130		Temple	TX	76502	10/18/2019	2026	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	Enrollment Contact			Hensley	Berenice		2547731330	310				bereniceh@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	08/16/2016	2026	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	General Contact	Medicare Coordinator	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	MA Appeals/Grievances Contact		Mrs.	Hensley	Berenice		2547731330	310			2547747652	bereniceh@carehealthplan.com	P O Box 6130		Temple	TX	765036130	10/09/2023	2026	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	MA Claims Processing Contact for Public Website		Mrs.	Hensley	Berenice		2547731330	310			2547747652	bereniceh@carehealthplan.com	P O Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Marketing Contact		Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P O Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Medical Director		Mrs.	Hensley	Berenice		2547731330	306			2547747652	bereniceh@carehealthplan.com	P O Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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 Coordinator	Medicare Coordinator	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Part C Application Contact		Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P O Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Payment Contact	CFO	Ms.	Ross	Tracy		2547731330	307			2547748029	tracyr@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	01/30/2019	2026	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	Plan Directory Contact for Public Website	Medicare Coordinator	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Quality Contact	Medicare Coordinator	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Surveillance Contact		Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	System Contact	IT Manager	Mr.	Thomas	Jeffrey		2547731330	402			2547747652	jefft@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	User Access Contact	Medicare Coordinator	Ms.	Cumby	Shelly		2547731330	306			2547747652	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	10/09/2023	2026	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	Utilization Management Contact	CEO/Administrator	Ms.	Cumby	Shelly		2547731330	306			2547748029	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	08/16/2016	2026	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	Utilization Review Contact	CEO/Administrator	Ms.	Cumby	Shelly		2547731330	306			2547748029	shellyc@carehealthplan.com	P.O. Box 6130		Temple	TX	765036130	08/16/2016	2026	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
H4604	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H4604	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4604	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4604	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H4604	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4604	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF THE ROCKIES, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4605	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Encounter Data & Risk Adjustment Operations Contact	AD Risk Adjustment Analytics		Aryal	Binaya		5032255305					Binaya.Aryal@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/06/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	MA Appeals/Grievances Contact	Healthcare Svcs Program Mgr Sr	Ms.	Huque	Nita		5035531462					Nita.Huque@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	MA Claims Processing Contact for Public Website	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part C Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part C Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H4605	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H4605	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H4605	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				PPO - BBA		C	Dallas
H4605	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				PPO - BBA		C	Dallas
H4605	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				PPO - BBA		C	Dallas
H4605	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Quality Contact	Director, Quality Management	Mr.	Mcclure	Andy		5032206189					Andrew.Mcclure@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Utilization Management Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4605	Utilization Review Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF UTAH	Local CCP	Regence BlueCross BlueShield of Utah	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H4610	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H4610	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4610	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H4610	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H4610	Plan Directory Contact for Public Website			Customer Service	UHC		8889501170					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4610	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4623	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4623	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H4623	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4623	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H4623	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H4623	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H4623	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4623	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA REGIONAL HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4624	Agent/Broker Compensation Data Contact	Chief Revenue Officer	Mr.	Van Der Bosch	Matthew		3123818453					matthew.vanderbosch@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	07/09/2025	2026	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	Automated TrOOP Balance Transfer Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	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	Backup User Access Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Bid Audit Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Bid Primary Contact	V.P.  Product Development		Pamanian	Lily		3127763356	325				lily.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	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	CAP Report Contact for Public Website	Chief Information Officer	Mr.	Shah	Vrajesh		3122057948	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Clifton	Andrew		3128588400					andrew.clifton@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Clifton	Andrew		3128588400					andrew.clifton@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Interim CFO	Ms.	Hoenstine	Jennifer		3127249092	157				jennifer.hoenstine@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	10/30/2025	2026	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 Operating Officer	COO	Mr.	Collins	GARFIELD		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Director, Compliance Audit and Monitoring		Gordon	Reneatha		3128097947					reneatha.gordon@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Complaints Tracking Contact	Director, Compliance Audit and Monitoring	Ms.	Gordon	Reneatha		3128097947					compliance@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Corporate Mailing						6126077433					reneatha.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	COO	Mr.	Collins	Garfield		3123195468	101				garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	DIR Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	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	Discount Program Payment Contact	Controller	Ms.	Jackson	Amy		3128833465					amy.jackson@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Emergency Part D Contact	Chief Medical Officer	Dr.	Fessenden	Michael		8472170105					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Emergency Part D Contact (Secondary)	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60606	02/20/2025	2026	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	Employer Waiver Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Enrollment Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	EOB Transfer Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Financial Audit Contact	Interim CFO	Ms.	Hoenstine	Jennifer		3127249092	157				jennifer.hoenstine@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	10/30/2025	2026	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	Financial Reporting Contact	Controller	Ms.	Jackson	Amy		3128833465					amy.jackson@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Formulary Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60624	02/20/2025	2026	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	Formulary Contact (Secondary)	Director, Pharmacy Services		Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60606	02/20/2025	2026	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	General Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	General Counsel and Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676					russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	HIPAA Privacy Officer	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	V.P. Clinical Operations		Wohkittel	Karen		3128585770					karen.wohkittel@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	MA Appeals/Grievances Contact	Director, Grievance & Appeals		Simpson	Reugenia		3126904781					reugenia.simpson@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	07/09/2025	2026	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	MA Claims Processing Contact for Public Website	COO	Mr.	Collins	Garfield		3122057948					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Marketing Contact	Chief Revenue Officer		Van Der Bosch	Matthew		3123818453					matthew.vanderbosch@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	07/09/2025	2026	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	Medical Director	Chief Medical Officer	Dr	Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	07/09/2025	2026	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		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Coordinator	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Part D Opioid Overutilization Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	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	Medication Therapy Management Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street, Suite 450		Chicago	IL	60606	02/20/2025	2026	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	OffShore Subcontractor Contact	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 C Application Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 C Reporting Contact	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Appeals	Chief Medical Officer		Fessenden	Michael							michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	3123003495				HMO - Health Maintenance Organization		C	Chicago
H4624	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Santaya	Carlos							carlos.santaya@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	01/23/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	3122057948	247			HMO - Health Maintenance Organization		C	Chicago
H4624	Part D Application Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Benefits Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	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 Claims Submission Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	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	Chief Medical Officer		Fessenden	Michael							michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	3123003495				HMO - Health Maintenance Organization		C	Chicago
H4624	Part D Exceptions Contact (Secondary)	Director, Pharmacy Services		Santaya	Carlos							carlos.santaya@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	01/23/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	3122057948	247			HMO - Health Maintenance Organization		C	Chicago
H4624	Part D Price File Contact (Back-up)	Director, Pharmacy Services		Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	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 Price File Contact (Primary)	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	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 Quality Assurance Contact	CMO	Dr.	Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Reporting Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	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	Patient Safety Contact	CMO	Dr.	Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Payment Contact	Controller	Ms.	Jackson	Amy		3128833465					accountspayable@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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 Director	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	02/20/2025	2026	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 Network Management Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	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 Network Management Contact (Secondary)	Director, Pharmacy Services	Mr.	Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	01/23/2025	2026	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	Chief Medical Officer		Fessenden	Michael							michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	HMO/HMOPOS		Zing Health Consolidator, Inc	730	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H4624	Plan Directory Contact for Public Website	COO	Mr.	Collins	Garfield		8669464458					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Plan to Plan Reconciliation Contact	Controller	Ms.	Jackson	Amy		3128833465					amy.jackson@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Processor Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Quality Contact	Sr. V.P.  Stars & Quality	Mr.	Weaver	Daniel		3126615667					daniel.weaver@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Reconciliation Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Recovery Audit Contact	Director, Compliance Audit and Monitoring	Ms.	Gordon	Reneatha		3128097947					reneatha.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	SNP Application Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	SNP State Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Surveillance Contact	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	System Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Third Party Administrator (TPA) Liaison	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	User Access Contact	Director of Compliance Audit and Monitoring	Ms.	Gordon	Reneatha		3122057948	121				reneatha.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Utilization Management Contact	V.P. Clinical Operations		Wohkittel	Karen		3128585770					karen.wohkittel@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Utilization Review Contact	V.P. Clinical Operations		Wohkittel	Karen		3128585770					karen.wohkittel@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	01/23/2025	2026	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	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Backup User Access Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Best Available Evidence Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Bid Primary Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	CAP Report Contact for Public Website	Sr. Director Health Plan Operatoins	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					rpottharst@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					hpms@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	01/31/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Chief Financial Officer	CEO	Mr.	Pottharst	Robert		9292692222					hpms@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	01/31/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Chief Operating Officer	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Chief Information Officer	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Chief Information Security Officer	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	CMS Casework Communication Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Complaints Tracking Contact	National Director of Quality and Compliance Progra	Dr	Flake	Crissy	L	2138008886					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Contact for Fraud Investigations	National Director of Quality and Compliance Progra	Dr	Flake	Crissy	L	2137299856					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	03/14/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Coordination of Benefits Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Corporate Mailing						8338832889					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Customer Service Operations Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	DIR Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	DIR Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Discount Program Payment Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Emergency Part D Contact	Sr. Director Health Plan Operations	Ms.	Da	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Emergency Part D Contact (Secondary)	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Encounter Data & Risk Adjustment Operations Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Enrollment Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	EOB Transfer Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851				9295672060	HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Financial Audit Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Ca		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Financial Reporting Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Formulary Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Formulary Contact (Secondary)	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	General Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2138008889					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	02/10/2025	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Government Relations Contact	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	HIPAA Privacy Officer	National Director of Quality and Compliance Progra	Dr	Flake	Crissy	L	2138008886					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	HIPAA Security Officer	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Interoperability Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	MA Appeals/Grievances Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	MA Claims Processing Contact for Public Website	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Marketing Contact	Director - Marketing & Growth	Ms.	Boersma	Amie		2137674984					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	08/29/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Medical Director	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Medicare Compliance Officer	National Director of Quality and Compliance Progra	Dr.	Flake	Crissy	L	2138008886					hpms@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Medicare Coordinator	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Medicare Part D Opioid Overutilization Contact	Senior Director Health Plan Ops	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	02/10/2025	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Medication Therapy Management Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part C Application Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part D Appeals	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	2137299851				PACE - Nat		C	San Francisco
H4626	Part D Appeals Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert							HPMS@myplacehealth.com	121 S Mountain View Ave	#100	Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	6172247969				PACE - Nat		C	San Francisco
H4626	Part D Application Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part D Benefits Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part D Claims Submission Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part D Exceptions Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	2137299851				PACE - Nat		C	San Francisco
H4626	Part D Exceptions Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	6172247969				PACE - Nat		C	San Francisco
H4626	Part D Price File Contact (Back-up)	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part D Price File Contact (Primary)	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part D Quality Assurance Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Part D Reporting Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Patient Safety Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Payment Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Personal Health Record Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Pharmacy Director	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Pharmacy Network Management Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Pharmacy Network Management Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Pharmacy Technical Help Desk Contact	VP & Head of Product	Mrs.	Gobalan	Anupama							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	7148584942				PACE - Nat		C	San Francisco
H4626	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	2137299851				PACE - Nat		C	San Francisco
H4626	PHR Beneficiary Contact																	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE	myPlace Greater LA PACE Inc	SCAN Group	768	Yes	Active	8338832889				PACE - Nat		C	San Francisco
H4626	Plan Directory Contact for Public Website	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Plan to Plan Reconciliation Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Processor Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Quality Contact	National Director of Quality and Compliance	Dr.	Flake	Crissy	L	2137299856					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	10/29/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Reconciliation Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Reconciliation Contact (Secondary)	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra	A	2137299851					HPMS@myplacehealth.com	121 South Mountain View Avenue		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Recovery Audit Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Surveillance Contact	Director Marketing & Growth	Ms.	Boersma	Amie		2137674984					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	08/29/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	System Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Third Party Administrator (TPA) Liaison	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	User Access Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Utilization Management Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4626	Utilization Review Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	myPlace Greater LA PACE Inc.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H4647	Agent/Broker Compensation Data Contact	Controller		Reiner	Marc		2029043022					MReiner@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/31/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Automated TrOOP Balance Transfer Contact	Supervisor, Medicare Operations		Distel	Chris		8587906376					PartDCAT@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Backup User Access Contact	Asst. Director MA Compliance		Grifa	Megan		3302285091					mgrifa@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/30/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Best Available Evidence Contact	Asst. Dir, Billing and Enrollment		Casillas Vasquez	Zaira		3103015140					zcasillasvasquez@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Bid Audit Contact	Compliance Officer		Cleveland	Pamela		2165367985					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Bid Audit Site Contact	Asst. Director MA Compliance		Grifa	Megan		3302285091					mgrifa@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/30/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Bid Primary Contact	Lead Actuary		Younsoo	Kim		4244026074					yskim@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	CAP Report Contact for Public Website	Dir, Medicare Advantage Growth Office and Strategy		Wittenberg	Grace		3104316885					GWittenberg@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	CEO - CMS Administrator Contact	CEO/CFO	Mr.	Arrington	Jonathon		3108691394					JArrington@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	CEO - Senior Official for Contracting	CEO/CFO	Mr.	Arrington	Jonathon		3108691394					JArrington@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Chief Financial Officer	CEO/CFO	Mr.	Arrington	Jonathon		3108691394					JArrington@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Chief Operating Officer	COO	Ms.	Davis	Alicia		3109234472					AliciaDavis@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Chief Information Officer	Chief Information Security Officer	Mr.	Tijerino	Edgar		3102673396					etijerino@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	12/19/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Chief Information Security Officer	Chief Information Security Officer	Mr.	Tijerino	Edgar		3102673396					etijerino@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	12/19/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	CMMI Model Point of Contact	COO		Davis	Alicia		3109234472					AliciaDavis@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	CMS Casework Communication Contact	CMO		Ang	Eddy	Z	3105927012				4242347897	ezang@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	01/06/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Complaints Tracking Contact	Manager, Appeals and Grievances		Lopez	Javier		8182322526					JavierLopez@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/08/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Contact for Fraud Investigations	Ass. Dir, Audit and Fraud		Knight	Christophe	W	3109090428					cknight@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/30/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Coordination of Benefits Contact	COO		Davis	Alicia		3109234472					AliciaDavis@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Corporate Mailing						3109234472					AliciaDavis@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Customer Service Operations Contact	Contact Center Mgr, MA Operations		Thorpe	William	M	3103024378					wthorpe@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	DIR Contact	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	11/01/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Discount Program Payment Contact	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	11/01/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Electronic Health Record Contact	Director, Contracting		Armani	Shannon		2013703932					SArmani@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Emergency Part D Contact	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Encounter Data & Risk Adjustment Operations Contact	Asst. Dir, Claim Encounters		Singhal	Vibhuti		3109483884					VSinghal@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Enrollment Contact	Asst. Dir, Billing and Enrollment		Casillas Vasquez	Zaira		3103015140					zcasillasvasquez@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	EOB Transfer Contact	Asst. Dir, Med Adv Ops		Dugan	Nicolle		3103016889				3103015250	NDugan@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Financial Audit Contact	Controller	Mr.	Reiner	Marc		2029043022					MReiner@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	11/01/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Financial Reporting Contact	Controller		Reiner	Marc		2029043022					MReiner@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/31/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Formulary Contact	Manager, Formulary Administration and Maintenance		Nyawabila	Christina		8587906297					Christina.Nyawabila@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Formulary Contact (Secondary)	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	General Contact	Compliance Officer		Cleveland	Pamela		2165367985					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Government Relations Contact	Compliance Officer		Cleveland	Pamela		2165367985					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	HIPAA Privacy Officer	Privacy and Civil Rights Manager, MA		Nwigwe	Vaniecy		3103024092					VNwigwe@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	06/24/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	HIPAA Security Officer	Dir, Revenue Cycle Applications		Sherman	Scott		3109236207					ssherman@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	06/24/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Hospice Contact	Asst. Dir, Billing and Enrollment		Casillas Vasquez	Zaira		3103015140					zcasillasvasquez@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Interoperability Contact	Dir, Revenue Cycle Applications	Mr.	Sherman	Scott		3109236207					SSherman@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	MA Appeals/Grievances Contact	Manager, Appeals and Grievances		Lopez	Javier		8182322526					JavierLopez@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/08/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	MA Claims Processing Contact for Public Website	Asst. Dir, Med Adv Ops		Dugan	Nicolle		3103016889					NDugan@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Marketing Contact	Director, Medicare Advantage Growth Office and Str		Wittenberg	Grace		3104316885					GWittenberg@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Medical Director	Medical Director	Dr.	Bui	Diane		4245183697					DianeBui@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	02/11/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Medicare Compliance Officer	Compliance Officer	Ms.	Cleveland	Pamela		2165367985					pcleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Medicare Coordinator	Asst. Director MA Compliance		Grifa	Megan		3302285091					mgrifa@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/30/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Medicare Part D Opioid Overutilization Contact	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Medication Therapy Management Contact	Clinical Program Operations Manager III		Nguyen	Linh		8587906627					mtmp@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	OffShore Subcontractor Contact	Asst. Director MA Compliance		Grifa	Megan		3302285091					mgrifa@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/30/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Online Enrollment Center Contact (Back-up)	Manager, Billing & Enrollment		Rendon	Leo		5622847050					LJRendon@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Online Enrollment Center Contact (Optional)	COO		Davis	Alicia		3109234472					AliciaDavis@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Online Enrollment Center Contact (Primary)	Asst. Dir, Billing and Enrollment		Casillas Vasquez	Zaira		3103015140					zcasillasvasquez@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part C Application Contact	Compliance Officer		Cleveland	Pamela		2165367985					Pcleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part C Reporting Contact	Asst. Director, MA Compliance		Grifa	Megan		3302285091					mgrifa@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/30/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Appeals	Manager, Appeals and Grievances		Martin	Dawn							Dawn.Martin@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/24/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active	8587907118				HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Appeals Contact (Secondary)	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy							AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active	4244677411				HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Application Contact	Compliance Officer		Cleveland	Pamela		2165367985					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Benefits Contact	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Claims Submission Contact	Supervisor, Medicare Operations		Distel	Chris		8587906376					PDE@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Exceptions Contact	Director, PA & UM Programs		Emoto	Julianne							Julianne.Emoto@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Exceptions Contact (Secondary)	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy							AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active	4244677411				HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Price File Contact (Back-up)	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Price File Contact (Primary)	GPS Program Manager III		Keller	Shanon		8587907104					Shanon.Keller@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Quality Assurance Contact	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Part D Reporting Contact	Asst. Director MA Compliance		Scott	Susan		8587906585					susan.scott@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/09/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Patient Safety Contact	Director, PA & UM Programs		Emoto	Julianne		8587905846					Julianne.Emoto@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Payment Contact	Controller		Reiner	Marc		2029043022					MReiner@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/31/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Personal Health Record Contact	Asst. Dir, Billing and Enrollment		Casillas Vasquez	Zaira		3103015140					zcasillasvasquez@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Pharmacy Director	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Pharmacy Network Management Contact	Director, Pharmacy Network Administration		Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Pharmacy Network Management Contact (Secondary)	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/21/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active	8009263841				HMO - Health Maintenance Organization		C	Dallas
H4647	Pharmacy Technical Help Desk Contact (Secondary)	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy							AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/10/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active	4244677411				HMO - Health Maintenance Organization		C	Dallas
H4647	Physician Incentive Contact	Director, Contracting		Armani	Shannon		2013703932					SArmani@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Plan Directory Contact for Public Website			Website	Inquiries		8336278252					hpoperations@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/14/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Plan to Plan Reconciliation Contact	Dir of Pharmacy, Medicare Advantage		Nguyen	Andy		4244677411					AndyANguyen@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	04/03/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Processor Contact	Asst. Dir, Med Adv Ops		Dugan	Nicolle		3103016889					NDugan@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Quality Contact	Asst. Director, Quality and Equity		Waters	Mary	K	1111111111					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	01/07/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Reconciliation Contact	Controller		Reiner	Marc		2029043022					MReiner@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	10/31/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Recovery Audit Contact	Director, Risk Adjustment	Ms.	Mendrella	Kari		9518701753					KMendrella@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Surveillance Contact	Compliance Officer		Cleveland	Pamela		2165367985					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	System Contact	Compliance Officer		Cleveland	Pamela		2165367985					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Third Party Administrator (TPA) Liaison	Controller		Reiner	Marc		2029043022					MReiner@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	02/18/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	User Access Contact	Compliance Officer		Cleveland	Pamela		2165367985					PCleveland@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	07/11/2024	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Utilization Management Contact	Medical Director		Bui	Diane		3103028493					dianebui@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	06/16/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4647	Utilization Review Contact	Medical Director		Bui	Diane		3103028493					dianebui@mednet.ucla.edu	5757 West Century Blvd	Suite 200	Los Angeles	CA	90045	06/16/2025	2026	NEW CENTURY HEALTH PLAN, INC.	Local CCP	UCLA Health Medicare Advantage Plan	HMO/HMOPOS		The Regents of the University of California	831	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H4661	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	05/12/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Chief Information Officer	Executive VP, Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	07/25/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Contact for Fraud Investigations	Sr. Director, Special Investigations Unit (SIU)		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/29/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/30/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/30/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	07/31/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7676 Forsyth Blvd		Clayton	MO	63105	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	08/04/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	08/04/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	08/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/07/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/22/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H4661	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H4661	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Benefits Contact	Director, Pharmacy	Mr.	Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		h	TX	77027	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/22/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	09/03/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H4661	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/03/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H4661	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504230				HMO - Health Maintenance Organization		C	Denver
H4661	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504230				HMO - Health Maintenance Organization		C	Denver
H4661	PHR Beneficiary Contact																	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449089				HMO - Health Maintenance Organization		C	Denver
H4661	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/10/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	CA	91367	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/15/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4661	Utilization Review Contact	Senior VP, Medical Management		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	05/06/2024	2026	CELTIC INSURANCE COMPANY	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4676	Agent/Broker Compensation Data Contact	VP, Delivery and Development		Kirchberg	Mark		9203502157					mark.kirchberg@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	10/22/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Automated TrOOP Balance Transfer Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Backup User Access Contact	Sr Compliance Analyst		Young	Elisa		5408414151					elisa@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	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	Director, Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Bid Audit Contact	Senior Director, Actuarial Consulting		Rasmussen	Michael		7633407961					michael.I.rasmussen@optum.com	11000 Optum Cir,		Eden Prairie	MN	55344	03/11/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Bid Primary Contact	Senior Director, Actuarial Consulting		Rasmussen	Michael		7633407961					michael.I.rasmussen@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	03/11/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	CAP Report Contact for Public Website	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 1378		Westborough	MA	01581	09/24/2025	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	CEO - CMS Administrator Contact	CEO	Mr.	Lipkind	Ethan		8474942677					ethan@troymedicare.com	P.O. Box 1378		Westborough	MA	01581	09/24/2025	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	CEO - Senior Official for Contracting	CEO	Mr.	Lipkind	Ethan		8474942677					ethan@troymedicare.com	P.O. Box 1378		Westborough	MA	01581	09/24/2025	2026	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	Ms.	Browning	Emily		3527776934					emily@troymedicare.com	P.O. Box 1378		Westborough	MA	01581	09/24/2025	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Chief Operating Officer	Chief Operating Officer	Ms.	Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Chief Information Officer		Ms.	Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	06/27/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Chief Information Security Officer		Ms.	Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	06/27/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	CMMI Model Point of Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	07/02/2024	2026	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		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Complaints Tracking Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Contact for Fraud Investigations	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	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	Director, Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Corporate Mailing						5026453161					sally@troymedicare.com	P.O. Box 1293		Westborough	MA	01581	03/09/2024	2026	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		Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	DIR Contact	Chief Financial Officer		Browning	Emily		3527776934					emily@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	10/22/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	DIR Contact (Secondary)	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/05/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Discount Program Payment Contact	Chief Financial Officer		Browning	Emily		3527776934					emily@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	10/22/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Emergency Part D Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Emergency Part D Contact (Secondary)	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Encounter Data & Risk Adjustment Operations Contact	Chief Operating Officer		Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	07/02/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Enrollment Contact	Chief Operating Officer		Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	EOB Transfer Contact	Chief Operating Officer		Za	Christina		9103701115	222			9193753533	christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Financial Audit Contact	Chief Compliance Officer	Ms.	Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 1378		Westborough	MA	01581	09/29/2025	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Financial Reporting Contact	Chief Financial Officer		Browning	Emily		7776934352					emily@troymedicare.com	P.O. Box 1378		Westborough	MA	01581	09/24/2025	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Formulary Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Formulary Contact (Secondary)	Troy Formulary Team		Formulary	Troy		5026453161					formulary@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	09/26/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	General Contact	Chief Compliance Officer	Ms.	Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	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		7036970339					srharrison@srhlaw.us	1200 G St., NW	Suite 800	Washington	DC	20005	02/10/2019	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	HIPAA Privacy Officer	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	HIPAA Security Officer			Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	06/27/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Hospice Contact	Director, Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Interoperability Contact			Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	06/27/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	MA Appeals/Grievances Contact	Chief Operations Officer		Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	MA Claims Processing Contact for Public Website	Chief Operating Officer		Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Marketing Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Medical Director	Chief Medical Officer	Dr.	Fitzgerald	Mike		8434691459					jennifer.murphy@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	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		5026453161					sally@troymedicare.com	P.O. Box 1378		Westborough	MA	01581	09/29/2025	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Medicare Coordinator	Chief Operating Officer		Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box  11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Medication Therapy Management Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part C Application Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	07/02/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part C Reporting Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Appeals	Director of Pharmacy		Elmes	Samuel							samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	9104600553				HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Appeals Contact (Secondary)	Chief Compliance Officer		Scott	Sally							sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	5026453161				HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Application Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	07/02/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Benefits Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Claims Submission Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	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		Elmes	Samuel							samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	9104600553				HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Exceptions Contact (Secondary)	Chief Compliance Officer		Scott	Sally							sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	5026453161				HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Price File Contact (Back-up)	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Price File Contact (Primary)	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Quality Assurance Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Part D Reporting Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Patient Safety Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Payment Contact	Chief Financial Officer		Browning	Emily		3527776934					emily@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	10/22/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Pharmacy Director	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Pharmacy Network Management Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Pharmacy Network Management Contact (Secondary)	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	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	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	8665606052				HMO - Health Maintenance Organization		C	Atlanta
H4676	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy		Elmes	Samuel							samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active	9104600553				HMO - Health Maintenance Organization		C	Atlanta
H4676	Plan Directory Contact for Public Website			Service	Customer		8884948769					contact@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	08/14/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Plan to Plan Reconciliation Contact	Chief Financial Officer		Browning	Emily		3527776934					emily@troymedicare.com	PO Box 748997		Atlanta	GA	30384	10/22/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Processor Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Quality Contact	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Reconciliation Contact	Chief Financial Officer		Browning	Emily		3527776934					emily@troymedicare.com	P.O Box 11267		Charlotte	NC	28220	10/22/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Reconciliation Contact (Secondary)	Director of Pharmacy		Elmes	Samuel		9104600553					samuel@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/05/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Recovery Audit Contact	Chief Compliance Officer	Ms.	Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	SNP Application Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	07/02/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Surveillance Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	System Contact			Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	06/27/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Third Party Administrator (TPA) Liaison	Chief Operating Officer		Za	Christina		9103701115	222				christina.za@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	User Access Contact	Chief Compliance Officer		Scott	Sally		5026453161					sally@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Utilization Management Contact			Murphy	Jennifer		7045340045	175				jennifer.murphy@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	TROY HEALTH, INC.	Local CCP	Troy Medicare	HMO/HMOPOS		Troy Holdings, Inc.	734	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4676	Utilization Review Contact			Murphy	Jennifer		7045340045	175				jennifer.murphy@troymedicare.com	P.O. Box 11267		Charlotte	NC	28220	03/09/2024	2026	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	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739					cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie	A	7206829848				3039961600	Lteter@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending	9096779517				PACE - Nat		C	San Francisco
H4682	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Chief Operating Officer	Market President	Ms.	Hopkins	Laura		7208127180				9094249948	lhopkins@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Chief Information Security Officer	Chief Information Security Officer	Mr.	Naus	Cole		7204564635				3039961600	mnaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	CMS Casework Communication Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Complaints Tracking Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Coordination of Benefits Contact	Medicare Compliance Manager	Ms.	Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Corporate Mailing						3038694664				3039961600	bgutierrez@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Customer Service Operations Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	DIR Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/22/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Government Relations Contact	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Interoperability Contact	SVP, Application Systems		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	MA Appeals/Grievances Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Appeals	Director of Compliance		Martin	Jeremy						3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending	7208796016				PACE - Nat		C	San Francisco
H4682	Part D Appeals Contact (Secondary)	Director of Compliance		Martin	Jeremy						3039961600	jmartin@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending	7208796016				PACE - Nat		C	San Francisco
H4682	Part D Application Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending	7206663817				PACE - Nat		C	San Francisco
H4682	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending	7207896083				PACE - Nat		C	San Francisco
H4682	Part D Price File Contact (Back-up)	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Quality Assurance Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Part D Reporting Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending	7206663817				PACE - Nat		C	San Francisco
H4682	PHR Beneficiary Contact																	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE	Total Longterm Care, Inc.			Yes	Pending	8772776163	732			PACE - Nat		C	San Francisco
H4682	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	AKizewsk@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/08/2023	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Reconciliation Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	System Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Third Party Administrator (TPA) Liaison	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	User Access Contact	Director of Compliance		Martin	Jeremy		7207896016					jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4682	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOCARE PACE OF BAKERSFIELD, LLC	National PACE	InnovAge California PACE - Bakersfield	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H4694	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	06/27/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/11/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	OffShore Subcontractor Contact	Compliance Director		Hodge	Susan		4632692105					susan.hodge@elevancehealth.com	220 Virginia Avenue		Indianapolis	IN	46204	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	06/27/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Quality Assurance Contact	VP/Chief Clinical Officer - IngenioRx		Haines	Colleen		9373710575					colleen.haines@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Patient Safety Contact	VP/Chief Clinical Officer - IngenioRx		Haines	Colleen		9373710575					colleen.haines@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	12/23/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4694	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amym.matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	12/23/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H4694	PHR Beneficiary Contact																	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H4694	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	10/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/07/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4694	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	HEALTHKEEPERS, INC.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4704	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	CMS Casework Communication Contact	Director Process Improvement		Sallee	Teia		5136497052				8884581406	teia.sallee@anthem.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/02/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H4704	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H4704	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H4704	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H4704	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H4704	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H4704	PHR Beneficiary Contact																	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H4704	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/06/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4704	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H4711	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H4711	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/11/2018	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4711	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF NEBRASKA, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4714	Automated TrOOP Balance Transfer Contact	Director of Finance and Administration	CFO	Witt	Anne		7048740604				7048341998	awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Backup User Access Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Bid Primary Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	CAP Report Contact for Public Website	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	CEO - CMS Administrator Contact	Executive Director	Ms	Kenzig	Cathy		7048740600					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	CEO - Senior Official for Contracting	Executive Director	CEO	Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	CFO	CFO	Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	04/11/2025	2026	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 Operating Officer	Executive Director	COO	Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Information Officer	Director of Quality & Corporate Compliance	Ms	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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 Information Security Officer	Compliance & Quality Director	CIO	Alexander	Lydia		7048740639					lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	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	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Complaints Tracking Contact	Director of Finance and Administration	CFO	Witt	Anne		7048740604					awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Contact for Fraud Investigations	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Finance Director		Witt	Anne		7048740604					awitt@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Corporate Mailing						7048740600				7048743307	ckenzig@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	DIR Contact	CFO		Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	04/11/2025	2026	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	DIR Contact (Secondary)	Health Data Specialist		Powell	Greg		7048873898					gpowell@seniortlc.org	1875 Remount Rd.		Gastonia	NC	28054	04/14/2025	2026	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	Discount Program Payment Contact	CFO	CFO	Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	05/29/2025	2026	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	Emergency Part D Contact	Executive Director		Kenzig	Cathy		7048740600					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Compliance & Quality Director		Alexander	Lydia		7048740639					lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	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	Enrollment Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	EOB Transfer Contact	Executive Director		Kenzig	Cathy		7048740603				7048667732	ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Financial Audit Contact	Health Plan Data Specialist	Mr.	Powell	Greg		7048873898					gpowell@seniortlc.org	1875 Remount Rd.		Gastonia	NC	28054	04/14/2025	2026	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	Financial Reporting Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Formulary Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	General Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	HIPAA Privacy Officer	Director Corporate Compliance		Alexander	Lydia		7048740600					lyalexander@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	HIPAA Security Officer	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Interoperability Contact			Kenzig	Catherine		7048740603					ckenzig@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	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	MA Appeals/Grievances Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	MA Claims Processing Contact for Public Website	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Marketing Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Medical Director	Medical Director	Dr	Vanessa	Crerar		7048740600				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/17/2025	2026	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 & Quality Director	CIO	Alexander	Lydia		7048740639					lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	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 Coordinator	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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	Medication Therapy Management Contact	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/14/2025	2026	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 C Application Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Appeals	Quality Coordinator	Ms	Alexander	Lydia						7048740600	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active	8553277852				PACE - Nat		C	Atlanta
H4714	Part D Appeals Contact (Secondary)			Alexander	Lydia						7048341998	lyalexander@seniortlc.org	1875 Remount Road		Gastonia	NC	28054	04/11/2025	2026	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active	8553277852				PACE - Nat		C	Atlanta
H4714	Part D Application Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Benefits Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Claims Submission Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Executive Director		Kenzig	Cathy							ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active	8553277852				PACE - Nat		C	Atlanta
H4714	Part D Exceptions Contact (Secondary)	Health Data Specialist		Powell	Greg							gpowell@seniortlc.org	6133 The Plaza		Charlotte	NC	28215	04/11/2025	2026	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active	7048873857				PACE - Nat		C	Atlanta
H4714	Part D Price File Contact (Back-up)	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Price File Contact (Primary)	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Quality Assurance Contact	Quality Coordinator	Ms	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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 Reporting Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Patient Safety Contact	Medical Director	Dr	Crerar	Vanessa		7048740600				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/14/2025	2026	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	Payment Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Personal Health Record Contact	Finance Director		Alexander	Lydia		7048740639					lyalexander@seniortlc.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Director	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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 Network Management Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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 Network Management Contact (Secondary)	Program Director	Ms.	Kenzig	Cathy		7048873869				7048873844	ckenzig@seniortlc.org	6133 The Plaza		Charlotte	NC	28215	04/11/2025	2026	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	Executive Director		Kenzig	Cathy							ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	PACE OF THE SOUTHERN PIEDMONT, INC.	National PACE	PACE of the Southern Piedmont	National PACE		PACE of the Southern Piedmont, Inc.	509	Yes	Active	8882987770				PACE - Nat		C	Atlanta
H4714	Plan Directory Contact for Public Website	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Plan to Plan Reconciliation Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Processor Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Quality Contact	Quality Coordinator	Ms	Alexander	Lydia		7048740600				7048654385	lyalexander@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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	Reconciliation Contact	CFO		Nickerson	Kirby		7047548228					knickerson@LSCarolinas.net	1416 S. Martin Luther King Blvd		Salisbury	NC	28145	04/11/2025	2026	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	Recovery Audit Contact	Finance Director	MS	Witt	Anne		7048740600				7048743307	awitt@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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	Surveillance Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	System Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Third Party Administrator (TPA) Liaison	Director fo Administration and Finance	CIO	Witt	Anne		7048740600				7048654785	awitt@seniortlc.org	1875 Remount Raod		Gastonia	NC	28054	04/11/2025	2026	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	User Access Contact	Executive Director		Kenzig	Cathy		7048740603					ckenzig@seniorTLC.org	1875 Remount Rd.		Gastonia	NC	28054	04/11/2025	2026	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	Utilization Management Contact	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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	Utilization Review Contact	Medical Director	Dr	Crerar	Vanessa		7048740619				7048743307	vcrerar@seniorTLC.org	1875 Remount Rd		Gastonia	NC	28054	04/11/2025	2026	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
H4723	Automated TrOOP Balance Transfer Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Backup User Access Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Best Available Evidence Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Bid Primary Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	CAP Report Contact for Public Website	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	CEO - CMS Administrator Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	CEO - Senior Official for Contracting	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Chief Financial Officer	CFO	Mr	Isaacs	William		8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Chief Operating Officer	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Chief Information Officer	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Chief Information Security Officer	CEO	Ms	Everitt	Nancy	C	8852095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	CMS Casework Communication Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Complaints Tracking Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Contact for Fraud Investigations	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Coordination of Benefits Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Corporate Mailing						8852095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Customer Service Operations Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	DIR Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	DIR Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Discount Program Payment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Emergency Part D Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Emergency Part D Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Encounter Data & Risk Adjustment Operations Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Enrollment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	EOB Transfer Contact	CEO	Ms	Everitt	Nancy	C	8552095451				8666113827		PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Financial Audit Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Financial Reporting Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Formulary Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Formulary Contact (Secondary)	SVP Program Operations, Quality and Compliance	Mr.	Kapolas	Peter		8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	General Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Government Relations Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	HIPAA Privacy Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	HIPAA Security Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Interoperability Contact	SVP Information Technology	Mr	Cantoria	Stephen	C	8852095451					scantoria@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	MA Appeals/Grievances Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	MA Claims Processing Contact for Public Website	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Marketing Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Medical Director	Medical Director	Mr	Wells	Wayne	O	8552095451					wwells@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Medicare Compliance Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Medicare Coordinator	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Medicare Part D Opioid Overutilization Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/28/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Medication Therapy Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part C Application Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part D Appeals	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H4723	Part D Appeals Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr.	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H4723	Part D Application Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part D Benefits Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part D Claims Submission Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part D Exceptions Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H4723	Part D Price File Contact (Back-up)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part D Price File Contact (Primary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part D Quality Assurance Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Part D Reporting Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Patient Safety Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Payment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Pharmacy Director	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Pharmacy Network Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Pharmacy Technical Help Desk Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H4723	Plan Directory Contact for Public Website	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Plan to Plan Reconciliation Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Processor Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Quality Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Reconciliation Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Recovery Audit Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Surveillance Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	System Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Third Party Administrator (TPA) Liaison	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	User Access Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Utilization Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4723	Utilization Review Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	06/27/2024	2026	LIFE COORDINATED  COMMONWEALTH PACE II, INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE II INC	National PACE		LIFE COORDINATED Commonwealth PACE II, Inc	844	Yes	Pending					PACE - Nat		C	Atlanta
H4733	Agent/Broker Compensation Data Contact	Chief Operating Officer		Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Rivera-Aquino	Denisse		8587905873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/05/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Backup User Access Contact	Compliance Audit Manager		Guzman	Guillermo		6196781833					gguzman@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	06/10/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Best Available Evidence Contact	Enrollment Manager		Fernandez	Judith		6194986418				6194269437	jferna@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Bid Audit Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Bid Audit Site Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Bid Primary Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	CAP Report Contact for Public Website	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Diaz	Norma		6199472959				6194225930	ndiaz@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/27/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Diaz	Norma		6194986416				6194225930	ndiaz@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Chief Financial Officer	Chief Financial Officer	Mr.	Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Chief Operating Officer	Chief Operating Officer	Mr.	Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Chief Information Officer	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Chief Information Security Officer	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	CMMI Model Point of Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	CMS Casework Communication Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Complaints Tracking Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Contact for Fraud Investigations	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Coordination of Benefits Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Corporate Mailing						6194220422				6194225930	info@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Customer Service Operations Contact	Director of Member Services		Duenas	Chris		6192408923					cduenas@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	DIR Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	DIR Contact (Secondary)	Director of Corporate Quality		Koizumi	Noreen		6194986578					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Discount Program Payment Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Electronic Health Record Contact	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Emergency Part D Contact	Director of Corporate Quality		Koizumi	Noreen		6193008758					NKoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/27/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Emergency Part D Contact (Secondary)	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/12/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Encounter Data & Risk Adjustment Operations Contact	Director of Information Systems		Flora	Tatsani	I	6194986439					tinkha@chgsd.com	2420 Fenton Street	S-100	Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Enrollment Contact	Enrollment Manager		Fernandez	Judith		6194986418				6194269437	jferna@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	EOB Transfer Contact	Claims Administration Director		Valdez	Elizabeth		6199842109				6194258726	evaldez@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Financial Audit Contact	Chief Financial Officer	Mr.	Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Financial Reporting Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Formulary Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Formulary Contact (Secondary)	Part D Manager, Formulary Administration & Strateg		Wong	Tim		8587906297					fas@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/20/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	General Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Government Relations Contact	Associate CEO		Warren	Ann		6194986516				6194225930	awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/02/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	HIPAA Privacy Officer	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	HIPAA Security Officer	Chief Information Officer		Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Hospice Contact	Senior Director of Healthcare Services		Farook	Yousaf		6194986540					yfaroo@chgsd.com	2420 Fenton Street		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Interoperability Contact	Director of Information Systems		Flora	Tatsani	I	6194986439					tinkha@chgsd.com	2420 Fenton Street		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	MA Appeals/Grievances Contact	Corporate Quality Director		Koizumi	Noreen		6194986470					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	MA Claims Processing Contact for Public Website	Director of Claims Administration		Valdez	Elizabeth		6199842109					evaldez@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Marketing Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Medical Director	Chief Medical Officer		Conrad, MD	Alan		6192714769					aconrad@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/27/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Medicare Compliance Officer	Associate Chief Executive Officer	Ms	Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Medicare Coordinator	Chief Operating Officer		Garcia	Joseph		6194986557				6194225930	jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Medicare Part D Opioid Overutilization Contact	Pharmacist		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Medication Therapy Management Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Online Enrollment Center Contact (Back-up)	Enrollment Specialist		Padilla	Paloma		6199842073					ppadilla@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Online Enrollment Center Contact (Primary)	Enrollment Manager		Fernandez	Judith		6194986418					jferna@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part C Application Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part C Reporting Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Appeals	Director of Corporate Quality		Koizumi	Noreen							nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8882444430				HMO - Health Maintenance Organization		C	New York
H4733	Part D Appeals Contact (Secondary)	Grievance and Appeals Supervisor		Herrera	Yessenia							yesseniaherrera@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	03/24/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8882444430				HMO - Health Maintenance Organization		C	New York
H4733	Part D Application Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Benefits Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Claims Submission Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Exceptions Contact	Director of Corporate Quality		Koizumi	Noreen							nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	6194986476				HMO - Health Maintenance Organization		C	New York
H4733	Part D Exceptions Contact (Secondary)	Director of Corporate Quality		Koizumi	Noreen						6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/30/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8882444430				HMO - Health Maintenance Organization		C	New York
H4733	Part D Price File Contact (Back-up)	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Price File Contact (Optional)	Medicare Part D Project Manager		Keller	Shanon		8587907104					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/05/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Price File Contact (Primary)	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	06/06/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Quality Assurance Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	06/06/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Part D Reporting Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Patient Safety Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	06/06/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Payment Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Pharmacy Director	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/04/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Pharmacy Network Management Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/04/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Administration		Hunt	Brian		8007882949				8587906011	pharmacynetworkadministrators@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/05/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Pharmacy Technical Help Desk Contact	VP, Customer Contact Services		Battle	Dorry						8587906075	Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8886486758				HMO - Health Maintenance Organization		C	New York
H4733	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Manager		Nicks	Ronald							rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/04/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	6192408859				HMO - Health Maintenance Organization		C	New York
H4733	Physician Incentive Contact	Chief Operating Officer		Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Plan Directory Contact for Public Website	Director of Member Services		Duenas	Chris		6192408923					cduenas@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Plan to Plan Reconciliation Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	07/08/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Processor Contact	Claims Administration Director		Valdez	Elizabeth		6199842109				6194258726	evaldez@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Quality Contact	Corporate Quality Director		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Reconciliation Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Reconciliation Contact (Secondary)	Senior Financial Analyst		Nissan	Silver		6194986543					snissan@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Recovery Audit Contact	Associate Chief Executive Officer	Ms.	Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	SNP Application Contact	Compliance & Fraud Prevention Officer		Chavez	Francisca		6194986578					FChave@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	12/02/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	SNP State Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Surveillance Contact	Chief Operating Officer		Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	System Contact	Chief Information Officer		Sombillo	Allan		6194986413				6194763818	asombi@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	01/03/2022	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	User Access Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/02/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Utilization Management Contact	Director of Utilization Management		Vargas	Barbara		6195007516					bvargas@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	06/28/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4733	Utilization Review Contact	Director of Utilization Management		Vargas	Barbara		6195007516					bvargas@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	06/28/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4739	Agent/Broker Compensation Data Contact	National Director Retail Sales	Mr.	Javor	Chris		2159378396					cjavor@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Automated TrOOP Balance Transfer Contact	Business Systems Analyst	Ms.	Murray	Karla		2672985899					kdmurray@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Backup User Access Contact	Medicare Compliance Sr Operations Analyst	Ms	Morris	Gail		2158635141					gpmorris@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Bid Audit Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Bid Audit Site Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Bid Primary Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	05/07/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	CEO - CMS Administrator Contact	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	CEO - Senior Official for Contracting	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Chief Operating Officer	President, Medicare Markets	Mr.	McDade	Chris		5704179770					cmcdad@amerihealthcaritas.com	AmeriHealth Caritas Families of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Chief Information Officer	Exec. Vice President, Chief Information Officer	Mr.	Dickson	Fred		2158636570					fdickson@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	CMS Casework Communication Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Complaints Tracking Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Contact for Fraud Investigations	Director, SIU	Mr.	McCall	Trevor		4844971241					tmccall2@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Coordination of Benefits Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Corporate Mailing						2159378725					KGrimmett@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive, 1st Floor	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		2672981794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	DIR Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/07/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	DIR Contact (Secondary)	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2824045991					AKindred@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Discount Program Payment Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Electronic Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Emergency Part D Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Emergency Part D Contact (Secondary)	VP, Corporate Pharmacy		Cherian	Sheena		2158635768					scherian@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	2002 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare ACA and Risk Adjustment	Mr.	Greer	Kevin		2159378761					kgreer@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Enrollment Contact	Manager, Enrollment Operations	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	EOB Transfer Contact	VP, Medicare Claims	Mr.	Boyer	Joseph		2158636668				2159375321	jboyer@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Financial Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					ak16850@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Financial Reporting Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Formulary Contact	Director of Clinical Services, Formulary/DUR	Ms.	Megargell	Lauren		2159374135					Lauren.megargell@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	General Contact	VP, Medicare Strategy & Execution	Mr.	Sukhu	Chistopher		4844233175					csukhu@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	06/27/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Government Relations Contact	VP, Government Relations, External Affairs	Mr.	Cozzo	Steven		2159378236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	HIPAA Privacy Officer	Director Privacy	Ms.	Desipio	Nicole		4844971132					ndesipio@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Hospice Contact	Dir.  Medicare Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Interoperability Contact	Director, Medicare Performance Management		Kindred	Amanda		2484045991					akindred@amerihealthcaritas.com	4000 Town Center	Suite 1300	Southfield	MI	48075	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	MA Appeals/Grievances Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	MA Claims Processing Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Marketing Contact	Medicare Compliance Sr Operations Analyst	Ms.	Morris	Gail	P	2158635141					gpmorris@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Medical Director	Chief Medical Officer, Population Health	Dr.	Wright	Julia		2159378000					jwright6@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Medicare Coordinator	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Medication Therapy Management Contact	Director, Clinical Outcomes & Therapeutic Optimiz	Ms.	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	OffShore Subcontractor Contact	Esquire	Ms.	Sitner	Roni		8602149125					rsitner@ameriheathcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Online Enrollment Center Contact (Primary)	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part C Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part C Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Appeals	Director,  Medicare Appeals and Grievances	Ms.	Lopez	Yismell							yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158635677				HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Appeals Contact (Secondary)	Appeals & Grievance Administrator	Ms	Christian	Yolanda							ychristian@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	8552210045				HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Benefits Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Claims Submission Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Prior Authorization	Mr.	McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens drive	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Price File Contact (Back-up)	Medicare Part D program Analyst	Ms.	Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	00909	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Price File Contact (Optional)	Claims Processor Associate	Ms	Canales	Desiree		7875231212	1107				desiree.canales@abarcahealth.com	Abarca Health	650 Ave Munoz Rivera	San Juan	PR	00918	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Price File Contact (Primary)	Medicare Part D Program Anaylst	Ms.	West	Ariel		3133781225					Ariel.West@abarcahealth.com	PerformRx	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Part D Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Patient Safety Contact	Director,Clinical Outcomes &Therap Optimization	Ms	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Payment Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Personal Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Pharmacy Director	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Pharmacy Network Management Contact	President, Network Strategy	Mr	Sullivan	Tim		6303303638					tssullivan@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Pharmacy Network Management Contact (Secondary)	Network Operations Analyst	Mr.	Kramerov	Allen		2159374120					akramerov@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Pharmacy Technical Help Desk Contact	Manager, Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H4739	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H4739	PHR Beneficiary Contact																	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS	AmeriHealth Caritas	Independence Health Group, Inc.	609	Yes	Active	2672985710				HMO - Health Maintenance Organization		C	Chicago
H4739	Physician Incentive Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Plan Directory Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Plan to Plan Reconciliation Contact	Director, Finance	Ms	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	P.O. 7137	London	KY	40742	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Processor Contact	Director of Clincal Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerFormrx	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Quality Contact	Director, Quality Management	Ms.	Popiolek	Rose		6107234450					rpopiolek@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Reconciliation Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Reconciliation Contact (Secondary)	Manager, Medicare Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Recovery Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	SNP Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	SNP State Contact	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Surveillance Contact	Director, Retail Sales Operations	Ms.	Bech	Mary		4146875533					mbech@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	System Contact	Manager, Medicare IS	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Third Party Administrator (TPA) Liaison	Manager, MCR Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/06/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	User Access Contact	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Utilization Management Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4739	Utilization Review Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	SELECT HEALTH OF SOUTH CAROLINA, INC.	Local CCP	First Choice VIP Care (HMO D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H4754	Agent/Broker Compensation Data Contact	Regional Sales Manager - Medicare		Fox	Ryan		5412252612					Ryan.Fox@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Automated TrOOP Balance Transfer Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Backup User Access Contact	Compliance Project Specialist	Ms	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Best Available Evidence Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Bid Audit Contact	Compliance Project Specialist	Ms	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Bid Audit Site Contact	Compliance Project Specialist	Ms	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Bid Primary Contact	Executive VP, Lines of Business		Hopper	Lindsey		5417065066					Lindsey.Hopper@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	CAP Report Contact for Public Website	President and Chief Executive Officer (CEO)	Mr.	Espinola	John		5416845286					John.Espinola@pacificsource.com	555 International Way		Springfield	OR	97477	04/03/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	CEO - CMS Administrator Contact	President and Chief Executive Officer (CEO)	Mr.	Espinola	John		5416845286					John.Espinola@PacificSource.com	555 International Way		Springfield	OR	97477	04/03/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	CEO - Senior Official for Contracting	President and Chief Executive Officer (CEO)	Mr.	Espinola	John		5416845286					John.Espinola@pacificsource.com	555 International Way		Springfield	OR	97477	04/03/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Chief Financial Officer	Senior Vice President and Chief Financial Officer	Mr	Fellner	Brian		2085632342					Brian.Fellner@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	10/28/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Chief Operating Officer	Senior Vice President, Health Plan Operations	Mr.	Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	555 International Way		Springfield	OR	97477	03/17/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Chief Information Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Chief Information Security Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	CMS Casework Communication Contact	Team Leader Appeals and Grievances		Downey	Reanna		5417065031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Complaints Tracking Contact	Team Leader Appeals and Grievances		Downey	Reanna		5417065031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Contact for Fraud Investigations	Director, Corporate Compliance - Commercial		Holliday	Gary		5416845251					Gary.Holliday@pacificsource.com	555 International Way		Springfield	OR	97477	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Coordination of Benefits Contact	Claims Manager COB-TPL		Keeler	Dena		5412253765					Dena.Keeler@pacificsource.com	555 International Way		Springfield	OR	97477	04/14/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Corporate Mailing						5413855315				5413853008	Lindsey.Hopper@pacificsource.com	PO Box 7469		Bend	OR	97708	02/12/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Customer Service Operations Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	DIR Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999				8003664873	RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	DIR Contact (Secondary)	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413304999					connie.riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	12/01/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Discount Program Payment Contact	Senior Accounts Receivable Accountant		Beaty	Charlene		5416845250					Charlene.Beaty@pacificsource.com	555 International Way		Springfield	OR	97477	08/08/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Emergency Part D Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999				8003664873	RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Analytic Manager		Kellogg	Ariel		5412253719					Ariel.Kellogg@pacificsource.com	555 International Way		Springfield	OR	97477	12/20/2021	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Enrollment Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	EOB Transfer Contact	Senior Vice President, Health Plan Operations	Mr	Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Financial Audit Contact	Vice President of Finance	Ms	Patterson	Kari		5416845594					Kari.Patterson@pacificsource.com	408 E Parkcenter Boulevard, Suite 100		Boise	ID	83706	09/26/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Financial Reporting Contact	Executive VP and Chief Financial Officer (CFO)	Mr.	Davidson	Peter		5416845212				5413853008	Peter.Davidson@pacificsource.com	555 International Way		Springfield	OR	97477	09/16/2020	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Formulary Contact	Rx Clinical Services Team		Services	Pharmacy		5038025965				5413853008	rxclinical@pacificsource.com	PO Box 7469		Bend	OR	97708	12/05/2019	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Formulary Contact (Secondary)	Pharmacy Compliance Specialist		Ryan	Alyssa		5418023031					Alyssa.Ryan@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	General Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327				5413853008	Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Government Relations Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327				5413853008	Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	HIPAA Privacy Officer	HIPAA Privacy Specialist		Olson	Terrie		5416408765					Terrie.Olson@pacificsource.com	555 International Way		Springfield	OR	97477	08/08/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	HIPAA Security Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	08/26/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Hospice Contact	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413304999				8003664873	Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Interoperability Contact	VP of IT Infrastructure and Analytics		Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	MA Appeals/Grievances Contact	Team Leader Appeals and Grievances		Downey	Reanna		5417065031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	MA Claims Processing Contact for Public Website	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Marketing Contact	Executive VP and Chief Sales and Marketing Officer		Havens	Jim		2532384011					Jim.Havens@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Medical Director	Medical Director	Dr.	McDonell	Miriam		5417493571					Miriam.McDonell@pacificSource.com	33 Nichols Pkwy	Suite 120	Hood River	OR	97031	01/23/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Medicare Compliance Officer	Interim Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	11/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Medicare Coordinator	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Medicare Part D Opioid Overutilization Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Medication Therapy Management Contact	Pharmacy Clinical Team		Clinical	Pharmacy		5413304999					RxClinical@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	OffShore Subcontractor Contact	Compliance Project Specialist	Ms	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Online Enrollment Center Contact (Primary)	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part C Application Contact	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part C Reporting Contact	Compliance Project Specialist	Ms	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Appeals	Team Leader Appeals and Grievances		Downey	Reanna							Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	07/20/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active	5417065031				PPO - BBA		C	Dallas
H4754	Part D Appeals Contact (Secondary)	Manager of Appeals and Grievances		Waltman	Jessica						5413226424	Jessica.Waltman@pacificsource.com	408 E Parkcenter Boulevard, Suite 100		Boise	ID	83706	11/12/2019	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active	2089085825				PPO - BBA		C	Dallas
H4754	Part D Application Contact	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Benefits Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Claims Submission Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Exceptions Contact	Pharmacy Services Leadership Team		Services	Pharmacy							RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active	5413304999				PPO - BBA		C	Dallas
H4754	Part D Price File Contact (Back-up)			Loveland	Chet		4806064873				4013357984	Chet.Loveland@CVSHealth.com	CVS Caremark | Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	01/10/2020	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Price File Contact (Optional)	SR. Manager, PBM Financial Operations		Okrie	Courtney		4803181864					Courtney.Okrie@CVSHealth.com	CVS Caremark | Caremark	9501 E. Shea Blvd.	Scottsdale	AZ	85260	01/06/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Price File Contact (Primary)	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	12/17/2021	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Quality Assurance Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Part D Reporting Contact	Compliance Project Specialist	Ms	Ely	Shelley		5413304914				5413853008	Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Patient Safety Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Payment Contact	Executive VP and Chief Financial Officer (CFO)	Mr.	Davidson	Peter		5416845212				5413853008	Peter.Davidson@pacificsource.com	555 International Way		Springfield	OR	97477	09/16/2020	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Pharmacy Director	Director of Clinical Pharmacy Services		Briones	Danielle		5413304999				8003664873	rxleadership@pacificsource.com	408 E Parkcenter Boulevard, Suite 100		Boise	ID	83706	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Pharmacy Network Management Contact	SR. Manager, PBM Financial Operations		Okrie	Courtney		4803181864					Courtney.Okrie@CVSHealth.com	9501 E. Shea Blvd, MC080		Scottsdale	AZ	85620	01/06/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Pharmacy Network Management Contact (Secondary)	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999					RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Pharmacy Technical Help Desk Contact	Government Programs Pharmacy Services		Services	Pharmacy							pharmacy@pacificsource.com	PO Box 7469		Bend	OR	97708	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active	8884377728				PPO - BBA		C	Dallas
H4754	Pharmacy Technical Help Desk Contact (Secondary)			Helpdesk	Pharmacy								CVS Caremark | Caremark	9501 E. Shea Blvd.	Scottsdale	AZ	85260	12/01/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active	8666934620				PPO - BBA		C	Dallas
H4754	Physician Incentive Contact	VP of Provider Network		McGarry	Peter		5038025338					Peter.McGarry@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Plan Directory Contact for Public Website	Customer Service		Service	Customer		5413855315					MedicareCS@PacificSource.com	PO Box 7469		Bend	OR	97708	03/11/2019	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Plan to Plan Reconciliation Contact	Enrollment and Billing Representative		Yeakey	Paula		5417065172					P2Padmin@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Processor Contact	SR. Manager, PBM Financial Operations		Okrie	Courtney		4803181864					Courtney.Okrie@CVSHealth.com	CVS Caremark | Caremark	9501 E. Shea Blvd	Scottsdale	AZ	85260	01/06/2022	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Quality Contact	Director, Quality Improvement Programs		Farmer	Melodie		5038025328					Melodie.Farmer@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	01/23/2024	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Reconciliation Contact	Pharmacy Services Leadership Team		Services	Pharmacy		5413304999				8003664873	RxLeadership@pacificsource.com	PO Box 7469		Bend	OR	97708	10/17/2018	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Reconciliation Contact (Secondary)	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413304999				8003664873	Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	02/24/2023	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Recovery Audit Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Surveillance Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	10/30/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	System Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Third Party Administrator (TPA) Liaison	Manager of Pharmacy Administration, Govt		Riffle	Connie		5413307309					Connie.Riffle@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	User Access Contact	Compliance Project Specialist - Medicare	Mrs.	Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Utilization Management Contact	Vice President of Medical Management		Mussenden	Tracy-Ann		2532384017					Tracy-Ann.Mussenden@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4754	Utilization Review Contact	Vice President of Medical Management		Mussenden	Tracy-Ann		2532384017					Tracy-Ann.Mussenden@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/20/2025	2026	PACIFICSOURCE COMMUNITY HEALTH PLANS	Local CCP	PacificSource Medicare	Local PPO		PacificSource	429	Yes	Active					PPO - BBA		C	Dallas
H4805	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Backup User Access Contact		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Best Available Evidence Contact			Cadena	Maria		6505022961					maria.cadena@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	CEO - CMS Administrator Contact		Mr.	Darragh	Jeff		6302201698					jeff.darragh@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	CEO - Senior Official for Contracting		Mr.	Darragh	Jeff		6302201698					jeff.darragh@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Chief Financial Officer		Mr.	Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Chief Operating Officer		Ms.	Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		Pasadena	CA	91105	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Chief Information Officer	Chief Information Officer	Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Chief Information Security Officer		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	CMS Casework Communication Contact	Compliance Director		Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Complaints Tracking Contact	Compliance Director		Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Contact for Fraud Investigations			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Coordination of Benefits Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Customer Service Operations Contact			Darragh	Jeff		6302201698					jeff.darragh@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	DIR Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	DIR Contact (Secondary)		Ms.	Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Emergency Part D Contact (Secondary)			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Enrollment Contact			Cadena	Maria		6505022961					maria.cadena@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	EOB Transfer Contact			Cadena	Maria		6505022961				6263600082	maria.cadena@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Formulary Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	General Contact			Darragh	Jeff		6302201698					jeff.darragh@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Government Relations Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	HIPAA Privacy Officer			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	HIPAA Security Officer		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Interoperability Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	MA Claims Processing Contact for Public Website			Grant	Alexsa		6503360300					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Medical Director	Chief Medical Officer		Hirota	David		8007348041					david.hirota@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/30/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Medicare Compliance Officer		Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Medicare Coordinator			Darragh	Jeff		6302201698					jeff.darragh@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Medicare Part D Opioid Overutilization Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Medication Therapy Management Contact		Ms.	Lincoln-Giang	Pam		7143925198					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	2192106392				PACE - Nat		C	San Francisco
H4805	Part D Appeals Contact (Secondary)			Darragh	Jeff							jeff.darragh@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	8882755240				PACE - Nat		C	San Francisco
H4805	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part D Benefits Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part D Claims Submission Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part D Exceptions Contact		Ms.	Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	7143925198				PACE - Nat		C	San Francisco
H4805	Part D Price File Contact (Back-up)			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part D Price File Contact (Primary)			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part D Quality Assurance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Part D Reporting Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Patient Safety Contact		Ms.	Lincoln-Giang	Pam		7143925198					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Pharmacy Director			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Pharmacy Network Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending	8007348041				PACE - Nat		C	San Francisco
H4805	Plan Directory Contact for Public Website			Grant	Alexsa		6503360300					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Plan to Plan Reconciliation Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Processor Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Quality Contact			Simon	Jillian		0000000000					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/12/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Reconciliation Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Reconciliation Contact (Secondary)			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Surveillance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	System Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	User Access Contact		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4805	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/06/2025	2026	WELBEHEALTH OREGON PACE, LLC	National PACE	WELBEHEALTH	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H4808	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H4808	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H4808	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H4808	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H4808	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H4808	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H4808	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H4808	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H4830	Automated TrOOP Balance Transfer Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Backup User Access Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Best Available Evidence Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Bid Primary Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	CAP Report Contact for Public Website			Driscoll	Faith		8004924227					driscollf@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	CEO - CMS Administrator Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	CEO - Senior Official for Contracting	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Chief Financial Officer		Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Chief Operating Officer	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Chief Information Officer	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Chief Information Security Officer	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	CMS Casework Communication Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Complaints Tracking Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Contact for Fraud Investigations			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Coordination of Benefits Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Corporate Mailing						8004924227					contact@uhc.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Customer Service Operations Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	DIR Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Discount Program Payment Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Emergency Part D Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Encounter Data & Risk Adjustment Operations Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Enrollment Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	EOB Transfer Contact			Maldonado	Jesus		8004924227				8557715224		3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Financial Audit Contact	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Financial Reporting Contact	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Formulary Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	General Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Government Relations Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	HIPAA Privacy Officer			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	HIPAA Security Officer			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Interoperability Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	MA Appeals/Grievances Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	MA Claims Processing Contact for Public Website			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Marketing Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Medical Director			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Medicare Compliance Officer	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Medicare Coordinator	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Medicare Part D Opioid Overutilization Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Medication Therapy Management Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part C Application Contact			Rodriguez	Miguel		5596466618	0021				rodriguezm@unitedhealthcenters.org	3875 W. Beechwood Avenue		Fresno	CA	93711	04/11/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part D Appeals			Williams	Gregory							preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending	8004924227				PACE - Nat		C	San Francisco
H4830	Part D Application Contact			Rodriguez	Miguel		5596466618	0021				rodriguezm@unitedhealthcenters.org	3875 W. Beechwood Avenue		Fresno	CA	93711	04/11/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part D Benefits Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part D Claims Submission Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part D Exceptions Contact			Williams	Gregory							preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending	8004924227				PACE - Nat		C	San Francisco
H4830	Part D Price File Contact (Back-up)			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part D Price File Contact (Primary)			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part D Quality Assurance Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Part D Reporting Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Patient Safety Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Payment Contact	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Pharmacy Director			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Pharmacy Network Management Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Pharmacy Technical Help Desk Contact			Williams	Gregory								3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending	8004924227				PACE - Nat		C	San Francisco
H4830	Plan Directory Contact for Public Website			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Plan to Plan Reconciliation Contact	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Processor Contact	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Quality Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Reconciliation Contact	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Recovery Audit Contact	CFO	Mr.	Maldonado	Jesus		8004924227					maldonadoj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Surveillance Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	System Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Third Party Administrator (TPA) Liaison	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	User Access Contact	CEO	Mr.	Preas	Justin		8004924227					preasj@unitedhealthcenters.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Utilization Management Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4830	Utilization Review Contact			Williams	Gregory		8004924227					williamsg@unitedhealthcenter.org	3875 West Beechwood Ave		Fresno	CA	93711	06/27/2024	2026	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY	National PACE	UHC PACE	National PACE		United Health Centers of the San Joaquin Valley	853	Yes	Pending					PACE - Nat		C	San Francisco
H4835	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H4835	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/11/2018	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4835	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF OKLAHOMA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4847	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H4847	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H4847	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H4847	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H4847	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4847	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4847	PHR Beneficiary Contact																	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H4847	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4847	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H4868	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H4868	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H4868	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H4868	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4868	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H4868	PHR Beneficiary Contact																	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H4868	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4868	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H4869	Agent/Broker Compensation Data Contact	Director of Sales Technology		Wandoloski	Matthew		5203602585					matthew.wandoloski@goldkidney.com	4600 E Washington St, #300	Apt 711	Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Automated TrOOP Balance Transfer Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Backup User Access Contact	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Best Available Evidence Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Bid Audit Contact	Medicare Product Director		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Bid Primary Contact	Medicare Product Director		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	CAP Report Contact for Public Website	CEO		Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	CEO - CMS Administrator Contact	CEO	Mr,	Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	CEO - Senior Official for Contracting	CEO	Mr,	Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Chief Financial Officer	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Chief Operating Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Chief Information Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Chief Information Security Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	CMMI Model Point of Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	CMS Casework Communication Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Complaints Tracking Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Contact for Fraud Investigations	Medicare Compliance Officer		Smith	Nakia		8442946535					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Coordination of Benefits Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Corporate Mailing						8442946535					dominic.henriques@goldkidney.com	PO 285		Portsmouth	NH	03802	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Customer Service Operations Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	DIR Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Discount Program Payment Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Emergency Part D Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Encounter Data & Risk Adjustment Operations Contact	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Enrollment Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	EOB Transfer Contact	Senior Business Analyst		Taylor	Jay		8442946535				8559156513	jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Financial Audit Contact	Controller/CFO	Mr.	Becker	Ryan		8442946535					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Financial Reporting Contact	Controller/CFO	Mr,	Becker	Ryan		8442946535					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Formulary Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	General Contact	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Government Relations Contact	CEO	Mr,	Henriques	Dominic		8442946535					dominic.henriques@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	HIPAA Privacy Officer	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	HIPAA Security Officer	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Hospice Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Interoperability Contact	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	MA Appeals/Grievances Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	MA Claims Processing Contact for Public Website	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Marketing Contact	Senior Compliance Analyst		Tran	Triet		8442946535					Triet.Tran@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Medical Director	CMO		Sahani	Mandeep		6023202916					mandeep.sahani@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Medicare Coordinator	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Medicare Part D Opioid Overutilization Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Medication Therapy Management Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part C Application Contact	Product Manager		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part C Reporting Contact	Senior Compliance Analyst		Tran	Triet		8442946535					Triet.Tran@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part D Appeals	Senior Director of Value Based Care		Abduljabbar	Fawaz							fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	8442946535				HMO - Health Maintenance Organization		C	Boston
H4869	Part D Application Contact	Product Manager		Mauro	Jennifer		8137708578					jennifer.mauro@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part D Benefits Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part D Claims Submission Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part D Exceptions Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz							fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	8442946535				HMO - Health Maintenance Organization		C	Boston
H4869	Part D Price File Contact (Back-up)	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part D Price File Contact (Primary)	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part D Quality Assurance Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Part D Reporting Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Patient Safety Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Payment Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Pharmacy Director	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Pharmacy Network Management Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/23/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active	8886727206				HMO - Health Maintenance Organization		C	Boston
H4869	Plan Directory Contact for Public Website	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Plan to Plan Reconciliation Contact	Senior Director of Value Based Care		Abduljabbar	Fawaz		8442946535					fawaz.abduljabbar@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Processor Contact	Senior Business Analyst		Taylor	Jay		8442946535					jay.taylor@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Quality Contact	CMO		Sahani	Mandeep		6023202916					mandeep.sahani@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Reconciliation Contact	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Smith	Nakia		3072502082					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Surveillance Contact	Medicare Compliance Officer		Smith	Nakia		8442946535					nakia.smith@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	System Contact	COO	Ms,	Mahoney	Michelle		8442946535					michele.mahoney@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Third Party Administrator (TPA) Liaison	CFO	Mr,	Becker	Ryan		4127227686					ryan.becker@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	User Access Contact	Sr. Compliance Specialist	Mr.	Tran	Triet		3072502082					triet.tran@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Utilization Management Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4869	Utilization Review Contact	Manager of Utilization & Care Management		Patel	Manishkuma		2565298836					manish.patel@goldkidney.com	4600 E Washington St, #300		Phoenix	AZ	85034	09/17/2025	2026	GOLD KIDNEY OF ARIZONA	Local CCP	Gold Kidney Health Plan	HMO/HMOPOS		Gold Kidney Health Plan	788	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H4875	Agent/Broker Compensation Data Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		6164648667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Backup User Access Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Bid Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Bid Audit Site Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Bid Primary Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	CAP Report Contact for Public Website	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	CEO - CMS Administrator Contact	President and Chief Health Plan Officer	Mr	Gates	Nick		6164648144					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	CEO - Senior Official for Contracting	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Chief Financial Officer	Senior Vice President, Finance	Mrs.	McIntyre	Celeste		6167745142					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Chief Operating Officer	SVP, Government/Consumer Markets	Mrs.	Kincaid	Carrie		6164648969					phcompliance@priorityhealth.com	1231 East Beltine NE		Grand Rapids	MI	49525	02/10/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Chief Information Officer	Chief Information Officer	Mr	Crook	Chris		6164649939					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Chief Information Security Officer	SVP, IS Technology Services	Mr	Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE	MC 843	Grand Rapids	MI	49503	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	CMMI Model Point of Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Complaints Tracking Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE	MS 1115	Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Contact for Fraud Investigations	Manager, Special Investigations Unit		Gross	Brenda		6164648152					Brenda.Gross@PriorityHealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Coordination of Benefits Contact	Claims Manager		Ball	Jill		8883896648					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Corporate Mailing						6169420954				6164640145	PH-DistributionSE@PriorityHealth.com	1231 East Beltline Ave, NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		5033309550					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	DIR Contact	Senior Accountant		Savic	Stephanie	M	6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	DIR Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel	K	6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	01/27/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Discount Program Payment Contact	Senior Accountant		Savic	Stephanie		6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Electronic Health Record Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Emergency Part D Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Emergency Part D Contact (Secondary)	Manager, Medicare Pharmacy Operations		VanLoenen	Amanda		6164648750					Amanda.VanLoenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Employer Waiver Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Encounter Data & Risk Adjustment Operations Contact			Florn	Cathy		7348902858					cathy.florn@priorityhealth.com	1239 E Beltline Ave Ne		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Enrollment Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	EOB Transfer Contact	Claims Manager		Ball	Jill		6164648044				6169750247	phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Financial Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Financial Reporting Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Formulary Contact	Medicare Part D Operations Manager		Van Loenen	Amanda		6164648750					PH-MedicareFormularyContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	General Contact	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Government Relations Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	HIPAA Privacy Officer	VP, Compliance & Privacy Officer		Rollenhagen	Cindy		6164648424					phcompliance@priorityhealth.com	1231 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	HIPAA Security Officer			Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE		Grand Rapids	MI	49503	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Hospice Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Interoperability Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	MA Appeals/Grievances Contact	Manager Grievance & Appeal		Macdonald	Amanda		6164648264					phcompliance@priorityhealth.com	1231 East Beltline Ave NE	MS 1115	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	MA Claims Processing Contact for Public Website	Claims Manager		Ball	Jill		6164648044					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Marketing Contact	Sr. Markets & Product Development Director		Brown	Samia		6164648002					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Medical Director	SVP Chief Medical Officer		Oker	Elif		6164643510					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Medicare Compliance Officer	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Medicare Coordinator	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Medicare Part D Opioid Overutilization Contact	Medicare Quality Manager		Gutierrez	Salvador		6165757622					salvador.gutierrez@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Medication Therapy Management Contact	Director of Pharmacy Operations		Chaffee	Jacob		6168261329					jacob.chaffee@priorityhealth.com	1231 East Beltline Dr Ne		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	OffShore Subcontractor Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Online Enrollment Center Contact (Optional)	Government Programs Enrollment Coordinator		Rice	Lori		6164648667					lori.rice@priorityhealth.com	1231 East Beltline Ave NE	MS 1180	Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part C Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part C Reporting Contact	Sr. Compliance Analyst		Eizinger	Eric		2178400871					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Appeals	Supervisor, Medicare Part D Appeals		Anderson	Melissa							PHMedicarePartDAPPLS@spectrumhealth.org	1231 East Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	6164648547				PPO - BBA		C	Seattle
H4875	Part D Appeals Contact (Secondary)	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather							phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	6164643510				PPO - BBA		C	Seattle
H4875	Part D Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Benefits Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Claims Submission Contact	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Exceptions Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	8004666642				PPO - BBA		C	Seattle
H4875	Part D Exceptions Contact (Secondary)	Mgr, Medicare Part D Operations	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	6164648750				PPO - BBA		C	Seattle
H4875	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					Medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Price File Contact (Optional)	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Quality Assurance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Part D Reporting Contact	Sr. Compliance Analyst		Eizinger	Eric		2178400871					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Patient Safety Contact	Clinical Pharmacy Program Manager	Mr	Chaffee	Jacob		6165756149					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Payment Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Personal Health Record Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Pharmacy Director	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Pharmacy Network Management Contact (Secondary)	Manager, Medicare Pharmacy Operations		Van Loenen	Amanda		6164648750					amanda.vanloenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	8004666642				PPO - BBA		C	Seattle
H4875	Pharmacy Technical Help Desk Contact (Secondary)	Mgr, Medicare Part D Ops	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active	6164648750				PPO - BBA		C	Seattle
H4875	Physician Incentive Contact	Director, Provider Strategy & Solutions		Ryan	Susan		3137010444					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Plan Directory Contact for Public Website			Service	Customer		8883896648					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Plan to Plan Reconciliation Contact	Business Systems Analyst		Robinson	Aminah		6168629827					aminah.robinson@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	07/01/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Processor Contact	ESI Sr Dir - Product Management Medicare		Mahon	Snezana		3146846361					SMahon@express-scripts.com	ESI	One Express Way	St. Louis	MO	63121	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Quality Contact	Manager, Quality	Mr	Straayer	Ian		6165752782					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Reconciliation Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Reconciliation Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel		6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Recovery Audit Contact	Manager Cost Recovery	Ms	Gross	Brenda		6164648152					brenda.gross@priorityhealth.com	1231 East Beltline NE	Mail Stop 2305	Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	SNP Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					janine.bishop@priorityhealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	SNP State Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					janine.bishop@priorityhealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Surveillance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	System Contact	Data Analytics Analyst-Senior, Sr Markets		Johnson	Joshua		6165755760					PH-MedicareSystemsContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Third Party Administrator (TPA) Liaison	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	User Access Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Utilization Management Contact	Director, Utilization Mgmt PH Pre-Service		Mahoney	Diana		8439068561					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4875	Utilization Review Contact	Director, Medicare Care Management		Scovel	Janet		6164648656					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH	Local CCP	Priority Health Medicare	Local PPO		Corewell Health	190	Yes	Active					PPO - BBA		C	Seattle
H4882	Agent/Broker Compensation Data Contact	VP Government Programs		Clelland	Jennifer	J	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	11/04/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Automated TrOOP Balance Transfer Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Backup User Access Contact	Coordinator Government Programs		Yu	Chao		9528837240					Chao.X.Yu@HealthPartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Best Available Evidence Contact	Sr. Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Bid Audit Contact	Director, Integrity and Compliance	Ms.	Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	11/17/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Bid Audit Site Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS:  21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Bid Primary Contact	Vice President, Actuary		Stewart	Sara	M	9528835049					sara.m.stewart@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21105H	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	CAP Report Contact for Public Website	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	CEO - CMS Administrator Contact	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	CEO - Senior Official for Contracting	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/04/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Chief Financial Officer	SVP & Chief Financial Officer	Ms.	Johnson	Kathleen	A	9528836531					kathy.a.johnson1@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	554401309	03/29/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Chief Operating Officer	EVP, Health Engagement and Informatics Officer	Ms.	Knudson	Susan	M	9528836185					susan.m.knudson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110A	Minneapolis	MN	554401309	01/28/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Chief Information Officer	Senior Vice President and CTO	Mr.	Thull	Tim	D	9528837636					timothy.d.thull@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/16/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Chief Information Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	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	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Complaints Tracking Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Contact for Fraud Investigations	Senior Manager Claims		Dahlberg	Kara	A	9529675640					kara.a.dahlberg@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  25510F	Minneapolis	MN	55101	07/09/2024	2026	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	9529677335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Corporate Mailing						9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/24/2017	2026	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		9529677668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	554409463	01/29/2020	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	DIR Contact	Sr. Pharmacy Plan Contract Manager		Reinhardt	Sandra	L	9528836739					sandra.l.reinhardt@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	DIR Contact (Secondary)	Consultant, Data Analysis		Binsfeld	David	T	9529675950					david.t.binsfeld@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS 21108Q	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Discount Program Payment Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Emergency Part D Contact	Sr. Director Pharmacy Services		Strahl	Christine	L	9528835022				9529676667	christine.l.strahl@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Emergency Part D Contact (Secondary)	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Employer Waiver Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Encounter Data & Risk Adjustment Operations Contact	Senior Manager, Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South	MS: 21103J	Minneapolis	MN	55425	02/19/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Enrollment Contact	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	EOB Transfer Contact	Sr. Manager Claims Production		Huseby	Pam	J	9529675530				9528837666	pam.j.huseby@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	08/30/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Financial Audit Contact	Director Monitoring and Compliance	Ms	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Financial Reporting Contact	Director Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	01/24/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Formulary Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	General Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	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	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	08/30/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	HIPAA Privacy Officer	Sr. Director Integrity Compliance Privacy Officer		Wells	Prasanta	K	9528837325					prasanta.k.wells@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103K	Minneapolis	MN	554401309	01/24/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	HIPAA Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Hospice Contact	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Interoperability Contact	Program Manager, IT		Geisler	Chris	J	6122479067					Chris.J.Geisler@HealthPartners.Com	8170 33rd Avenue South		Bloomington	MN	55425	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	MA Appeals/Grievances Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	MA Claims Processing Contact for Public Website	Sr. Manager Claims Production		Huseby	Pam	J	9529675530					RVSCProviderInquiry@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Marketing Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Medical Director	Health Plan Chief Medical Officer	Dr.	Kakacek	Virginia	L	9528837120					virginia.l.kakacek@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110Q	Minneapolis	MN	554401309	09/21/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Medicare Compliance Officer	Director, Integrity and Compliance	Ms.	Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	11/17/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Medicare Coordinator	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Medicare Part D Opioid Overutilization Contact	Pharmacy UM Systems and Data Analyst		Hamm	Sarah	K	9529677652					sarah.k.hamm@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Medication Therapy Management Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Online Enrollment Center Contact (Back-up)	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Online Enrollment Center Contact (Optional)	Admin Product Implementation Manager		Wessel	Sara	C	9529677623					sara.c.wessel@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/29/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Online Enrollment Center Contact (Primary)	Senior Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	12/17/2024	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part C Application Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part C Reporting Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Appeals	Manager Member Rights and Benefits		Kruse	Morgan	L						Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS:  21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8007963806				PPO - BBA		C	Chicago
H4882	Part D Appeals Contact (Secondary)	Supervisor, Member Rights and Benefits		Dress	Samantha							Samantha.L.Dress@HealthPartners.com	8170 33rd Avenue South	MS: 21103R	Bloomington	MN	55425	12/06/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8007963806				PPO - BBA		C	Chicago
H4882	Part D Application Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Benefits Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Claims Submission Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Exceptions Contact	Mgr Pharmacy Clinical Svcs & UM Pharm Clin Srv		Whelan	Hillary	A					8888835434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/17/2024	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8004927259				PPO - BBA		C	Chicago
H4882	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Price File Contact (Primary)	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Quality Assurance Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21108T	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Part D Reporting Contact	Director of Medicare and Shared Services		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	11/29/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Patient Safety Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Payment Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	01/24/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Pharmacy Director	VP Pharmacy		Busch	David	L	9529675049					david.l.busch@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	06/25/2020	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Pharmacy Network Management Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Pharmacy Network Management Contact (Secondary)	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/03/2025	2026	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					8888835434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/19/2022	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8004927259				PPO - BBA		C	Chicago
H4882	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Customer Service		Sahs	Dale							dale.sahs@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8009221557				PPO - BBA		C	Chicago
H4882	Plan Directory Contact for Public Website			Services	Provider		9528837699					RVSCProviderInquiry@HealthPartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/24/2017	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Plan to Plan Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Processor Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina		9528836536				9529676667	dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Quality Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Recovery Audit Contact	Director Monitoring and Compliance	Ms.	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Surveillance Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	System Contact	Senior Manager Operational Integrity		Smmith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21193J	Minneapolis	MN	554401309	02/19/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Third Party Administrator (TPA) Liaison	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/11/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	User Access Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Utilization Management Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4882	Utilization Review Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H4906	Backup User Access Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	CAP Report Contact for Public Website	Controller		Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	CEO - CMS Administrator Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	CEO - Senior Official for Contracting	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Chief Financial Officer	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Chief Operating Officer	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Chief Information Officer	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Chief Information Security Officer	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Complaints Tracking Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Contact for Fraud Investigations	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Corporate Mailing						5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Cost Report Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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		8006799135				5408624958	Rodney@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Enrollment Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	General Contact	Administrator	Mrs	Hoke	Michelle		5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	02/23/2024	2026	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		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Interoperability Contact	Administrator		Hoke	Michelle		5408625728					michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	09/05/2023	2026	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	MA Appeals/Grievances Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	MA Claims Processing Contact for Public Website	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Marketing Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Medical Director	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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 Coordinator	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Part C Application Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Payment Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Plan Directory Contact for Public Website	Medicare Dues Clerk		Nicely	Rodney		8006799135				5408624958	Rodney@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Quality Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Surveillance Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	System Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	User Access Contact	Administrator	Ms	Hoke	Michelle	M	5408625728				5408624958	michellehoke@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Utilization Management Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Utilization Review Contact	Benefits Manager	Mrs	Via	Brandi		5408625728				5408624958	brandivia@coeha.com	427 E Ridgeway Street		Clifton Forge	VA	24422	11/07/2022	2026	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	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/14/2022	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H4909	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H4909	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H4909	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H4909	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H4909	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H4909	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM INSURANCE COMPANIES, INC.	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H4909	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/28/2021	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie		7203929719				3039961600	lteter@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/25/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/25/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Chief Operating Officer	President & COO	Mr.	Scarbrough	Michael	A	7208127180				3039961600	mscarbrough@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	01/06/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Chief Information Security Officer	SVP of Information Technology	Mr.	Naus	Cole		7209210443				3039961600	MNaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	07/25/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	CMS Casework Communication Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Complaints Tracking Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Coordination of Benefits Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Corporate Mailing						3038694664				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/26/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Customer Service Operations Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	DIR Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Encounter Data & Risk Adjustment Operations Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Government Relations Contact	Senior Vice President, External Affairs		Koehn	John		7328098761					jkoehn1@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Interoperability Contact	SVP of Applications		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	07/26/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	MA Appeals/Grievances Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Medical Director	Regional Medical Officer	Dr.	Ferrance	Randy		8048226797					rferrance@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	04/29/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/26/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Appeals	Director of Compliance		Licht	Hannah						3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Atlanta
H4919	Part D Appeals Contact (Secondary)	Director of Compliance		Licht	Hannah						3039961600	hlicht@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Atlanta
H4919	Part D Application Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Atlanta
H4919	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Atlanta
H4919	Part D Price File Contact (Back-up)	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Quality Assurance Contact	SVP, Clinical Strategic Partnerships Clinical Oper		Cinque	Michael		7207444048				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/26/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Part D Reporting Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Atlanta
H4919	PHR Beneficiary Contact																	07/26/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE	Total Longterm Care Inc	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Atlanta
H4919	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Plan to Plan Reconciliation Contact	Finance and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	akizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/26/2023	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Quality Contact	Regional Director of Quality		Moran	Nicole		2159514263				3039961600	nmoran@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Reconciliation Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	System Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	User Access Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Utilization Management Contact	Regional Director Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/22/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4919	Utilization Review Contact	Regional Director Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	08/22/2025	2026	INNOVAGE FLORIDA PACE, LLC	National PACE	InnovAge Florida  PACE - Tampa	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Atlanta
H4931	Agent/Broker Compensation Data Contact	Senior Director, Government Programs Sales		Perry	Danielle		6024004768					Danielle.Perry@bannerhealth.com	2901 N Central Ave	Ste. 160	Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Backup User Access Contact	Sr. Government Programs Project Advisor		Croxon	Tracy		7752247134					buhpgovernmentprograms@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Best Available Evidence Contact	Director, Grievance and Appeals		Clayton	Natasha		5206673777				5208743462	natasha.clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	09/19/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Bid Audit Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Bid Audit Site Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Bid Primary Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	CAP Report Contact for Public Website	Interim Chief Executive Officer		Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	CEO - CMS Administrator Contact	Interim Chief Executive Officer	Mrs	Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	CEO - Senior Official for Contracting	Interim Chief Executive Officer	Mrs	Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Chief Financial Officer	Chief Financial Officer	Mr	Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Chief Operating Officer	Senior Director, Medicare Operations	Mr	McDonald	Kelly		4803905699					kelly.mcdonald@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	11/19/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Chief Information Officer	Executive Director, IT	Mr.	Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	05/01/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Chief Information Security Officer	Executive Director, IT	Mr.	Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	05/01/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	CMMI Model Point of Contact	Senior Director Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	CMS Casework Communication Contact	Director, Grievance and Appeals		Clayton	Natasha		6027478416				6023344683	Natasha.Clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Complaints Tracking Contact	Director, Grievance and Appeals		Clayton	Natasha		6027478416				6023344683	Natasha.Clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Contact for Fraud Investigations	Senior Director of Compliance		Dorazio	Terri		5208742847				5208747072	Theresa.Dorazio@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Coordination of Benefits Contact	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365					olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Corporate Mailing						5208745550				5208747083	silvia.parra@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	07/27/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Customer Service Operations Contact	Customer Care Director		Carrillo	Veronica		5208745349				5208747083	Veronica.Carrillo@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	DIR Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	DIR Contact (Secondary)	Director, Actuary		Marx	Blaiklen		4807208515					blaiklen.marx@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	07/24/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Discount Program Payment Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Electronic Health Record Contact	Executive Director, IT		Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Emergency Part D Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341				5208747083	Michael.Ramsey@bannerhealth.com	2901 N. Central Avenue		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Emergency Part D Contact (Secondary)	Executive Director Pharmacy		Jorn	Vincent		4023129969					Vincent.Jorn@bannerhealth.com	2901 N. Central Avenue		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Encounter Data & Risk Adjustment Operations Contact	Sr. Director Payment Integrity & Reimbursement		Horton	Tanner		4806845016					Tanner.Horton2@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Enrollment Contact	Associate Director, HP Operations Sales		Paredes	Nadya		5208745964				5208747083	Nadya.Paredes@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	EOB Transfer Contact	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365				5208747083	olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Financial Audit Contact	Chief Financial Officer	Mr	Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Financial Reporting Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Formulary Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Formulary Contact (Secondary)	Associate Director, Population Health Pharmacy		Pham	Vi		6027471125					vi.pham@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	09/12/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	General Contact	Sr. Director Compliance		Van Leeuwen	Kimberly		2132382980					kimberly.vanleeuwen@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	11/21/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Government Relations Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	HIPAA Privacy Officer	Senior Director of Compliance		Dorazio	Terri		5208742847				5208747072	Theresa.Dorazio@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	HIPAA Security Officer	Executive Director, IT		Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Hospice Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Interoperability Contact	Interoperability Healthcare Leader		Hall	Matt		4802805577					matt.hall@bannerhealth.com	2901 N Central Ave. Ste 160		Phoenix	AZ	85012	07/24/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	MA Appeals/Grievances Contact	Director, Grievance and Appeals		Clayton	Natasha		6027478416				6023344683	Natasha.Clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	MA Claims Processing Contact for Public Website	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365					olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Marketing Contact	Marketing Manager		Medina	AnaMaria		5208745082				5208747083	AnaMaria.Medina@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Medical Director	Chief Medical Officer	Dr	Ellis	Kevin		6027474000					kevin.ellis@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/05/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Medicare Compliance Officer	Sr. Compliance Director	Mrs.	Van Leeuwen	Kimberly		2132382980					kimberly.vanleeuwen@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	11/21/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Medicare Coordinator	Interim Chief Executive Officer	Mrs	Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Medicare Part D Opioid Overutilization Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave.	Ste. 160	Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Medication Therapy Management Contact	Director (Clinical & Trend Solutions)		Muralidharan	Adrienne		3143131932				8587906052	amuralidharan@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	12/21/2021	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	OffShore Subcontractor Contact	Sr. Director Compliance		Van Leeuwen	Kimberly		2132382980					kimberly.vanleeuwen@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	11/21/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Online Enrollment Center Contact (Back-up)	Senior Director, Government Programs Sales		Perry	Danielle		6024004768					Danielle.Perry@bannerhealth.com	2901 N Central Ave	Ste. 160	Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Online Enrollment Center Contact (Optional)	Enrollment Supervisor		Espinoza	Brianna		5208744192				5205855252	Brianna.Espinoza@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Online Enrollment Center Contact (Primary)	Associate Director, HP Operations Sales		Paredes	Nadya		5208745964				5208747083	Nadya.Paredes@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part C Application Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part C Reporting Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Appeals	Director, Grievance and Appeals		Clayton	Natasha						6023344683	natasha.clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	09/16/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	8668730029				HMO - Health Maintenance Organization		C	New York
H4931	Part D Appeals Contact (Secondary)	Director, Grievance & Appeals		Clayton	Natasha						6023344683	natasha.clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	10/07/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	6027476021				HMO - Health Maintenance Organization		C	New York
H4931	Part D Application Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Benefits Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Claims Submission Contact	Director Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	Express Scripts	One Express Way	St Louis	MO	63121	01/30/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Exceptions Contact	Express Scripts Sr. Manager Pharmacy Prio Auth		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/14/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	New York
H4931	Part D Exceptions Contact (Secondary)	Director, Managed Pharmacy Solutions		Ramsey	Michael							Michael.ramsey@bannerhealth.com	2901 N. Central Ave. Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	4806508341				HMO - Health Maintenance Organization		C	New York
H4931	Part D Price File Contact (Back-up)	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Price File Contact (Optional)	Express Scripts Manager, Regulated Markets		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	Express Scripts	4865 Dixie Hwy	Fairfield	OH	45014	03/26/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Price File Contact (Primary)	Express Scripts Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	Express Scripts	5151 Blazer Pkwy	Dublin	OH	43017	03/26/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Quality Assurance Contact	Sr. Director Quality Management		Robles Caraveo	Sandra		6233266425					sandra.roblescaraveo@bannerhealth.com	2901 N Central Ave		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Part D Reporting Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Patient Safety Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Payment Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Personal Health Record Contact	Sr. Director Quality Management		Robles Caraveo	Sandra		6233266425					sandra.roblescaraveo@bannerhealth.com	2901 N Central Ave		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Pharmacy Director	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Pharmacy Network Management Contact	Express Scripts Network Accountant Director		Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	01/30/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Pharmacy Network Management Contact (Secondary)	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Pharmacy Technical Help Desk Contact	Senior Director, Customer Service		Sahs	Dale							dale.sahs@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/04/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H4931	Pharmacy Technical Help Desk Contact (Secondary)	Senior Manager		Perkins	Holly							hperkins@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/04/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H4931	PHR Beneficiary Contact																	06/14/2022	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS	Express Scripts	Banner Health	389	Yes	Active	3143131932				HMO - Health Maintenance Organization		C	New York
H4931	Physician Incentive Contact	Payer Account Program Sr. Manager		Ruiz	Marcela		5208745215				5208747083	Marcela.Ruiz@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Plan Directory Contact for Public Website	BMA Customer Care		Care	Customer		5208743930				5208743434	memberservicesinquiries@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	07/27/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Plan to Plan Reconciliation Contact	Financial Analyst		Best	Heather		4806845188					Heather.Best@bannerhealth.com	PO Box 16423		Mesa	AZ	85211	05/12/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Processor Contact	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365					olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Quality Contact	Sr. Director Quality Management		Robles Caraveo	Sandra		6233266425					sandra.roblescaraveo@bannerhealth.com	2901 N Central Ave		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Reconciliation Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Reconciliation Contact (Secondary)	Director, Actuary		Marx	Blaiklen		4807208515					blaiklen.marx@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	07/24/2025	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Recovery Audit Contact	Sr Director, Payment Intergrity & Reimb Finance	Mr	Horton	Tanner		4806845016					tanner.horton@bannerhealth.com	525 W Brown Rd		Mesa	AZ	85201	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	SNP Application Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	SNP State Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Surveillance Contact	Marketing Associate Director		Medina	AnaMaria		5208745082					AnaMaria.Medina@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	System Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	User Access Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Utilization Management Contact	RN Director Utilization Management		Messing	Carla		6026171632					carla.messing@bannerhealth.com	525 W Brown Rd		Mesa	AZ	85201	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4931	Utilization Review Contact	Medical Management Associate Director		Wilson	Traci	R	4802702342					Traci.Wilson@bannerhealth.com	525 W Brown Rd		Mesa	AZ	85201	12/26/2024	2026	BANNER - UNIVERSITY CARE ADVANTAGE	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H4937	Agent/Broker Compensation Data Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		8182286374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Backup User Access Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Best Available Evidence Contact	Manager, Medicare Operations		Loreto	Alfonso		8182287005					Alfonso.Loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Bid Audit Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Bid Audit Site Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Bid Primary Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	CAP Report Contact for Public Website	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	CEO - CMS Administrator Contact	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	CEO - Senior Official for Contracting	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Chief Financial Officer	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Chief Operating Officer	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Chief Information Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Chief Information Security Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Complaints Tracking Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Contact for Fraud Investigations	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Coordination of Benefits Contact	Manager, Medicare Operations		Loreto	Alfonso		8182287005					alfonso.loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/02/2019	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Corporate Mailing						5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Customer Service Operations Contact	Director		Mathews	Carolyn		5626135004					Carolyn.Mathews@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	DIR Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	DIR Contact (Secondary)	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Discount Program Payment Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Emergency Part D Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Emergency Part D Contact (Secondary)	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Employer Waiver Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland HIlls	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Actuary		Rodgers	John		3107442643					John.Rodgers@blueshieldca.com	100 N. Sepulveda Boulevard		El Segundo	CA	90245	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Enrollment Contact	Manager, Medicare Operations		Loreto	Alfonso		8182287005					Alfonso.Loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	EOB Transfer Contact	Medicare Project & Program Manager		Zuehlke	Erica		2093713036				8558953519	zuehlke@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Financial Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Financial Reporting Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Formulary Contact	Director, Formulary Strategy and P&T		Nguyen	Nhi		9168410342					Nhi.Nguyen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Formulary Contact (Secondary)	Principal Pharmacist, Formulary Management		Trinh	Andy		3238276322					Andy.Trinh@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	General Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Government Relations Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	HIPAA Privacy Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	HIPAA Security Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Hospice Contact	Senior Program Manager		Fields	Torrie		4152295839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	01/02/2019	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Interoperability Contact	VP Enterprise Digital Growth		Grimm	David		6196864233					david.grimm@blueshieldca.com	2275 Rio Bonito Way	Suite 250	San Diego	CA	92108	02/15/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	MA Appeals/Grievances Contact	Supervisor, Medicare Appeals and Grievances		Lopez	Celina		8182286183				9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/02/2019	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	MA Claims Processing Contact for Public Website	Senior Manager, Medicare Operations		Halley	Derek		8182286374					Derek.Halley@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Marketing Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Medical Director	Medicare Medical Director	Dr.	Siddiq	Khaliq		5627137953					Khaliq.Siddiq@blueshieldca.com	555 Anton Boulevard	Suite 800	Costa Mesa	CA	92626	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Medicare Coordinator	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Medicare Part D Opioid Overutilization Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					OpioidDUR@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/13/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Medication Therapy Management Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					Dawn.Becker-Ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	OffShore Subcontractor Contact	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Online Enrollment Center Contact (Back-up)	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Online Enrollment Center Contact (Optional)	IT Product Manager, Consultant		Skuta	Paul		9168660922					Paul.Skuta2@blueshieldca.com	601 12th Street		Oakland	CA	94607	10/02/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Loreto	Alfonso		8182287005					Alfonso.Loreto@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part C Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part C Reporting Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part D Appeals	Supervisor, Medicare Appeals and Grievances		Lopez	Celina						9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/02/2019	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	8007764466				PPO - BBA		C	Dallas
H4937	Part D Appeals Contact (Secondary)	Senior Manager, Operations		Salam	Shahid							Shahid.Salam@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	8007764466				PPO - BBA		C	Dallas
H4937	Part D Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part D Benefits Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part D Claims Submission Contact	Lead Medicare Rx Benefits & Claims Specialist		Campbell	Leslie		5306263838					leslie.campbell@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/02/2019	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
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	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	8007764466				PPO - BBA		C	Dallas
H4937	Part D Exceptions Contact (Secondary)	Senior Manager, Medicare Compliance		Mata	Marcos							Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	8007764466				PPO - BBA		C	Dallas
H4937	Part D Price File Contact (Back-up)	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part D Price File Contact (Optional)	Business Analyst, Rx Benefit/Claims Implementation		Ng	Alvin		5106072964					alvin.ng@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/14/2020	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part D Price File Contact (Primary)	Business Analyst, Rx Benefit/Claims Implementation		Ng	Alvin		5106072964					Alvin.Ng@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part D Quality Assurance Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Part D Reporting Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Patient Safety Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					dawn.becker-ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/02/2019	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Payment Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Pharmacy Director	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Pharmacy Network Management Contact (Secondary)	Senior Program Manager, Medicare Rx Compliance		Nelson	Kimberly	C	5106073281					Kim.Nelson@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/20/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	8003757924				PPO - BBA		C	Dallas
H4937	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager		Nordby	Christina							cnordb01@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/30/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active	5626135252				PPO - BBA		C	Dallas
H4937	Physician Incentive Contact	Director, Provider Services - Network		Gonzalez	Maria		3238534445					Maria.Gonzalez2@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Plan Directory Contact for Public Website			Services	Member		8007764466					membersvcs@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Plan to Plan Reconciliation Contact	Supervisor Accounts Payable/Receivable		Perez	Cheryl		9167024442					BSCP2PRecon@blueshieldca.com	3021 Reynolds Ranch Parkway		Lodi	CA	95240	02/22/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Processor Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106073281					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Quality Contact	Senior Director, Program & Project Management		Blanchard	Heather		5106072420					heather.blanchard@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Reconciliation Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Reconciliation Contact (Secondary)	Senior Director, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Recovery Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Surveillance Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	System Contact	Sr. Director, IT Product Management		Chambers	Shelley		1916866073					Shelley.Chambers@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Third Party Administrator (TPA) Liaison	Director, Actuary		Shah	Dimple		5109068189					dimple.shah@blueshieldca.com	50 Beale Street		Oakland	CA	94105	12/04/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	User Access Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Utilization Management Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4937	Utilization Review Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	Local CCP	Blue Shield of California	Local PPO		California Physicians' Service	30	Yes	Active					PPO - BBA		C	Dallas
H4939	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Best Available Evidence Contact	Manager, Enrollment		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Chief Financial Officer	Chief Financial Officer	Ms.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Customer Service Operations Contact	Director, Inbound Contacts		Gillis	Tamra		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Government Relations Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Exceptions Contact	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H4939	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H4939	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4939	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H4961	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				PPO - BBA		C	Chicago
H4961	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			PPO - BBA		C	Chicago
H4961	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				PPO - BBA		C	Chicago
H4961	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				PPO - BBA		C	Chicago
H4961	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				PPO - BBA		C	Chicago
H4961	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				PPO - BBA		C	Chicago
H4961	PHR Beneficiary Contact																	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				PPO - BBA		C	Chicago
H4961	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4961	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H4982	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/25/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/12/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H4982	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/11/2018	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/12/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4982	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF CALIFORNIA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H4994	Part C Application Contact			Hoffman	Adam		3104099232					adam.hoffman@wisepace.org	17815 Ventura Blvd., #109		Encino	CA	91316	11/03/2025	2026	WELLNESS INSTITUTE FOR SENIOR EMPOWERMENT	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H4994	Part D Application Contact			Hoffman	Adam		3104099232					adam.hoffman@wisepace.org	17815 Ventura Blvd., #109		Encino	CA	91316	11/03/2025	2026	WELLNESS INSTITUTE FOR SENIOR EMPOWERMENT	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H4999	Automated TrOOP Balance Transfer Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Backup User Access Contact	Director of Training and Operational Development		Sheeder	Shelby		8145927615					shelby.sheeder@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Bid Primary Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	CAP Report Contact for Public Website	VP, Controller		Williams	kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Philadelphia
H4999	CEO - CMS Administrator Contact	Interim CEO	Mr.	Worland	Craig		8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	CEO - Senior Official for Contracting	Interim CEO	Mr.	Worland	Craig		8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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	Jeff		8144565433					jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Chief Operating Officer	Chief Operating Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	09/09/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Chief Information Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Chief Information Security Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Complaints Tracking Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Contact for Fraud Investigations	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Corporate Mailing						8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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	Chief Operating Officer		Worland	Craig	M	8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	DIR Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	DIR Contact (Secondary)	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Discount Program Payment Contact	CFP		Phillips	Jeffrey		4127205118					Jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Emergency Part D Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Emergency Part D Contact (Secondary)	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Encounter Data & Risk Adjustment Operations Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Enrollment Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	EOB Transfer Contact	Director Revenue Cycle		Toward	Karrie		8144565433				8144542500	Karrie.Toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Financial Audit Contact	VP, Controller	Ms.	Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Financial Reporting Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Formulary Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Formulary Contact (Secondary)	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	General Contact	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	HIPAA Privacy Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	HIPAA Security Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Interoperability Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	MA Appeals/Grievances Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	MA Claims Processing Contact for Public Website	Director of Network & Special Projects		Feldmann	William		8144565433					william.feldmann@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Marketing Contact	VP, Marketing and Intakes		Campbell	Marcie		8144565433					Marcie.Campbell@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Medical Director	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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	Chief Compliance Officer	Mrs.	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Medicare Coordinator	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Medicare Part D Opioid Overutilization Contact	Chief Compliance Officer		Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Medication Therapy Management Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Part C Application Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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 Appeals	VP, Controller		Williams	Kelly							kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Philadelphia
H4999	Part D Appeals Contact (Secondary)	Chief Compliance Officer		Kennedy	Jennifer						8144542500	jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	8444565433				PACE - Nat		C	Philadelphia
H4999	Part D Application Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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 Benefits Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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 Claims Submission Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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	Medical Director	Dr.	Rummel	James							james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Philadelphia
H4999	Part D Exceptions Contact (Secondary)	Chief Compliance Officer		Kennedy	Jennifer							jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Philadelphia
H4999	Part D Price File Contact (Back-up)	CFO		Phillips	Jeff		8144565433					jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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 Price File Contact (Primary)	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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 Quality Assurance Contact	Chief Compliance Officer		Kennedy	Jennifer	M	8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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 Reporting Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Patient Safety Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Payment Contact	Director of Revenue		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Personal Health Record Contact	Chief Compliance Officer		Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Pharmacy Director	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Pharmacy Network Management Contact	Director of Network & Special Projects		Feldmann	William		8144565433					wfeldmann@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Pharmacy Network Management Contact (Secondary)	Medical Director		Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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	VP, Controller		Williams	Kelly							kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Philadelphia
H4999	Pharmacy Technical Help Desk Contact (Secondary)	Director of Network & Special Projects		Feldmann	William							william.feldmann@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Philadelphia
H4999	Plan Directory Contact for Public Website	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Plan to Plan Reconciliation Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Processor Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Quality Contact	Chief Quality Officer		Lyons	Laura	M	8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Reconciliation Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Reconciliation Contact (Secondary)	CFO		Phillips	Jeff		8144565433					jphillips@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Recovery Audit Contact	VP, Controller	Mrs.	Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Surveillance Contact	VP, Marketing and Intake		Campbell	Marcie		8144565433					Marcie.Campbell@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	System Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Third Party Administrator (TPA) Liaison	CFO		Phillips	Jeffrey		4127205118					Jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	User Access Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Utilization Management Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	LIFE Northwestern Pennsylvania, LLC	National PACE	LIFE Northwestern Pennsylvania	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Philadelphia
H4999	Utilization Review Contact	Medical Director		Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	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		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Backup User Access Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Best Available Evidence Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Bid Primary Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	CAP Report Contact for Public Website	Health Plan Operations Manager		Wachsmuth	Rosalie		5032156556				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	CEO - CMS Administrator Contact		Ms.	Tuller	Susan		2066048256				2067606339	susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	12/27/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	CEO - Senior Official for Contracting	Executive Director	Ms.	Tuller	Susan		2063205325				2067606339	susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Chief Financial Officer		Ms	Barr	Natalie		5032153859					natalie.barr@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	01/27/2021	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Chief Operating Officer		Ms.	Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Chief Information Officer		Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Chief Information Security Officer		Ms.	Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	CMS Casework Communication Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	01/28/2021	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Complaints Tracking Contact	Quality, Compliance Manager		Vemuri	Susan		2063205325				2067606339	susan.vemuri@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Contact for Fraud Investigations	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	01/28/2021	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Coordination of Benefits Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Corporate Mailing						2063205325					velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Customer Service Operations Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	DIR Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	DIR Contact (Secondary)			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Discount Program Payment Contact	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/05/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Emergency Part D Contact			Schultz	Elizabeth		2066048256					elizabeth.schultz@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/27/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Encounter Data & Risk Adjustment Operations Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Enrollment Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	EOB Transfer Contact	PACEHealth Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Financial Audit Contact	Health Plan Operations Manager	Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Financial Reporting Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Formulary Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Formulary Contact (Secondary)			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	General Contact	Director of Operations	Ms.	Schultz	Elizabeth		4255256908				2067606339	elizabeth.schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Government Relations Contact			Noordijk	Cindy		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	HIPAA Privacy Officer	Director, Clinical Programs & Compliance		Noordijk	Cynthia		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	01/28/2021	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	HIPAA Security Officer	Director, Clinical Programs & Compliance		Noordijk	Cynthia		5032154124					cynthia.noordijk@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	01/28/2021	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Interoperability Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	MA Appeals/Grievances Contact			Chinn	Velaa		2063205325					velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	MA Claims Processing Contact for Public Website	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Marketing Contact	Marketing & Intake Representative		Kentta	Jenny		2063205325					jenny.kentta@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Medical Director	Medical Director		Kazemi	Assad		2063205325				2067606339	Assad.Kazemi@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Medicare Compliance Officer	Manager, Quality, Compliance & Education	Ms.	Vemuri	Susan		2067606414				2067606339	Susan.Vemuri@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Medicare Coordinator			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Medicare Part D Opioid Overutilization Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Medication Therapy Management Contact	Medical Director		Kazemi	Assad		2063205325				2067606339	assadullah.kazemi@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part C Application Contact	Executive Director	Ms.	Tuller	Susan		2063205325				2067606339	susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Appeals	Health Plan Operations Manager		Wachsmuth	Rosalie						5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg 1, Suite 200		Portland	OR	97213	01/06/2021	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active	5032153681				PACE - Nat		C	Seattle
H5007	Part D Appeals Contact (Secondary)			Chinn	Velaa							velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active	2063205325				PACE - Nat		C	Seattle
H5007	Part D Application Contact	Executive Director	Ms.	Tuller	Susan		2063205325				2067606339	susan.tuller@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Benefits Contact		Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Claims Submission Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Exceptions Contact	PACE Health Plan Data Analyst		Chambers	Perry						5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active	5032153672				PACE - Nat		C	Seattle
H5007	Part D Exceptions Contact (Secondary)			Wachsmuth	Rosalie							rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active	5032153681				PACE - Nat		C	Seattle
H5007	Part D Price File Contact (Back-up)			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Price File Contact (Optional)	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325					velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Price File Contact (Primary)			Chambers	Perry		5032153672					Perry.Chambers@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Quality Assurance Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Part D Reporting Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Patient Safety Contact			Reed	Rebecca		5032153465					rebecca.reed@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Payment Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Personal Health Record Contact	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Pharmacy Director			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Pharmacy Network Management Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Pharmacy Network Management Contact (Secondary)			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Pharmacy Technical Help Desk Contact			Service	Customer							Rosalie.Wachsmuth@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active	8884455518				PACE - Nat		C	Seattle
H5007	Pharmacy Technical Help Desk Contact (Secondary)			Wachsmuth	Rosalie							rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active	5032153681				PACE - Nat		C	Seattle
H5007	Plan Directory Contact for Public Website			Bering	Rika		5032153857					rika.bering@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Plan to Plan Reconciliation Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Processor Contact	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Quality Contact	Manager, Quality, Compliance & Education	Ms.	Vemuri	Susan		2067606414				2067606339	Susan.Vemuri@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Reconciliation Contact	PACE Health Plan Data Analyst		Chambers	Perry		5032153672				5032150685	perry.chambers@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Reconciliation Contact (Secondary)	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681					Rosalie.Wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	08/09/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Recovery Audit Contact	Health Plan Operations Manager	Ms.	Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Surveillance Contact	Mgr Admin and Support Svcs		Chinn	Velaa		2063205325				2067606339	velaa.chinn@providence.org	1801 Lind Ave SW, Suite W217		Re	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	System Contact			Schultz	Elizabeth		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Third Party Administrator (TPA) Liaison	Health Plan Operations Manager		Wachsmuth	Rosalie		5032153681				5032150685	rosalie.wachsmuth@providence.org	4400 NE Halsey, Building 1, Suite 200		Portland	OR	97213	12/05/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	User Access Contact			Schultz	Elizabeth		4255256908					Elizabeth.Schultz@providence.org	1801 Lind Ave SW, Suite W217		Renton	WA	98057	11/13/2024	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Utilization Management Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5007	Utilization Review Contact			Wachsmuth	Rosalie		5032153681					rosalie.wachsmuth@providence.org	4400 NE Halsey, Bldg. 1, Suite 200		Portland	OR	97213	02/25/2022	2026	PROVIDENCE HEALTH & SERVICES   WASHINGTON	National PACE	Providence ElderPlace	National PACE		Providence Health & Services	192	Yes	Active					PACE - Nat		C	Seattle
H5008	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H5008	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5008	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5008	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H5008	Plan Directory Contact for Public Website			Customer Service	UHC		8448766176					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5008	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5009	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Encounter Data & Risk Adjustment Operations Contact	AD Risk Adjustment Analytics		Aryal	Binaya		5032255305					Binaya.Aryal@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/06/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	MA Appeals/Grievances Contact	Healthcare Svcs Program Mgr Sr	Ms.	Huque	Nita		5035531462					Nita.Huque@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	MA Claims Processing Contact for Public Website	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part C Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part C Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H5009	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H5009	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				PPO - BBA		C	Dallas
H5009	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				PPO - BBA		C	Dallas
H5009	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				PPO - BBA		C	Dallas
H5009	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				PPO - BBA		C	Dallas
H5009	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Quality Contact	Director, Quality Management	Mr.	Mcclure	Andy		5032206189					Andrew.Mcclure@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Utilization Management Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5009	Utilization Review Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	REGENCE BLUESHIELD	Local CCP	Regence BlueShield	Local PPO		Cambia Health Solutions, Inc.	227	Yes	Active					PPO - BBA		C	Dallas
H5015	Agent/Broker Compensation Data Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Automated TrOOP Balance Transfer Contact	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Backup User Access Contact	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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		Muegge	Shmonica		3618276546					smuegge@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	07/21/2023	2026	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	Bid Audit Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Bid Audit Site Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Bid Primary Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	CAP Report Contact for Public Website	VP of Operations		Spencer	Caroline		3618278970				3613331587	cspencer@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	CEO - CMS Administrator Contact	President & CEO	Mr.	Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	CEO - Senior Official for Contracting	President & CEO	Mr.	Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	VP Finance	Mr.	Rodriguez	Jessie		3618940886				3615826810	jrodriguez@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	02/20/2023	2026	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 Operating Officer	President & CEO	Mr.	Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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 Information Officer	Chief Information Officer	Mr	Dossey	Jon		3614843980					jdossey@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	05/09/2023	2026	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 Information Security Officer	Chief Information Officer	Mr	Dossey	Jon		3614843980				3615510303	jdossey@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	05/09/2023	2026	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		3618276215					lclay2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Complaints Tracking Contact	Member Services/A&G Manager		Clay	Lori		3618276215					lclay2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Contact for Fraud Investigations	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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		3615760694					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Corporate Mailing						3615760694					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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		3618278970				3613331587	cspencer@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	DIR Contact	Director, Reporting & Analytics		Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/03/2025	2026	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	DIR Contact (Secondary)	Manager, HP Finance		Parkin	Frank		2038148504					frank.parkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/03/2025	2026	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	Discount Program Payment Contact	Financial Analyst		Batchelder	Holly		3615760694					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Emergency Part D Contact	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Emergency Part D Contact (Secondary)	CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/05/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact	Sr. Director of Operations		Macias	Yvonne		3615760694					ymacias@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Enrollment Contact	Enrollment & Billing Manager		Muegge	Shmonica		3618276546					smuegge@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	07/21/2023	2026	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	EOB Transfer Contact	VP of Operations		Spencer	Caroline		3618278970				3613331587	cspencer@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	01/02/2025	2026	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	Financial Audit Contact	Financial Analyst	Ms	Batchelder	Holly		3618940169					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Financial Reporting Contact	President & CEO	Mr.	Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Formulary Contact	Formulary Pharmacist		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent Street, Suite 250		Victoria	TX	77901	02/06/2024	2026	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	General Contact	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	HIPAA Privacy Officer	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	HIPAA Security Officer	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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		3618276215					lclay2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Interoperability Contact	Chief Information Officer		Dossey	Jon		3614843980					jdossey@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	05/09/2023	2026	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	MA Appeals/Grievances Contact	Member Services/A&G Manager		Clay	Lori		3618276215					lclay2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	01/02/2025	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8334718447					info@txindependencehealthplan.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	10/29/2023	2026	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	Marketing Contact	Compliance Officer		Gifford	Tammy		3616768119				3615415608	tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Medical Director	Medical Director	Dr.	Fry	Liam		3615760694					lfry@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	D	3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	05/15/2025	2026	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 Coordinator	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 Part D Opioid Overutilization Contact	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Medication Therapy Management Contact	Dir of Pharmacy		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	05/30/2024	2026	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	OffShore Subcontractor Contact	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 C Application Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 C Reporting Contact	VP of Operations		Spencer	Caroline		3618278970				3613331587	cspencer@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 Appeals	Pharmacy Director		Luu	Cindy							cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	3614849214				HMO - Health Maintenance Organization		C	Dallas
H5015	Part D Appeals Contact (Secondary)	Director Clinical Operations		Collins	Andrea						8775037231	andrea.collins@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/06/2025	2026	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	8662131594				HMO - Health Maintenance Organization		C	Dallas
H5015	Part D Application Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 Benefits Contact	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/22/2025	2026	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	Director Clinical Operations		Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/06/2025	2026	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	8662131594				HMO - Health Maintenance Organization		C	Dallas
H5015	Part D Exceptions Contact (Secondary)	Pharmacy Director		Luu	Cindy							cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	3614849214				HMO - Health Maintenance Organization		C	Dallas
H5015	Part D Price File Contact (Back-up)	Dir, Reporting & Analytics		Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/22/2025	2026	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 Price File Contact (Optional)	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent		Victoria	TX	77901	01/02/2025	2026	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 Price File Contact (Primary)	Mgr Reporting Analytics		Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/27/2025	2026	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 Quality Assurance Contact	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 Reporting Contact	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Patient Safety Contact	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Payment Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 Director	Pharmacy Director		Luu	Cindy		3614849214					cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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 Network Management Contact	Director of Pharmacy Network Administration		Hunt	Brian		8587907092				8665242629	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/18/2025	2026	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							Todd.Conn@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	05/30/2025	2026	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	8662131594				HMO - Health Maintenance Organization		C	Dallas
H5015	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Director		Luu	Cindy							cluu@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	TEXAS INDEPENDENCE HEALTH PLAN, INC.	Local CCP	Texas Independence Health Plan	HMO/HMOPOS		Regency ISNP Holdings LLC	741	Yes	Active	3614849214				HMO - Health Maintenance Organization		C	Dallas
H5015	Plan Directory Contact for Public Website			Service	Customer		8334718447					info@txindependencehealthplan.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	10/29/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Analyst		Batchelder	Holly		3615760694					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Processor Contact	VP of Operations		Spencer	Caroline		3618278970				3613331587	cspencer@txihp.com	1908 N. laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Quality Contact	Medical Director	Dr.	Fry	Liam		3615760694					lfry@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Reconciliation Contact	Financial Analyst		Batchelder	Holly		3615760694					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Reconciliation Contact (Secondary)	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	SNP Application Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	SNP State Contact	President & CEO		Dekowski	Devan		3616491371					dedekowski@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Surveillance Contact	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	System Contact	VP of Operations		Spencer	Caroline		3618278970				3613331587	cspencer@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Third Party Administrator (TPA) Liaison	Financial Analyst		Batchelder	Holly		3615760694					hbatchelder@regencyhealthcare.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	User Access Contact	Medicare Compliance Officer		Gifford	Tammy		3616768119					tgifford@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Utilization Management Contact	Utilization Management Director		Mitchell	Jennie		3618278917					jmitchell2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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	Utilization Review Contact	Utilization Management Director		Mitchell	Jennie		3618278917					jmitchell2@txihp.com	1908 N. Laurent	Suite 250	Victoria	TX	77901	12/29/2022	2026	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		2765230599	310			2765236483	tara.collinsworth@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/01/2022	2026	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	Backup User Access Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Bid Primary Contact	CFO	Ms	Sprinkle	Stephanie		2765234202	310			2765236483	ssprinkle@meoc.org	PO Box 888		Big Stone Gap	VA	24219	04/16/2020	2026	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	CAP Report Contact for Public Website	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	CEO - CMS Administrator Contact	Executive Director	Mr.	Wampler	Michael		2768702022				2765234208	mwampler@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	12/21/2021	2026	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	CEO - Senior Official for Contracting	Executive Director	Mr.	Wampler	Michael		2765234202				2765234208	mwampler@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	02/21/2013	2026	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		4233068354				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	12/21/2021	2026	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 Operating Officer	PACE Director and COO	Ms	Greer	Ruth		2763931692	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Information Officer	IT Director	Mr.	Aguirre	Walter		2765234202	479			2765234208	waguirre@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/04/2021	2026	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 Information Security Officer	IT Director	Mr.	Aguirre	Walter		2765234202	479				waguirre@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/04/2021	2026	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		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Complaints Tracking Contact	Quality Manager		Turner	Bethany		2765230599				2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/09/2022	2026	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	Contact for Fraud Investigations	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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		2765230599	306			2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	11/26/2018	2026	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	Corporate Mailing						2765230599				2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	04/26/2022	2026	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		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	DIR Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	DIR Contact (Secondary)	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Discount Program Payment Contact	CFO	Ms.	Sprinke	Stephanie		2765234202					ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	01/24/2025	2026	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	Emergency Part D Contact	NP	Ms.	Wade	Melanie		2765230599				2765236480	melanie.wade@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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	Emergency Part D Contact (Secondary)	Executive Director	Mr.	Wampler	Michael		2768702022				2765234208	mwampler@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	12/21/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	Administrative Specialist	Ms	Turner	Bethany		2765234202					bethany.turner@meoc.org	PO Box 888		Big Stone Gap	VA	24219	04/16/2020	2026	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	Enrollment Contact	Administrative Specialist	Ms.	Turner	Bethany		2765230599	310			2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	11/13/2017	2026	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	EOB Transfer Contact	Administrative Specialist	Ms.	Turner	Bethany		2765230599				2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	11/13/2017	2026	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	Financial Audit Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Financial Reporting Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Formulary Contact	Medical Director/Primary Care Physician	Dr.	Cooperstein	Elizabeth		2765230599				2765236480	elizabeth.cooperstein@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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	Formulary Contact (Secondary)	NP	Ms	Wade	Melanie		2765230599				2765236480	melanie.wade@meoc.org	1508  Third Ave	PO Box 888	Big Stone Gap	VA	24219	03/06/2023	2026	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	General Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	HIPAA Privacy Officer	IT Director	Mr.	Aguirre	Walter		2765234202	479			2765234208	waguirre@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/04/2021	2026	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	HIPAA Security Officer	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	PO Box 888		Big Stone Gap	VA	24219	04/16/2020	2026	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	Interoperability Contact	PACE Director and COO		Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P.O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	MA Appeals/Grievances Contact	Quality Manager	Ms.	Turner	Bethany		2765230599				2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/09/2022	2026	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	MA Claims Processing Contact for Public Website	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Marketing Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Medical Director	Medical Director/Primary Care Physician	Dr.	Cooperstein	Elizabeth		2765230599				2765236480	elizabeth.cooperstein@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Coordinator	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Part D Opioid Overutilization Contact	PACE Medical Director	Dr	Cooperstein	Elizabeth		2765230599	310			2765236483	elizabeth.cooperstein@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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	Medication Therapy Management Contact	Medical Director/Primary Care Physician	Dr.	Cooperstein	Elizabeth		2765230599				2765236480	elizabeth.cooperstein@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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	Online Enrollment Center Contact (Back-up)	Administrative Specialist	Ms.	Greer	Ruth		2765230599				2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Online Enrollment Center Contact (Optional)	IT Support Specialist	Mr.	Poff	Elliott		2765234202	458			2765234208	elliott.poff@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/04/2021	2026	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	Online Enrollment Center Contact (Primary)	Director of Information Technology	Mr.	Aguirre	Walter		2765234202	479			2765234208	waguirre@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/04/2021	2026	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 C Application Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Appeals	Medical Director/Primary Care Physician	Dr.	Cooperstein	Elizabeth						2765236480	elizabeth.cooperstein@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	2765230599				PACE - Nat		C	Philadelphia
H5037	Part D Appeals Contact (Secondary)	CFO	Ms.	Sprinkle	Stephanie						2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	8667937223				PACE - Nat		C	Philadelphia
H5037	Part D Application Contact	CFO	Ms	Sprinkle	Stephanie		2765234202	310			2765236483	ssprinkle@meoc.org	PO Box 888		Big Stone Gap	VA	24219	04/16/2020	2026	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 Benefits Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Claims Submission Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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						2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	8667937223				PACE - Nat		C	Philadelphia
H5037	Part D Exceptions Contact (Secondary)	PACE Center Manager	Ms.	Collinsworth	Tara						2765236480	tara.collinsworth@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/01/2022	2026	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	8667937223				PACE - Nat		C	Philadelphia
H5037	Part D Price File Contact (Back-up)	Nurse Practitioner	Ms.	Wade	Melanie		2765230599				2765236480	melanie.wade@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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 Price File Contact (Optional)	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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 Price File Contact (Primary)	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Quality Assurance Contact	Quality Manager	Ms.	Turner	Bethany		2765230599	307			2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/09/2022	2026	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 Reporting Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Patient Safety Contact	Quality Manager	Ms.	Turner	Bethany		2765230599	307			2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/09/2022	2026	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	Payment Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Personal Health Record Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Director	Medical Director/Primary Care Physician	Dr.	Cooperstein	Elizabeth		2765230599				2765236480	elizabeth.cooperstein@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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 Network Management Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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 Network Management Contact (Secondary)	NP	Ms	Wade	Melanie		2765230599				2765236480	melanie.wade@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	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						2765234208	waguirre@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/04/2021	2026	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	8667937223	479			PACE - Nat		C	Philadelphia
H5037	Pharmacy Technical Help Desk Contact (Secondary)	NP	Ms	Wade	Melanie						2765236480	melanie.wade@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/06/2023	2026	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE		Mountain Empire Older Citizens, Inc	362	Yes	Active	2765230599				PACE - Nat		C	Philadelphia
H5037	PHR Beneficiary Contact																	04/23/2009	2026	MOUNTAIN EMPIRE OLDER CITIZENS, INC.	National PACE	Mountain Empire PACE	National PACE	Mountain Empire PACE	Mountain Empire Older Citizens, Inc	362	Yes	Active	8667937223				PACE - Nat		C	Philadelphia
H5037	Plan Directory Contact for Public Website	IT Assistant Director	Mr.	Aguirre	Walter		2765230599	310			2765236483	waguirre@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	03/09/2020	2026	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	Plan to Plan Reconciliation Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Processor Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Quality Contact	Quality Manager	Ms.	Turner	Bethany		2765230599				2765236483	bethany.turner@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/09/2022	2026	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	Reconciliation Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Reconciliation Contact (Secondary)	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Recovery Audit Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Surveillance Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	System Contact	CFO	Ms.	Sprinkle	Stephanie		2765234202				2765234208	ssprinkle@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	09/30/2014	2026	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	Third Party Administrator (TPA) Liaison	Part D Analyst	Ms	Mosley	Jennifer		2765234202				2765234208	jennifer.mosley@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	01/24/2025	2026	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	User Access Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Utilization Management Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Utilization Review Contact	PACE Director and COO	Ms	Greer	Ruth		2765230599	310			2765236483	rgreer@meoc.org	P. O. Box 888		Big Stone Gap	VA	24219	05/26/2022	2026	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	Agent/Broker Compensation Data Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Automated TrOOP Balance Transfer Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Backup User Access Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Best Available Evidence Contact	Manager, Enrollment & Billing		Salzer	Cheryl		5186414170					cheryl.salzer@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Bid Audit Contact	Medicare Actuary	Mr	Budhiraja	Puneet		5186415568				5186414605	Puneet.Budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Bid Audit Site Contact	Medicare Actuary	Mr	Budhiraja	Puneet		5186415568				5186414605	Puneet.Budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Bid Primary Contact	Medicare Actuary	Mr	Budhiraja	Puneet		5186415568				5186414605	Puneet.Budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	CAP Report Contact for Public Website	Medicare Compliance Officer		Dibble	Laura		5853397745				5186414605	laura.dibble@lifethc.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	CEO - CMS Administrator Contact	President and CEO	Mr	OGrady	Brian		5186415110				5186415506	Brian.O'Grady@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	CEO - Senior Official for Contracting	President and CEO	Mr	OGrady	Brian		5186415110				5186415506	Brian.O'Grady@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Chief Financial Officer	EVP/Finance/CFO	Mr	Kahlon	Sikander		5186414050					paul.kahlon@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Chief Operating Officer	Chief Operating Officer	Mr.	Thornton	Barry		5854536456					Barry.Thornton@cdphp.com	6 Wellness Way		Latham	NY	12110	11/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Chief Information Officer	Chief Operating Officer	Mr.	Thornton	Barry		5854536456					Barry.Thornton@cdphp.com	6 Wellness Way		Latham	NY	12110	11/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Ewing	Jeff		5186415369					jeffrey.ewing@cdphp.com	6 Wellness Way		Latham	NY	12110	11/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	CMS Casework Communication Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Complaints Tracking Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Contact for Fraud Investigations	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Coordination of Benefits Contact	Medicare Reimbursement Coordinator		Moye	Nancy		5186415274				5186414605	Medicare_Compliance_Inquiries@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Corporate Mailing						5186413000				5186414605	info@cdphp.com	Capital District Physicians' Health Plan	6 Wellness Way	Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Customer Service Operations Contact	Director, Member Services		Spinner	Carmen		5186413741				5186413507	carmen.spinner@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	DIR Contact	Revenue Accounting Supervisor		Keller	Alexis		5183414012					Alexis.Keller@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	DIR Contact (Secondary)	Senior Healthcare Accounting Analyst	Ms	Anderson	Tiffany		5186414044				5186414605	Tiffany.Anderson@cdphp.com	6 Wellness Way		Latham	NY	12110	07/28/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Discount Program Payment Contact	Accounts Receivable Accountant		Ogden	Wendy		5186414057					wendy.ogden@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Emergency Part D Contact	Medicare Compliance Coordinator		Noonan	Michelle		5183387282				5186413207	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Employer Waiver Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Encounter Data & Risk Adjustment Operations Contact	Mgr. Encounter Ops Compliance and Recoveries		Uline	Nicole		5186414571					nicole.uline@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Enrollment Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	EOB Transfer Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Financial Audit Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Financial Reporting Contact	CFO	Mr	Kahlon	Paul		5186414050				5186414006	paul.kahlon@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Formulary Contact	Clinical Pharmacist		Reed	Lisa		5186413231				5186413208	Lisa.Reed@cdphp.com	6 Wellness Way		Latham	NY	12210	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Formulary Contact (Secondary)			Sgambati	John		5186413313					John.Sgambati@cdphp.com	6 Wellness Way		Latham	NY	12110	10/20/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	General Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Government Relations Contact	VP Communications and External Affairs		Skinner	Ali		5186415035				5186415506	ali.skinner@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	HIPAA Privacy Officer	Privacy Officer		Hinman	Todd		5186415261				5186415505	todd.hinman@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	HIPAA Security Officer	VP Information Risk and Governance (Interim CISO)		Ewing	Jeff		5186415369				5186414004	jeffrey.ewing@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Hospice Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664					luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Interoperability Contact	Mgr. Medicare Operations		Kozak	Stephanie		5186414661					stephanie.kozak@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	MA Appeals/Grievances Contact	Team Lead - Medicare Quality and Appeals		Lucas	June		5186413249				5186413203	june.lucas@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	MA Claims Processing Contact for Public Website	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Marketing Contact	Mgr. Medicare Operations		Kozak	Stephanie		5186414661					stephanie.kozak@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Medical Director	EVP/Chief Medicare Officer (inerim)	Dr.	Coplin	Bruce		5186413370				5186413205	bruce.coplin@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Medicare Compliance Officer	Compliance Program Administrator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/31/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Medicare Coordinator	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Medicare Part D Opioid Overutilization Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	11/10/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Medication Therapy Management Contact	Lead Managed Care Pharmacist		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	OffShore Subcontractor Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Online Enrollment Center Contact (Back-up)	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12210	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Online Enrollment Center Contact (Optional)	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	Michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Online Enrollment Center Contact (Primary)	Manager, Web Services		Monthony	Regina		5186415023				5186415506	regina.monthony@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part C Application Contact	Product Manager Sales Innovation		Kozak	Stephanie		5186414661					Stephanie.kozak@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part C Reporting Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Appeals	Team Lead- Medicare Quality and Appeals		Lucas	June						5186413203	june.lucas@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	5186413249				PPO - BBA		C	Chicago
H5042	Part D Appeals Contact (Secondary)	Clinical Appeals Specialist		Julian	Lisa						5186413401	lisa.julian@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	5186413343				PPO - BBA		C	Chicago
H5042	Part D Application Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Benefits Contact	Lead Managed Care Pharmacist		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Claims Submission Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Exceptions Contact	Lead Managed Care Pharmacist		Reed	Lisa						5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	5186413231				PPO - BBA		C	Chicago
H5042	Part D Exceptions Contact (Secondary)	Lead Managed Care Pharmacist		Reed	Lisa						5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	5186413231				PPO - BBA		C	Chicago
H5042	Part D Price File Contact (Back-up)	Pharmacy Enterprise Medicare Advisor Lead		Sgambati	John		5186413313					John.Sgambati@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Price File Contact (Optional)	Dir. Comm Pharmacy Prgrms and Medicare		Reed	Lisa		5186413231					lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Price File Contact (Primary)	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Quality Assurance Contact	Dir. Medicare Part Pharmacy Programs		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Part D Reporting Contact	Pharmacy Compliance Coordinator		Bedell	Luke		5186414664				5186414605	luke.bedell@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Patient Safety Contact	Senior Vice President/Chief Quality Officer		Golderman	Renee		5186413240				5186413208	renee.golderman@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Payment Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Pharmacy Director	Dir. Medicare Part D Pharmacy Programs		Reed	Lisa		5186413231				5186413208	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Pharmacy Network Management Contact	Dir. Medicare Part D Pharmacy Programs		Reed	Lisa		5186413231				5186413508	lisa.reed@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Pharmacy Network Management Contact (Secondary)	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186413208	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
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	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active	8335991018				PPO - BBA		C	Chicago
H5042	Physician Incentive Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Plan Directory Contact for Public Website	Medicare Compliance Coordinator		Noonan	Michelle		8009267526				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Plan to Plan Reconciliation Contact	VP Financial Analytics and Risk Adjustment		Burby	Casidhe		5186414074				5186414102	P2PADMIN@cdphp.com	Attn Risk Management - P2P	6 Wellness Way	Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Processor Contact	Manager, Membership and Billing		Salzer	Cheryl		5186414170				5186414008	cheryl.salzer@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Quality Contact	Senior Vice President/Chief Quality Officer		Golderman	Renee		5186413240				5186413208	renee.golderman@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Reconciliation Contact	Actuarial Director		Budhiraja	Puneet		5186415568					puneet.budhiraja@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Recovery Audit Contact	Medicare Compliance Coordinator	Mrs	Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Surveillance Contact	Medicare Compliance Officer		Dibble	Laura		5853397745				5186414605	laura.dibble@lifethc.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	System Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Third Party Administrator (TPA) Liaison	Revenue Accountant		Ogden	Wendy		5186414057					wendy.ogden@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	User Access Contact	Medicare Compliance Coordinator		Noonan	Michelle		5186415282				5186414605	michelle.noonan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/12/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Utilization Management Contact	Director Utilization Management		Hannan	Priscilla		5186413423				5186413205	Priscilla.Hannan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5042	Utilization Review Contact	Director Utilization Management		Hannan	Priscilla		5186413423					Priscilla.Hannan@cdphp.com	6 Wellness Way		Latham	NY	12110	03/03/2025	2026	CDPHP UNIVERSAL BENEFITS, INC.	Local CCP	CDPHP Medicare Advantage	Local PPO		Lifetime Healthcare, Inc.	87	Yes	Active					PPO - BBA		C	Chicago
H5050	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	09/01/2017	2026	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	Dallas
H5050	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2026	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	Dallas
H5050	Backup User Access Contact	Medicare Marketing & Enrollment Specialist	Mr.	Anderson	John		2066304260				2068770655	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	980579055	04/08/2019	2026	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	Dallas
H5050	Best Available Evidence Contact	Medicare Marketing & Enrollment Specialist	Mr.	Anderson	John		2066304260				2068770655	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	980579055	08/06/2018	2026	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	Dallas
H5050	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	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	Dallas
H5050	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H5050	Bid Primary Contact	Actuary		Wang	Yiwei		9254258707					KPMedicareBids@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/27/2024	2026	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	Dallas
H5050	CAP Report Contact for Public Website	Medicare Compliance Lead	Ms.	Cooper	Lynn		7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	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	Dallas
H5050	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	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	Dallas
H5050	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	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	Dallas
H5050	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	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	Dallas
H5050	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	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	Dallas
H5050	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	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	Dallas
H5050	CMS Casework Communication Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	Complaints Tracking Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	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	Dallas
H5050	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2026	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	Dallas
H5050	Corporate Mailing						7205279215					lynn.m.cooper@kp.org	Lynn Cooper, Medicare Compliance Lead	2715 Naches Ave. SW, PO Box 9010	Renton	WA	980579010	03/29/2024	2026	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	Dallas
H5050	Customer Service Operations Contact	Operations Manager		Millspaugh	Jessica		5092417155					Jessica.L.Millspaugh@kp.org	5615 West Sunset Highway		Spokane	WA	99224	11/21/2025	2026	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	Dallas
H5050	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	03/09/2020	2026	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	Dallas
H5050	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	07/17/2018	2026	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	Dallas
H5050	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/06/2023	2026	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	Dallas
H5050	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	07/02/2018	2026	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	Dallas
H5050	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/04/2022	2026	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	Dallas
H5050	Emergency Part D Contact (Secondary)	Manager Medicare Pharmacy Programs	Mr.	Popiel	Nicholas	B	3135060337					Nicholas.B.Popiel@kp.org	2921 Naches Ave., SW		Renton	WA	98057	12/21/2021	2026	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	Dallas
H5050	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	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	Dallas
H5050	Enrollment Contact	Data Reporting Analyst	Mr.	Vasquez	Reynaldo	R	2069887504					reynaldo.r.vasquez@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	980579055	04/08/2022	2026	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	Dallas
H5050	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	10/07/2021	2026	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	Dallas
H5050	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H5050	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H5050	Formulary Contact	Formulary Coordinator		Martinez	Melina		2066307900					Melina.X1.Martinez@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	980579009	11/13/2024	2026	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	Dallas
H5050	Formulary Contact (Secondary)	Sr Manager		Toyoda	Yayoi		2066307900					Yayoi.Toyoda@kp.org	PO Box 9009, Bldg RCA, Mail Stop - RCA-B2N-02	2921 Naches Ave, SW, Bldg RCA	Renton	WA	98057	04/07/2025	2026	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	Dallas
H5050	General Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	Government Relations Contact	Senior Vice President, Government Relations	Mr.	Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/07/2021	2026	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	Dallas
H5050	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	11/06/2020	2026	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	Dallas
H5050	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					Bill.D.Vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/26/2020	2026	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	Dallas
H5050	Hospice Contact	Membership Administration Technical Support	Mr.	Wells	John		2066302740					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	980579010	08/06/2018	2026	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	Dallas
H5050	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					cathy.p.plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	11/03/2021	2026	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	Dallas
H5050	MA Appeals/Grievances Contact	Sr. Manager, Grievances and Appeals		McGaughy	Rachel		7206033201					Rachel.X.McGaughy@kp.org	7901 E. Lowry Blvd.		Denver	CO	80230	12/04/2024	2026	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	Dallas
H5050	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	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	Dallas
H5050	Marketing Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					KP-MedicareFilings@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	11/16/2020	2026	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	Dallas
H5050	Medicare Compliance Officer	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	Medicare Coordinator	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	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	Dallas
H5050	Medication Therapy Management Contact	Pharmacy Care Delivery Specialist	Ms.	Thieman	Ingrid	L	3603252667					ingrid.l.thieman@kp.org	189 Telegraph Rd.		Bellingham	WA	98226	02/18/2025	2026	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	Dallas
H5050	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street	2nd Floor   Cubicle: 023W02	Rancho Cucamonga	CA	91730	08/26/2020	2026	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	Dallas
H5050	Online Enrollment Center Contact (Back-up)	Consultant Health Plan IT	Mr.	Van Atta	Paul		2066306890					Paul.A.Van.Atta@kp.org	PO Box 9010, Bldg RCR, Mail Stop RCR-A2S-01	2715 Naches Ave. SW, Bldg RCR, Mail Stop RCR-A2S-01	Renton	WA	980579010	08/06/2018	2026	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	Dallas
H5050	Online Enrollment Center Contact (Optional)	Consultant Health Plan IT	Mr.	Van Atta	Paul		2066306890					Paul.A.Van.Atta@kp.org	PO Box 9010, Bldg RCR, Mail Stop RCR-A2S-01	2715 Naches Ave. SW, Bldg RCR, Mail Stop RCR-A2S-01	Renton	WA	980579010	10/30/2019	2026	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	Dallas
H5050	Online Enrollment Center Contact (Primary)	Consultant Health Plan IT	Mr.	Boyce	David		2066306852					David.R.Boyce@kp.org	PO Box 9010, Bldg RCR, Mail Stop RCR-A2S-03	2715 Naches Ave. SW, Bldg RCR, Mail Stop RCR-A2S-03	Renton	WA	980579010	08/06/2018	2026	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	Dallas
H5050	Part C Application Contact	Medicare Marketing & Enrollment Specialist	Mr.	Anderson	John		2066304260				2068770655	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	980579055	12/05/2018	2026	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	Dallas
H5050	Part C Reporting Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/16/2023	2026	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	Dallas
H5050	Part D Appeals	Sr. Manager, Grievances and Appeals		McGaughy	Rachel							Rachel.X.McGaughy@kp.org	7901 E. Lowry Blvd		Denver	CO	80230	12/04/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	7206033201				HMO - Health Maintenance Organization		C	Dallas
H5050	Part D Application Contact	Medicare Marketing & Enrollment Specialist	Mr.	Anderson	John		2066304260				2068770655	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	980579055	12/05/2018	2026	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	Dallas
H5050	Part D Benefits Contact	Manager, Pharmacy Medicare Programs	Mr.	Popiel	Nicholas		2066301077				2069014410	nicholas.b.popiel@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	980579009	08/02/2021	2026	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	Dallas
H5050	Part D Claims Submission Contact	Manager, Pharmacy Medicare Programs	Mr.	Popiel	Nicholas		2066301077				2069014410	nicholas.b.popiel@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	980579009	08/02/2021	2026	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	Dallas
H5050	Part D Exceptions Contact	Manager, Pharmacy Ancillary Services	Ms.	Maktabi	Noushin						2069014410	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	980579009	08/06/2018	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8007291174				HMO - Health Maintenance Organization		C	Dallas
H5050	Part D Exceptions Contact (Secondary)	Director Clinical Pharmacy Programs	Ms.	Burks	Sharon						2069014410	Sharon.S.Burks@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	980579009	08/06/2018	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8007291174				HMO - Health Maintenance Organization		C	Dallas
H5050	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	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	Dallas
H5050	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	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	Dallas
H5050	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/26/2023	2026	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	Dallas
H5050	Part D Quality Assurance Contact	Coordinator, Pharmacy ClinicalPrograms	Ms.	Forrester	Sara		2066301043				2069014410	Sara.H.Chung@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	980579009	02/23/2021	2026	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	Dallas
H5050	Part D Reporting Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/16/2023	2026	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	Dallas
H5050	Patient Safety Contact	Manager, Pharmacy Medicare Programs	Mr.	Popiel	Nicholas		2066301077				2069014410	nicholas.b.popiel@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	980579009	08/02/2021	2026	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	Dallas
H5050	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H5050	Pharmacy Director	Manager, Pharmacy Program	Mr.	Conway	Collin		2066301088				2069014410	Collin.S.Conway@kp.org	PO Box 9009, Mail Stop RCA-B2N-02	2921 Naches Ave. SW, GSE, Mail Stop RCA-B2N-02	Renton	WA	980579009	08/06/2018	2026	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	Dallas
H5050	Pharmacy Network Management Contact	Manager, Pharmacy Medicare Programs	Mr.	Conway	Collin		2066301088				2069014410	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	980579009	12/01/2020	2026	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	Dallas
H5050	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Medicare Programs	Mr.	Popiel	Nicholas		2066301077				2069014410	nicholas.b.popiel@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	980579009	08/02/2021	2026	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	Dallas
H5050	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Ancillary Services	Ms.	Maktabi	Noushin						2069014410	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	980579009	08/06/2018	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8007291174				HMO - Health Maintenance Organization		C	Dallas
H5050	Pharmacy Technical Help Desk Contact (Secondary)	Director Clinical Pharmacy Programs	Ms.	Burks	Sharon						2069014410	Sharon.S.Burks@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	980579009	08/06/2018	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8007291174				HMO - Health Maintenance Organization		C	Dallas
H5050	PHR Beneficiary Contact																	06/08/2017	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	Local CCP	Kaiser Permanente	HMO/HMOPOS	Kaiser Foundation Health Plan of WA, Kaiser Permanente	Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8889014600	4600			HMO - Health Maintenance Organization		C	Dallas
H5050	Plan Directory Contact for Public Website	Health Plan Operations		Assistance Unit	Provider		8887674670				5092497615	Elizabeth.B.Johnson@kp.org	Kaiser Permanente, Kaiser Foundation Health Plan of WA	PO Box 204 Mail Stop: ACN-AC17	Spokane	WA	992109809	08/06/2018	2026	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	Dallas
H5050	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/20/2023	2026	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	Dallas
H5050	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	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	Dallas
H5050	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	05/25/2022	2026	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	Dallas
H5050	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H5050	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	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	Dallas
H5050	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/03/2022	2026	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	Dallas
H5050	SNP Application Contact	Medicare Marketing & Enrollment Specialist		Anderson	John		2066304260				2068770655	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	980579055	07/27/2020	2026	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	Dallas
H5050	Surveillance Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	02/16/2023	2026	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	Dallas
H5050	System Contact	IT Engineer Applications	Mr.	Boyce	David	R	2066306852					david.r.boyce@kp.org	Naches Ave-SW. 2715,[WS008-1]		Renton	WA	980579055	04/08/2022	2026	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	Dallas
H5050	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	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	Dallas
H5050	User Access Contact	Medicare Compliance Lead	Ms.	Cooper	Lynn	M	7205279215					lynn.m.cooper@kp.org	10350 East Dakota Ave.		Denver	CO	80247	04/06/2022	2026	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	Dallas
H5050	Utilization Management Contact	Director, Utilization Management		Pfarr	Michelle		5093194442					Michelle.C.Pfarr@kp.org	2715 Naches Ave SW		Renton	WA	98057	12/04/2024	2026	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	Dallas
H5050	Utilization Review Contact	Director, Utilization Management		Pfarr	Michelle		5093194442					Michelle.C.Pfarr@kp.org	2715 Naches Ave SW		Renton	WA	98057	12/04/2024	2026	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	Dallas
H5080	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Best Available Evidence Contact	Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	700 E Walnut		Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	CAP Report Contact for Public Website	Director of Compliance		Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	CMS Casework Communication Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcoooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Corporate Mailing						7326643786					Kgaffney@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/05/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Customer Service Operations Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	700 E Walnut St	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Formulary Contact	Finance Specialist		Partlow	Jennie		6406501565					jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	General Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	700 E Walnut St		Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation		Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Medical Director	Chief Medical Officer	Dr.	Everette	Kenya		2196142067					keverette@boldagepace.com	700 East walnut Street	Suite B	Evansville	IN	47713	08/29/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Medicare Coordinator	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Medication Therapy Management Contact	Finance Specialist		Partlow	Jennie		9548395000				7325923500	jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		8558012653					maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part D Appeals	Director of Compliance	Ms	Cooper	Wanda							wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	2675751196				PACE - Nat		C	New York
H5080	Part D Appeals Contact (Secondary)	Chief Health Plan Operations		Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7328063224				PACE - Nat		C	New York
H5080	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part D Exceptions Contact	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H5080	Part D Exceptions Contact (Secondary)	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H5080	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part D Quality Assurance Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Patient Safety Contact	Finance Specialist		Partlow	Jennie		9548395000					jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Pharmacy Director	Medical Director	Dr	Everette	Kenya		9548395000					Keverette@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H5080	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H5080	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Plan to Plan Reconciliation Contact	Financial Specialist		Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Surveillance Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	700 E Walnut St	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/03/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	User Access Contact	Business Administrator	Ms	Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5080	Utilization Review Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	700 E Walnut St	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE INDIANA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H5085	Automated TrOOP Balance Transfer Contact	CFO		Smith	Michael		2316524618					msmith@visitingnurse.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Backup User Access Contact	Quality  Director		Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Best Available Evidence Contact	Quality  Director		Carter	Miranda		8006896675				2316895038	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Bid Primary Contact	Executive Director		Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	CAP Report Contact for Public Website	Executive Director	Ms	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	06/20/2025	2026	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	Atlanta
H5085	CEO - CMS Administrator Contact	Executive Director	Ms.	Runions	Christine		2318524357				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	CEO - Senior Official for Contracting	Executive Director	Ms.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Chief Financial Officer	Financial Officer	Mr.	Smith	Michael		8664278578				2317330035	msmith@visitingnurse.com	1909 Ruddiman Drive		North Muskegon	MI	49445	09/07/2023	2026	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	Atlanta
H5085	Chief Operating Officer	Center Manager	Mrs.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	04/26/2022	2026	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	Atlanta
H5085	Chief Information Officer	Quality  Director	Mrs.	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Chief Information Security Officer	Executive Director	Ms.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	CMS Casework Communication Contact	Executive Director	Ms	Runions	Christine		8006896675				2316895038	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Complaints Tracking Contact	Quality  Director	Mrs.	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Contact for Fraud Investigations	Executive Director	Ms	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Coordination of Benefits Contact	Executive Director	Ms.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Corporate Mailing						2316524618				2316524620	kbruno@visitingnurse.com	231 W. Pine Lake Drive		Newaygo	MI	49337	09/08/2023	2026	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	Atlanta
H5085	Customer Service Operations Contact	Executive Director	Ms	Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	06/20/2025	2026	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	Atlanta
H5085	DIR Contact	Executive Director	Ms.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	DIR Contact (Secondary)		Ms.	Bruno	Kelsey		2316524618				2316524620	kbruno@visitingnurse.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Discount Program Payment Contact	Chief Financial Officer		Smith	Michael		8664278578				2317330030	msmith@communitypace.com	1909 Ruddiman Dr.		Muskegon	MI	49445	03/21/2025	2026	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	Atlanta
H5085	Emergency Part D Contact	Executive Director	Ms.	Runions	Christine		2318524357				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Emergency Part D Contact (Secondary)			Bruno	Kelsey		2318524357				2316895038	kbruno@visitingnurse.com	231 West Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Encounter Data & Risk Adjustment Operations Contact	Executive Director		Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Enrollment Contact	Executive Director	Ms	Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	06/20/2025	2026	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	Atlanta
H5085	EOB Transfer Contact	Executive Director		Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Financial Audit Contact	Chief Financial Officer	Mr	Smith	Michael		8664278578				2317330035	msmith@visitingnurse.com	1909 Ruddiman Drive		North Muskegon	MI	49445	09/11/2023	2026	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	Atlanta
H5085	Financial Reporting Contact	Financial Officer	Mr.	Smith	Michael		8664278578				2317330035	msmith@visitingnurse.com	1909 Ruddiman Drive		North Muskegon	MI	49445	09/11/2023	2026	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	Atlanta
H5085	Formulary Contact	Executive Director	Ms.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Formulary Contact (Secondary)	Quality  Director		Carter	Miranda		8006896675				2316895038	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	05/13/2024	2026	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	Atlanta
H5085	General Contact	Executive Director		Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Government Relations Contact	Executive Director		Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	HIPAA Privacy Officer	Quality  Director	Mrs.	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	05/13/2024	2026	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	Atlanta
H5085	HIPAA Security Officer	Quality  Director	Mrs.	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Interoperability Contact	Executive Director		Runions	Christine		8006896675				2316895038	crunions@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	MA Appeals/Grievances Contact	Quality  Director	Mrs.	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	05/13/2024	2026	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	Atlanta
H5085	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	12/11/2023	2026	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	Atlanta
H5085	Marketing Contact	Outreach Coordinator	Ms	Busciano	Jessica		2316524618					jbusciano@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	11/20/2024	2026	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	Atlanta
H5085	Medical Director		Dr.	Levin	Frederic		2316524618				2316524620	flevin@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	01/29/2024	2026	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	Atlanta
H5085	Medicare Compliance Officer		Ms.	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Medicare Coordinator	Quality  Director		Carter	Miranda		8006896675				2316895038	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Medicare Part D Opioid Overutilization Contact			Runions	Christine		2316524618				2316895038	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Medication Therapy Management Contact		Ms.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Part C Application Contact	Executive Director		Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Part D Appeals	Quality  Director	Mrs	Carter	Miranda						2316895038	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	05/13/2024	2026	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active	2316524618				PACE - Nat		C	Atlanta
H5085	Part D Appeals Contact (Secondary)			Bruno	Kelsey							kbruno@visitingnurse.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active	2316524618				PACE - Nat		C	Atlanta
H5085	Part D Application Contact	Chief Financial Officer		Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	12/06/2023	2026	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	Atlanta
H5085	Part D Benefits Contact	Executive Director		Runions	Christine		2316524618					kbruno@visitingnurse.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Part D Claims Submission Contact	Billing Administrator		Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	12/06/2023	2026	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	Atlanta
H5085	Part D Exceptions Contact	Executive Director		Runions	Christine						2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active	2316524618				PACE - Nat		C	Atlanta
H5085	Part D Exceptions Contact (Secondary)			Bruno	Kelsey							kbruno@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active	2316524618				PACE - Nat		C	Atlanta
H5085	Part D Price File Contact (Back-up)	Quality  Director	Mrs	Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	12/06/2023	2026	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	Atlanta
H5085	Part D Price File Contact (Primary)	Chief Financial Officer		Smith	Michael		2316524618					msmith@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	12/11/2023	2026	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	Atlanta
H5085	Part D Quality Assurance Contact	Quality  Director	Mrs.	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Part D Reporting Contact	Chief Financial Officer		Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	12/11/2023	2026	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	Atlanta
H5085	Patient Safety Contact	Quality  Director	Mrs	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Payment Contact	Chief Financial Officer	Mr	Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	12/11/2023	2026	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	Atlanta
H5085	Pharmacy Director	Medical Director	Dr.	Levin	Frederic		2316524618				2316524620	flevin@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Pharmacy Network Management Contact	Executive Director		Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Pharmacy Technical Help Desk Contact	Executive Director	Ms.	Runions	Christine						2316524620	crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	COMMUNITY PACE AT HOME, INC	National PACE	Community PACE at Home, Inc,	National PACE		Community PACE at Home, Inc	659	Yes	Active	2316524618				PACE - Nat		C	Atlanta
H5085	Plan Directory Contact for Public Website	Executive Director	Mrs	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	06/20/2025	2026	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	Atlanta
H5085	Plan to Plan Reconciliation Contact	Executive Director		Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Processor Contact	Chief Financial Officer		Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	12/11/2023	2026	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	Atlanta
H5085	Quality Contact	Quality Director		Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Reconciliation Contact	Chief Financial Officer		Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	12/11/2023	2026	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	Atlanta
H5085	Recovery Audit Contact	Quality  Director	Mrs	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	05/13/2024	2026	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	Atlanta
H5085	Surveillance Contact	Executive Director	Mrs.	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	04/07/2025	2026	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	Atlanta
H5085	System Contact	Executive Director		Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Smith	Michael		2316524618				2316524620	msmith@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	User Access Contact	Executive Director	Ms	Runions	Christine		2316524618				2316524620	crunions@communitypace.com	231 W Pine Lake Drive		NEWAYGO	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Utilization Management Contact	Executive Director		Runions	Christine		2316524618					crunions@communitypace.com	231 W. Pine Lake Drive		Newaygo	MI	49337	04/07/2025	2026	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	Atlanta
H5085	Utilization Review Contact	Quality  Director	Mrs	Carter	Miranda		2316524618				2316524620	mcarter@communitypace.com	231 West Pine Lake Drive		Newaygo	MI	49337	05/13/2024	2026	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	Atlanta
H5087	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H5087	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5087	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5087	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5087	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H5087	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H5087	PHR Beneficiary Contact																	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H5087	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5087	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF CALIFORNIA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5106	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/10/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	09/25/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Corporate Mailing						4125447031					Thomas.Boettler@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Customer Service Operations Contact	Director, Customer Experience		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/04/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5182205661				5184232294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	06/23/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	06/23/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Encounter Data & Risk Adjustment Operations Contact	Director, Actuarial Services	Mr.	DelPrince	Vincent	M	4125443939					Vincent.Delprince@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	08/04/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Enrollment Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	EOB Transfer Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	bob.opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					justine.patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Interoperability Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	MA Appeals/Grievances Contact	Manager, Appeals & Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	MA Claims Processing Contact for Public Website	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Medical Director	VP, Executive Medical Director	Dr,	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing	Mr.	Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part C Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125444579				PPO - BBA		C	Boston
H5106	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125441596				PPO - BBA		C	Boston
H5106	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite SPECARE	Pittsburgh	PA	15222	08/04/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8006002227				PPO - BBA		C	Boston
H5106	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	9013817109				PPO - BBA		C	Boston
H5106	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Payment Contact	Vice President, Accounting and Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		Buffalo	NY	14203	02/14/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
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	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8009221557				PPO - BBA		C	Boston
H5106	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	5705783579				PPO - BBA		C	Boston
H5106	PHR Beneficiary Contact																	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO	Highmark Inc	Highmark Health	123	Yes	Active	8665886967				PPO - BBA		C	Boston
H5106	Physician Incentive Contact	VP Prov Reimbursement & Network	Mr.	McDonald	Brendan		4125446611					brendan.mcdonald@highmarkhealth.org	120 5th Avenue Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Plan Directory Contact for Public Website			Service	Provider		8665886967					resourcecenter@highmark.com	120 Fifth Ave		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	7173022748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 898820	Camp Hill	PA	170890407	06/28/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Quality Contact	Director, Clinical Quality		Christian	Shari		7168878811					shari.christina@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/29/2025	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Utilization Management Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5106	Utilization Review Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK SENIOR SOLUTIONS COMPANY	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5117	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H5117	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5117	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5117	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5117	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H5117	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H5117	PHR Beneficiary Contact																	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H5117	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5117	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	LOUISIANA HEALTHCARE CONNECTIONS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5119	Agent/Broker Compensation Data Contact	Chief Financial Officer		Buchanan	Brian	A	4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Buchanan	Brian	A	4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Backup User Access Contact	Chief Financial Officer		Buchanan	Brian	A	4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Best Available Evidence Contact	Chief Financial Officer		Buchanan	Brian		4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Bid Audit Contact	Chief Financial Officer		Buchanan	Brian		4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Bid Primary Contact	Chief Financial Officer		Buchanan	Brian		4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	CAP Report Contact for Public Website	Communications Coordinator		Fischer	Karl		9259572682					karl.fischer@cchealth.org	1120 Morello Ave	Suite 210	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Lo	Irene		9255429877					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	04/14/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	CEO - Senior Official for Contracting	Chief Executive Officer	Dr.	Lo	Irene		9255429877					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	04/14/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Chief Financial Officer	Chief Financial Officer	Mr.	Buchanan	Brian		4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Chief Operating Officer	Chief Operating Officer	COO	Vacant	Currently		9256088277					compliance@cchealth.org	595 Center Ave	Ste 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Chief Information Officer	Chief Information Officer	Dr.	Pramanik	Rajiv		9257658689					rajiv.pramanik@cchealth.org	2500 Alhambra Ave		Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Chief Information Security Officer	Chief Information Security Officer	Ms.	Bell	Megan		9253358700					megan.bell@cchealth.org	2530 Arnold Drive		Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	CMS Casework Communication Contact	Director of Case Management		Avecilla	Leizl		9253136887	81				leizl.avecilla@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Complaints Tracking Contact	Director of Utilization Management and Appeals & G		Perez	Jill	L	9256089944					jill.perez@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Contact for Fraud Investigations	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Coordination of Benefits Contact	Director of Member Services, Marketing		Engelbert	Brandon		9256087828					brandon.engelbert@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Corporate Mailing						9256089464					norman.hicks@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Customer Service Operations Contact	Member Services Manager		Teutle	Belkys		8447298412					belkys.teutle@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	11/06/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	DIR Contact	Director of Provider Relations		McAdoo	Nancy		9256089401					Nancy.McAdoo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	11/06/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Discount Program Payment Contact	Director of Provider Relations		McAdoo	Nancy		9256089401					Nancy.McAdoo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	11/06/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Emergency Part D Contact	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Emergency Part D Contact (Secondary)			Lo	Irene		9256089850					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Encounter Data & Risk Adjustment Operations Contact	HS IT Assistant Director of Clinical Systems		Temeltas	Ates		9253358827					ates.temeltas@cchealth.org	2530 Arnold Dr	Suite 300	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Enrollment Contact	HS IT Assistant Director of Clinical Systems		Temeltas	Ates		9253358827					ates.temeltas@cchealth.org	2530 Arnold Dr	Suite 300	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	EOB Transfer Contact	Director of Member Services, Marketing		Engelbert	Brandon		9256087828				9256088298	brandon.engelbert@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Financial Audit Contact	Chief Financial Officer	Mr.	Buchanan	Brian		4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Financial Reporting Contact	Chief Financial Officer	Mr.	Buchanan	Brian		4156906377					brian.buchanan@cchealth.org	50 Douglas Dr	Suite 310	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Formulary Contact	PerformRx Director of Clinical Services, Formulary		Megargell	Lauren		2159374135					lmegargell@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Formulary Contact (Secondary)	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave Suite 200		Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	General Contact	Chief Executive Officer	Dr.	Lo	Irene		9255429877					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	04/14/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Government Relations Contact	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	HIPAA Privacy Officer	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	HIPAA Security Officer	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Hospice Contact	Medical Director	Dr.	Levin	Sara		9256085102					sara.levin@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Interoperability Contact	Director of Analysis, Reporting, & Technology		Escobar	Sonia		9256088222					sonia.escobar@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	MA Appeals/Grievances Contact	Director of Utilization Management and Appeals & G		Perez	Jill	L	9256089944					jill.perez@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	MA Claims Processing Contact for Public Website	Director of Member Services, Marketing		Engelbert	Brandon		9256087828					brandon.engelbert@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Marketing Contact	Interim COO		Hernandez	Elizabeth		9255885976					elizabeth.hernandez@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/14/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Medical Director	Chief Medical Officer		Lo	Irene		9256089850					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Medicare Compliance Officer	Deputy Executive Director / Compliance Officer	Ms.	Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Medicare Coordinator	Health Services Administrator		Putta	Jayanthi	L	9253136985					jayanthi.putta@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Medication Therapy Management Contact	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Online Enrollment Center Contact (Back-up)	Member Services Manager		Teutle	Belkys		9256087600					belkys.teutle@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Online Enrollment Center Contact (Optional)	Health Plan Patient Services Supervisor		Laird	Cynthia		9256087856					cynthia.laird@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Online Enrollment Center Contact (Primary)	Director of Member Services, Marketing		Engelbert	Brandon		9256087828					brandon.engelbert@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part C Application Contact	Chief Executive Officer	Dr.	Lo	Irene		9255429877					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	04/14/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part C Reporting Contact	Director of Analysis, Reporting, & Technology		Escobar	Sonia		9256088222					sonia.escobar@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Appeals	Deputy Chief Medical Officer	Dr.	Barcelo	Nicholas							Nicolas.Barcelo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/17/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active	8447298411	2			HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Application Contact	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Benefits Contact	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Claims Submission Contact	PerformRx - Director of Clinical Operations		Ortiz	Noel		2159375326					nortiz@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Exceptions Contact	PerformRx - Director of Pharmacy Utlization Manage		Bonko	Gerald							gbonko@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active	8552879128				HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Price File Contact (Back-up)	Chief Medical Officer		Lo	Irene		9256089850					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Price File Contact (Optional)	Information Specialist - BI		Card	Ariah		9253358879					ariah.card@cchealth.org	2530 Arnold Dr	Suite 300	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Price File Contact (Primary)	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Quality Assurance Contact	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Part D Reporting Contact	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Patient Safety Contact	Peronnel, Building, Safety Warden		Gomez	Pam		9256087904					pam.gomez@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Payment Contact	Director of Member Services, Marketing		Engelbert	Brandon		9256087828					brandon.engelbert@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Pharmacy Director	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Pharmacy Network Management Contact	PerformRx Vice President Network Strategy		Sullivan	Tim		6303303638					tim.sullivan@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy		Cardinalli	Joseph		9256087897					joseph.cardinalli@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Pharmacy Technical Help Desk Contact	PerformRx Vice President Network Strategy		Sullivan	Tim							tim.sullivan@performrx.com	200 Stevens Drive		Philadelphia	PA	19113	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active	8552879128				HMO - Health Maintenance Organization		C	Chicago
H5119	Physician Incentive Contact	Chief Medical Officer		Lo	Irene		9256089850					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Plan Directory Contact for Public Website	Communications Coordinator		Fischer	Karl		9259572682					karl.fischer@cchealth.org	1120 Morello Ave	Suite 210	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Plan to Plan Reconciliation Contact	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Processor Contact	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Quality Contact	Quality Director		Hernandez	Elizabeth		9255885976					elizabeth.hernandez@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Reconciliation Contact	Director of Member Services, Marketing		Engelbert	Brandon		9256087828					brandon.engelbert@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Reconciliation Contact (Secondary)	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Recovery Audit Contact	Deputy Executive Director / Compliance Officer	Ms.	Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	SNP Application Contact	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	SNP State Contact	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Surveillance Contact	Deputy Executive Director / Compliance Officer		Gonzales	Chanda		9255329837					chanda.gonzales@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	System Contact	Director of Analysis, Reporting, & Technology		Escobar	Sonia		9256088222					sonia.escobar@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Third Party Administrator (TPA) Liaison	Director of Member Services, Marketing		Engelbert	Brandon		9256087828					brandon.engelbert@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	12/15/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	User Access Contact	Director of Analysis, Reporting, & Technology		Escobar	Sonia		9256088222					sonia.escobar@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/10/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Utilization Management Contact	Chief Medical Officer		Lo	Irene		9256089850					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5119	Utilization Review Contact	Chief Medical Officer		Lo	Irene		9256089850					irene.lo@cchealth.org	595 Center Ave	Suite 200	Martinez	CA	94553	02/07/2025	2026	CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH PLAN	Local CCP	Contra Costa Health Care Plus (HMO D-SNP)	HMO/HMOPOS		Contra Costa Health Services	68	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5124	Automated TrOOP Balance Transfer Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Backup User Access Contact	PACE Center Manager	Ms.	Escobedo	Kace		3175288933					Kace.Escobedo@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Best Available Evidence Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Bid Primary Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	CAP Report Contact for Public Website	Financial Operations Manager	Mr.	Johnson	Andy		3175287223					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	CEO - CMS Administrator Contact	CNO	Mrs.	Therady	Agnes		5742546401					Agnes.Therady@franciscanalliance.org	8111 South Emerson		Indianapolis	IN	46237	03/12/2021	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	CEO - Senior Official for Contracting	CNO	Mrs.	Therady	Agnes		5742546401					Agnes.Therady@FranciscanAlliance.org	8111 S. Emerson Ave.		Indianapolis	IN	46237	03/12/2021	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Chief Financial Officer	Chief Financial Officer	Mr	Wessel	Mark		3177054530					mark.wessel@franciscanalliance.org	4527 East 82nd Street		Indianapolis	IN	46250	09/05/2017	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Chief Operating Officer	CNO	Mrs.	Therady	Agnes		5742546401					Agnes.Therady@FranciscanAlliance.org	8111 S. Emerson Ave.		Indianapolis	IN	46237	03/12/2021	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Chief Information Officer		Mr	Wagner	Charles		3177826212					charles.wagner@franciscanalliance.org	8111 Emerson Ave		Indianapolis	IN	46237	05/13/2020	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Chief Information Security Officer		Mr	Wagner	Charles		3177826212					charles.wagner@franciscanalliance.org	8111 Emerson Ave		Indianapolis	IN	46237	05/13/2020	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	CMS Casework Communication Contact	PACE Administrative Director		Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	03/19/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Complaints Tracking Contact	PACE Center Manager	Ms.	Escobedo	Kace		3175287223					Kace.Escobedo@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Contact for Fraud Investigations	PACE Administrative Director	Mrs.	Nack	Brooke		2172275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Coordination of Benefits Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliane.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Corporate Mailing						2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	03/19/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Customer Service Operations Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	DIR Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	DIR Contact (Secondary)	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Discount Program Payment Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					andy.johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Emergency Part D Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Emergency Part D Contact (Secondary)	PACE Center Manager	Ms.	Escobedo	Kace		3175287223					Kace.Escobedo@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Encounter Data & Risk Adjustment Operations Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Enrollment Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	EOB Transfer Contact	PACE Center Manager	Ms.	Escobedo	Kace		3175287223				3175286399	Kace.Escobedo@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Financial Audit Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Financial Reporting Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Formulary Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	General Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					brooke.nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Government Relations Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	HIPAA Privacy Officer	Compliance Officer		Heim	Joy		3177828009					Joy.Heim@franciscanalliance.org	421 N. Emerson Ave.		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	HIPAA Security Officer	Compliance Officer		Heim	Joy		3177828009					Joy.Heim@franciscanalliance.org	421 N. Emerson Ave.		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Interoperability Contact	Compliance Officer		Heim	Joy		3177828009					Joy.heim@franciscanalliance.org	421 N. Emerson Ave.		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	MA Appeals/Grievances Contact	PACE Administrative Director		Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	MA Claims Processing Contact for Public Website	Home Care Coordinator		McCord	Lynita		2198642029					Lynita.McCord@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	02/05/2025	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Marketing Contact	PACE Administrative Director		Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Medical Director	PACE Physician	Dr.	Munoz	Alisia		7657678840					alisia.munoz@franciscanalliance.org	1116 N 16th St		Lafayette	IN	47904	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Medicare Compliance Officer	Compliance Officer	Ms	Heim	Joy		3177828009					Joy.Heim@franciscanalliance.org	421 N. Emerson Ave.		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Medicare Coordinator	PACE Center Manager	Ms.	Escobedo	Kace		8448177223					Kace.Escobedo@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Medicare Part D Opioid Overutilization Contact	PACE Administrative Director		Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Medication Therapy Management Contact	Medical Director	Dr.	Priscu	Nicolas		3175287223					Nicolas.Priscu@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part C Application Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part D Appeals	PACE Administrative Director		Nack	Brooke							Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	08/23/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active	2192275226				PACE - Nat		C	New York
H5124	Part D Appeals Contact (Secondary)	Financial Operations Manager	Mr.	Johnson	Andy	R						Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active	3173403150				PACE - Nat		C	New York
H5124	Part D Application Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part D Benefits Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part D Claims Submission Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part D Exceptions Contact	PACE Administrative Director	Mrs.	Nack	Brooke							Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active	2192275226				PACE - Nat		C	New York
H5124	Part D Exceptions Contact (Secondary)	Business Operations Manager	Mr.	Meade	Evan							Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active	3174604411				PACE - Nat		C	New York
H5124	Part D Price File Contact (Back-up)	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part D Price File Contact (Primary)	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part D Quality Assurance Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Part D Reporting Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Patient Safety Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Payment Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Personal Health Record Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Pharmacy Director	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Pharmacy Network Management Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Pharmacy Network Management Contact (Secondary)	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Pharmacy Technical Help Desk Contact	Business Operations Manager	Mr.	Meade	Evan							Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active	3174604411				PACE - Nat		C	New York
H5124	Plan Directory Contact for Public Website	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					Brooke.Nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Plan to Plan Reconciliation Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Processor Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Quality Contact	PACE Physician	Dr.	Munoz	Alisia		7657678840					alisia.munoz@franciscanalliance.org	1116 N 16th St		Lafayette	IN	47904	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Reconciliation Contact	Financial Operations Manager	Mr.	Johnson	Andy	R	3173403150					Andy.Johnson@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Reconciliation Contact (Secondary)	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Recovery Audit Contact	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Surveillance Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					brooke.nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	System Contact	PACE Administrative Director	Mrs.	Nack	Brooke		2192275226					brooke.nack@franciscanalliance.org	2150 Gettler Street		Dyer	IN	46311	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Third Party Administrator (TPA) Liaison	Business Operations Manager	Mr.	Meade	Evan		3174604411					Evan.Meade@franciscanalliance.org	1040 Sierra Drive, Suite 600		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	User Access Contact	Compliance Officer		Heim	Joy		3177828009					joy.heim@franciscanalliance.org	421 N. Emerson Ave.		Greenwood	IN	46143	11/13/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Utilization Management Contact	PACE Physician	Dr.	Munoz	Alisia		7657678840					alisia.munoz@franciscanalliance.org	1116 N 16th St		Lafayette	IN	47904	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5124	Utilization Review Contact	PACE Physician	Dr.	Munoz	Alisia		7657678840					alisia.munoz@franciscanalliance.org	1116 N 16th St		Lafayette	IN	47904	09/17/2024	2026	FRANCISCAN ACO, INC.	National PACE	Franciscan  Senior Health & Wellness	National PACE		Franciscan Alliance, Inc.	563	Yes	Active					PACE - Nat		C	New York
H5141	Agent/Broker Compensation Data Contact	Telesales Director	Mr.	Gorman	Scott		7576399577					scott.gorman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O.Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Backup User Access Contact	Compliance Sr. Associate	Mrs.	Terrell	Linda		8324927622				2012554173	linda.terrell@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Bid Audit Contact	Chief Actuary	Mr.	Cap	Dale		8324927622				2012554173	dale.cap@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Bid Audit Site Contact	Chief Actuary	Mr.	Cap	Dale		8324927622				2012554173	dale.cap@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Bid Primary Contact	Chief Compliance Officer	Mrs.	Richey	Wendy		5512252014				2012554173	wendy.richey@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	CAP Report Contact for Public Website	Chief Compliance Officer	Mrs.	Richey	Wendy		5512252014				2012554173	Wendy.Richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs	Reynoso	Jamie		2014322133					jamie.reynoso@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs.	Reynoso	Jamie		2014322133					jamie.reynoso@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Chief Operating Officer	COO	Mr.	Brand	Joseph		2014322133					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Chief Information Officer	President	Mr.	Toy	Andrew		6463183182					andrew.toy@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Chief Information Security Officer	Chief Security Officer	Mr.	Ross	Christophe		4257378141					christopher.ross@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	CMMI Model Point of Contact	CCO	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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		2013200506					robert.davis@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Complaints Tracking Contact	Sr Compliance Director	Mr.	Davis	Robert		2012554173					robert.davis@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Corporate Mailing						5512252014				2018587355	wendy.richey@cloverhealth.com	Clover Health	P.O. Box 21164	Eagan	MN	55121	03/12/2025	2026	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	COO	Mr.	Brand	Joseph		2014322133				2012554173	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	DIR Contact	Manager	Ms	Bhatt	Mital		5513584582					mital.bhatt@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	DIR Contact (Secondary)	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Discount Program Payment Contact	Sr. Accountant	Ms.	Bhatt	Mital		5513584582				2018587355	Mital.Bhatt@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Electronic Health Record Contact	COO	Mr.	Brand	Joseph		2015322133					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Emergency Part D Contact	VP of Pharmacy	Mr.	Pica	Michael		7188735606				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Ms.	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Employer Waiver Contact	CCO	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Encounter Data & Risk Adjustment Operations Contact	Chief Actuary	Mr.	Cap	Dale		2014322133					dale.cap@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Enrollment Contact	Enrollment Director	Ms	Newman	Jennifer		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	EOB Transfer Contact	COO	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Financial Audit Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Financial Reporting Contact	CFO	Mr.	Thronton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Formulary Contact	VP of Pharmacy	Mr.	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Formulary Contact (Secondary)	Pharmacy Operations Manager	Ms.	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	General Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	HIPAA Privacy Officer	Privacy Officer	Ms	Shah	Devi		7327131229					devi.shah@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	HIPAA Security Officer	Security Officer	Mr.	Ross	Christophe		4257378141					christopher.ross@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Interoperability Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	MA Appeals/Grievances Contact	COO	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	MA Claims Processing Contact for Public Website	Chief Information Officer	Ms.	Safe	Theresa		5513221075				2012554173	theresa.safe@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Marketing Contact	Sr. Compliance Director	Mr.	Davis	Robert		2012554173				2012554171	robert.davis@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Medical Director	Chief Medical Officer / Medical Director	Dr.	Gupta	Shelly		2014322133				2012554173	shelly.gupta@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Medicare Coordinator	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Medicare Part D Opioid Overutilization Contact	Pharmacy Operations Manager	Ms.	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Medication Therapy Management Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	OffShore Subcontractor Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Online Enrollment Center Contact (Back-up)	Telesales Director	Mr.	Gorman	Scott		7576399577					scott.gorman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Online Enrollment Center Contact (Primary)	Enrollment Director	Ms	Newman	Jennifer		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part C Application Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part C Reporting Contact	Chief Compliance Officer	Ms	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Appeals	VP Pharmacy	Mr	Pica	Mike							mike.pica@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	2014322133				PPO - BBA		C	New York
H5141	Part D Appeals Contact (Secondary)	Pharmacy Operations Manager	Ms.	Zawadzki	Marta						8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	5513490059				PPO - BBA		C	New York
H5141	Part D Application Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Benefits Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Claims Submission Contact	VP Pharmacy	Mr.	Pica	Michael		8887781478				2014322133	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	10/09/2025	2026	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						2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	2014322133				PPO - BBA		C	New York
H5141	Part D Exceptions Contact (Secondary)	Pharmacy Operations Manager	Ms	Zawadzki	Marta						8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	5513490059				PPO - BBA		C	New York
H5141	Part D Price File Contact (Back-up)	Pharmacy operations manager	Ms	Zawadzki	Marta		5513490059					pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Price File Contact (Optional)	Pharmacy Manager	Ms	Zawadzki	Marta		5513490059					pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Price File Contact (Primary)	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Quality Assurance Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Part D Reporting Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Patient Safety Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Payment Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Personal Health Record Contact	President	Mr	Toy	Andrew		6463183182					andrew.toy@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Pharmacy Director	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Pharmacy Network Management Contact	SV Pharmacy	Mr	Pica	Michael		2014322133				4803146023	mike.pica@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Pharmacy Network Management Contact (Secondary)	Pharmacy operations manager	Ms	Zawadzki	Marta		5513490059					pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	8666934620				PPO - BBA		C	New York
H5141	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy operations manager	Ms	Zawadzki	Marta							pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active	5513490059				PPO - BBA		C	New York
H5141	PHR Beneficiary Contact																	12/19/2023	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO	Clover Health	Clover Health Holdings, Inc.	491	Yes	Active	8886571207				PPO - BBA		C	New York
H5141	Physician Incentive Contact	Vice President Provider Experience	Ms.	Jones	Rachel		9144175963					rachel.jones@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Plan Directory Contact for Public Website	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Plan to Plan Reconciliation Contact	Accounting Manager	Mr.	Bhatt	Mital		5513584582					mital.bhatt@cloverhealth.com	c/o PNC Bank	PO Box 825694	Philadelphia	PA	19182	08/06/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Processor Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Quality Contact	COO	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Reconciliation Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Recovery Audit Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	SNP Application Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	SNP State Contact	SVP, Deputy, General Counsel	Ms.	Soares	Karen		2059087838					karen.soares@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Surveillance Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	System Contact	Chief Information Officer	Ms.	Safe	Theresa		5513221075					theresa.safe@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Third Party Administrator (TPA) Liaison	Sr. Accountant	Ms.	Bhatt	Mital		5513584582				2018587355	Mital.Bhatt@Cloverhealth.com	P.O. Box 21164	Suite 803	Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	User Access Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Utilization Management Contact	COO	Mr.	Brand	Joseph		2010432213					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5141	Utilization Review Contact	COO	Mr.	Brand	Joseph		2014322133					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER INSURANCE COMPANY	Local CCP	Clover Health	Local PPO		Clover Health Holdings, Inc.	491	Yes	Active					PPO - BBA		C	New York
H5163	Agent/Broker Compensation Data Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/27/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Automated TrOOP Balance Transfer Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Backup User Access Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Best Available Evidence Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Bid Audit Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Bid Primary Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	CAP Report Contact for Public Website	Chief Risk Officer	Mr.	Brown	Tariq	S	7144648009					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8882565123				HMO - Health Maintenance Organization		C	Atlanta
H5163	CEO - CMS Administrator Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	CEO - Senior Official for Contracting	President/CEO	Mr.	Vo	Frank		6572864322					Frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Chief Financial Officer	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	04/21/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Chief Operating Officer	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Chief Information Officer	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Chief Information Security Officer	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	CMS Casework Communication Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Complaints Tracking Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Contact for Fraud Investigations	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Coordination of Benefits Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Corporate Mailing						8882565123					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Customer Service Operations Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	DIR Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Discount Program Payment Contact	Chief Compliance Officer	Mr.	Brown	TARIQ	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	04/15/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Emergency Part D Contact	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Emergency Part D Contact (Secondary)	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Encounter Data & Risk Adjustment Operations Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Enrollment Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	EOB Transfer Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204				8773613788	carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Financial Audit Contact	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	05/06/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Financial Reporting Contact	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	05/06/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Formulary Contact	Manager, Formulary Admin	Ms.	Nyawablia	Christina		8587906297					fmt@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	04/26/2023	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Formulary Contact (Secondary)	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	General Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Government Relations Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	HIPAA Privacy Officer	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	HIPAA Security Officer	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Hospice Contact	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Interoperability Contact	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	MA Appeals/Grievances Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	MA Claims Processing Contact for Public Website	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Marketing Contact	Chief Growth Officer	Mr.	Bond	Christophe		6574526244					christopherb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/19/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Medical Director	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Medicare Compliance Officer	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Medicare Coordinator	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Medication Therapy Management Contact	Clinical Solutions Manager III	Ms.	Nguyen	Linh		8587906627					mtmp@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	03/27/2023	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Online Enrollment Center Contact (Back-up)	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Online Enrollment Center Contact (Primary)	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part C Application Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@VerdaHealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part C Reporting Contact	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Appeals	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn							carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8882565123				HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Appeals Contact (Secondary)			Martin	Dawn							Dawn.Martin@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8587907118				HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Application Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@VerdaHealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Benefits Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Claims Submission Contact	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn		6574526204					carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Exceptions Contact	Chief Medical Officer	Dr.	Tong	Tri							trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8882565123				HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Exceptions Contact (Secondary)	Dir PA & UM Programs	Ms.	Emoto	Julianne							Julianne.emoto@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Price File Contact (Back-up)	Medicare Part D Program Manager	Ms.	Keller	Shanon		8587907104					Shanon.keller@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/14/2023	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Price File Contact (Optional)	Medicare Part D Program Manager	Ms.	Keller	Shanon		8587907104					shanon.keller@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	03/27/2023	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Price File Contact (Primary)	Medicare Part D Program Manager	Ms.	Keller	Shanon		8587907104					shanon.keller@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2023	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Quality Assurance Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Part D Reporting Contact	Chief Operating Officer	Ms.	Chan	Dorothy		6572864323					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Patient Safety Contact	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Payment Contact	Senior Vice President of Finance	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	05/06/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Pharmacy Director	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Pharmacy Network Management Contact	Director, Pharmacy Network Administration	Mr.	Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services	Ms.	Brewer	Kathy							CustomerService@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/23/2023	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8667054182				HMO - Health Maintenance Organization		C	Atlanta
H5163	Pharmacy Technical Help Desk Contact (Secondary)	Associate Vice President, Member Experience	Ms.	Mathews	Carolyn							carolynm@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active	8882565123				HMO - Health Maintenance Organization		C	Atlanta
H5163	Plan Directory Contact for Public Website	Chief Operating Officer	Ms.	Chan	Dorothy		8882565123					dorothyc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Plan to Plan Reconciliation Contact	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	05/06/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Processor Contact	SVP Government Programs and Services	Mr.	Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/04/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Quality Contact	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Reconciliation Contact	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	05/06/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Reconciliation Contact (Secondary)	President/CEO	Mr.	Vo	Frank		6572864322					frankv@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Recovery Audit Contact	VP Finance & Controller	Mr.	Rout	Pranab		5627324431					pranabr@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	05/06/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	SNP Application Contact	President/CEO	Mr.	Vo	Frank		6572864322					frankv@Verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Surveillance Contact	Chief Risk Officer	Mr.	Brown	Tariq	S	2699295172					tariqb@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	11/18/2024	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	System Contact	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Third Party Administrator (TPA) Liaison	Vice President of Finance	Mr.	Rout	Pranab		5627324431					pranabr@VerdaHealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	06/05/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	User Access Contact	Chief Information Officer	Mr.	Carren	Marc		6574526231					marcc@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Utilization Management Contact	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5163	Utilization Review Contact	Chief Medical Officer	Dr.	Tong	Tri		9493811481					trit@verdahealthcare.com	7755 Center Avenue	Suite 1200	Huntington Beach	CA	92647	02/10/2025	2026	VERDA HEALTH PLAN OF TEXAS INC	Local CCP	Verda Health Plan of Texas	HMO/HMOPOS		Verda Healthcare, Inc.	806	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5167	Automated TrOOP Balance Transfer Contact	HIM Manager	Mr.	Madwell	Jason		7194668777	657			7192140149	jmadwell@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/23/2024	2026	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	Backup User Access Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643				pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Bid Primary Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	CAP Report Contact for Public Website	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	12/08/2025	2026	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	7194668777	758			PACE - Nat		C	Dallas
H5167	CEO - CMS Administrator Contact	President	Mr.	Hartman	Mark		7194399885					mhartman@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	CEO - Senior Official for Contracting	President	Mr.	Hartman	Mark		7194399885					Mhartman@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Kuitse	Johan		7193142327	627				jkuitse@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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 Information Officer	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758			7193140149	jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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 Information Security Officer	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758			7193140149	jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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	Complaints Tracking Contact	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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	Contact for Fraud Investigations	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Corporate Mailing						7194668777	625			7194730628	nolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758			7193140149	jolson@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	12/08/2025	2026	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	DIR Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193170149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	DIR Contact (Secondary)	Controller	Ms.	Oliverius	Audrey		7194668777	392			7193140149	aoliverius@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Discount Program Payment Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Emergency Part D Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Emergency Part D Contact (Secondary)	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana		7192086173					svanmaldehem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	04/07/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	HIM Manager	Mr.	Madwell	Jason		7194668777	657				jmadwell@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Enrollment Contact	Senior Revenue Analyst	Ms.	Madigan	Tracy		7194668777	640				tmadigan@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	EOB Transfer Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Financial Audit Contact	Chief Financial Officer	Mr.	Masar	Paul		7193142327	643			7193140149	pmasar@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	08/09/2022	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Formulary Contact	Chief Medical Officer	Dr.	Ammatelli	Paul		7193142327	266				pammatelli@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	03/05/2024	2026	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	Formulary Contact (Secondary)	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana		7194668777	538				svanmaldeghem@rmhcare.org	2502 E. Pikes Peak Ave. Suite 100		Colorado Springs	CO	80909	04/07/2025	2026	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	General Contact	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758			7193140149	jolson@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	12/08/2025	2026	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	Vice President of External Relations	Ms.	McDonough	Andi		7194668777	335				amcdonough@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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	HIPAA Privacy Officer	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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	HIPAA Security Officer	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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	Interoperability Contact	HIM Manager	Mr.	Madwell	Jason		7194668777	657				jmadwell@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	MA Appeals/Grievances Contact	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Marketing Contact	Chief Growth Officer	Ms.	Kerr	Melissa		7194668777	624				mkerr@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Elliott	Eric		7193142327					eelliott@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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 Coordinator	Vice President of External Relations	Ms.	McDonough	Andi		7194668777	335				amcdonough@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	05/23/2025	2026	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 Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Ammatelli	Paul		7193142327	266				pammatelli@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	03/05/2024	2026	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	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Ammatelli	Paul		7193142327	266				pammatelli@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	03/05/2024	2026	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	Online Enrollment Center Contact (Back-up)	Chief Operating Officer	Mr.	Kuitse	Johan		7194668777	627				jkuitse@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Online Enrollment Center Contact (Primary)	Chief Growth Officer	Ms.	Kerr	Melissa		7194668777	624				mkerr@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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 C Application Contact	Chief Operating Officer	Mr.	Kuitse	Johan		7193142327	627				jkuitse@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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 Appeals	Pharmacist	Ms.	Kennedy	Erin							ekennedy@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	7194668777				PACE - Nat		C	Dallas
H5167	Part D Application Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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 Benefits Contact	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana		7193142327					svanmaldeghem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	04/07/2025	2026	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 Claims Submission Contact	Med Room Manager	Mr.	Lewallen	Shane		7194668777	378			7193140149	slewallen@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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 Nursing Officer	Ms.	VanMaldeghem	Santiana						7193140149	svanmaldeghem@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	7194668777	538			PACE - Nat		C	Dallas
H5167	Part D Exceptions Contact (Secondary)	Med Room Manager	Mr.	Lewallen	Shane						7194730628	slewallen@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	12/08/2025	2026	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	8665038916	378			PACE - Nat		C	Dallas
H5167	Part D Price File Contact (Back-up)	Medical Director	Dr.	Ammatelli	Paul		7194668777				7193140149	pammatelli@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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 Price File Contact (Optional)	Chief Operating Officer	Mr.	Kuitse	Johan		7194668777	335			7194730628	jkuitse@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	05/23/2025	2026	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 Price File Contact (Primary)	Chief Medical Officer	Dr.	Elliott	Eric		7193142327					eelliott@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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 Quality Assurance Contact	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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 Reporting Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Patient Safety Contact	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana		7193142327					svanmaldeghem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	04/07/2025	2026	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	Payment Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Personal Health Record Contact	HIM Manager	Mr.	Madwell	Jason		7194668777	657				jmadwell@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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 Director	Pharmacist	Ms.	Kennedy	Erin		7193142327					ekennedy@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	12/08/2025	2026	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 Network Management Contact	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana		7194668777				7194730628	svanmaldeghem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	04/07/2025	2026	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 Network Management Contact (Secondary)	Pharmacist		Kennedy	Erin		7193142327					ekennedy@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	12/08/2025	2026	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	Pharmacist	Ms.	Kennedy	Erin						7194730628	ekennedy@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	12/08/2025	2026	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	7194668777				PACE - Nat		C	Dallas
H5167	Pharmacy Technical Help Desk Contact (Secondary)	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana						7194730628	svanmaldeghem@rmhcare.org	8595 Explorer Drive		Colorado Springs	CO	80920	12/08/2025	2026	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE		Rocky Mountain Health Care Services	359	Yes	Active	7194668777				PACE - Nat		C	Dallas
H5167	PHR Beneficiary Contact																	03/13/2017	2026	ROCKY MOUNTAIN HEALTH CARE SERVICES	National PACE	Rocky Mountain PACE	National PACE	Rocky Mountain Health Care Services	Rocky Mountain Health Care Services	359	Yes	Active	8665038916				PACE - Nat		C	Dallas
H5167	Plan Directory Contact for Public Website	Chief Growth Officer	Ms.	Kerr	Melissa		7194668777	624				mkerr@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Processor Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Quality Contact	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Reconciliation Contact (Secondary)	Controller	Ms.	Oliverius	Audrey		7194668777	392				aoliverius@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/17/2023	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmaser@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	Surveillance Contact	Chief Growth Officer	Ms.	Kerr	Melissa		7194668777	624				mkerr@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	System Contact	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr.	Masar	Paul		7194668777	643			7193140149	pmasar@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	04/07/2025	2026	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	User Access Contact	Chief Risk Officer	Mr.	Olson	Jay		7194668777	758				jolson@rmhcare.org	8595 Explorer Dr		Colorado Springs	CO	80920	07/17/2025	2026	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	Utilization Management Contact	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana		7194668777				7194730628	svanmaldeghem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	04/07/2025	2026	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	Utilization Review Contact	Chief Nursing Officer	Ms.	VanMaldeghem	Santiana		7194668777				7194730628	svanmaldehem@rmhcare.org	2502 E. Pikes Peak Ave., Suite 100		Colorado Springs	CO	80909	04/07/2025	2026	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	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H5178	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H5178	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5178	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5190	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/08/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H5190	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5190	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5190	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5190	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H5190	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H5190	PHR Beneficiary Contact																	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H5190	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5190	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUNSHINE STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5209	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H5209	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H5209	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5209	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H5209	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5209	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5209	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5209	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	Molina Healthcare of Wisconsin, Inc.	Local CCP	My Choice Wisconsin	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5211	Agent/Broker Compensation Data Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Automated TrOOP Balance Transfer Contact	Medicare Part D Coordinator		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/06/2019	2026	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	Dallas
H5211	Backup User Access Contact	Director of Product Development		Howey	Kristina		7152215406				7152219500	howey.kristina@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	08/19/2022	2026	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	Dallas
H5211	Best Available Evidence Contact	Enrollment Services Team Lead		Ronning	Amy		7152219590				7152219500	ronning.amy@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	54449	05/17/2021	2026	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	Dallas
H5211	Bid Audit Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	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	Dallas
H5211	Bid Audit Site Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	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	Dallas
H5211	Bid Primary Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	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	Dallas
H5211	CAP Report Contact for Public Website	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	8007525863				HMO - Health Maintenance Organization		C	Dallas
H5211	CEO - CMS Administrator Contact	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	CEO - Senior Official for Contracting	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Chief Financial Officer	Chief Financial Officer	Mr.	Custis	Stephen		6129649158					Stephen.Custis@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	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	Dallas
H5211	Chief Operating Officer	Vice President of Operations	Ms.	Foemmel	Sara		7153836634					foemmel.sara@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	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	Dallas
H5211	Chief Information Officer	Chief Information Officer	Mr.	Reimer	Brad		6053287937					Brad.Reimer@SandfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	04/14/2025	2026	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	Dallas
H5211	Chief Information Security Officer	Vice President, Information Security Officer	Mr.	Hogstad	Kimberly		6053287410					Kimberly.Hogstad@SandfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	04/14/2025	2026	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	Dallas
H5211	CMS Casework Communication Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	11/08/2022	2026	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	Dallas
H5211	Complaints Tracking Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	shp.compliance.dept@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	03/14/2024	2026	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	Dallas
H5211	Contact for Fraud Investigations	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Coordination of Benefits Contact	Part D COB Specialist		Hollatz	Lori		7152219814				7152219500	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/20/2021	2026	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	Dallas
H5211	Corporate Mailing						7152219897				7152219500	shpcsweb@securityhealth.org	1515 Saint Joseph Avenue	PO Box 8000	Marshfield	WI	54449	10/27/2017	2026	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	Dallas
H5211	Customer Service Operations Contact	Director of Customer Service Contact Center		Nagel	Jessica		8779980998				7152219500	nagel.jessica@securityhealth.org	1515  Saint Joseph Avenue		Marshfield	WI	54449	04/11/2025	2026	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	Dallas
H5211	DIR Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/20/2025	2026	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	Dallas
H5211	DIR Contact (Secondary)	Government Programs Coordinator		Hollatz	Lori		7152219771				7152219814	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/29/2025	2026	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	Dallas
H5211	Discount Program Payment Contact	Accountant II		Staver	Jannel		7152219864				7152219500	staver.jannel@securityhealth.org	1515 Saint Joseph Avenue		Marshfied	WI	54449	12/31/2019	2026	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	Dallas
H5211	Emergency Part D Contact	Pharmacy Services		Wittig	Kurt		7152219261				7152219719	wittig.kurt@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/29/2025	2026	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	Dallas
H5211	Emergency Part D Contact (Secondary)	Pharmacy Services Director		Schilling	Gretchen		6053122741					gretchen.schilling@sanfordhealth.org	300 45th St S		Sioux Falls	SD	57108	06/06/2025	2026	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	Dallas
H5211	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Revenue Operations Specialist		Kolbeck	Patricia		7152219824				7152219500	kolbeck.patricia@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	12/31/2019	2026	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	Dallas
H5211	Enrollment Contact	Enrollment Team Lead		Zajackowski	Juliann		7152219925				7152219500	zajackowski.juliann@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	54449	03/02/2020	2026	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	Dallas
H5211	EOB Transfer Contact	Medicare Part D Coordinator		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/06/2019	2026	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	Dallas
H5211	Financial Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Financial Reporting Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	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	Dallas
H5211	Formulary Contact	Clinical Pharmacy Specialist		Wittig	Kurt		7152219261				7152219719	wittig.kurt@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Formulary Contact (Secondary)	Medicare Part D Coordinator		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	12/31/2019	2026	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	Dallas
H5211	General Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	07/30/2025	2026	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	Dallas
H5211	Government Relations Contact	Head of Government Affairs	Mr.	Wheeler	Dylan		6053287186					Dylan.Wheeler@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	HIPAA Privacy Officer	Lead Privacy Officer	Ms.	Sundby	Jennifer		6053625407					Jennifer.Sundby@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	HIPAA Security Officer	Information Security Compliance Officer	Mr.	Otte	Brody		6053126563					Brody.Otte@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Hospice Contact	Interim PharmQuality Assurance-Auditing Specialist		Hollatz	Lori		7152219814				7152219500	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54440	01/14/2022	2026	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	Dallas
H5211	Interoperability Contact	Director of Information Systems		Preston	Todd		7152218336					preston.todd@securityhealth.org	1515 St Joseph Ave		Marshfield	WI	54449	02/08/2022	2026	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	Dallas
H5211	MA Appeals/Grievances Contact	Director of Health Plan Quality		Jacobson	Paula		7152219644				7152219500	jacobson.paula@securityhealth.org	1515  Saint Joseph Avenue		Marshfield	WI	54449	02/17/2023	2026	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	Dallas
H5211	MA Claims Processing Contact for Public Website	Vice President of Operations		Foemmel	Sara		7152219950				7152219500	foemmel.sara@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/08/2022	2026	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	Dallas
H5211	Marketing Contact	Director of Marketing		McCloskey	Diana		6053122762					Diana.McCloskey@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	04/14/2025	2026	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	Dallas
H5211	Medical Director	Medical Director		Cox	John		7152219289	36525			7152219500	cox.john@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Medicare Coordinator	Implementation Manager		Pierce	Sheryl		2088910185					pierce.sheryl@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/28/2024	2026	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	Dallas
H5211	Medicare Part D Opioid Overutilization Contact	Quality Assurance - Auditing Specialist		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/11/2024	2026	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	Dallas
H5211	Medication Therapy Management Contact	Clinical Pharmacy Specialist		Wittig	Kurt		7152219261				7152219719	wittig.kurt@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	OffShore Subcontractor Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Online Enrollment Center Contact (Back-up)	Enrollment Team Leader		Zajackowski	Juliann		7152219925				7152219500	zajackowski.juliann@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	54449	10/27/2017	2026	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	Dallas
H5211	Online Enrollment Center Contact (Primary)	Enrollment Services Team Lead		Ronning	Amy		7152219590				7152219500	ronning.amy@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	54449	05/17/2021	2026	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	Dallas
H5211	Part C Application Contact	Implementation Manager		Pierce	Sheryl		2088910185					pierce.sheryl@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/28/2024	2026	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	Dallas
H5211	Part C Reporting Contact	Implementation Manager		Pierce	Sheryl		2088910185					pierce.sheryl@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/28/2024	2026	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	Dallas
H5211	Part D Appeals	Program Coordinator - Government Products		Hollatz	Lori						7152219814	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	8778735611				HMO - Health Maintenance Organization		C	Dallas
H5211	Part D Appeals Contact (Secondary)	Pharmacy Services		Wittig	Kurt						7152219719	wittig.kurt@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/29/2025	2026	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	7152219261				HMO - Health Maintenance Organization		C	Dallas
H5211	Part D Application Contact	Implementation Manager		Pierce	Sheryl		2088910185					pierce.sheryl@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/28/2024	2026	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	Dallas
H5211	Part D Benefits Contact	Program Coordinator - Government Products		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Part D Claims Submission Contact	Program Coordinator - Government Products	Ms.	Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Part D Exceptions Contact	Program Coordinator - Government Products		Hollatz	Lori						7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	06/06/2025	2026	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	8778735611				HMO - Health Maintenance Organization		C	Dallas
H5211	Part D Exceptions Contact (Secondary)	Pharmacy Services		Wittig	Kurt						7152219920	wittig.kurt@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/29/2025	2026	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	8778735611				HMO - Health Maintenance Organization		C	Dallas
H5211	Part D Price File Contact (Back-up)	Program Coordinator - Government Products		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Part D Price File Contact (Optional)	Pharmacy Systems Support Spec		Horn	Dawn		7152219405				7152219719	horn.dawn@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Part D Price File Contact (Primary)	Medicare Part D Project Manager		Niemi	Kirstin		8587906455					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	09/13/2017	2026	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	Dallas
H5211	Part D Quality Assurance Contact	Program Coordinator - Government Products		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue	PO Box 8000	Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Part D Reporting Contact	Director of Product Development		Howey	Kristina		7152215406				7152219500	howey.kristina@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	08/19/2022	2026	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	Dallas
H5211	Patient Safety Contact	Clinical Pharmacy Specialist		Wittig	Kurt		7152219261				7152219719	wittig.kurt@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/06/2025	2026	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	Dallas
H5211	Payment Contact	Director of Finance and Accounting		Bell	Lacey		7152219160				7152219500	bell.lacey@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/04/2020	2026	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	Dallas
H5211	Personal Health Record Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Pharmacy Director	Pharmacy Services Director		Schilling	Gretchen		6053122741				7152219719	gretchen.schilling@sanfordhealth.org	300 45th St S		Sioux Falls	SD	57108	07/29/2025	2026	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	Dallas
H5211	Pharmacy Network Management Contact	Program Coordinator - Government Products		Hollatz	Lori		7152219814				7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue	PO Box 8000	Marshfield	WI	54449	07/08/2025	2026	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	Dallas
H5211	Pharmacy Network Management Contact (Secondary)	Manager, PNS & Claims Operations		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/06/2017	2026	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	Dallas
H5211	Pharmacy Technical Help Desk Contact	Program Coordinator - Government Products		Hollatz	Lori						7152219719	hollatz.lori@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/10/2025	2026	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	8778735611				HMO - Health Maintenance Organization		C	Dallas
H5211	Pharmacy Technical Help Desk Contact (Secondary)	Director, Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/11/2024	2026	SECURITY HEALTH PLAN OF WISCONSIN, INC.	Local CCP	Security Health Plan of Wisconsin, Inc.	HMO/HMOPOS		Marshfield Clinic Health System, Inc.	149	Yes	Active	8009263004				HMO - Health Maintenance Organization		C	Dallas
H5211	Plan Directory Contact for Public Website	VP - Operations		Foemmel	Sara		7152219950					foemmel.sara@securityhealth.org	1515  Saint Joseph Avenue		Marshfield	WI	54449	04/18/2025	2026	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	Dallas
H5211	Plan to Plan Reconciliation Contact	Director of Finance and Accounting		Bell	Lacey		7152219160				7152219500	bell.lacey@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/23/2023	2026	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	Dallas
H5211	Processor Contact	Director, Claims & Payment Integrity		Bores	April		8004722363					bores.april@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/08/2025	2026	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	Dallas
H5211	Quality Contact	Director of Health Plan Quality		Jacobson	Paula		7152219644				7152219500	jacobson.paula@securityhealth.org	1515  Saint Joseph Avenue		Marshfield	WI	54449	02/17/2023	2026	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	Dallas
H5211	Reconciliation Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	06/20/2025	2026	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	Dallas
H5211	Recovery Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	SNP Application Contact	Implementation Manager		Pierce	Sheryl		2088910185					pierce.sheryl@securityhealth.org	1515 Saint Joseph Ave		Marshfield	WI	54449	02/28/2024	2026	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	Dallas
H5211	SNP State Contact	Director of Product Development		Howey	Kristina		7152215406				7152219500	howey.kristina@securityhealth.org	1515 Saint Joseph Ave		Marshfield	WI	54449	08/19/2022	2026	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	Dallas
H5211	Surveillance Contact	Chief Legal and Compliance Officer		Boero	Lisa		7152217231				7152219500	shp.compliance.dept@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	544498000	02/08/2022	2026	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	Dallas
H5211	System Contact	Enrollment Team Lead		Zajackowski	Juliann		7152219925				7152219500	zajackowski.juliann@securityhealth.org	1515 Saint Joseph  Avenue		Marshfield	WI	54449	10/27/2017	2026	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	Dallas
H5211	Third Party Administrator (TPA) Liaison	Accountant II		Staver	Jannel		7152219864				7152219500	staver.jannel@securityhealth.org	1515 Saint Joseph Avenue		Marshfied	WI	54449	12/31/2019	2026	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	Dallas
H5211	User Access Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Dallas
H5211	Utilization Management Contact	Health Services Clinical Manager		Cunningham	Ashley		7152219939				7152219500	cunningham.ashley@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	02/28/2024	2026	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	Dallas
H5211	Utilization Review Contact	Health Services Clinical Manager		Cunningham	Ashley		7152219939				7152219500	cunningham.ashley@securityhealth.org	1515  Saint Joseph Avenue		Marshfield	WI	54449	02/28/2024	2026	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	Dallas
H5212	Automated TrOOP Balance Transfer Contact			N/A (PACE)	N/A (PACE)		4149026044					michael.garlie@communitycareinc.org	N/A		Milwaukee	WI	53215	08/20/2008	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Backup User Access Contact	Chief Compliance & Quality Officer		Garlie	Michael	J	2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Best Available Evidence Contact	Accounting Specialist - Medicare	Ms.	Instefjord	Lori		2622079374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Bid Primary Contact	Financial Planning Manager	Mr.	Siddiqui	Imran		2622079372					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	CAP Report Contact for Public Website	Chief Compliance & Quality Officer		Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	CEO - CMS Administrator Contact	CEO	Mr	Munson	Kenneth		4142314000					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2013	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	CEO - Senior Official for Contracting	CEO	Mr	Munson	Kenneth		4142314000					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2013	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Chief Financial Officer	Chief Financial Officer	Mr.	Newmeister	Troy		4142314000					troy.newmeister@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/25/2025	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Chief Operating Officer	Chief Program Officer	Ms.	Carter	Kelly		4142314000					kelly.carter@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	03/07/2025	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Chief Information Officer	Chief Information Officer	Ms.	Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet Street		Milwaukee	WI	53208	02/25/2016	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Chief Information Security Officer	Chief Information Officer	Ms.	Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet Street		Milwaukee	WI	53208	02/26/2016	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	CMS Casework Communication Contact	Chief Compliance & Quality Officer		Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Complaints Tracking Contact	Member Rights Specialist		Olson	Chris		2622079325					MemberRights@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Contact for Fraud Investigations	Compliance Specialist	Ms	Frazer	Amanda		2622079326					amanda.frazer@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Coordination of Benefits Contact	Claims Manager	Mr	Hau	Jeremy		2629538627					jeremy.hau@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	11/30/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Corporate Mailing						4142314000					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/14/2013	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Customer Service Operations Contact	Program Officer	Ms.	Carter	Kelly		2622079323					kelly.carter@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/22/2021	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	DIR Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/21/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	DIR Contact (Secondary)	Chief Financial Officer	Mr.	Newmeister	Troy		2622079371					troy.newmeister@communitycareinc.org	205 Bishops way		Brookfield	WI	53005	06/25/2025	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Discount Program Payment Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Emergency Part D Contact	Director-Financial Planning	Mr.	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	04/07/2025	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Emergency Part D Contact (Secondary)	Pharmacy Manager	Mr.	Hamdan	Mohammad		4149022475					mohammad.hamdan@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	10/02/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Encounter Data & Risk Adjustment Operations Contact	Financial Planning Manager	Mr.	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishop's Way		Brookfield	WI	53005	06/22/2021	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Enrollment Contact	Claims Manager	Mr	Hau	Jeremy		2629538627					jeremy.hau@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	11/30/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	EOB Transfer Contact	Operations Support Supervisor	Ms	Vang	Jane		8882987770				7158367683	jvang@pharmastar.com	P.O. Box 3217		Eau Claire	WI	547023217	03/02/2021	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Financial Audit Contact	Chief Financial Officer	Mr.	Newmeister	Troy		2622079371					troy.newmeister@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/25/2025	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Financial Reporting Contact	Chief Financial Officer	Mr.	Newmeister	Troy		2622079371					troy.newmeister@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/25/2025	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Formulary Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	10/02/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Formulary Contact (Secondary)	Pharmacy Manager	Mr.	Hamdan	Mohammad		4149022475					mohammad.hamdan@communitycareinc.org	1555 S. Layton Blvd.		Milwaukee	WI	53215	10/02/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	General Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/21/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Government Relations Contact	Chief Executive Officer		Munson	Kenneth		2622079339					kenneth.munson@communitycareinc.org	205 Bishops Way		Brookkfield	WI	53005	03/23/2015	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	HIPAA Privacy Officer	Chief Compliance & Quality Officer		Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	HIPAA Security Officer	Chief Information Officer		Kramer	Virginia		4142314292					virginia.kramer@communitycareinc.org	3220 W. Vliet St.		Milwaukee	WI	53208	03/26/2025	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Interoperability Contact	Chief Information Officer	Ms.	Kramer	Virginia		4142314292					Virginia.Kramer@communitycareinc.org	3220 W. Vliet Street		Milwaukee	WI	53208	04/12/2022	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	MA Appeals/Grievances Contact	Member Rights Specialist		Olson	Chris		2622079325					MemberRights@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	MA Claims Processing Contact for Public Website	Claims Manager		Hau	Jeremy		2629538627					jeremy.hau@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Marketing Contact	Marketing & Communications Manager		Yank	Sarah		2622079337					sarah.yank@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Medical Director	Medical Director	Dr.	Almas	Rakhshinda		2622079338					rakshinda.almas@communitycareinc.org	205 Biships Way		Brookfield	WI	53005	03/23/2015	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Medicare Compliance Officer	Chief Compliance and Quality Officer	Mr	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Medicare Coordinator	Chief Compliance & Quality Officer		Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Medication Therapy Management Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part C Application Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/21/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part D Appeals	Member Rights Specialist		Olson	Chris							MemberRights@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active	2622079325				PACE - Nat		C	San Francisco
H5212	Part D Appeals Contact (Secondary)	Director of Quality		Baker	Theresa							theresa.baker@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active	2622079308				PACE - Nat		C	San Francisco
H5212	Part D Application Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/21/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part D Benefits Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/29/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part D Claims Submission Contact	Client Support Supervisor	Ms	Vang	Jane		8882987770					jvang@pharmastar.com	2503 N. Hillcrest Pkwy.		Altoona	WI	54720	03/02/2021	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part D Exceptions Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan							megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/29/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active	8669926600	22527			PACE - Nat		C	San Francisco
H5212	Part D Price File Contact (Back-up)	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part D Price File Contact (Primary)	Formulary & Plan Benefit Coordinator	Ms	Biren	Alicia		7158522061					abiren@pharmastar.com	Pharmastar	P.O. Box 3217	Eau Claire	WI	54702	03/02/2021	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part D Quality Assurance Contact	Director of Quality		Baker	Theresa		2622079308					theresa.baker@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Part D Reporting Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/21/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Patient Safety Contact	Chief Compliance & Quality Officer		Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Payment Contact	Financial Planning Manager	Mr.	Siddiqui	Imran		2622079353					imran.siddiqui@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	06/22/2021	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Pharmacy Director	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan	M	4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/29/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Pharmacy Network Management Contact	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Pharmacy Technical Help Desk Contact			Service	Customer								2503 N. Hillcrest Parkway		Altoona	WI	547202569	03/08/2006	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active	8882987770				PACE - Nat		C	San Francisco
H5212	Plan Directory Contact for Public Website			Hotline	Provider		8669372783					claimsinquiries@communitycareinc.org	1801 Dolphin Drive		Waukesha	WI	53186	02/17/2010	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Plan to Plan Reconciliation Contact	Accounting Specialist - Medicare	Ms	Instefjord	Lori		2622079374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Processor Contact	Client Support Supervisor	Ms	Vang	Jane		7158522064				7158367683	jvang@pharmastar.com	2503 N. Hillcrest Parkway		Altoona	WI	547202569	03/02/2021	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Quality Contact	Director of Quality		Baker	Theresa		2622079308					theresa.baker@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/08/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Reconciliation Contact	Accounting Specialist - Medicare	Ms.	Instefjord	Lori		2622079374					lori.instefjord@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	10/25/2016	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Reconciliation Contact (Secondary)	Mbr. Accounting Mgr.		Burgess	Valerie		2622079376					valerie.burgess@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	02/20/2024	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Recovery Audit Contact	Chief Compliance & Quality Officer	Mr.	Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Surveillance Contact	Chief Compliance & Quality Officer		Garlie	Michael		2622079307					michael.garlie@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	System Contact	Chief Information Officer		Kramer	Virginia		4142314292					Virginia.Kramer@communitycareinc.org	3220 W. Vliet Street		Milwaukee	WI	53208	05/09/2013	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Third Party Administrator (TPA) Liaison	Clinical Pharmacist	Mrs.	Farley-Snieg	Megan		4149022527					megan.farley-snieg@communitycareinc.org	1555 S Layton Blvd		Milwaukee	WI	53215	09/14/2023	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	User Access Contact	Chief Information Officer		Kramer	Virginia		4142314292					Virginia.Kramer@communitycareinc.org	3220 W. Vliet Street		Milwaukee	WI	53208	05/09/2013	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Utilization Management Contact	Medical Director	Dr.	Almas	Rakhshinda		2622079338					rakhshinda.almas@communitycareinc.org	205 Bishops Way		Brookfield	WI	53005	08/17/2020	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5212	Utilization Review Contact	Medical Director	Dr.	Almas	Rakhshinda		2622079338					rakhshinda.almas@communitycareinc.org	205 Bishops Waay		Brookfield	WI	53005	03/23/2015	2026	COMMUNITY CARE, INC.	National PACE	Community Care	National PACE		Community Care, Inc.	62	Yes	Active					PACE - Nat		C	San Francisco
H5213	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/26/2023	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739					cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie	A	7206829848				3039961600	Lteter@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	9096779517				PACE - Nat		C	Dallas
H5213	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Chief Operating Officer	Market President	Ms.	Hopkins	Laura		7208127180				9094249948	lhopkins@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Chief Information Security Officer	Chief Information Security Officer	Mr.	Naus	Cole		7204564635				3039961600	mnaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	12/08/2023	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	CMS Casework Communication Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Complaints Tracking Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Coordination of Benefits Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Corporate Mailing						7207602984				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Customer Service Operations Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	DIR Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Government Relations Contact	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Interoperability Contact	SVP, Application Systems		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/26/2023	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	MA Appeals/Grievances Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Medical Director	Regional Medical Officer	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	04/29/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/26/2023	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Appeals	Director of Compliance		Martin	Jeremy							jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Dallas
H5213	Part D Appeals Contact (Secondary)	Director of Compliance		Martin	Jeremy						3039961600	jmartin@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Dallas
H5213	Part D Application Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Dallas
H5213	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Dallas
H5213	Part D Price File Contact (Back-up)	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Quality Assurance Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/26/2023	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Part D Reporting Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Dallas
H5213	PHR Beneficiary Contact																	07/26/2023	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Dallas
H5213	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	AKizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/28/2023	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Reconciliation Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	System Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Third Party Administrator (TPA) Liaison	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	User Access Contact	Director of Compliance		Martin	Jeremy		7208796016					jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5213	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL COMMUNITY CARE, L.L.C.	National PACE	InnovAge New Mexico PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H5215	Agent/Broker Compensation Data Contact	Director, Individual Sales		Gehrke	Kimberly		9207201569					kgehrke@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Backup User Access Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Best Available Evidence Contact	Manager, Enrollment & Business Analysis Integratio		Crocker	Brian		9207201640					bcrocker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	06/26/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Bid Audit Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Bid Audit Site Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Bid Primary Contact	Manager, Actuarial Pricing		Lanier	Eric		9207201636				9207201912	elanier@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	CAP Report Contact for Public Website	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	CEO - CMS Administrator Contact	President & CEO	Mrs.	Dicus-Johnson	Coreen		2628259689					Coreen.DicusJohnson@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	CEO - Senior Official for Contracting	President & CEO	Mrs.	Dicus-Johnson	Coreen		2628259689					Coreen.DicusJohnson@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Chief Financial Officer	Chief Financial Officer	Mr	Ollech	Brian		9207201886					bollech@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Chief Operating Officer	Vice President, Operations	Mrs.	Vander Zanden	Jessica		9207201652					jvanderz@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Chief Information Officer	Chief Information Officer	Mr	Riley	Timothy		9207201895					triley@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/19/2016	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Chief Information Security Officer	Chief Information Security Officer	Mr	Bloedorn	Dave		9207201410					dbloedor@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	CMS Casework Communication Contact	Regulatory Support Administrator		Lee	Chia		9206287268					clee@networkhealth.com	1570 Midway Place		Menasha	WI	54952	08/04/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Complaints Tracking Contact	Director, Regulatory Affairs		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	02/14/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Contact for Fraud Investigations	VP, Risk Adjustment & Payment Integrity		Weisbrod	Josh		9207201461					jweisbro@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Coordination of Benefits Contact	Director, Pharmacy Benefits		Wheaton	Andy		9207201612				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/01/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Corporate Mailing						9207201200					nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Customer Service Operations Contact	Manager, Customer Service		Schwandner	Stacy		9207201309				9207201908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	07/27/2018	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	DIR Contact	Medicare Pharmacist		Peterson Sanders	Anna		9207201672					apeterso@networkhealth.com	1570 Midway Place		Menasha	WI	54952	02/18/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	DIR Contact (Secondary)	Director, Pharmacy Benefits		Wheaton	Andy		9207201612					awheaton@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Discount Program Payment Contact	Senior Accountant		Cymerman	Tricia		9207201658					tcymerma@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/24/2020	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Electronic Health Record Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Emergency Part D Contact	Director, Pharmacy Benefits		Wheaton	Andy		9202058528					awheaton@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Emergency Part D Contact (Secondary)	Medicare Pharmacist		Peterson Sanders	Anna		9207201672					apeterso@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/20/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Employer Waiver Contact	Director, Individual Sales		Gehrke	Kimberly		9207201569					kgehrke@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/01/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Encounter Data & Risk Adjustment Operations Contact	VP, Risk Adjustment & Payment Integrity		Weisbrod	Josh		9207201461					jweisbro@networkhealth.com	1570 Midway Place		Fond du Lac	WI	54935	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Enrollment Contact	Manager, Enrollment & Business Analysis Integratio		Crocker	Brian		9207201640					bcrocker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	06/26/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	EOB Transfer Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Financial Audit Contact	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Financial Reporting Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Formulary Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Formulary Contact (Secondary)	Director, Pharmacy Benefits		Wheaton	Andy		9207201612				9207201906	awheaton@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	General Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Government Relations Contact	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	HIPAA Privacy Officer	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	HIPAA Security Officer	Chief Information Security Officer	Mr	Bloedorn	Dave		9207201410					dbloedor@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Hospice Contact	Pharmacy Benefits Program Manager		Kempfer	Amanda		9207201607					pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/13/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Interoperability Contact	Director, IT Development		Zirbel	Justin		9207201202					jzirbel@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/13/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	MA Appeals/Grievances Contact	Manager, Appeals and Grievances		Skinner	Jeanne		9207201382					jskinner@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/20/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	MA Claims Processing Contact for Public Website	Manager, Claims		Adamick	Crystal		9207201547					cadamick@networkhealth.com	1570 Midway Place		Menasha	WI	54952	02/12/2018	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Marketing Contact	VP of Marketing		Sengkhammee	David		9207201236				9207201912	dsengkha@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Medical Director	Chief Medical Officer	Dr.	Hassan	Mushir		2628259727					mhassan@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/13/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Medicare Compliance Officer	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Medicare Coordinator	Vice President, Operations		Vander Zanden	Jessica		9207201573				9207201912	jvanderz@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Medicare Part D Opioid Overutilization Contact	Staff Pharmacist		Coopman	Beth		9206287411					pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/08/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Medication Therapy Management Contact	Network Account Director, Retail Strategy & Contra		Muralidharan	Adrienne		3143131932					amuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	08/04/2021	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	OffShore Subcontractor Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Online Enrollment Center Contact (Back-up)	Process Lead, Enrollment		Dessell	Tracy		9207201223				9207201912	tdessell@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Online Enrollment Center Contact (Optional)	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Business Analysis Integratio		Crocker	Brian		9207201640					bcrocker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	06/26/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part C Application Contact	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part C Reporting Contact	Regulatory Compliance Administrator		Vanlandghen	Ashlynn		9207201373				9207201912	avanland@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Appeals	Manager, Appeals and Grievances		Skinner	Jeanne						9207201382	jskinner@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/20/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active	8003785234				PPO - BBA		C	Boston
H5215	Part D Appeals Contact (Secondary)	Vice President, Pharmacy Benefits		Regalia	Ted						9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active	8003785234				PPO - BBA		C	Boston
H5215	Part D Application Contact	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Benefits Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Claims Submission Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Exceptions Contact	Sr. Manager - Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/27/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active	5132920563				PPO - BBA		C	Boston
H5215	Part D Exceptions Contact (Secondary)	Vice President, Pharmacy Benefits		Regalia	Ted						9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active	8003785234				PPO - BBA		C	Boston
H5215	Part D Price File Contact (Back-up)	Director, Pharmacy Benefits		Wheaton	Andy		9207201612				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Price File Contact (Optional)	Pharmacy Benefits Program Manager		Kempfer	Amanda		9207201607					pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/13/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Quality Assurance Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Part D Reporting Contact	Regulatory Compliance Administrator		Vanlandghen	Ashlynn		9207201373				9207201912	avanland@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Patient Safety Contact	Medicare Pharmacist		Peterson Sanders	Anna		9207201672				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/08/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Payment Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Personal Health Record Contact	Vice President, Care Services		Dencker	Sarah		9207201694				9207201908	sdencker@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Pharmacy Director	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Pharmacy Network Management Contact			Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/19/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
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	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active	8009221557				PPO - BBA		C	Boston
H5215	PHR Beneficiary Contact																	03/28/2007	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO	Network Health Insurance Corporation	Network Health, Inc.	670	Yes	Active	8003785234				PPO - BBA		C	Boston
H5215	Physician Incentive Contact	Senior VP, Network Dev & Contract Management		Wille	Scott		2628259790					swille@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Plan Directory Contact for Public Website			Service	Customer		8003785234				9207201908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	07/27/2018	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Plan to Plan Reconciliation Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Processor Contact	Director, Government Programs, Medicare		Steffen	Jeff		6363351729					jhsteffen@express-scripts.com	One Express Way		St Louis	MO	63121	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Quality Contact	VP, Quality and Clinical Integration		Willis	John		2628259783					jwillis@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Reconciliation Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Reconciliation Contact (Secondary)	Senior Accountant		Cymerman	Tricia		9207201658					tcymerma@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/24/2020	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Recovery Audit Contact	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	SNP Application Contact	Director, Care Management		Reinsch	Laura		9207201711					lreinsch@networkhealth.com	1570 Midway Pl	PO Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	SNP State Contact	Managed Care Policy Analyst		Froelich	Brooke		6082677281					BrookeS.Froelich@dhs.wi.gov	1 Wilson Street, Room 350		Madison	WI	537010309	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Surveillance Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	System Contact	Manager, IT Infrastructure		Petersen	Chris		9207201445					cpeterse@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Third Party Administrator (TPA) Liaison	Senior Accountant		Cymerman	Tricia		9207201658					tcymerma@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/24/2020	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	User Access Contact	Information Security Risk Analyst		Pfefferle	Trisha		9207201225					tpfefferle@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Utilization Management Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5215	Utilization Review Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	03/25/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	Local PPO		Network Health, Inc.	670	Yes	Active					PPO - BBA		C	Boston
H5216	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/14/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H5216	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024989871				PPO - BBA		C	Kansas City
H5216	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H5216	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024682494				PPO - BBA		C	Kansas City
H5216	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8008658715				PPO - BBA		C	Kansas City
H5216	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5025800475				PPO - BBA		C	Kansas City
H5216	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5216	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5232	Agent/Broker Compensation Data Contact	Dir, Administrative Expense Management		Fiala	Ladimir		2166877820					ladimir.fiala@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Automated TrOOP Balance Transfer Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Backup User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Best Available Evidence Contact	Medicare Operations Analyst II		Crowley	Lauren		2166876585					BAEdocs@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Bid Audit Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Bid Audit Site Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Bid Primary Contact	Lead Medicare Products Analyst		Kotecki	Bradley		2166872762					bradley.kotecki@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	CAP Report Contact for Public Website	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	CEO - CMS Administrator Contact	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	CEO - Senior Official for Contracting	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Chief Financial Officer	VP, Chief Financial Officer	Mr.	McNutt	Jim		2166877006					james.mcnutt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Chief Operating Officer	EVP, President of Paramount Health	Ms.	Johnston	Lori		2166877000					lori.johnston@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Chief Information Officer	Chief Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Chief Information Security Officer	Chief Data & Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	CMS Casework Communication Contact	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Complaints Tracking Contact	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Contact for Fraud Investigations	Manager, Financial Investigations		Jorz	Nicholas		2166877433					nicholas.jorz@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Coordination of Benefits Contact	Manager, COB and Workers Comp		Njaim	Stephanie		4194737733					Stephanie.Njaim@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Corporate Mailing						2166877000					macompliance@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Customer Service Operations Contact	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	DIR Contact	Mgr, Financial Reporting		Spruch	Kevin		2166872759					kevin.spruch@medmutual.com	100 American Road		Cleveland	OH	44144	07/01/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	DIR Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Discount Program Payment Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					michelle.stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Electronic Health Record Contact	Manager, Compliance		Dean	Herbert		2166877000					herbert.dean@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Emergency Part D Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Emergency Part D Contact (Secondary)	Mgr, Medicare Pharmacy Operations		Lamento	Angela		2166877917					angela.lamento@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Employer Waiver Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Encounter Data & Risk Adjustment Operations Contact	Dir, Risk Adjutment Program		Curry	Deborah		4198872215					deborah.curry@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Enrollment Contact	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	EOB Transfer Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344				2166877675	katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Financial Audit Contact	Lead Financial Analyst	Ms.	Lohrke	Maureen		2162933190					maureen.lohrke@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Financial Reporting Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					cory.hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Formulary Contact	Clinical Pharmacist		Ivec	Carl		2166876017					Carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Formulary Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katherine		2166877344					Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	General Contact	Medicare Compliance Officer		Beadle	Nicole		3976812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Government Relations Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	HIPAA Privacy Officer	Chief Compliance and Privacy Officer		Fichter	Lynn		2166872617					Lynn.Fichter@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	HIPAA Security Officer	EVP, Chief Data and Information Officer		Donovan	Chris		4408786450					Chris.Donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Hospice Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Interoperability Contact	Manager, EDI Compliance		Huebler	Kathleen		4408785420					kathleen.huebler@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	MA Appeals/Grievances Contact	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	MA Claims Processing Contact for Public Website	Director, Claims Operations		Rittner	Kim		2166874377					kim.rittner@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Marketing Contact	Director, Acquisition Marketing Govermnt Prgms		Schultz	Melissa		2166877000					Melissa.Schultz@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Medical Director	VP, Sr. Medical Officer	Dr.	Bialecki-Haase	Dee		2166877000					dee.bialeckihaase@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Beadle	Nicole		2166877830					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Medicare Coordinator	Lead Compliance Analyst		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44115	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Medicare Part D Opioid Overutilization Contact	Pharmacist		Hall	Sarah		3306479145					sarah.hall@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Medication Therapy Management Contact	Clinical Pharmacist		Ivec	Carl		2166876017					carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	OffShore Subcontractor Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Online Enrollment Center Contact (Back-up)	Manager, Member Services & System Administration		Bartholomai	Diane		2166877357					Diane.Bartholomai@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Online Enrollment Center Contact (Optional)	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Online Enrollment Center Contact (Primary)	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part C Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part C Reporting Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Appeals	Dir, Pharmacy - Medicare and Information		Goff	Katie							katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				PPO - BBA		C	Chicago
H5232	Part D Appeals Contact (Secondary)	Dir, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				PPO - BBA		C	Chicago
H5232	Part D Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Benefits Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Claims Submission Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877830					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Exceptions Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie							katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				PPO - BBA		C	Chicago
H5232	Part D Exceptions Contact (Secondary)	Mgr, Medicare Pharmacy Operations		Lamento	Angela							angela.lamento@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877917				PPO - BBA		C	Chicago
H5232	Part D Price File Contact (Back-up)	Senior Consultant, Finance Med D		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd	MC121	Scottsdale	AZ	85260	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Price File Contact (Optional)	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877830				2166872623	katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Price File Contact (Primary)	Senior Manager, Regulatory Reporting		Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	9501 E. Shea Blvd	MC121	Scottsdale	AZ	85260	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Quality Assurance Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Part D Reporting Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Patient Safety Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Payment Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					Cory.Hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Personal Health Record Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Pharmacy Director	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Pharmacy Network Management Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					lisa.trost@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Pharmacy Network Management Contact (Secondary)	Mgr, Medicare Pharmacy Operations		Lamento	Angela		2166877917					angela.lamento@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Rodriguez	Alex							alex.rodriguez@cvs.health	2401 Cherahala Blvd		Knoxville	TN	37932	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	8666934620				PPO - BBA		C	Chicago
H5232	Pharmacy Technical Help Desk Contact (Secondary)	Dir, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				PPO - BBA		C	Chicago
H5232	Physician Incentive Contact	Mgr, Clinical QUality Improvement		Brooks	Melissa		4408784163					melissa.brooks@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Plan Directory Contact for Public Website	Provider and Claims Operations AVP		Curtland	Tanya		4194731631					tanya.curtland@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Plan to Plan Reconciliation Contact	PAR - Financial Analyst III		Short	Nicole		4193498621					Nicole.Short@medmutual.com	100 American Road		Cleveland	OH	44144	11/03/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Processor Contact	Dir, Pharmacy - Medicare and Information		Goff	Katie		2166877344					katie.goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Quality Contact	Mgr, Clinical QUality Improvement		Hoskins	Julie		4198872940					julie.hoskins@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Reconciliation Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Reconciliation Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Recovery Audit Contact	VP, Health Plan Payment Integrity	Mr.	Palace	Ted		2166872807					Ted.Palace@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Surveillance Contact	Director, Individual Sales and Compliance		Coyne	Jaime		2166872676					MASalesCompliance@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	System Contact	VP, Chief Technology Officer		Stein	Matt		4408786460					matt.stein@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Third Party Administrator (TPA) Liaison	PAR - Financial Analyst III		Short	Nicole		4193498621					Nicole.Short@medmutual.com	100 American Road		Cleveland	OH	44144	11/03/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Utilization Management Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5232	Utilization Review Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	PARAMOUNT INSURANCE COMPANY	Local CCP	Paramount Elite Medicare Plans	Local PPO		MEDICAL MUTUAL OF OHIO	289	Yes	Active					PPO - BBA		C	Chicago
H5244	Agent/Broker Compensation Data Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	CEO - CMS Administrator Contact	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	CEO - Senior Official for Contracting	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Chief Financial Officer	Chief Financial Officer	Mr.	Plumb	Michael		5629971589				5623083707	mplumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/10/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Chief Information Officer	Chief Information Officer	Mr	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	CMS Casework Communication Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Complaints Tracking Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459				5629890101	tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	DIR Contact (Secondary)	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/27/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/31/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Employer Waiver Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Encounter Data & Risk Adjustment Operations Contact	Chief Data Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	04/17/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Enrollment Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Financial Audit Contact	Sr. Dir Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/21/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	General Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Government Relations Contact	VP of Government Relations		Kazan	Matt		8005593500				5629899439	m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	MA Appeals/Grievances Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Medical Director	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Medicare Compliance Officer	Sr. Dir Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/19/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195					c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	OffShore Subcontractor Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part C Application Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part C Reporting Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Appeals	Sr. Director of Grievances and Appeals	Ms.	Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5629895100	1290			HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization	Ms.	Herbert	Joshua						5629890958	Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	1290			HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Application Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization	Mr.	Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	733326			HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4348			5629973196	a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Part D Reporting Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	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	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H5244	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Processor Contact	Senior Director Government Programs, Medicare	Ms.	Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St. Louis	MO	63121	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Recovery Audit Contact	Sr. Dir Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	SNP Application Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	SNP State Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Surveillance Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/06/2023	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	User Access Contact	Sr. Dir Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5244	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN (NM)	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5253	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H5253	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5253	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5253	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H5253	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5253	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5256	Agent/Broker Compensation Data Contact	Medicare Compliance Analyst		Digmann	Jodi		5635568070	4836			5635565134	jdigmann@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Backup User Access Contact	Manager of Regulatory Affairs and QI		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Bid Primary Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	CAP Report Contact for Public Website	Manager of Regulatory Affairs and QI		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	CEO - CMS Administrator Contact	CEO	Mr.	Keeling	Zachary		5635568070					zkeeling@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Keeling	Zachary		5635568070				5635565134	zkeeling@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Chief Financial Officer	Director of Finance	Ms.	Robson	Lynee		5635844773					lrobson@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Chief Operating Officer	Chief Operating Officer	Ms	Oishi	Nicole		5635568070				5635565134	noishi@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Chief Information Officer	Director of Information Technology	Mr.	Wulfekuhle	Jeremy		5635844000					jwulfekuhle@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Chief Information Security Officer	Director of Information Technology	Mr.	Wulfekuhle	Jeremy		5635844000					jwulfekuhle@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	CMS Casework Communication Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Complaints Tracking Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Contact for Fraud Investigations	Manager of Regulatory Affairs and QI	Ms.	Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Corporate Mailing						5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Cost Report Contact	Director of Finance		Cook	Elizabeth		5635568070	4751			5635565134	lcook@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Customer Service Operations Contact	Member Services Supervisor		Boge	Laura		5695568070	4857			5695565134	lboge@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Encounter Data & Risk Adjustment Operations Contact	Claims Manager		Simmons	Sherie		5635568070					ssimmons@maheatlcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Enrollment Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	EOB Transfer Contact	Claims Manager		Simmons	Sherie		5635568070	4825			5635565134	ssimmons@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Financial Reporting Contact	Director of Finance		Robson	Lynee		5635843000					lrobson@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	General Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635568070	4836			5635565134	jdigmann@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Government Relations Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Interoperability Contact	Medicare Compliance Analyst		Digmann	Jodi		5635568070					jdigmann@mahealthcare.com	1605 Associates Dr., Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	MA Appeals/Grievances Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	MA Claims Processing Contact for Public Website	Claims Manager		Simmons	Sherie		5635568070	4825			5635565134	ssimmons@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Marketing Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Medical Director	Interim Chief Medical Officer	Dr.	Sullivan	Brian		5635843000				5635565134	bsullivan@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Medicare Compliance Officer	Manager of Regulatory Affairs and QI	Mr.	Walters	Richard		5635568070	4864			5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Medicare Coordinator	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Part C Application Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Part C Reporting Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Payment Contact	Director of Finance		Robson	Lynee		5635843000					lrobson@mahealthcare.com	1500 Associates Drive		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Plan Directory Contact for Public Website	Marketing Specialist		Backhaus	Matt		5635568070	4844			5635565134	mbackhaus@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Quality Contact	MAHP Quality Improvement		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Surveillance Contact	Manager of Regulatory Affairs and QI		Walters	Rick		5635568070				5635565134	rwalters@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	System Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	User Access Contact	Medicare Compliance Analyst		Digmann	Jodi	A	5635844836				5635565134	jdigmann@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Utilization Management Contact	Health Care Services Manager		Wedewer	Krystal		5635568070				5635565134	kwedewer@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5256	Utilization Review Contact	Health Care Services Manager		Wedewer	Krystal		5635568070				5635565134	kwedewer@mahealthcare.com	1605 Associates Drive, Suite 101		Dubuque	IA	52002	10/08/2025	2026	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	Atlanta
H5262	Agent/Broker Compensation Data Contact	Manager, Individual Market Sales		Schiro	Rick		6084714891					rick.schiro@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Automated TrOOP Balance Transfer Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Backup User Access Contact	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Best Available Evidence Contact	Director, Enrollment, Billing & Collections		Jones	Jenny		6084714695					jenny.jones@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Bid Audit Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Bid Audit Site Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Bid Primary Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	CAP Report Contact for Public Website	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	CEO - CMS Administrator Contact	President and CEO	Ms	Senty, J.D.	Christine		6084714802					christine.senty@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	CEO - Senior Official for Contracting	President and CEO	Ms	Senty, J.D.	Christine		6084714802					christine.senty@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Chief Financial Officer	Senior Vice President, CFO, Treasurer	Mr.	Butcher	Jeff		6084714771					jeffrey.butcher@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Chief Operating Officer	Vice President, Operations	Ms.	Schiffman	Debra		6086431408					debra.schiffman@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Chief Information Officer	Sr. VP, Chief Information & Digital Officer	Mr	Balu	Siva		6084714830					siva.balu@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Chief Information Security Officer	Senior Director, Information Security	Mr	Olson	Jeff		6084714662					jeff.olson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	CMS Casework Communication Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Complaints Tracking Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Coordination of Benefits Contact	Director, Enrollment, Billing & Collections		Jones	Jenny		6084714695					jenny.jones@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Corporate Mailing						6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	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		6086441433					lori.greubel@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	DIR Contact	Director, Actuarial Services		Heuer	Troy		6084714817					troy.heuer@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	DIR Contact (Secondary)	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Discount Program Payment Contact	Lead Financial Analyst		Cheung	Sheila		6088818082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Emergency Part D Contact	Pharmacy Manager		Suhr	Anessa		6083178565				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Emergency Part D Contact (Secondary)	Director of Clinical Pharmacy		Fejfar	Jeremy		6083851887				6088818308	jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Encounter Data & Risk Adjustment Operations Contact	Lead Healthcare Informatics Analyst		Gault	Angie		6086048299					angie.gault@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Enrollment Contact	Director, Enrollment, Billing & Collections		Jones	Jenny		6084714695					jenny.jones@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	EOB Transfer Contact	Vice President, Operations		Schiffman	Debra		6086431408				6088818307	debra.schiffman@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Financial Audit Contact	Manager, Actuarial Services	Mrs.	Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Financial Reporting Contact	Senior Vice President, CFO, Treasurer	Mr.	Butcher	Jeff		6084714771					jeffrey.butcher@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Formulary Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Formulary Contact (Secondary)	Pharmacy Director of Government & Quality Programs		Fejfar	Jeremy		6088818603					jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	General Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Government Relations Contact	Chief Compliance Officer	Mrs.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	HIPAA Privacy Officer	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	HIPAA Security Officer	Senior Director, Information Security		Olson	Jeff		6084714662					jeff.olson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	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		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Interoperability Contact	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	MA Appeals/Grievances Contact	Manager, Appeals and Grievances		Salveson	Kate		6086431527					kathryn.salveson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	MA Claims Processing Contact for Public Website			Service	Customer		8003945566					customerservice@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Marketing Contact	Director, Product Marketing		Alexander	Cari		6084714864					cari.alexander@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Medical Director	SVP, Chief Clinical Officer	Ms	Berger	Jami		6084714806					jami.berger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Skifton	Kelly	N	6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Medicare Coordinator	Medicare Product Director		Scholze	Amanda		6088818094					amanda.scholze@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Medicare Part D Opioid Overutilization Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Medication Therapy Management Contact	Pharmacy Director of Clinical Pharmacy	Mr	Fejfar	Jeremy		6088818603				6088818308	jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Online Enrollment Center Contact (Back-up)	Member Enrollment Analyst		Petersen	Gerri		6088818197					geraldine.petersen@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Online Enrollment Center Contact (Primary)	Member Enrollment Analyst		Petersen	Gerri		6088818197					geraldine.petersen@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part C Application Contact	Medicare Product Manager		Griffin	Jessica		6088818199					jessica.griffin@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part C Reporting Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefis.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Appeals	Manager, Appeal & Grievances		Salveson	Kate							kathryn.salveson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	6086431527				HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Appeals Contact (Secondary)	Appeals Specialist		Specialists	Appeals						6086443500	appeals.specialists@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	8003945566	308284			HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Application Contact	Medicare Product Manager		Griffin	Jessica		6088818199					jessica.griffin@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Benefits Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Claims Submission Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	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						6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	8003945566				HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Price File Contact (Back-up)	Director of Pharmacy Government Programs		Fejfar	Jeremy		6088818603					jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Price File Contact (Optional)	Sr. Business Analyst, OptumRx		Kim	Kevin		6265334804					kevin.kim@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Price File Contact (Primary)	Sr. Business Analyst, OptumRx		Kim	Kevin		6265334804					kevin.kim@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Quality Assurance Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Part D Reporting Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Patient Safety Contact	Director of Pharmacy Government Programs	Mr	Fejfar	Jeremy		6088818603					jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Payment Contact	Senior Vice President, CFO, Treasurer	Mr.	Butcher	Jeff		6084714771					jeffrey.butcher@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Pharmacy Director	Director, Pharmacy Medicare Operations		Lojkovic	Kathy		8475020855					kathy.lojkovic@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Pharmacy Network Management Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Pharmacy Technical Help Desk Contact	OptumRx Senior Manager, PhD		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	8005064614				HMO - Health Maintenance Organization		C	Chicago
H5262	Plan Directory Contact for Public Website			Service	Customer		8003945566					customerservice@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Plan to Plan Reconciliation Contact	Lead Financial Analyst		Cheung	Sheila		6088818082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Processor Contact	Pharmacy Manager		Suhr	Anessa		6088818616					anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Quality Contact	Manager, Consulting Analytics		Traastad	Maggie		6088818609					maggie.traastad@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Reconciliation Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Recovery Audit Contact	Chief Compliance Officer	Ms.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	SNP Application Contact	Medicare Product Manager		Griffin	Jessica		6088818199					jessica.griffin@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	SNP State Contact	Medicaid Products & Government Affairs Director		Moody	Jonathan		6084714756					jonathan.moody@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Surveillance Contact	Chief Compliance Officer	Ms.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	System Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Third Party Administrator (TPA) Liaison	Lead Financial Analyst		Cheung	Sheila		6088818082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	User Access Contact	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Utilization Management Contact	Senior Vice President, Chief Clinical Officer	Ms	Berger	Jami		6084714806					jami.berger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5262	Utilization Review Contact	Senior Vice President, Chief Clinical Officer	Ms	Berger	Jami		6084714806					jami.berger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5264	Agent/Broker Compensation Data Contact	Director, Sales Effectiveness		Franciscus	Stephanie		9529922196					stephanie.franciscus@medica.com	401 Carlson Parkway, CP 265		Minnetonka	MN	55305	10/23/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Backup User Access Contact	Compliance Consultant		Johnston	Rikki		9529923841					rikki.johnston@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Bid Primary Contact	Director - Products		Schaefer	Jennifer		6124147383					jennifer.schaefer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/22/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	CAP Report Contact for Public Website	Manager - Compliance		Herbst	Travis		6088272856					Travis Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	CEO - CMS Administrator Contact	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Chief Financial Officer	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Chief Operating Officer	Chief Operations Officer	Mr	Hjerpe	Adam		6123861065					COO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Chief Information Officer	VP, Chief Technology Officer	Mr	Peterson	Scott		9529922625					Scott.Peterson@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	09/05/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Chief Information Security Officer	Sr. Director of Information Risk Management - CISO	Mr.	Abbott	Brad		9529920081					Bradley.Abbott@medica.com	301 Carlson		Minnetonka	MN	55305	02/01/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	CMS Casework Communication Contact	Manager, Consumer Advisor		Blum	Adam		6088274420					Adam.Blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Complaints Tracking Contact	Consumer Affairs Supervisor		Riske	Christina		8002791302					Christina.Riske@deancare.com	1277 Deming Way		Madison	WI	53717	08/23/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Contact for Fraud Investigations	Director, Special Investigations Unit		Kalin	Dan		9529922587					Daniel.Kalin@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/05/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Corporate Mailing						9529922900					Nichole.MeltonMitchell@medica.com	401 Carlson Parkway	P.O. Box 9310 CP320	Minnetonka	MN	55305	04/09/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Cost Report Contact	Sr. Financial Analyst		Anderson	Jennifer		9529922900					Jennifer.Anderson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/27/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Customer Service Operations Contact	Manager Customer Service		Riske	Christina		8002791302					Christina.Riske@deancare.com	1277 Deming Way		Madison	WI	53717	08/23/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Employer Waiver Contact	Manager - Compliance		Herbst	Travis		6088272856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Encounter Data & Risk Adjustment Operations Contact	Director- Risk Adjustment Operations		Werwinski	Michelle		6088305958					Michelle.Werwinski@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Enrollment Contact	Enrollment & Billing Manager		Kaderabek	Kay	L	6088281976					kay.kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	EOB Transfer Contact	Clinical Pharmacist		Seabright	Diane		9203514627				6087292688	Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Financial Reporting Contact	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	General Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Government Relations Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Interoperability Contact	Director of Privacy		Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/24/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	MA Appeals/Grievances Contact	Manager, Consumer Advisor		Blum	Adam		6088274420					Adam.Blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	MA Claims Processing Contact for Public Website	Manager Claims		Sago	Murielle		8002791302					Murielle.Sago@deancare.com	1277 Deming Way		Madison	WI	53717	08/23/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Marketing Contact	Legal & Regulatory Analyst		Warren	Jennifer		6088305919					jennifer.warren1@deancare.com	1277 Deming Way		Madison	WI	53717	06/22/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Medical Director	Medical Director	MD	Shenkir	Gloria		6088246980					gloria.shenkir@deancare.com	1277 Deming Way		Madison	WI	53717	06/12/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Medicare Compliance Officer	VP Compliance	Mrs	Koranteng	Milly		9529922090					complianceofficer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Medicare Coordinator	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	OffShore Subcontractor Contact	Director of Privacy		Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/24/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Part C Application Contact	Director - Products		Olmscheid	Rebecca	D	7638077574					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/22/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Part C Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Payment Contact	Senior Financial Analyst		Johnson	Derek		8002791302					derek.johnson@deancare.com	1277 Deming Way		Madison	WI	53717	06/12/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8884223326					DHP.CustomerRelationsResolutionTeam@medica.com	1277 Deming Way		Madison	WI	53717	02/01/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Quality Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Surveillance Contact	Manager - Compliance		Herbst	Travis		6088272856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	System Contact	Manager - Compliance		Herbst	Travis		6088272856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	User Access Contact			Harrington	Dana		6122129075					dana.harrington@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Utilization Management Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5264	Utilization Review Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	1876 Cost	Dean Health Plan, Inc.	1876 Cost		Medica Holding Company	439	No	Active					Cost1		1	Dallas
H5272	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504244				HMO - Health Maintenance Organization		C	Dallas
H5272	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504244				HMO - Health Maintenance Organization		C	Dallas
H5272	PHR Beneficiary Contact																	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Dallas
H5272	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/17/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5272	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	ABSOLUTE TOTAL CARE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5273	Agent/Broker Compensation Data Contact	Manager, Sales Operations		Chowdhury	Nahar		6179729400	60926				Nahar.Chowdury@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Automated TrOOP Balance Transfer Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Backup User Access Contact	Lead Govt Prgms Compliance Manager		Foster	Amber		7816128333					Amber.Foster@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	3152780				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Bid Audit Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Bid Audit Site Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Bid Primary Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	CAP Report Contact for Public Website	Director, Government Programs Compliance Officer		Geroski	Tami		7816121000	86892				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	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	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Chief Operating Officer	Chief Operating Officer	Ms.	Catlender	Kathryn		7816126840	84588				Katie.Catlender@point32health.org	1 Wellness Way		Canton	MA	02021	07/14/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Chief Information Officer	SVP and Chief Information Officer	Ms.	Ferhatbegovic	Selma		7816121000	84633				Selma.Ferhatbegovic@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Complaints Tracking Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				Sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Contact for Fraud Investigations	VP,  Privacy, Fraud Prevention & Recovery		Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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			COB Inquiries	Medicare		7816121000					Medicare_COB_Inquiries@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Corporate Mailing						7816121000					R.Scott.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Villatoro	Yesly		7816121000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	DIR Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	DIR Contact (Secondary)	Pharmacy Analyst Senior		Santino	Cristina		7816121000	82560				cristina.santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Discount Program Payment Contact	Sr. Manager, Accounting		Parikh	Roshni		7816121000	84512				roshni.parikh@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Electronic Health Record Contact	Director, Core Administration System Application		Pavao	Joseph		7816121000	83289				Joseph.Pavao@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Emergency Part D Contact	Director, Pharmacy Operations		Bonica	Joseph		7816123342					joseph.bonica@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Emergency Part D Contact (Secondary)	Senior Manager, Pharmacy Operations		MacAuley	Jacqueline		6176123059					jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/04/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Employer Waiver Contact	Manager, Client Services		Bartkiewicz	Mary		7816121000	83937				Mary.Bartkiewicz@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment Data & Reporting		Quinlan	Judith		7816121000	83377				judith.quinlan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Enrollment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	EOB Transfer Contact	Manager, Business Implementation		Nesmith	Tanisha		7816124861				6176730286	tanisha.nesmith@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Financial Audit Contact	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Financial Reporting Contact	Assistant Corporate Controller		Jaiswal	Ruchi		6179729400	84518				Ruchi.Jaiswal@point32health.org	1 Wellness Way		Canton	MA	02021	08/01/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Formulary Contact	Clinical Pharmacist Senior		Kowalski	Alec		7816121000	82045				alec.kowalski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	General Contact	Medicare Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Lewis	Kristin		7816121000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	HIPAA Privacy Officer	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	10/06/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	HIPAA Security Officer	VP Chief  Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		MacAuley	Jacqueline		7816121000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Interoperability Contact	VP, Information Security Officer		Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Gonzalez	Michelle		6179729400	83114				michelle.gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	MA Claims Processing Contact for Public Website	Director, Claims		Patel	Monal		7816121000	88187				Monal.Patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Marketing Contact	Director, Marketing		Walsh	Tim		7816121000	87541				Tim.Walsh@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Medical Director	Medical Director	Dr.	Courtemanche	Abbie		7816121000	67024				Abbie.Courtemanche@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Medicare Coordinator	Vice President, Medicare		Walker	Eddie		7816121000	84471				Edward.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Dohan	David		7816121000	82615				David.Dohan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Medication Therapy Management Contact	Sr Pharmacy Program Manager		Burns	Ashlyn		7816122239					ashlyn.burns@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Ben-Ezra	Daniel		7816121000	54054				Daniel.Ben-Ezra@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Online Enrollment Center Contact (Optional)	Supervisor, Enrollment		Maloney	Kimberly		7816121000	83576				Kimberly.Maloney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Online Enrollment Center Contact (Primary)	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Part C Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Part C Reporting Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Appeals	Director, Appeals & Grievances		Gonzalez	Michelle							Michelle.Gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	83114			HMO - Health Maintenance Organization		C	Boston
H5273	Part D Appeals Contact (Secondary)	Sr. Program Manager, Appeals & Grievances		Mello	Sheri							sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	84862			HMO - Health Maintenance Organization		C	Boston
H5273	Part D Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Benefits Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Claims Submission Contact	Senior Manager, Pharmacy Operations		Alves	Heather		7816121000	82988				heather.alves@point32health.org	1 Wellness Way		Canton	MA	02021	10/09/2025	2026	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		Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	82370			HMO - Health Maintenance Organization		C	Boston
H5273	Part D Exceptions Contact (Secondary)	Supervisor, Pharmacy Utilization Management		Bannan	Philip							Philip.Bannan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	60178			HMO - Health Maintenance Organization		C	Boston
H5273	Part D Price File Contact (Back-up)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					Tim.Sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Price File Contact (Optional)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					tim.sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Price File Contact (Primary)	Sr Business Analyst		Moore-Elliott	Shalandria		7637974305					shalandria.moore-elliott@optum.com	1600 McConnor Pwy.		Schaumburg	IL	60173	04/03/2025	2026	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 Quality Assurance Contact	Vice President, Pharmacy		Fenton	Karen		7186121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Reporting Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Patient Safety Contact	Sr Pharmacy Implementation Specialist		von Fritzinger	Lisa		7816123778					lisa.vonfritzinger@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Payment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Pharmacy Director	Vice President, Pharmacy		Fenton	Karen		7816121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Pharmacy Network Management Contact	Manager, Retail Network Operations		Hagan	Kyle		3039895828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Ashby	JoLynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	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	Sr. Manager		Villaneuva	Juan							Juan.Villanueva@optum.com	3515 S Harbor Blvd.		Costa Mesa	CA	92626	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H5273	Pharmacy Technical Help Desk Contact (Secondary)	Associate Director, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H5273	Plan Directory Contact for Public Website	Marketing Materials Production Manager		Kayser	Kenneth		7816121000	83518				kenneth.kayser@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Plan to Plan Reconciliation Contact	Manager, Finance Operations Compliance		Schumaker	Tyler		6179729400	87394				Tyler.Schumaker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Processor Contact	Director, Claims		Patel	Monal		7816121000	88187				monal.patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Quality Contact	Director, HEDIS Quality Informatics		McCoy	Kelly		7816121000	83515				kelly.mccoy@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Reconciliation Contact	Senior Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Reconciliation Contact (Secondary)	Pharmacy Analyst Sr.		Santino	Cristina		7816121000	82560				Cristino.Santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Recovery Audit Contact	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Surveillance Contact	Director, Sales Operations		Tollefsen	John		7816122266					John.Tollefsen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	System Contact	Senior Manager, Business Account Management		Allen	Jeffrey		7816121000	83167			6179729008	Jeffrey.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Third Party Administrator (TPA) Liaison	Manager, Accounting		Gatzen	Kelly	A	8609896689					kelly.gatzen@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	User Access Contact	Director Medicare Compliance Officer		Geroski	Tami	A	5708142999	0				Tami.Geroski@Point32health.org	1 Wellness Way		Canton	MA	02021	10/21/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Utilization Management Contact	Director, Utilization Management		Walker	Karen		7816121000					Karen.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5273	Utilization Review Contact	Lead Medical Director, Clinical Reviews	Dr.	Slota	Janet		6179729400	87527				Janet.Slota@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	CAREPARTNERS OF CONNECTICUT, INC.	Local CCP	CarePartners of Connecticut	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5292	Automated TrOOP Balance Transfer Contact	VP of IT		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Backup User Access Contact	SVP, Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Best Available Evidence Contact	VP of Operational Support		Rosen	Richard		3478423684					richard.rosen@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Bid Primary Contact	SVP, Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	CAP Report Contact for Public Website	VP of Quality		Konrad	Marcia		9142688418					marcia.konrad@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	CEO - CMS Administrator Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	CEO - Senior Official for Contracting	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Chief Financial Officer	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Chief Operating Officer	Senior Vice President	Ms.	Lau	Julieanne		3478423544					Julieanne.Lau@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Chief Information Officer	VP of IT	Mr.	Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Chief Information Security Officer	VP of IT	Mr.	Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	CMS Casework Communication Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Complaints Tracking Contact	Director of Contracts and Compliance		Wong	Diana		3478423666					diana.wong@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Contact for Fraud Investigations	SVP, Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Coordination of Benefits Contact	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Corporate Mailing						8007710088					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Customer Service Operations Contact	VP of Member Services		Hron	Patty		3478423541					patty.hron@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	DIR Contact	AVP of Compliance		Khassanov	Yana		3478423509					yana.khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	DIR Contact (Secondary)	Director of Medicare		Williams	Sadirah		9292436197					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Discount Program Payment Contact	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Emergency Part D Contact	Director of Medicare		Williams	Sadirah		9292436197					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Encounter Data & Risk Adjustment Operations Contact	VP of IT		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Enrollment Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	EOB Transfer Contact	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505				8666907596	andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Financial Audit Contact	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Financial Reporting Contact	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Formulary Contact	Director of Medicare		Williams	Sadirah		3477787881					sadirah.williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	General Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Government Relations Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	HIPAA Privacy Officer	SVP, Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	HIPAA Security Officer	VP of IT		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Interoperability Contact	VP of IT		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	MA Appeals/Grievances Contact	VP of Quality		Konrad	Marcia		9142688418					marcia.konrad@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	MA Claims Processing Contact for Public Website	VP of Claims		Flanagan	Fiona		3478423526					fiona.flanagan@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Marketing Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Medical Director	Medical Director		Gold	Jonathan		9147030550					jon.gold@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Medicare Compliance Officer	SVP, Regulatory Affairs	Ms.	Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Medicare Coordinator	AVP of Compliance		Khassanov	Yana		3478423509					yana.khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Medicare Part D Opioid Overutilization Contact	Director of Medicare		Williams	Sadirah		2018320060					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	09/30/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Medication Therapy Management Contact	AVP of Compliance		Khassanov	Yana		3478423509					Yana.Khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part C Application Contact	Executive Vice President	Ms.	Aldrich	Susan		8009509000					Susan.Aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part D Appeals	Director of Medicare		Williams	Sadriah							Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending	2018320060				PACE - Nat		C	New York
H5292	Part D Appeals Contact (Secondary)	VP of Quality		Konrad	Marcia							marcia.konrad@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending	8009509000				PACE - Nat		C	New York
H5292	Part D Application Contact	Executive Vice President	Ms.	Aldrich	Susan		8009509000					Susan.Aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part D Benefits Contact	AVP of Compliance		Khassanov	Yana		3478423509					Yana.Khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part D Claims Submission Contact	Director of Medicare		Williams	Sadirah		2018320060					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	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	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending	2018320060				PACE - Nat		C	New York
H5292	Part D Price File Contact (Back-up)	Director of Medicare		Williams	Sadirah		2018320060					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part D Price File Contact (Optional)	AVP of Compliance		Khassanov	Yana		3478423509					yana.khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part D Price File Contact (Primary)	Director of Medicare		Williams	Sadirah		2018320060					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part D Quality Assurance Contact	Director of Medicare		Williams	Sadirah		2018320060					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Part D Reporting Contact	SVP, Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Patient Safety Contact	Senior Vice President	Ms.	Lau	Julieanne		3478423554					julieanne.lau@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Payment Contact	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Pharmacy Director	AVP of Compliance		Khassanov	Yana		3478423509					Yana.Khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Pharmacy Network Management Contact	Director of Medicare		Williams	Sadirah		2018320060					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	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	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending	2018320060				PACE - Nat		C	New York
H5292	Plan Directory Contact for Public Website	AVP of Network Development		Altamirano	Bolivar		3478423527					bolivar.altamirano@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Plan to Plan Reconciliation Contact	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Processor Contact	VP of Claims		Flanagan	Fiona		3478423526					fiona.flanagan@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Quality Contact	VP of Quality		Konrad	Marcia		9142688418					marcia.konrad@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Reconciliation Contact	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Reconciliation Contact (Secondary)	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Recovery Audit Contact	SVP of Finance	Mr.	Cavaliere	Andrew		3478423505					andy.cavaliere@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Surveillance Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	System Contact	VP of IT		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Third Party Administrator (TPA) Liaison	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	User Access Contact	AVP of Compliance		Khassanov	Yana		3478423509				8887778279	Yana.Khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Utilization Management Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5292	Utilization Review Contact	Medical Director		Gold	Jonathan		9147030550					jon.gold@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	08/31/2022	2026	ELDERSERVE HEALTH, INC.	National PACE	RiverSpring Health Plans	National PACE		RiverSpring Living Holding Corp.	524	Yes	Pending					PACE - Nat		C	New York
H5294	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Medical Director	Deputy Chief Health Officer	Mr.	Harmon	David		5124163782	22182				dharmon@centene.com	5900 E. Ben White Blvd.		Austin	TX	78741	08/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H5294	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5294	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5294	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5294	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/17/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504258				HMO - Health Maintenance Organization		C	Denver
H5294	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504258				HMO - Health Maintenance Organization		C	Denver
H5294	PHR Beneficiary Contact																	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H5294	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5294	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	SUPERIOR HEALTHPLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5296	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5296	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5296	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	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	Chicago
H5296	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5296	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	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	Chicago
H5296	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H5296	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			HMO - Health Maintenance Organization		C	Chicago
H5296	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5296	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	06/19/2025	2026	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	Chicago
H5296	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H5296	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				HMO - Health Maintenance Organization		C	Chicago
H5296	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5296	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5296	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	06/19/2025	2026	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	Chicago
H5296	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				HMO - Health Maintenance Organization		C	Chicago
H5296	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				HMO - Health Maintenance Organization		C	Chicago
H5296	PHR Beneficiary Contact																	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				HMO - Health Maintenance Organization		C	Chicago
H5296	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5296	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5296	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5296	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5299	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H5299	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H5299	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H5299	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H5299	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5299	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H5299	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H5299	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H5302	PHR Beneficiary Contact																	08/11/2015	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H5302	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5302	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (GA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5314	Agent/Broker Compensation Data Contact	Manager, Sales Operations		Chowdhury	Nahar		6179729400	60926				Nahar.Chowdury@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Automated TrOOP Balance Transfer Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Backup User Access Contact	Lead Govt Prgms Compliance Manager		Foster	Amber		7816128333					Amber.Foster@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Best Available Evidence Contact	Manager, Member Services		Allen	Anthony		7816121000	82203				Anthony.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	02/10/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Bid Audit Contact	Sr. Manager, Actuarial Services-Credentialed		Azeredo	Andrew		7816122128					Andrew.Azeredo@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Bid Audit Site Contact	Sr. Manager, Actuarial Services-Credentialed		Azeredo	Andrew		7816122128					Andrew.Azeredo@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Bid Primary Contact	Sr. Manager, Actuarial Services-Credentialed		Azeredo	Andrew		7816122128					Andrew.Azeredo@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	CAP Report Contact for Public Website	Director, Government Programs Compliance Officer		Geroski	Tami		7816121000	86892				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Chief Financial Officer	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Chief Operating Officer	Chief Operating Officer	Ms.	Catlender	Kathryn		7816126840	84588				Katie.Catlender@point32health.org	1 Wellness Way		Canton	MA	02021	07/14/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Chief Information Officer	SVP and Chief Information Officer	Ms.	Ferhatbegovic	Selma		7816121000	84633				Selma.Ferhatbegovic@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	CMS Casework Communication Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Complaints Tracking Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				Sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Contact for Fraud Investigations	VP,  Privacy, Fraud Prevention & Recovery		Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Coordination of Benefits Contact			COB Inquiries	Medicare		7816121000					Medicare_COB_Inquiries@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Corporate Mailing						7816121000					R.Scott.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Customer Service Operations Contact	Manager, Member Services		Allen	Anthony		7816121000	82203				Anthony.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	02/10/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	DIR Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	DIR Contact (Secondary)	Pharmacy Analyst Senior		Santino	Cristina		7816121000	82560				cristina.santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Discount Program Payment Contact	Sr Manager, Accounting		Parikh	Roshni		7816121000	84512				roshni.parikh@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Electronic Health Record Contact	Director, Core Administration System Application		Pavao	Joseph		7816121000	83289				Joseph.Pavao@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Emergency Part D Contact	Director, Pharmacy Operations		Bonica	Joseph		7816123342					joseph.bonica@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Emergency Part D Contact (Secondary)	Senior Manager , Pharmacy		Alves	Heather		6179729400	82988				Heather.Alves@point32health.org	1 Wellness Way		Canton	MA	02021	12/09/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Employer Waiver Contact	Manager, Client Services		Bartkiewicz	Mary		7816121000	83937				Mary.Bartkiewicz@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Encounter Data & Risk Adjustment Operations Contact	Lead Risk Adjustment Data Analyst		Terral	Aurelien		7816121000	82246				Aurelien.Terral@point32health.org	1 Wellness Way		Canton	MA	02021	02/10/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Enrollment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	EOB Transfer Contact	Manager, Business Implementation		Nesmith	Tanisha		7816124861				6176730286	tanisha.nesmith@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Financial Audit Contact	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Financial Reporting Contact	Assistant Corporate Controller		Jaiswal	Ruchi		6179729400	84518				Ruchi.Jaiswal@point32health.org	1 Wellness Way		Canton	MA	02021	08/01/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Formulary Contact	Clinical Pharmacist Senior		Kowalski	Alec		7816121000	82045				alec.kowalski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	General Contact	Medicare Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Government Relations Contact	Chief Government Affairs Officer		Lewis	Kristin		7816121000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	HIPAA Privacy Officer	VP Privacy & Special Investigation		Walsh	Chris		7816121000	82508				Christopher.walsh@point32health.org	1600 Crown Colony Drive		Quincy	MA	02169	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	HIPAA Security Officer	VP Chief  Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Hospice Contact	Senior Manager , Pharmacy		Alves	Heather		6179729400	82988				Heather.Alves@point32health.org	1 Wellness Way		Canton	MA	02021	12/09/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Interoperability Contact	VP, Information Security Officer		Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Gonzalez	Michelle		6179729400	83114				michelle.gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	MA Claims Processing Contact for Public Website	Director, Claims		Patel	Monal		7816121000	88187				Monal.Patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Marketing Contact	Director, Marketing		Walsh	Tim		7816121000	87541				Tim.Walsh@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Medical Director	VP, Chief Medical Officer PP	Dr.	Elvin	David		6179729400	87943				David.Elvin@point32health.org	1 Wellness Way		Canton	MA	02021	02/10/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Medicare Compliance Officer	Government Programs Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	12/09/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Medicare Coordinator	Vice President, Medicare		Walker	Eddie		7816121000	84471				Edward.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Dohan	David		7816121000	82615				David.Dohan@point32health.org	1 Wellness Way		Canton	MA	02021	04/24/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Medication Therapy Management Contact	Sr Pharmacy Program Manager		Burns	Ashlyn		7816122239					ashlyn.burns@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Ben-Ezra	Daniel		7816121000	54054				Daniel.Ben-Ezra@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Online Enrollment Center Contact (Optional)	Supervisor, Enrollment		Maloney	Kimberly		7816121000	83576				Kimberly.Maloney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Online Enrollment Center Contact (Primary)	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part C Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part C Reporting Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Appeals	Director, Appeals & Grievances		Gonzalez	Michelle							Michelle.Gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	83114			HMO - Health Maintenance Organization		C	Boston
H5314	Part D Appeals Contact (Secondary)	Sr. Program Manager, Appeals & Grievances		Mello	Sheri							sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	84862			HMO - Health Maintenance Organization		C	Boston
H5314	Part D Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Benefits Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Claims Submission Contact	Senior Manager , Pharmacy		Alves	Heather		6179729400	82988				Heather.Alves@point32health.org	1 Wellness Way		Canton	MA	02021	12/09/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Exceptions Contact	Director, Pharmacy Utilization Management		Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	82370			HMO - Health Maintenance Organization		C	Boston
H5314	Part D Exceptions Contact (Secondary)	Supervisor, Pharmacy Utilization Management		Bannan	Philip							Philip.Bannan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	60178			HMO - Health Maintenance Organization		C	Boston
H5314	Part D Price File Contact (Back-up)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					Tim.Sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Price File Contact (Optional)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					tim.sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Price File Contact (Primary)	Sr Business Analyst		Moore-Elliott	Shalandria		7637974305					shalandria.moore-elliott@optum.com	1600 McConnor Pwy.		Schaumburg	IL	60173	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Quality Assurance Contact	Vice President, Pharmacy		Fenton	Karen		7186121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Part D Reporting Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Patient Safety Contact	Sr Pharmacy Implementation Specialist		von Fritzinger	Lisa		7816123778					lisa.vonfritzinger@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Payment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Pharmacy Director	Vice President, Pharmacy		Fenton	Karen		7816121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Pharmacy Network Management Contact	Manager, Retail Network Operations		Hagan	Kyle		3039895828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Ashby	JoLynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Pharmacy Technical Help Desk Contact	Sr. Manager		Villaneuva	Juan							Juan.Villanueva@optum.com	3515 S Harbor Blvd.		Costa Mesa	CA	92626	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H5314	Pharmacy Technical Help Desk Contact (Secondary)	Associate Director, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H5314	Plan Directory Contact for Public Website	Marketing Materials Production Manager		Kayser	Kenneth		7816121000	83518				kenneth.kayser@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Plan to Plan Reconciliation Contact	Manager, Finance Operations Compliance		Schumaker	Tyler		6179729400	87394				Tyler.Schumaker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Processor Contact	Director, Claims		Patel	Monal		7816121000	88187				monal.patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Quality Contact	Director, HEDIS Quality Informatics		McCoy	Kelly		7816121000	83515				kelly.mccoy@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Reconciliation Contact	Senior Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Reconciliation Contact (Secondary)	Pharmacy Analyst Sr.		Santino	Cristina		7816121000	82560				Cristino.Santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Recovery Audit Contact	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	SNP Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	SNP State Contact	Director, Business Implementation		Chukwu	Matthew		7816123967					matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Surveillance Contact	Director, Sales Operations		Tollefsen	John		7816122266					John.Tollefsen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	System Contact	Senior Manager, Business Account Management		Allen	Jeffrey		7816121000	83167			6179729008	Jeffrey.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Third Party Administrator (TPA) Liaison	Manager, Accounting		Parikh	Roshni		7816121000	84512				roshni.parikh@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	User Access Contact	Director Gov't Programs Compliance Officer		Geroski	Tami	A	5708142999	0				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	12/09/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Utilization Management Contact	Director, Utilization Management		Walker	Karen		7816121000					Karen.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5314	Utilization Review Contact	Lead Medical Director, Clinical Reviews	Dr.	Slota	Janet		6179729400	87527				Janet.Slota@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS HEALTH PUBLIC PLANS, INC.	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H5322	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5322	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5322	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H5322	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5322	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5325	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/18/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H5325	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5325	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF KANSAS, INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5354	Part C Application Contact			Kole	Jon		9144783700	3002				jkole@andruson.org	185 Old Broadway		Hastings-On-Hudson	NY	10706	11/02/2025	2026	WESTCHESTER PACE PROGRAM, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H5354	Part D Application Contact			Kole	Jon		9144783700	3002				jkole@andrusonhudson.org	185 Old Broadway		Hastings-On-Hudson	NY	10706	11/02/2025	2026	WESTCHESTER PACE PROGRAM, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H5361	Agent/Broker Compensation Data Contact	Mgr. Sales Onboarding		Heckman	Jim		2152411994					jim.heckman@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	07/09/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Automated TrOOP Balance Transfer Contact	Lead Business Systems Support Admin		Jimenez	Barbara		2676751825					barbara.jimenez@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	02/27/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Backup User Access Contact	Regulatory Performance Mgmt. Analyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Best Available Evidence Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					geraldine.caldwell@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Bid Audit Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Bid Audit Site Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Bid Primary Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	CAP Report Contact for Public Website	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active	2152413648				PPO - BBA		C	Chicago
H5361	CEO - CMS Administrator Contact	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614					juan.lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	11/01/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	CEO - Senior Official for Contracting	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614					juan.lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	11/01/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Chief Financial Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614					juan.lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	03/21/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Chief Operating Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614					juan.lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	03/21/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Chief Information Officer	EVP and Chief Strategy, Corp. Dev., & Info Officer	Mr.	Vennera	Michael		2152419525					michael.vennera@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	04/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Chief Information Security Officer	Director Information Security	Mr.	Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901 Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	CMS Casework Communication Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Complaints Tracking Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Contact for Fraud Investigations	Director, Financial Investigations		Deery	Christophe	E	2156407302	27302			2152382287	christopher.deery@ibx.com	1901 Market Street	42nd Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Coordination of Benefits Contact	Manager, COB/OPL		Hawkins	Veronica		2156407507	27507				veronica.hawkins@ibx.com	1901 Market Street	17th Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Corporate Mailing						2152412400					mitchell.goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Customer Service Operations Contact	Director, Contact Center		Lentz	Michael		2157933262	63262				michael.lentz@ibx.com	1900 Market Street	5th Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	DIR Contact	Manager Gov. Markets - Commercial Risk Adjustment		Sanders	Sean		2152419420					sean.sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	DIR Contact (Secondary)	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2152417265					geoffrey.wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	01/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Discount Program Payment Contact	Lead Accountant		Murphy	Stacey		2152413522					stacey.murphy@ibx.com	1901 Market Street	36th Floor	Philadelphia	PA	19103	04/24/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Emergency Part D Contact	Pharmacy Services Mgr   Pharmacy		Parisi	Dana		2152413265					dana.parisi@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	12/19/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Emergency Part D Contact (Secondary)	Director Medicare Regulatory Peformance Mgmt.		Adams	Desiree		2152327982					desiree.adams@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	04/10/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Employer Waiver Contact	SVP Government Markets, Sales & Mkt. Leadership	Ms.	Cruz	Kortney		2152414762					kortney.cruz@ibx.com	1901 Market	35th Floor	Philadelphia	PA	19103	01/26/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Encounter Data & Risk Adjustment Operations Contact	Manager Data Delivery and Reporting		Heifetz	Nata		2152410511					nata.heifetz@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	01/20/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Enrollment Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					geraldine.caldwell@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	01/20/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	EOB Transfer Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152413526	kathy.erdman@ibx.com	1901 Markets Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Financial Audit Contact	VP Corporate Compliance	Mr	Zipfel	Michael		2152414908				2155674542	Michael.Zipfel@ibx.com	1901 Market Street		Philadelphia	PA	19103	09/05/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Financial Reporting Contact	EVP, CFO, & Treasurer		Lopez	Jaun		2152414614					juan.lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	11/01/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Formulary Contact	Clinical Pharmacist		Urbanek	Michael		2152419003				2152413526	michael.urbanek@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/25/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Formulary Contact (Secondary)	Clinical Consultant-Optum Rx		Sosinsky	Inna		7633616985					inna.sosinsky@Optum.com	1100 Optum Circle		Eden Parairie	MN	55344	04/18/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	General Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Government Relations Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	HIPAA Privacy Officer	Director, Privacy Officer		Rieben	Laura		2152414462					laura.rieben@ibx.com	1901 Market Street		Philadelphia	PA	19013	02/13/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	HIPAA Security Officer	Director Information Security		Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901  Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Hospice Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654					kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	06/29/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Interoperability Contact	Healthcare Interoperability Director		Denyer	James		2152410858					james.denyer@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/10/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	MA Appeals/Grievances Contact	Manager, Medicare Member Appeals and Grievances		Tobias	Bobbi		2152410669					Bobbi.Tobias@ibx.com	1901 Market Street	Mailstop, 12th Floor.	Philadelphia	PA	19103	04/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	MA Claims Processing Contact for Public Website	Director Claims Operations		Perfetto	Lisa		2152414126					lisa.perfetto@ibx.com	1901 Market Street	15th Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Marketing Contact	RPM Analyst II		Dunn	DeVonda		2152413837					devonda.dunn@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/16/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Medical Director	Medical Director		Ranziano	Dr. Donna		2155281935					donna.raziano@ibx.com	1901 Market Street		Philadelphia	PA	19103	11/12/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Medicare Compliance Officer	Director, Corporate Compliance, Medicare and Comme	Mr.	Goldberg	Mitchell		2152419516				2155674542	mitchell.goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19013	02/13/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Medicare Coordinator	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Soribe	Nneka		2152414729				2152413526	nneka.soribe@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	03/05/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Medication Therapy Management Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Services		Kelley	Joshua		2152414829					joshua.kelley@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Online Enrollment Center Contact (Optional)	RPM Anarlyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Online Enrollment Center Contact (Primary)	Sr. Business Analyst		Caldwell	Geraldine		2676751809					geraldine.caldwell@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part C Application Contact	Sr. Product & Capability Manager		Keenan	Kate		2152419495					kate.keenan@ibx.com	1901 Market St	35th Floor	Philadelphia	PA	19103	01/26/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part C Reporting Contact	Manager, Government Markets Reporting		Pippett	Andrew		2152417416					andrew.pippett@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Appeals	Manager, Medicare Member Appeals and Grievances		Tobias	Bobbi							Bobbi.Tobias@ibx.com	1901 Market Street	Mailstop, 12th Floor.	Philadelphia	PA	19103	04/19/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8887183333				PPO - BBA		C	Chicago
H5361	Part D Appeals Contact (Secondary)	Supervisor, Medicare Member Appeals and Grievances		Byrd	Kelly							kelly.byrd@ibx.com	1901 Market Street Mailstop,	12th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8887183333				PPO - BBA		C	Chicago
H5361	Part D Application Contact	Sr. Product & Capability Manager		Keenan	Kate		2152419495					kate.keenan@ibx.com	1901 Market St	35th Floor	Philadelphia	PA	19103	01/26/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Benefits Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152412408	kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Claims Submission Contact	Pharmacy Service Process & Governance Director		Erdamn	Kathy		2152412654				2152413526	kathy.erdman@ibx.com	1901 Markets Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Exceptions Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy						2152412654	kathy.erdman@ibx.com	1901 Market Street	29th Floor	Phildelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8886787015				PPO - BBA		C	Chicago
H5361	Part D Exceptions Contact (Secondary)	Manager, Prior Authorization		Mourad	Hala							hala.mourad@optum.com	1100 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active	6308905558				PPO - BBA		C	Chicago
H5361	Part D Price File Contact (Back-up)	Senior Business Analyst, Plan Finder		Moore-Elliott	Shalandria		7637974305					Mshalandria.moore-elliott@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Price File Contact (Optional)	Project Leader		Coursey	Yarminah		2152413955					yaminah.coursey@ibx.com	1900 Market Street	29th Floor	Philadelphia	PA	19103	02/15/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Price File Contact (Primary)	Senior Business Analyst, Plan Finder		Lam	Annie		6124286588					annie.lam@optum.com	11000 Optum Circle		Eden Prairie Eden	MN	55344	10/25/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Quality Assurance Contact	Director Quality Management		Donohue	Kathleen		2152413277					kathleen.donohue@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Part D Reporting Contact	Manger Government Markets Reporting		Pippett	Andrew		2152417416					andrew.pippett@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	01/26/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Patient Safety Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Payment Contact	Director Risk Adjustment & Data Delivery		Buscher	Harry		2152410806					harry.buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Pharmacy Director	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152413526	kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Pharmacy Network Management Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152413526	kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Perez	Felix	M	7632833503					felix.perez@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Pharmacy Technical Help Desk Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy						2152413526	kathy.erdman@ibx.com	1901 Market Street	29th Floor	Phildelphia	PA	19103	12/19/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8886787015				PPO - BBA		C	Chicago
H5361	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	1100 Optum Circle		Eden Parairie	MN	55344	12/19/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active	8886787015				PPO - BBA		C	Chicago
H5361	Physician Incentive Contact	VP DGC & Asst. Corporate Secretary, Corp. Legal Ad		Dianno	Mark		2152412919					mark.dianno@ibx.com	1901 Market Street	43rd Floor	Philadelphia	PA	19103	07/09/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Plan Directory Contact for Public Website			Service	Customer		8006453965					info@ibxmedicare.com	PO Box 7799		Philadelphia	PA	191017799	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Plan to Plan Reconciliation Contact	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2156407265				2152412408	geoffrey.wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Processor Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654				2152413526	kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Quality Contact	Director Quality Management		Donohue	Kathleen		2152413277					kathleen.donohue@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Reconciliation Contact	Director Risk Adjustment & Data Delivery		Buscher	Harry		2152410806					harry.buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Reconciliation Contact (Secondary)	Mgr. Gov. Mkts. Commercial Risk Analytics		Sanders	Sean		2152419420					sean.sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	01/24/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Recovery Audit Contact	Director of Regulatory Performance Management	Ms.	Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	SNP Application Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	SNP State Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Surveillance Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	System Contact	VP Enterprise Data & Integrations		Varghese	John		2152414553					john.varghese@ibx.com	1901 Market Street	21th Floor	Philadelphia	PA	19103	07/09/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Third Party Administrator (TPA) Liaison	Lead Accountant		Murphy	Stacey		2152413522					stacey.murphy@ibx.com	1901 Market Street,	36th Floor, Corporate Accounting	Philadelphia	PA	19103	04/24/2024	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	User Access Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					tara.wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Utilization Management Contact	Director Care Managment		McGurk	Cheryl		2152414542					cheryl.mcgurk@ibx.com	1901 Market Street	30th Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5361	Utilization Review Contact	Director Care Managment		McGurk	Cheryl		2152414542					cheryl.mcgurk@ibx.com	1901 Market Street	30th Floor	Philadelphia	PA	19103	01/23/2023	2026	AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	AmeriHealth	Local PPO		Independence Health Group, Inc.	609	Yes	Active					PPO - BBA		C	Chicago
H5374	Agent/Broker Compensation Data Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Automated TrOOP Balance Transfer Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Backup User Access Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Best Available Evidence Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Bid Audit Contact			Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Bid Audit Site Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Bid Primary Contact		Mr.	Granow	Les		5614440709					Les.Granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	CAP Report Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	CEO - CMS Administrator Contact		Mr.	Lerer	Ben		5614440780					Ben.lerer@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H5374	CEO - Senior Official for Contracting		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Chief Financial Officer		Mr.	Granow	Les		5614440709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Chief Operating Officer		Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Chief Information Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Chief Information Security Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	CMS Casework Communication Contact			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Complaints Tracking Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Contact for Fraud Investigations			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Coordination of Benefits Contact		Ms.	Crowl	Lacey		7657921412					Lacey.crowl@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Corporate Mailing						5616901134					compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Customer Service Operations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	DIR Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H5374	DIR Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Discount Program Payment Contact		Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	Longevity Health Plan	485 Madison Avenue Suite 202	New York	NY	10022	05/30/2025	2026	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	Seattle
H5374	Electronic Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Emergency Part D Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Emergency Part D Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Encounter Data & Risk Adjustment Operations Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Enrollment Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	EOB Transfer Contact		Ms.	Socoski	Beth		5616901134				5616901134	Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Financial Audit Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Financial Reporting Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Formulary Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Formulary Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	General Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Government Relations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	HIPAA Privacy Officer	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	HIPAA Security Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Hospice Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Interoperability Contact	CIO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	MA Appeals/Grievances Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	MA Claims Processing Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Marketing Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Medical Director		Mr.	Orgain	Javette		3127206656					javette.orgain@longevityhealthplan.com	Longevity Health Plan	1611 Church Street	Evanston	IL	60201	05/30/2025	2026	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	Seattle
H5374	Medicare Compliance Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Medicare Coordinator	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Medicare Part D Opioid Overutilization Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Medication Therapy Management Contact		Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	OffShore Subcontractor Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part C Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part C Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H5374	Part D Appeals Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H5374	Part D Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part D Benefits Contact		Mr.	Latko	Jeff		6363352997					JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H5374	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		8002040016					Rosario_dovico@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H5374	Part D Exceptions Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H5374	Part D Price File Contact (Back-up)	Product Manager Advisor	Ms.	Williams	Stephanie		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part D Price File Contact (Optional)	Medicare Compliance Director	Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part D Price File Contact (Primary)	sr mgr, Government Programs		Dolfi	Amanda		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part D Quality Assurance Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Part D Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Patient Safety Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Payment Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Personal Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Pharmacy Director	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		8002040016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Pharmacy Network Management Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						8882358551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H5374	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Account Manager	Ms.	Lennox	Melyssa							Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H5374	Physician Incentive Contact		Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Plan Directory Contact for Public Website	Medicare Compliance Director	Ms.	Socoski	Beth		8883133609					Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Plan to Plan Reconciliation Contact		Ms.	Ajayi	Bisi		5616328915					bisi.ajayi@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Processor Contact		Mr.	Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Quality Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Reconciliation Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Reconciliation Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Recovery Audit Contact	VP Compliance	Ms.	Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	SNP Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	SNP State Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Surveillance Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	System Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Third Party Administrator (TPA) Liaison	COO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	User Access Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Utilization Management Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5374	Utilization Review Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H5377	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H5377	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H5377	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H5377	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H5377	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H5377	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H5377	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5377	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5380	Automated TrOOP Balance Transfer Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Backup User Access Contact	Chief Information Officer		Gil	Steven		7606315000	1128				sgil@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Best Available Evidence Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Bid Primary Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	CAP Report Contact for Public Website	Chief Development Officer		Heightman	Betsy	L	7606315000	1139				Betsy@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending	8778227223				PACE - Nat		C	San Francisco
H5380	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Sanudo	Fernando	L	7606315000	1131				fernando@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	CEO - Senior Official for Contracting	Chief Compliance Officer	Ms.	Lujan	Dorothy	L	7606315000	1133				dl@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Chief Financial Officer	Chief Financial Officer	Ms.	Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Chief Operating Officer	Chief Operating Officer	Mr.	Connelly	Mark		7606315000	1444				mconnelly@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Chief Information Officer	Chief Information Officer	Mr.	Gil	Steven		7606315000	1128				sgil@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Chief Information Security Officer	Chief Information Officer	Mr.	Gil	Steven		7606315000	1128				sgil@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	CMS Casework Communication Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Complaints Tracking Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Contact for Fraud Investigations	Chief Compliance Officer		Lujan	Dorothy	L	7606315000	1133				dl@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Coordination of Benefits Contact	Revenue Cycle Director		Wingrove	Mary Ann	L	7606315000	6103				maryann.wingrove@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Corporate Mailing						7606315000	1131				karen.a.lopez@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Customer Service Operations Contact	Chief Development Officer		Heightman	Betsy	L	7606315000	1139				Betsy@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	DIR Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	DIR Contact (Secondary)	Chief Operations Officer		Connelly	Mark		7606315000	1444				mconnelly@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Discount Program Payment Contact	Chief Financial Officer	Ms.	Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Emergency Part D Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Emergency Part D Contact (Secondary)	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Ms.	Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Enrollment Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	EOB Transfer Contact	Revenue Cycle Director		Wingrove	Mary Ann	L	7606315000	6103			8182373419	maryann.wingrove@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Financial Audit Contact	Chief Financial Officer	Ms.	Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Financial Reporting Contact	Chief Financial Officer	Ms.	Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Formulary Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Formulary Contact (Secondary)	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	General Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Government Relations Contact	Chief Development Officer		Heightman	Betsy	L	7606315000	1140				Betsy@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	HIPAA Privacy Officer	Chief Compliance Officer		Lujan	Dorothy	L	7606315000	1133				dl@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	HIPAA Security Officer	Chief Information Officer	Mr.	Gil	Steven		7606315000	1128				sgil@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Interoperability Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	MA Appeals/Grievances Contact	Chief Compliance Officer		Lujan	Dorothy	L	7606315000	1133				dl@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	MA Claims Processing Contact for Public Website	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Marketing Contact	Chief Development Officer		Heightman	Betsy	L	7606315000	1140				Betsy@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Medical Director	Chief Medical Officer		Fatland	Sarah	E	7606315000	1343				Sarah.E.Fatland@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Lujan	Dorothy	L	7606315000	1133				dl@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Medicare Coordinator	Revenue Analyst, Senior		Baird	Aaron	L	7606315000	6105				Aaron.J.Baird@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Medicare Part D Opioid Overutilization Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Medication Therapy Management Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	OffShore Subcontractor Contact	Chief Executive Officer		Sanudo	Fernando	L	7606315000	1131				fernando@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Online Enrollment Center Contact (Back-up)	Chief Executive Officer		Sanudo	Fernando	L	7606315000	1131				fernando@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Online Enrollment Center Contact (Optional)	Chief Executive Officer		Sanudo	Fernando	L	7606315000	1131				fernando@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Online Enrollment Center Contact (Primary)	Chief Executive Officer		Sanudo	Fernando	L	7606315000	1131				fernando@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part C Application Contact			Sanudo	Fernando		7606315000					fernando@vcc.org	1000 Vale Terrace		Vista	CA	92084	01/03/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Appeals	Pharmacy Director		Nguyen	Emily							enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending	7606315000	1270			PACE - Nat		C	San Francisco
H5380	Part D Appeals Contact (Secondary)	Chief Compliance Officer		Lujan	Dorothy	L						dl@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending	7606315000	1133			PACE - Nat		C	San Francisco
H5380	Part D Application Contact	Chief Executive Officer		Sanudo	Fernando		7606315000					fernando@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Benefits Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Claims Submission Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Exceptions Contact	Pharmacy Director		Nguyen	Emily							enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending	7606315000	1270			PACE - Nat		C	San Francisco
H5380	Part D Exceptions Contact (Secondary)	Pharmacy Director		Nguyen	Emily							enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending	7606315000	1270			PACE - Nat		C	San Francisco
H5380	Part D Price File Contact (Back-up)	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Price File Contact (Optional)	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Price File Contact (Primary)	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Quality Assurance Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Part D Reporting Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Patient Safety Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Payment Contact	Revenue Cycle Director		Wingrove	Mary Ann	L	7606315000	6103				maryann.wingrove@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Personal Health Record Contact	Chief Medical Officer		Fatland	Sarah	E	7606315000	1343				Sarah.E.Fatland@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Pharmacy Director	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Pharmacy Network Management Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Pharmacy Network Management Contact (Secondary)	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Pharmacy Technical Help Desk Contact	Pharmacy Director		Nguyen	Emily							enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending	7606315000	1270			PACE - Nat		C	San Francisco
H5380	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Director		Nguyen	Emily							enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending	7606315000	1270			PACE - Nat		C	San Francisco
H5380	PHR Beneficiary Contact																	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE	Vista Community Clinic PACE	Vista Community Clinic	840	Yes	Pending	8778227223				PACE - Nat		C	San Francisco
H5380	Plan Directory Contact for Public Website	Chief Development Officer		Heightman	Betsy	L	7606315000	1141				Betsy@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Plan to Plan Reconciliation Contact	Chief Financial Officer		Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Processor Contact	Revenue Cycle Director		Wingrove	Mary Ann	L	7606315000	6103				maryann.wingrove@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Quality Contact	Pharmacy Director		Nguyen	Emily		7606315000	1270				enguyen@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Reconciliation Contact	Chief Financial Officer		Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Reconciliation Contact (Secondary)	Revenue Cycle Director		Wingrove	Mary Ann	L	7606315000	6103				maryann.wingrove@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Recovery Audit Contact	Chief Innovation Officer	Ms.	Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Surveillance Contact	Chief Development Officer		Heightman	Betsy	L	7606315000	1141				Betsy@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	System Contact	Chief Information Officer		Gil	Steven		7606315000	1128				sgil@vcc.org	1000 Vale Terrace Dr.		Vista	CA	92084	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	User Access Contact	Chief Innovation Officer		Brazee	Cynthia	L	7606315000	1008				Cynthia.L.Brazee@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Utilization Management Contact	Chief Financial Officer		Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5380	Utilization Review Contact	Chief Financial Officer		Lambert	Michele	L	7606315000	6106				mlambert@vcc.org	465 La Tortuga Dr.		Vista	CA	92081	02/29/2024	2026	VISTA COMMUNITY CLINIC	National PACE	Vista Community Clinic PACE	National PACE		Vista Community Clinic	840	Yes	Pending					PACE - Nat		C	San Francisco
H5384	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Backup User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Best Available Evidence Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	CAP Report Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending	5703717371				PACE - Nat		C	Atlanta
H5384	CEO - CMS Administrator Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Chief Operating Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Complaints Tracking Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Contact for Fraud Investigations	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Coordination of Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Customer Service Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	DIR Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Encounter Data & Risk Adjustment Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Enrollment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Financial Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	General Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Government Relations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	HIPAA Privacy Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	HIPAA Security Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	MA Appeals/Grievances Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Marketing Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Medical Director	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Medicare Compliance Officer	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	11/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Medicare Coordinator	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Medicare Part D Opioid Overutilization Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part C Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part D Appeals	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending	5703717371				PACE - Nat		C	Atlanta
H5384	Part D Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part D Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part D Claims Submission Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending	5703717371				PACE - Nat		C	Atlanta
H5384	Part D Price File Contact (Back-up)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part D Price File Contact (Primary)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part D Quality Assurance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Part D Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending	5703717371				PACE - Nat		C	Atlanta
H5384	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Quality Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Reconciliation Contact (Secondary)	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	System Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5384	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF SOUTH FLORIDA, LLC	National PACE	Kinship PACE of South Florida, LLC	National PACE		CitiPACE Holding Company	841	Yes	Pending					PACE - Nat		C	Atlanta
H5386	Agent/Broker Compensation Data Contact	Manager, Medicare and IFP Business Development		Fields	Trent		8584992109					trent.fields@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	02/14/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Backup User Access Contact	Vice President, Chief Administrative Officer		Limon	Gregory		8584998388					Gregory.Limon@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	02/05/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Best Available Evidence Contact	EDI Management Supervisor		Guglielmetti	Brett		8584998108					Brett.Guglielmetti@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/06/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Bid Audit Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Bid Audit Site Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Bid Primary Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	CAP Report Contact for Public Website	Dir Compliance/Reg Affairs		Mooney	Ryan		8584998237					ryan.mooney@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	07/08/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	8555628853				HMO - Health Maintenance Organization		C	Boston
H5386	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Byrd	Michael		8584998233					michael.byrd@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/17/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Byrd	Michael		8584998233					michael.byrd@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/17/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Chief Financial Officer	Vice President and Chief Financial Officer	Ms.	Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Chief Operating Officer	Chief Administrative Officer	Mr.	Limon	Gregory		8584998388					gregory.limon@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/09/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Chief Information Officer	VP IT Risk Management/Chief ISO	Mr	Franzen	Chase		8584996837					chase.franzen@sharp.com	4000 Ruffin Rd	Suite D	San Diego	CA	92123	07/09/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Chief Information Security Officer	VP IT Risk Management/Chief ISO	Mr	Franzen	Chase		8584996837					chase.franzen@sharp.com	3571 Corporate Court	ISD Administration	San Diego	CA	92123	07/09/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	CMS Casework Communication Contact	Director, Ops & Performance Improvement		Smith	Jason		8584998077					JASON.SMITH@SHARP.COM	8520 Tech Way	Suite 201	San Diego	CA	921231450	04/02/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Complaints Tracking Contact	Director, Ops & Performance Improvement		Smith	Jason		8584998077					JASON.SMITH@SHARP.COM	8520 Tech Way	Suite 201	San Diego	CA	921231450	04/02/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Contact for Fraud Investigations	Sr. Compliance/Regulatory Spec FWA		Knutson	Kathleen		8584993835					kathleen.knutson@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	03/31/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Coordination of Benefits Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Corporate Mailing						8584998050				8584998244	summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Customer Service Operations Contact	Manager, Customer Care		Meredith	Olivia		8584998019					olivia.meredith@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/19/2019	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	DIR Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	DIR Contact (Secondary)	Director of Finance		Piche	Paul		8584998201					paul.piche@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	03/16/2018	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Discount Program Payment Contact	Director of Finance		Piche	Paul		8584998201					Paul.Piche@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	06/01/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Emergency Part D Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	12/23/2020	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Emergency Part D Contact (Secondary)	Pharmacy Benefits Specialist-Med D		Nguyen	Jenny		8584998190					jenny.nguyen@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/15/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Employer Waiver Contact	Manager, Product Development		Aragon	Benjamin		8584998320					ben.aragon@sharp.com	8520 Tech Way		San Diego	CA	92123	07/08/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Encounter Data & Risk Adjustment Operations Contact	Manager, EDI Management		Guglielmetti	Brett		8584998108					Brett.Guglielmetti@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	11/18/2019	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Enrollment Contact	EDI Management Supervisor		Guglielmetti	Brett		8584998108					Brett.Guglielmetti@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/06/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	EOB Transfer Contact	Vice President, Chief Administrative Officer		Limon	Gregory		8584998388				8586362276	Gregory.Limon@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	02/05/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Financial Audit Contact	Manager, Accounting & Finance	Mr.	Bauters	Danny		8584998142					danny.bauters@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/09/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Financial Reporting Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Formulary Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Formulary Contact (Secondary)	Pharmacy Benefits Specialist-Med D		Nguyen	Jenny		8584998190					jenny.nguyen@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/15/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	General Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Government Relations Contact	Dir Compliance/Reg Affairs		Mooney	Ryan		8584998237					ryan.mooney@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	07/08/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	HIPAA Privacy Officer	Dir Compliance/Reg Affairs		Mooney	Ryan		8584998237					ryan.mooney@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123	07/08/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	HIPAA Security Officer	VP IT Risk Management/Chief ISO	Mr	Franzen	Chase		8584996837					chase.franzen@sharp.com	4000 Ruffin Rd		San Diego	CA	92123	07/09/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Hospice Contact	Lead Data Quality - EDI Management		Shah	Dipali		8584998005					dipali.shah@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	02/21/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Interoperability Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	MA Appeals/Grievances Contact	Supervisor, Appeals and Grievances		Chuol	Nyeruon		8584998300					NYERUON.CHUOL@SHARP.COM	8520 Tech Way	Suite 201	San Diego	CA	921231450	07/11/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	MA Claims Processing Contact for Public Website	Vice President, Chief Administrative Officer		Limon	Gregory		8584998388					Gregory.Limon@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	02/05/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Marketing Contact	Manager, Brand & Product Marketing		McMorrow	Allison		8584998371					allison.mcmorrow@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	04/08/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Medical Director	Vice President and Chief Medical Officer	Dr.	Shames	Cary		8584998350				8586362426	Cary.Shames@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	06/01/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Mooney	Ryan		8584998327					ryan.mooney@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/09/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Medicare Coordinator	Manager, EDI Management		Guglielmetti	Brett		8584998108					Brett.Guglielmetti@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/26/2023	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/03/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Medication Therapy Management Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/03/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Online Enrollment Center Contact (Back-up)	Vice President, Chief Administrative Officer		Limon	Gregory		8584998388				8586362276	Gregory.Limon@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	02/05/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Online Enrollment Center Contact (Optional)	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Online Enrollment Center Contact (Primary)	EDI Management Supervisor		Guglielmetti	Brett		8584998108					Brett.Guglielmetti@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/06/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part C Application Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part C Reporting Contact	Manager, EDI Management		Guglielmetti	Brett		8584998108					Brett.Guglielmetti@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/26/2023	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part D Appeals	Supervisor, Appeals and Grievances		Chuol	Nyeruon							NYERUON.CHUOL@SHARP.COM	8520 Tech Way	Suite 201	San Diego	CA	921231450	07/11/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	8555628853				HMO - Health Maintenance Organization		C	Boston
H5386	Part D Appeals Contact (Secondary)	Appeals and Grievance Coordinator		Garcia	Norma						8586362256	NORMA.GARCIA@SHARP.COM	8520 Tech Way	Suite 201	San Diego	CA	921231450	04/02/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	8555628853				HMO - Health Maintenance Organization		C	Boston
H5386	Part D Application Contact	Vice President and Chief Financial Officer	Ms.	Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part D Benefits Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part D Claims Submission Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	8555628853				HMO - Health Maintenance Organization		C	Boston
H5386	Part D Exceptions Contact (Secondary)	Pharmacy Benefits Specialist-Med D		Nguyen	Jenny							jenny.nguyen@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/15/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	8555628853				HMO - Health Maintenance Organization		C	Boston
H5386	Part D Price File Contact (Back-up)	Pharmacy Benefits Specialist-Med D		Nguyen	Jenny		8584998190					jenny.nguyen@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/15/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part D Price File Contact (Optional)	Manager, Pharmacy Benefits		Tepedino	Kate		8584998353					kate.tepedino@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	06/23/2020	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part D Price File Contact (Primary)	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part D Quality Assurance Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Part D Reporting Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Patient Safety Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Payment Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Pharmacy Director	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Pharmacy Network Management Contact	Director, Pharmacy Benefits	Mr.	Contreras	Zachary		8584995358					zachary.contreras@sharp.com	8520 Tech Way	Suite 200	San Diego	CA	92123	05/27/2021	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Pharmacy Network Management Contact (Secondary)	Pharmacy Benefits Specialist-Med D		Nguyen	Jenny		8584998190					jenny.nguyen@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	12/15/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H5386	Plan Directory Contact for Public Website	Medicare Compliance Officer		Mooney	Ryan		8584998237					ryan.mooney@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/09/2025	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Plan to Plan Reconciliation Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					summer.lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Processor Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Quality Contact	Director of Quality Improvement		Aguirre	Andres		8584998264					Andres.Aguirre@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	07/13/2018	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Reconciliation Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Reconciliation Contact (Secondary)	Director of Finance		Piche	Paul		8584998201					Paul.Piche@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	06/01/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Recovery Audit Contact	Vice President and Chief Financial Officer	Ms.	Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Surveillance Contact	Dir Compliance/Reg Affairs		Mooney	Ryan		8584998237					ryan.mooney@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	07/08/2022	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	System Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Third Party Administrator (TPA) Liaison	Vice President and Chief Financial Officer		Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	92123	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	User Access Contact	Vice President and Chief Financial Officer		Lee	Summer		8584998203					Summer.Lee@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	10/25/2024	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Utilization Management Contact	Medical Management Manager		Donaldson	Ruth		8584998145				8586362426	Ruth.Donaldson@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	08/09/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5386	Utilization Review Contact	Medical Management Manager		Donaldson	Ruth		8584998145				8586362426	Ruth.Donaldson@sharp.com	8520 Tech Way	Suite 201	San Diego	CA	921231450	08/09/2016	2026	SHARP HEALTH PLAN	Local CCP	Sharp Health Plan	HMO/HMOPOS		Sharp Healthcare	444	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5387	Automated TrOOP Balance Transfer Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Backup User Access Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Best Available Evidence Contact	Executive Director	Mr	Lau	Christophe		6264576900					clau@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Bid Primary Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	CAP Report Contact for Public Website	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	CEO - CMS Administrator Contact	Executive Director	Mr	Lau	Christophe		6264576900					clau@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	CEO - Senior Official for Contracting	Executive Director	Mr	Lau	Christophe		6264576900					clau@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Chief Financial Officer	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Chief Operating Officer	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Chief Information Officer	Information Technology Director	Mr	Contreras	Percy		6264576900					pconteras@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Chief Information Security Officer	Information Technology Director	Mr	Contreras	Percy		6264576900					pconteras@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	CMS Casework Communication Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Complaints Tracking Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Contact for Fraud Investigations	Compliance Officer	Mrs	Devera	Gennie		6264576900					gdevera@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Coordination of Benefits Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Corporate Mailing						6264576900					clau@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Customer Service Operations Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	DIR Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Discount Program Payment Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Emergency Part D Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Enrollment Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	EOB Transfer Contact	Finance Director	Mrs	Gonzales	Ann		6264576900				6264576900	agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Financial Audit Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Financial Reporting Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Formulary Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	General Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Government Relations Contact	Executive Director	Mr	Lau	Christophe		6264576900					clau@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	HIPAA Privacy Officer	Compliance Officer	Mrs	Devera	Gennie		6264576900					gdevera@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	HIPAA Security Officer	Compliance Officer	Mrs	Devera	Gennie		6264576900					gdevera@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Interoperability Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	MA Appeals/Grievances Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	MA Claims Processing Contact for Public Website	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Marketing Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Medical Director	Medical Director	Mr	Munoz	Ruben		6264576900					rmunoz@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Medicare Compliance Officer	Compliance Officer	Mrs	Devera	Gennie		6264576900					gdevera@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Medicare Coordinator	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Medicare Part D Opioid Overutilization Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Medication Therapy Management Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	OffShore Subcontractor Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd, Suite 140		Columbia	SC	29209	08/21/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part D Appeals	Finance Director	Mrs	Gonzales	Ann							agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending	6264576900				PACE - Nat		C	San Francisco
H5387	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd, Suite 140		Columbia	SC	29209	08/21/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part D Benefits Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part D Claims Submission Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part D Exceptions Contact	Finance Director	Mrs	Gonzales	Ann							agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending	6264576900				PACE - Nat		C	San Francisco
H5387	Part D Price File Contact (Back-up)	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part D Price File Contact (Primary)	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part D Quality Assurance Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Part D Reporting Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Patient Safety Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Payment Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Personal Health Record Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Pharmacy Director	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Pharmacy Network Management Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Pharmacy Technical Help Desk Contact	Executive Director	Mr	Carrillo	Bernard							bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending	6264576900				PACE - Nat		C	San Francisco
H5387	Plan Directory Contact for Public Website	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Plan to Plan Reconciliation Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Processor Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Quality Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Reconciliation Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Recovery Audit Contact	Finance Director	Mrs	Gonzales	Ann		6264576900					agonzales@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Surveillance Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	System Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Third Party Administrator (TPA) Liaison	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	User Access Contact	Information Technology Director	Mr	Contreras	Percy		6264576900					pconteras@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Utilization Management Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5387	Utilization Review Contact	Executive Director	Mr	Carrillo	Bernard		6264576900					bcarrillo@necc.net	2550 W. Main Street		Alhambra	CA	91801	08/26/2024	2026	NORTHEAST COMMUNITY CLINIC	National PACE	Northeast Community Clinic	National PACE		NORTH EAST COMMUNITY CLINIC	859	Yes	Pending					PACE - Nat		C	San Francisco
H5397	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H5397	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Atlanta
H5397	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	Atlanta
H5397	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5397	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF HAWAII, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5403	Automated TrOOP Balance Transfer Contact	Health Plan Manager		Li	Jiewen		4152928692				4152928745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	12/16/2019	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Backup User Access Contact	Compliance Officer		Mayeda	Mark		4157711011				4152928745	mark.mayeda@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	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		6282088442				4152928745	alan@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/23/2018	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Bid Primary Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	CAP Report Contact for Public Website	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Li	Grace		4152928883				4152928745	graceli@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/01/2016	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Li	Grace		4152928883				4152928745	graceli@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/01/2016	2026	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	Chief Financial Officer	Mr.	Jenkins	Robert		6282088469				4152928745	rjenkins@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/16/2024	2026	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 Operating Officer	Chief Executive Officer	Ms.	Li	Grace		4152928883				4152928745	graceli@onlok.org	1333 Bush Street		San Francisco	CA	94109	01/08/2021	2026	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 Information Officer	Chief Executive Officer	Ms.	Li	Grace		4152928883				4152928745	graceli@onlok.org	1333 Bush Street		San Francisco	CA	94109	05/31/2024	2026	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 Information Security Officer	Chief Executive Officer	Ms.	Li	Grace		4152928883				4152928745	graceli@onlok.org	1333 Bush Street		San Francisco	CA	94109	05/31/2024	2026	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		4152928692				4152928745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	12/16/2019	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Complaints Tracking Contact	Health Plan Manager		Li	Jiewen		4152928692				4152928745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	12/16/2019	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Contact for Fraud Investigations	Compliance Officer		Mayeda	Mark		4157711011				4152928745	mark.mayeda@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	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	Senior Director of Health Plan Services		Pitkin	Tammie		6692713777				4152928745	tpitkin@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Corporate Mailing						4152928888				4152928745	info@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/01/2008	2026	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	Senior Director of Health Plan Services		Pitkin	Tammie		6692713777				4152928745	tpitkin@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	DIR Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Discount Program Payment Contact	Chief Financial Officer		Jenkins	Robert		6282088469				4152928745	rjenkins@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/16/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Emergency Part D Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Encounter Data & Risk Adjustment Operations Contact	Senior Director of Health Plan Services		Pitkin	Tammie		6692713777				4152928745	tpitkin@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Enrollment Contact	Senior Director of Health Plan Services		Pitkin	Tammie		6692713777				4152928745	tpitkin@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	EOB Transfer Contact	Health Plan Manager		Li	Jiewen		4152928692				4152928745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	12/16/2019	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Financial Audit Contact	Chief Financial Officer	Mr.	Jenkins	Robert		6282088469				4152928745	rjenkins@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/16/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Financial Reporting Contact	Chief Financial Officer		Jenkins	Robert		6282088469				4152928745	rjenkins@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/16/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Formulary Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	General Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/17/2025	2026	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	Director of Government Affairs		Kelly	Katherine		6282088405				4152928745	kkelly@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	HIPAA Privacy Officer	Compliance Officer		Mayeda	Mark		4157711011				4152928745	mark.mayeda@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/15/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	HIPAA Security Officer	Director of IT Infrastructure		Zhu	Edmund		6282088561				4152928745	edmund.zhu@onlok.org	1333 Bush Street		San Francisco	CA	94109	05/31/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Interoperability Contact			Pitkin	Tammie		6692713777				4152928745	tpitkin@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	MA Appeals/Grievances Contact	Health Plan Manager		Li	Jiewen		4152928692				4152928745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	12/16/2019	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	MA Claims Processing Contact for Public Website	Senior Software Architect		Lin	Alan		6282088442				4152928745	alan@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/23/2018	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Marketing Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	01/09/2017	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Medical Director	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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	Compliance Officer	Mr.	Mayeda	Mark		4157711011				4152928745	mark.mayeda@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/15/2024	2026	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 Coordinator	Chief Operating Officer		Torres	Nicole		4152928799				4152928745	nicole@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	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 Part D Opioid Overutilization Contact	Director of Pharmacy Services		Yi	Thomas		4152928327				4152928745	tyi@onlok.org	1333 Bush Street		San Francisco	CA	94109	03/20/2019	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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 C Application Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	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 Appeals	Senior Director of Health Plan Services		Pitkin	Tammie						4152928745	tpitkin@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active	8889966565				PACE - Nat		C	San Francisco
H5403	Part D Appeals Contact (Secondary)	Director of Regulatory Affairs and Compliance		Chau	Jonathan						4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active	8889966565				PACE - Nat		C	San Francisco
H5403	Part D Application Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	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 Benefits Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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 Claims Submission Contact	Director of Pharmacy Services		Yi	Thomas		4152928327				4152928745	tyi@onlok.org	1333 Bush Street		San Francisco	CA	94109	05/23/2014	2026	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						4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active	8889966565				PACE - Nat		C	San Francisco
H5403	Part D Price File Contact (Back-up)	Senior Software Architect		Lin	Alan		6282088442				4152928745	alan@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/23/2018	2026	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 Price File Contact (Primary)	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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 Quality Assurance Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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 Reporting Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Patient Safety Contact	Director of Pharmacy Services		Yi	Thomas		4152928327				4152928745	tyi@onlok.org	1333 Bush Street		San Francisco	CA	94109	05/23/2014	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Payment Contact	Chief Financial Officer		Jenkins	Robert		6282088469				4152928745	rjenkins@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/16/2024	2026	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 Director	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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 Network Management Contact	Chief Medical Officer	Dr.	Lui	Benjamin		4152922882				4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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						4152928745	blui@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active	8889966565				PACE - Nat		C	San Francisco
H5403	Plan Directory Contact for Public Website	Health Plan Manager		Li	Jiewen		4152928895				4152928745	jiewenl@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/21/2025	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Plan to Plan Reconciliation Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	01/09/2017	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Processor Contact	Senior Software Architect		Lin	Alan		6282088442				4152928745	alan@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/23/2018	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Quality Contact	Medical Director	Dr.	Eng	Jessica		4152928605				4152928745	jessica.eng@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Reconciliation Contact	Chief Financial Officer		Jenkins	Robert		6282088469				4152928745	rjenkins@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/16/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Recovery Audit Contact	Chief Financial Officer	Mr.	Jenkins	Robert		6282088469				4152928745	rjenkins@onlok.org	1333 Bush Street		San Francisco	CA	94109	10/16/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Surveillance Contact	Chief Operating Officer		Torres	Nicole		4152928799				4152928745	nicole@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	System Contact	Senior Software Architect		Lin	Alan		6282088442				4152928745	alan@onlok.org	1333 Bush Street		San Francisco	CA	94109	04/23/2018	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Third Party Administrator (TPA) Liaison			Chau	Jonathan		4152928852					jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2016	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	User Access Contact	Director of Regulatory Affairs and Compliance		Chau	Jonathan		4152928852				4152928745	jchau@onlok.org	1333 Bush Street		San Francisco	CA	94109	11/04/2024	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Utilization Management Contact	Medical Director	Dr.	Eng	Jessica		4152928605				4152928745	jessica.eng@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	ON LOK SENIOR HEALTH SERVICES	National PACE	On Lok PACE	National PACE		On Lok, Inc.	176	Yes	Active					PACE - Nat		C	San Francisco
H5403	Utilization Review Contact	Medical Director	Dr.	Eng	Jessica		4152928605				4152928745	jessica.eng@onlok.org	1333 Bush Street		San Francisco	CA	94109	06/03/2022	2026	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	General Counsel	Mr.	Williamson	Brian	J	5103870222					bwilliamson@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	06/23/2025	2026	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	Backup User Access Contact	General Counsel	Mr.	Williamson	Brian	J	5103870222				5108440189	bwilliamson@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	06/23/2025	2026	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		5104331150	7117			5104528836	JMittelberger@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2026	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	Bid Primary Contact	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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	CAP Report Contact for Public Website	CEO	Ms.	Zamora	Maria		5104528812				5104528836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	01/28/2025	2026	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active	8443191150				PACE - Nat		C	San Francisco
H5405	CEO - CMS Administrator Contact	CEO	Ms.	Zamora	Maria		5104528812				5104528836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/09/2021	2026	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	CEO - Senior Official for Contracting	CEO	Ms.	Zamora	Maria		5104528812				5104528836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/09/2021	2026	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		5103184714				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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 Operating Officer	CEO	Ms.	Zamora	Maria		5104528812				5104528836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Dhillon	Amarjit		5104331150					adhillon@cei.elders.org	510 17th St. Suite 400		Oakland	CA	94612	09/29/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Dhillon	Amarjit		5104331150					adhillon@cei.elders.org	510 17th Street, Suite 400		Oakland	CA	94612	09/29/2025	2026	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	Senior Director of Operations	Ms.	Zepeda	Crystal		5106075181					czepeda@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	Complaints Tracking Contact	Senior Director of Operations	Mr.	Zepeda	Crystal		5106075181					czepeda@cei.elders.org	510 17th Street	Suite 400	Oakland	CA	94612	09/29/2025	2026	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	Contact for Fraud Investigations	General Counsel and Compliance Officer	Mr.	Williamson	Brian		5103187138				5104528836	b.williamson@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	08/20/2025	2026	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	General Counsel	Mr.	Williamson	Brian	J	5103870222					bwilliamson@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	06/23/2025	2026	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	Corporate Mailing						5104331160	8821			5104528836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	08/25/2021	2026	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	Senior Director of Operations	Ms.	Zepeda	Crstal		5106075181					czepeda@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	DIR Contact	Controller	Mrs.	Srinivasan	Sheela		5103187142					ssrinivasan@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	09/29/2025	2026	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	DIR Contact (Secondary)	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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	Discount Program Payment Contact	Controller	Mrs.	Srinivasan	Sheela		5103187142					ssrinivasan@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	09/29/2025	2026	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	Emergency Part D Contact	Financial Analyst	Mr.	Moon	Geoff		5104331160	7158			5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2026	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	Emergency Part D Contact (Secondary)	CMO	Dr.	Mittelberger	James		5104331150	7117			5104528836	JMittelberger@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street	510 17th Street	Oakland	CA	94612	05/01/2025	2026	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	Enrollment Contact	Director of Sales and Enrollment	Ms.	Yi	Chi		5104331160	8825			5104528836	cyi@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	04/06/2022	2026	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	EOB Transfer Contact	General Counsel	Mr.	Williamson	Brian	J	5103870222				5104528836	bwilliamson@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	06/23/2025	2026	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	Financial Audit Contact	CFO	Ms.	Holden	Laura		5103187140				5104528836	lholden@cei.elders.org	510 17th Street		Oakland	CA	94612	06/23/2025	2026	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	Financial Reporting Contact	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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	Formulary Contact	Chief Financial Officer		Holden	Laura		5103187140	7158			5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	09/29/2025	2026	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	General Contact	CEO	Ms.	Zamora	Maria		5104528812				5104528836	mzamora@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/09/2021	2026	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	Director, Government & Community Affairs	Mr.	Uwahemu	Uche		5104528838					UUwahemu@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	HIPAA Privacy Officer	General Counsel	Mr.	Williamson	Brian		5103870222					bwilliamson@cei.elders.org	510 17th St., Suite 400		Oakland	CA	94612	06/23/2025	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Dhillon	Amarjit		5104331150					adhillon@cei.elders.org	510-17th St		Oakland	CA	94612	09/29/2025	2026	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	Interoperability Contact	Chief Information Officer		Dhillon	Amarjit		5104331150					adhillon@cei.elders.org	510 17th Street		Oakland	CA	94612	09/29/2025	2026	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	MA Appeals/Grievances Contact	Senior Director of Operations		Zepeda	Crystal		5106075181					czepeda@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	MA Claims Processing Contact for Public Website	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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	Marketing Contact	Senior Vice President - Business Development		Tamillo	Justine		5103188869					JTamillo@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	Medical Director	CMO	Dr.	Mittelberger	James		5104331150	7117			5104528836	JMittelberger@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2026	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	General Counsel	Mr.	Williamson	Brian	J	5022026330					bwilliamson@cei.elders.org	510 17th St., Suite 400		Oakland	CA	94612	06/23/2025	2026	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 Coordinator	Director of Sales and Enrollment	Ms.	Yi	Chi		5104331160	8825			5104528836	cyi@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	04/06/2022	2026	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 Part D Opioid Overutilization Contact	CMO	Dr.	Mittelberger	James		5104331150	7117			5104528836	JMittelberger@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2026	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	Medication Therapy Management Contact	CMO	Dr.	Mittelberger	James		5104331160	7117			5104528836	JMittelberger@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2026	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	Online Enrollment Center Contact (Back-up)	Director of Sales and Enrollment		Yi	Chi		5104331160					cyi@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	04/06/2022	2026	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	Online Enrollment Center Contact (Optional)	Director of Sales and Enrollment	Ms.	Yi	Chi		5104331150					cyi@cei.elders.org	510 17th St.		Oakland	CA	94612	04/06/2022	2026	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 C Application Contact	Senior Director of Operations		Zepeda	Crystal		5106075181					czepeda@cei.elders.org	510 17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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 Appeals	Chief Financial Officer		Holden	Laura							LHolden@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active	8443191150				PACE - Nat		C	San Francisco
H5405	Part D Application Contact	Financial Analyst	Mr.	Moon	Geoff		5104331160	7158			5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2026	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 Benefits Contact	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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 Claims Submission Contact	Financial Analyst	Mr.	Moon	Geoff		5104331160	7158			5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2026	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						5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	07/10/2012	2026	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active	5104331160	7158			PACE - Nat		C	San Francisco
H5405	Part D Exceptions Contact (Secondary)	CFO	Ms.	Holden	Laura						5108440189	LHolden@cei.elders.org	510 17th Street	2nd Floor	Oakland	CA	94612	05/01/2025	2026	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active	5103187140				PACE - Nat		C	San Francisco
H5405	Part D Price File Contact (Back-up)	Chief Financial Officer		Holden	Laura		5103187140					Lholden@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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 Price File Contact (Primary)	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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 Quality Assurance Contact	Financial Analyst	Mr.	Moon	Geoff		5104331150				5104528836	gmoon@cei.edlers.org	510-17th St., Suite 400		Oakland	CA	94612	08/25/2021	2026	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 Reporting Contact	Financial Analyst	Mr.	Moon	Geoff		5104331160	7158			5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2026	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	Patient Safety Contact	Safety Officer		Zepeda	Crystal		5104331150	5181			5104528836	cmccloud@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2026	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	Payment Contact	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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 Director	CMO	Dr	Mittelberger	James		5104331160	7117			5104528836	JMittelberger@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	04/14/2022	2026	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 Network Management Contact	Financial Analyst	Mr.	Moon	Geoff		5104331160	7158			5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2026	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 Network Management Contact (Secondary)	Consultant - Pharma Star	Ms.	Brempell	Melissa		7158522043					mbrempell@pharmastar.com	P.O. Box 3217		Eau Claire	WI	54702	08/25/2021	2026	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						5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2026	CENTER FOR ELDERS INDEPENDENCE	National PACE	Center For Elders' Independence	National PACE		Center For Elders Independence	53	Yes	Active	5104331160	7158			PACE - Nat		C	San Francisco
H5405	Plan Directory Contact for Public Website	Senior Vice President - Business Development		Tamillo	Justine		5103188869					JTamillo@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	Plan to Plan Reconciliation Contact	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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	Processor Contact	Chief Information Officer		Dhillon	Amarjit		5104331150					adhillon@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	Quality Contact	Director of Quality Improvement	Mr.	Amin	Farhan		5104331150	7374				famin@cei.elders.org	510-17th St., Suite 400		Oakland	CA	94612	03/03/2021	2026	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	Reconciliation Contact	Financial Analyst	Mr.	Moon	Geoff		5104331160	7158			5108440189	gmoon@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/16/2012	2026	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	Reconciliation Contact (Secondary)	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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	Recovery Audit Contact	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street 3rd Floor		Oakland	CA	94612	05/01/2025	2026	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	Surveillance Contact	Director of Sales and Enrollment	Ms.	Yi	Chi		5103188827					cyi@cei.elders.org	510 17th St.		Oakland	CA	94612	04/06/2022	2026	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	System Contact	Chief Information Officer	Mr.	Dhillon	Amarjit		5104331150	7103				adhillon@cei.elders.org	510 17th Street		Oakland	CA	94612	09/29/2025	2026	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	Third Party Administrator (TPA) Liaison	CFO	Ms.	Holden	Laura		5103187140				5108440189	LHolden@cei.elders.org	510 17th Street, Suite 400		Oakland	CA	94612	05/01/2025	2026	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	User Access Contact	Chief Information Officer		Dhillon	Amarjit		5104331150					adhillon@cei.elders.org	510 17th St., Suite 400		Oakland	CA	94612	09/29/2025	2026	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	Utilization Management Contact	Senior Director of Operations		Zepeda	Crystal		5106075181					czepeda@cei.elders.org	510-17th Street, Suite 400		Oakland	CA	94612	09/29/2025	2026	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	Utilization Review Contact	Chief Medical Officer		Mittelberger	Jim		5103187117					JMittelberger@cei.elders.org	510-17th Street, Suite 400		Oakland	CA	94612	09/29/2025	2026	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		9164913415				9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/22/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Backup User Access Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	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	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Bid Primary Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	CAP Report Contact for Public Website	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	CEO - CMS Administrator Contact	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	CEO - Senior Official for Contracting	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	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		9164913415				9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Chief Operating Officer	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Chief Information Officer	Clinical Application Director, I	Ms.	McEnroe	Casi		9167337221					mcenrocl@sutterhealth.org	3707 Schriever Ave		Mather	CA	95655	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Chief Information Security Officer	information Security Officer	Mr.	Lindley	Erick		9168092707					lindlej@sutterhealth.org	9100 Foothills Blvd		Roseville	CA	95747	05/18/2021	2026	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	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Complaints Tracking Contact	Quality Coordinator	Ms.	Robello-Kladde	Renee		9164913406					RobellRC@sutterhealth.org	444 N 3rd St	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Contact for Fraud Investigations	Ethics and Compliance Officer	Ms.	Arata	Aimee	E	9162979142					Aimee.Arata@sutterhealth.org	2700 Gateway Oaks Dr	Suite 1200	Sacramento	CA	95811	09/06/2024	2026	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		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Corporate Mailing						8335607223	63490			9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Ste 150	Sacramento	CA	95811	09/06/2024	2026	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	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	DIR Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	DIR Contact (Secondary)	Ethics and Compliance Officer	Ms.	Arata	Aimee		9162979142					Aimee.Arata@sutterhealth.org	2700 Gateway Oaks Dr	Suite 1200	Sacramento	CA	95833	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Discount Program Payment Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Emergency Part D Contact	Medical Director	MD	Khalsa	Maninder		8335607223					KhalsaM@sutterhealth.org	444 North 3rd Street, Ste 150		Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Emergency Part D Contact (Secondary)	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Encounter Data & Risk Adjustment Operations Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Enrollment Contact	Regional Manager, Market Development	Ms.	Grefrath	Lynette		8335607223				9164913408	grefral@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	08/10/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	EOB Transfer Contact	Finance Manager	Mr.	Salas	Rafael		9164913415				9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Financial Audit Contact	Finance Manager	Mr.	Salas	Rafael		9164913415				9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Financial Reporting Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Formulary Contact	Medical Director	MD	Khalsa	Maninder		8335607223					KhalsaM@sutterhealth.org	444 North 3rd Street, Ste 150		Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	General Contact	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	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	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	HIPAA Privacy Officer	Privacy Officer	Ms.	Batra	Shivani		6504452833					Shivani.Batra@Sutterhealth.org	9100 Foothills Blvd		Roseville	CA	95747	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	HIPAA Security Officer	Regional Info Security Officer	Ms.	Lancanshire	Andrew		9165413562					lancasa@sutterhealth.org	2750 Gateway Oaks		Sacramento	CA	95833	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Interoperability Contact	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	MA Appeals/Grievances Contact	QA Coordinator	Ms.	Robello-Kladde	Renee	C	8335607223				9164913408	RobellRC@sutterhealth.org	444 N. 3rd Street	Suite 150	Sacramento	CA	95823	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	MA Claims Processing Contact for Public Website	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Marketing Contact	Regional Manager, Market Development	Ms.	Grefrath	Lynette		8335607223				9164913408	grefral@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	08/10/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Medical Director	Medical Director	MD	Khalsa	Maninder		8335607223					KhalsaM@sutterhealth.org	444 North 3rd Street, Ste 150		Sacramento	CA	95811	05/18/2021	2026	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.	Arata	Aimee	E	5307518040					Aimee.Arata@sutterhealth.org	2700 Gateway Oaks Dr	Suite 1200	Sacramento	CA	95833	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Medicare Coordinator	Compliance Officer	Ms.	Arata	Aimee	E	9162979142					Aimee.Arata@sutterhealth.org	2700 Gateway Oaks Dr	Suite 1200	Sacramento	CA	95833	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Medicare Part D Opioid Overutilization Contact	Medical Director	MD	Khalsa	Maninder		8335607223					KhalsaM@sutterhealth.org	444 North 3rd Street, Ste 150		Sacramento	CA	95811	05/03/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Medication Therapy Management Contact	Medical Director	Dr.	Khalsa	Maninder		8335607223					KhalsaM@sutterhealth.org	444 North 3rd Street	Ste 150	Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part C Application Contact	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part D Appeals	Finance Manager	Mr.	Salas	Rafael						9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	8335607223				PACE - Nat		C	San Francisco
H5406	Part D Appeals Contact (Secondary)	Finance Manager	Mr.	Salas	Rafael						9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	8335607223				PACE - Nat		C	San Francisco
H5406	Part D Application Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part D Benefits Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part D Claims Submission Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	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						9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	8335607223				PACE - Nat		C	San Francisco
H5406	Part D Exceptions Contact (Secondary)	Chief Administrative Officer	Mrs.	Garcia	Romelia						9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	8335607223				PACE - Nat		C	San Francisco
H5406	Part D Price File Contact (Back-up)	Medical Director	MD	Khalsa	Maninder		8335607223					KhalsaM@sutterhealth.org	444 North 3rd Street, Ste 150		Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part D Price File Contact (Primary)	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part D Quality Assurance Contact	Quality Coordinator	Ms.	Robello-Kladde	Renee		9164913406					RobellRC@sutterhealth.org	444 N 3rd St	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Part D Reporting Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Patient Safety Contact	Quality Coordinator	Ms.	Robello-Kladde	Renee		9164913406					RobellRC@sutterhealth.org	444 N 3rd St	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Payment Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Pharmacy Director	Regional Pharmacy Director	Mr.	Stice	Ryan		9168777047					sticer@sutterhealth.org	2700 Gateway Oaks		Sacramento	CA	95833	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Pharmacy Network Management Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Pharmacy Network Management Contact (Secondary)	Regional Pharmacy Director	Mr.	Stice	Ryan		9168777047					sticer@sutterhealth.org	2700 Gateway Oaks		Sacramento	CA	95833	05/18/2021	2026	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						9164913484	burgesjr@sutterhealth.org	444 North 3rd Street	Ste 150	Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	8335607223				PACE - Nat		C	San Francisco
H5406	Pharmacy Technical Help Desk Contact (Secondary)	Accounting Technician	Ms.	Aceves	Maria						9164913484	acevesm@sutterhealth.org	444 North 3rd Street	Ste 150	Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active	8335607223				PACE - Nat		C	San Francisco
H5406	PHR Beneficiary Contact																	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE	Sutter SeniorCare PACE	Sutter Valley Hospitals	222	Yes	Active	8335607223				PACE - Nat		C	San Francisco
H5406	Plan Directory Contact for Public Website	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Plan to Plan Reconciliation Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Processor Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Quality Contact	Quality Coordinator	Ms.	Robello-Kladde	Renee		9164913406					RobellRC@sutterhealth.org	444 N 3rd St	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Reconciliation Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Reconciliation Contact (Secondary)	Accounting Technician	Ms.	Aceves	Maria		8335607223				9164916408	acevesm@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Recovery Audit Contact	Finance Manager	Mr.	Salas	Rafael		9164913415				9164916408	salasr@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Surveillance Contact	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	System Contact	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Third Party Administrator (TPA) Liaison	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	User Access Contact	Finance Manager	Mr.	Salas	Rafael		9164913415					salasr@sutterhealth.org	444 N 3rd Street	Suite 150	Sacramento	CA	95811	04/28/2022	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Utilization Management Contact	Medical Director	MD	Khalsa	Maninder		8335607223					KhalsaM@sutterhealth.org	444 North 3rd Street, Ste 150		Sacramento	CA	95811	05/18/2021	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5406	Utilization Review Contact	Chief Administrative Officer	Mrs.	Garcia	Romelia		8335607223				9164913408	Romelia.Garcia@sutterhealth.org	444 North 3rd Street	Suite 150	Sacramento	CA	95811	09/06/2024	2026	SUTTER VALLEY HOSPITALS	National PACE	Sutter SeniorCare PACE	National PACE		Sutter Valley Hospitals	222	Yes	Active					PACE - Nat		C	San Francisco
H5410	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	07/03/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H5410	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H5410	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H5410	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H5410	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H5410	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H5410	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5410	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	HEALTHSPRING OF FLORIDA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5420	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H5420	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5420	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5420	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H5420	Plan Directory Contact for Public Website			Customer Service	UHC		8004079069					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5420	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	Preferred Care Network, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5422	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/12/2025	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/12/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/12/2025	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/12/2025	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/12/2025	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/12/2025	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/12/2025	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	02/12/2025	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/12/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	02/12/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/12/2025	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/12/2025	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/12/2025	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/12/2025	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	02/12/2025	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	02/12/2025	2026	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	DIR Contact	Program Director		Browne	Nancy		3179197110					Nancy.Browne@anthem.com	220 Virginia Ave.		Indianapolis	IN	46204	02/12/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/16/2025	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/12/2025	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/12/2025	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	02/12/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	02/12/2025	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/12/2025	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/12/2025	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	02/12/2025	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/12/2025	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/12/2025	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/12/2025	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/12/2025	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	02/12/2025	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/12/2025	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	04/07/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/12/2025	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/12/2025	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	02/12/2025	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	02/12/2025	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/12/2025	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/12/2025	2026	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5422	Part D Appeals Contact (Secondary)	Director, PharmD Medicare Part D CAG		Zanolli	Mindy						8884581406	mindy.zanolli@elevancehealth.com	4361 Irwin Simpson Rd.	Mailstop OH0205-A537	Mason	OH	45040	02/12/2025	2026	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8144498744				HMO - Health Maintenance Organization		C	Chicago
H5422	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/12/2025	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/12/2025	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/12/2025	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/12/2025	2026	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5422	Part D Exceptions Contact (Secondary)	Product Management Director		Gray	Heather							heather.mckee@elevancehealth.com	5211 Pine Rockland Ave.		Lithia	FL	33547	05/14/2025	2026	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	9043474771				HMO - Health Maintenance Organization		C	Chicago
H5422	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	02/12/2025	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	02/12/2025	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/12/2025	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/12/2025	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/12/2025	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/12/2025	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/12/2025	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/12/2025	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	02/12/2025	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/12/2025	2026	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5422	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/12/2025	2026	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5422	PHR Beneficiary Contact																	02/12/2025	2026	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H5422	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	02/12/2025	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	02/12/2025	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/12/2025	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	02/12/2025	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/12/2025	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/12/2025	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/12/2025	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/12/2025	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/12/2025	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/12/2025	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	02/12/2025	2026	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	Agent/Broker Compensation Data Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189				mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Best Available Evidence Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/28/2019	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	CEO - CMS Administrator Contact	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	CEO - Senior Official for Contracting	Chief Executive Officer	Dr,	Jain	Sachin		5929898314				5629895225	sjain@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/30/2020	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Chief Financial Officer	Chief Financial Officer	Mr	Plumb	Michael		5629971589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/02/2020	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937	5189				kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Chief Information Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823				5629895225	v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	CMS Casework Communication Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Complaints Tracking Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189				mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2012	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/27/2014	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5625083546					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/21/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	DIR Contact (Secondary)	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/27/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/31/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/21/2022	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Employer Waiver Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Encounter Data & Risk Adjustment Operations Contact	Chief Data Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	04/11/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Enrollment Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/28/2019	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Financial Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2012	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/21/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	General Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Government Relations Contact	VP, Policy & Govt Affairs		Kazan	Matt		8005593500					m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	MA Appeals/Grievances Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/02/2021	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Medical Director	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Medicare Compliance Officer	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/19/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	OffShore Subcontractor Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/31/2015	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/09/2022	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part C Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part C Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Appeals	Sr. Director of Grievances and Appeals	Ms.	Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5629895100	1290			HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	04/29/2021	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Exceptions Contact	Sr. Manager - Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Price File Contact (Back-up)	Manager, Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	04/11/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4347				a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	04/11/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Part D Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2012	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/23/2023	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H5425	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/03/2020	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/09/2019	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Processor Contact	Senior Director Government Programs, Medicare		Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St, Louis	MO	63121	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/02/2015	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Recovery Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	SNP Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	SNP State Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Surveillance Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/17/2018	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	User Access Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5425	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN HEALTH PLAN	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072				PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	04/19/2023	2026	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	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Chief Operating Officer	Staff VP Ops & System Solutions	Mr.	Setzer	Pete		2394780540				3054603907	peter.setzer@elevancehealth.com	11430 NW 20th Street		Miami	FL	33172	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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	Dir II GBD G&A		Rolle	Celeste		8135066000	11469			8135066151	crolle@freedomh.com	5411 Sky Center Dr		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Complaints Tracking Contact	Dir II GBD G&A		Rolle	Celeste		8135066000	11469			8135066151	crolle@freedomh.com	5411 Sky Center Dr		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	04/19/2023	2026	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	Manager II, Financial Ops Dept	Ms.	Fonseca	Idany		3054488100	262			3054449148	idany.fonseca@healthsun.com	9250 West Flager Street	Suite 600	Miami	FL	33174	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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		8135066000	1621755			8135066150	CMSMemberServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	01/22/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Discount Program Payment Contact	Finance Acctg Database Analyst Sr		Racine	Max		8058163930					Max.Racine@Anthem.com	120 S Via Merida	Mail Stop: CAT202-J003	Thousand Oaks	CA	91362	04/22/2019	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Emergency Part D Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33604	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Emergency Part D Contact (Secondary)	Pharmacist Clinical Sr.		Parker	Suzi		8135645525					smparker@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33604	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Encounter Data & Risk Adjustment Operations Contact	Dir Reporting & Data Analysis		Shah	Parin		8135066000	11368				pshah@freedomh.com	5411 Skycenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Enrollment Contact	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	EOB Transfer Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Formulary Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Formulary Contact (Secondary)	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@anthem.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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		7274516800	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Interoperability Contact	Dir II Technology	Mr.	Kumbhani	Dev		8135066000	11146				cms@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	MA Appeals/Grievances Contact	Dir II GBD G&A		Rolle	Celeste		8135066000	11469				crolle@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	MA Claims Processing Contact for Public Website	VP of Finance	Mr	Caruso	David		8004012740				8135066236	CMSMemberServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Medical Director	Chief Medical Officer	Dr.	Rios, D.O.	Jeannette	M	7868310456				3054449148	jrios@simplyhealthcareplans.com	11430 NW 20th St	#300	Miami	FL	33172	08/20/2025	2026	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	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Medication Therapy Management Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	1621753			8134905338	bmarrocco@freedomh.com	5411 Sky Center Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Online Enrollment Center Contact (Back-up)	QM Acred/Reg Review Analyst		Barone-Raba	Michelle		8135066000	11444				CMSEnrollment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Pharmacy Clinical Ops		Marrocco	Brianna						8134905338	bmarrocco@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8135066000	1621753			HMO - Health Maintenance Organization		C	Chicago
H5427	Part D Appeals Contact (Secondary)	Pharmacist Clinical Sr.		Parker	Suzi						8134905338	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8135066000	1621401			HMO - Health Maintenance Organization		C	Chicago
H5427	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072				PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	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 Claims Submission Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072				PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	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	Dir II GBD G&A		Rolle	Celeste						8135066152	crolle@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8135066000	11469			HMO - Health Maintenance Organization		C	Chicago
H5427	Part D Exceptions Contact (Secondary)	Mgr I Grievance/Appleals		Anda	Diana						8135066152	diana.anda@wellpoint.com	11430 NW 20th St		Miami	FL	33172	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	3054488100				HMO - Health Maintenance Organization		C	Chicago
H5427	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Director II Technology		KUMBHANI	DEVCHAND		8135066000	11146				CMSTechsupport@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					amanda.nicholson-sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/08/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	05/21/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Payment Contact	Fin Acctg Database Analyst Sr	Mr.	Racine	Max	J	8058163930					Max.Racine@Anthem.com	2000 Corporate Center Drive	Mail Stop: CANP02-I001	Newbury Park	CA	91320	04/26/2023	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Pharmacy Director	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Road		Mason	OH	45040	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacey		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Drive		Woburn	MA	01801	07/05/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Road		Mason	OH	45040	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5427	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy	M						amym.matthews@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5427	PHR Beneficiary Contact																	06/07/2010	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS	Freedom Health, Inc.	Elevance Health, Inc.	1	Yes	Active	8004012740				HMO - Health Maintenance Organization		C	Chicago
H5427	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Plan Directory Contact for Public Website	Director of Member Services		Doroteo	Carlos		8004012740					cms@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Plan to Plan Reconciliation Contact	P2P Contact		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd	Ste 100 Mailstop CA9304-R04H	Woodland Hills	CA	91367	06/14/2021	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Processor Contact	Director Pharmacy Management		Fowler	Kendra		7573815066					kendra.fowler@Ingenio-Rx.com	1330 Amerigroup Way		Virginia Beach	VA	23464	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Quality Contact	Director Quality Management		Patel	Shetal		8135066000	11413				HealthServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/21/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	System Contact	Director II Technology	Mr	Kumbhani	Devchand		8135066000	11146				CMSTechsupport@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Third Party Administrator (TPA) Liaison	Finance Acctg Database Analyst Sr		Racine	Max		8058163930					Max.Racine@Anthem.com	120 S Via Merida	Mail Stop: CAT202-J003	Thousand Oaks	CA	91362	04/22/2019	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Utilization Management Contact	Staff VP Medicare Ops & Healthcare Management		Szabla	Sara		8135066000	11409			8135066236	HealthServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5427	Utilization Review Contact	Staff VP Medicare Ops & Healthcare Management		Szabla	Sara		8135066000	11409			8135066236	HealthServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	FREEDOM HEALTH, INC.	Local CCP	Freedom Health, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5431	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Data Analyst	Mr.	Roberts	Jerryon		3052349292	250				Jerryon_Roberts@healthsun.com	9250 West Flager Street		Miami	FL	33174	07/05/2024	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	04/19/2023	2026	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	Manager I, Membership		Holmes	Yaunna		3054488100				3054603907	yaunna.holmes@healthsun.com	11430 NW 20th Street		Miami	FL	33172	07/05/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	07/05/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	07/05/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	Staff VP Ops & System Solutions	Mr.	Setzer	Pete		2394780540				3054603907	peter.setzer@elevancehealth.com	11430 NW 20th Street		Miami	FL	33172	07/05/2024	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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	Manager I, Grievance & Appeal		Figueroa	Diana		3054488100				3054449148	g&a-extcomp@healthsun.com	9250 West Flager Street	Suite 600	Miami	FL	33174	08/26/2025	2026	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	Complaints Tracking Contact	Manager I, Grievance & Appeal		Figueroa	Diana		3054488100				3054449148	g&a-extcomp@healthsun.com	9250 West Flager Street	Suite 600	Miami	FL	33174	08/26/2025	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	04/26/2023	2026	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	Manager II, Financial Ops Dept	Ms.	Fonseca	Idany		3054488100	262			3054449148	idany.fonseca@healthsun.com	9250 West Flager Street	Suite 600	Miami	FL	33174	07/05/2024	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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		3054488100	559			3054449148	memberservicesleaders@healthsun.com	9250 West Flager Street	Suite 600	Miami	FL	33174	07/05/2024	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/23/2024	2026	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	Emergency Part D Contact	Director Pharmacy		Martinez	Massiel		3059260380					cms_partd@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/14/2025	2026	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	Emergency Part D Contact (Secondary)	Director Pharmacy		Martinez	Massiel		3059260380					Massiel.martinez@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/14/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Reporting & Data Analysis		Shah	Parin		8135066000	11368				pshah@freedomh.com	5411 Skycenter Drive		Tampa	FL	33607	05/22/2024	2026	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	Enrollment Contact	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	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	EOB Transfer Contact	Data Analyst	Mr.	Roberts	Jerryon		3052349292	250			3054449148	cms_troop@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/21/2024	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director of the Med D CPOps	Mr.	Vercueil	Alfonso		9492336807					Alfonso.Vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Director Pharmacy		Martinez	Massiel		3054488100	353				Massiel.martinez@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/14/2025	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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		3054488100	353				cms_partd@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/21/2024	2026	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	Interoperability Contact	Director II, Engineering		Devaguptapu	Raj		2243548711					raj.devaguptapu@elevancehealth.com	233 S. Wacker Drive		Chicago	IL	60606	07/05/2024	2026	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	MA Appeals/Grievances Contact	Manager I, Grievance & Appeal	Ms.	Figueroa	Diana		3058045087				3054603907	g&a-extcomp@healthsun.com	9250 West Flager Street	Suite 600	Miami	FL	33174	08/26/2025	2026	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	MA Claims Processing Contact for Public Website	HealthSun Provider Inquiry		Inquiry	Provider		8779997776				7863935722	Provider_Call_Unit@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/21/2024	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Rios, D.O.	Jeannette	M	7868310456				3054449148	jrios@simplyhealthcareplans.com	11430 NW 20th St	#300	Miami	FL	33172	10/09/2024	2026	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	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/14/2024	2026	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	Online Enrollment Center Contact (Back-up)	Enrollment Data Analyst III	Mr.	Rivera	Alexander		3054488100	297			3056750652	alexander.rivera@healthsun.com	9250 W. Flager Street	Suite 600	Miami	FL	33174	07/05/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager I, Grievance & Appeal	Ms.	Figueroa	Diana						3054603907	g&a-extcomp@healthsun.com	9250 W. Flager Street	Suite 600	Miami	FL	33174	08/26/2025	2026	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8773362069				HMO - Health Maintenance Organization		C	Chicago
H5431	Part D Appeals Contact (Secondary)	Director Clinical Programs		Martinez	Massiel						3054449148	cms_partd@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33132	05/21/2024	2026	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8773362069				HMO - Health Maintenance Organization		C	Chicago
H5431	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/31/2024	2026	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 Claims Submission Contact	Director Clinical Programs		Martinez	Massiel		3054488100	353				cms_partd@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/21/2024	2026	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	Manager I, Grievance & Appeal	Ms.	Figueroa	Diana							g&a-extcomp@healthsun.com	9250 W. Flager Street	Suite 600	Miami	FL	33174	08/26/2025	2026	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8773362069				HMO - Health Maintenance Organization		C	Chicago
H5431	Part D Exceptions Contact (Secondary)	Director II, GBD Grievance & Appeal	Ms.	Rolle	Celeste						3054603907	g&a-extcomp@healthsun.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8773362069				HMO - Health Maintenance Organization		C	Chicago
H5431	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Director Clinical Programs		Martinez	Massiel		3054488100	353				cms_partd@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/21/2024	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	07/05/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	07/05/2024	2026	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	Payment Contact	Fin Acctg Database Analyst Sr	Mr.	Racine	Max	J	8058163930					Max.Racine@Anthem.com	2000 Corporate Center Drive	Mail Stop: CANP02-I001	Newbury Park	CA	91320	08/09/2022	2026	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 Director	Director Pharmacy		Martinez	Massiel		3054488100	353				cms_partd@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/14/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Road		Mason	OH	45040	12/15/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacey		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Drive		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Road		Mason	OH	45040	12/15/2023	2026	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5431	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy	M						amym.matthews@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	12/15/2023	2026	HEALTHSUN HEALTH PLANS, INC.	Local CCP	HealthSun Health Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5431	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website	HealthSun Member Services		Services	Member		8773362069				3054485783	MemberServicesStaff@healthsun.com	11430 NW 20th Street	Suite 300	Miami	FL	33172	05/21/2024	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	06/14/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Staff VP Medicare Ops & Healthcare Management		Szabla	Sara		8135066000	11409			8135066236	HealthServices@freedomh.com	5411 Sky Center Drive		Tampa	FL	33607	05/14/2025	2026	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	Reconciliation Contact	Actuarial Analyst III		Slezewick	Michael		3173627850					michael.slezewick@ingenio-RX.com	4241 Irwin Simpson Road		Mason	OH	45040	07/05/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	03/21/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director II, Engineering		Devaguptapu	Raj		2243548711					raj.devaguptapu@elevancehealth.com	233 S. Wacker Drive		Chicago	IL	60606	07/05/2024	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	07/05/2024	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Staff VP Medicare Ops & HCM		Szabla	Sara		8135066000				3054449148	shszabla@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	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	Utilization Review Contact	Staff VP Medicare Ops & HCM		Szabla	Sara		8135066000				3054449148	shszabla@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/05/2024	2026	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	Agent/Broker Compensation Data Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		8587906250				8587906052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Backup User Access Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/24/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Best Available Evidence Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Bid Audit Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Bid Audit Site Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Bid Primary Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	CAP Report Contact for Public Website	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Hunn	Michael		7142729639					michael.hunn@caloptima.org	505 City Parkway West		Orange	CA	92868	01/06/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Hunn	Michael		6579001481					michael.hunn@caloptima.org	505 City Parkway West		Orange	CA	92868	03/08/2022	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Chief Financial Officer	Chief Financial Officer	Ms.	Huang	Nancy		6572356935					nhuang@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Chief Operating Officer	Chief Operating Officer	Ms.	Kim	Yunkyung		7149238834					yunkyung.kim@caloptima.org	505 City Parkway West		Orange	CA	92868	12/21/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Chief Information Officer	Chief Information Officer	Ms.	Linder	Kathleen		7144759291					kathleen.linder@caloptima.org	505 City Parkway West		Orange	CA	92868	01/17/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Chief Information Security Officer	Sr. Director Information Security Officer	Mr.	Steele	James		7144976046					james.steele@caloptima.org	505 City Parkway West		Orange	CA	92868	01/16/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	CMS Casework Communication Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	kendrixnguyen@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Complaints Tracking Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Contact for Fraud Investigations	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Coordination of Benefits Contact			Cardenas	Albert		7142468878					COBinquiries@caloptima.org	505 City Parkway West		Orange	CA	92868	04/21/2022	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Corporate Mailing						6572356994					aphillips@caloptima.org	505 City Parkway West		Orange	CA	92868	05/06/2021	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Customer Service Operations Contact	Executive Director, Operations		Khamseh	Ladan		7142468866					lkhamseh@caloptima.org	505 City Parkway West		Orange	CA	92868	04/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	DIR Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	DIR Contact (Secondary)	Program Manager		Kurth	Jennifer		7142468767					jkurth@caloptima.org	505 City Parkway West		Orange	CA	92868	11/01/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Discount Program Payment Contact	Manager, Accounting		Hoang	Ally		7147966133					ally.hoang@caloptima.org	505 City Parkway West		Orange	CA	92868	06/09/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Electronic Health Record Contact	Director, Information Services		Onishi	Nora		7142468630					nonishi@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Emergency Part D Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Emergency Part D Contact (Secondary)	Manager, Pharmacy Management		Pham	Jacqueline		7143473206					jpham@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Encounter Data & Risk Adjustment Operations Contact	Director, Financial Compliance		Klipfel	Kelly		7142468528					kklipfel@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Enrollment Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	EOB Transfer Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Financial Audit Contact	Director, Regulatory Affairs & Compliance Medicare	Ms.	Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Financial Reporting Contact	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Formulary Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Formulary Contact (Secondary)	Clinical Pharmacist, Pharmacy Management		Reeves	Christophe		7142468474				7149542297	creeves@caloptima.org	505 City Parkway West		Orange	CA	92868	01/15/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	General Contact	Director, Regulatory Affairs & Compliance		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Government Relations Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	HIPAA Privacy Officer	Director, Privacy		Royal	Eric		6579001313					eric.royal@caloptima.org	505 City Parkway West		Orange	CA	92868	07/31/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	HIPAA Security Officer	Director, Privacy		Royal	Eric		6579001313					eric.royal@caloptima.org	505 City Parkway West		Orange	CA	92868	07/31/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Hospice Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Interoperability Contact	IT Project Manager, Sr		DeFrain	Phil		7142468477					pdefrain@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	MA Appeals/Grievances Contact	Director, Grievances & Appeals Resolution Services		Sedillo	Heather		6576508997					heather.sedillo@caloptima.org	505 City Parkway West		Orange	CA	92868	03/27/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	MA Claims Processing Contact for Public Website	Director, Claims Administration		Tungol	Cesar		7147966141					ctungol@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Marketing Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Medical Director	OneCare Medical Director	Dr.	Arabo	Steven		6572356890					steven.arabo@caloptima.org	505 City Parkway West		Orange	CA	92868	04/27/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Medicare Compliance Officer	Director of Regulatory Affairs and Compliance, Med	Ms.	Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Medicare Coordinator	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Medication Therapy Management Contact	Manager, Clinical Pharmacy Management		Ghazanfarpour	Nicki		7147966166				7147966649	nghazanfarpour@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	OffShore Subcontractor Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Online Enrollment Center Contact (Back-up)	OneCare Customer Service Department		Garcia	Jesse		8774122734					onecareenrollment@caloptima.org	505 City Parkway West		Orange	CA	92868	11/09/2021	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Online Enrollment Center Contact (Optional)	OneCare Customer Service Department		Partners	OneCare		8774122734					onecareenrollment@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Online Enrollment Center Contact (Primary)	OneCare Customer Service Department		Cardenas	Albert		8774122734					onecareenrollment@caloptima.org	505 City Parkway West		Orange	CA	92868	11/09/2021	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part C Application Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part C Reporting Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Appeals	Manager, Pharmacy Management		Nguyen	Kendrix						7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	7142468646				HMO - Health Maintenance Organization		C	New York
H5433	Part D Appeals Contact (Secondary)	Manager, Pharmacy Management		Pham	Jacqueline							jpham@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	7143473206				HMO - Health Maintenance Organization		C	New York
H5433	Part D Application Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Benefits Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Claims Submission Contact			Rivera-Aquino	Denisse		8582915269					PDE@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Exceptions Contact	Manager, Pharmacy Management		Nguyen	Kendrix						7149542313	Kendrixnguyen@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	7142468646				HMO - Health Maintenance Organization		C	New York
H5433	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Management		Pham	Jacqueline							jpham@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	7143473206				HMO - Health Maintenance Organization		C	New York
H5433	Part D Price File Contact (Back-up)	Medicare Part D Manager		Keller	Shanon		8587906455				8587906038	planfindercommunications@medImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/16/2021	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Price File Contact (Optional)	Medicare Part D Manager		Keller	Shanon		8587906455				8587906038	planfindercommunications@medImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/16/2021	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Price File Contact (Primary)	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Quality Assurance Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Part D Reporting Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Patient Safety Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Payment Contact	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Pharmacy Director	Chief Medical Officer	Dr.	Pitts	Richard		7142468491					richard.pitts@caloptima.org	505 City Parkway West		Orange	CA	92868	01/17/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Pharmacy Network Management Contact	Manager, PNS & Claims Operations		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/28/2015	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Pharmacy Network Management Contact (Secondary)	Pharmacist, Pharmacy Management		Vigil	Susan		7143473296				7143383169	svigil@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
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	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	8008195532				HMO - Health Maintenance Organization		C	New York
H5433	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Management		Nguyen	Kendrix						7149542313	Kendrixnguyen@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active	7142468646				HMO - Health Maintenance Organization		C	New York
H5433	Physician Incentive Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Plan Directory Contact for Public Website			Service	Customer		8774122734					acardenas@caloptima.org	505 City Parkway West		Orange	CA	92868	02/28/2017	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Plan to Plan Reconciliation Contact	Controller		Kaing	Jason		6579001373					p2p@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Processor Contact	Director, Medicare Programs		Davis-Jones	De'Lona	M	8587906229					DeLona.Davis-Jones@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Quality Contact	Executive Director, Quality Improvement		Lee	Linda		6579001069					Linda.lee@caloptima.org	505 City Parkway West		Orange	CA	92868	04/27/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Reconciliation Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Reconciliation Contact (Secondary)	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Recovery Audit Contact	Director, Regulatory Affairs & Compliance Medicare	Ms.	Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	SNP Application Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	SNP State Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Surveillance Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	System Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	12/12/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Third Party Administrator (TPA) Liaison	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	User Access Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Utilization Management Contact	Executive Director		Giardina	Kelly		6579001013					kelly.giardina@caloptima.org	505 City Parkway West		Orange	CA	92868	09/08/2022	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5433	Utilization Review Contact	Executive Director		Giardina	Kelly		6579001013					Kelly.giardina@caloptima.org	505 City Parkway West		Orange	CA	92868	09/08/2022	2026	ORANGE COUNTY HEALTH AUTHORITY	Local CCP	CalOptima Health OneCare	HMO/HMOPOS		Orange County Health Authority	39	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5434	Agent/Broker Compensation Data Contact	VP Product, Growth and Operations		Davis	Andrea		8478265793					andrea.davis@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	11/01/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Automated TrOOP Balance Transfer Contact	Manager, PBM operations	Ms.	Hanson	Michelle		6127776755				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/27/2020	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Backup User Access Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	04/11/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Best Available Evidence Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Bid Audit Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Bid Audit Site Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Bid Primary Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	CAP Report Contact for Public Website	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	CEO - CMS Administrator Contact	EVP, Medicare Chief Innovation& Experience Officer	Mrs	Harrison	Camille		9049051801					Camille.Harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr.	Jacksonville	FL	32246	01/06/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	CEO - Senior Official for Contracting	EVP, Medicare, Chief Innovation&Experience Officer	Mrs.	Harrison	Camille		9049051801					camille.harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	12/26/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Chief Financial Officer	VP Medicare CFO	Mrs	Dorsett	Kareen		4048087542					Kareen.Dorsett@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400,	Jacksonville	FL	32246	02/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Chief Operating Officer	Senior Vice President Medicare	Ms.	Pieraccini	Alisha		7164659217					Alisha.Pieraccini@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	11/01/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Chief Information Officer	SVP Chief Information Officer	Mr.	Anderson	Gary		9049050180					gary.anderson@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 8th Floor	Jacksonville	FL	32246	01/27/2016	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Raymond	Jason		9049050070					jason.raymond@floridablue.com	4800 Deewood Campus Parkway	DCC Building 600, 2nd Floor	Jacksonville	FL	32246	04/04/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	CMS Casework Communication Contact	Sr Manager Med Ops & Integrity		Irizarry	Haydee		3212330635					Haydee.Irizarry@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	04/25/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Complaints Tracking Contact	Sr Manager Med Ops & Integrity		Irizarry	Haydee		3212330635					Haydee Irizarry@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	04/25/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Contact for Fraud Investigations	Sr. Manager Fraud Investigation		Ramos	Jose		9049055835					jose.romas@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 400, 6th Floor	Jacksonville	FL	32246	04/04/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Coordination of Benefits Contact	Manager PBM Operations		Hanson	Michelle		6127776755				3127776706	COBMedD@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	02/16/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Corporate Mailing						9049054668					Hillary.Simpson@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/16/2018	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Customer Service Operations Contact	Sr Director Member Contact		Gamble	LaTonya		9049052057					latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/04/2019	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	DIR Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	DIR Contact (Secondary)	Medicare Actuary Director		Dougherty	Emily		9049053894					Emily.Dougherty@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Discount Program Payment Contact	Accountant I, Corporate Receivables		Lance	Deavon		8134162412					Deavon.Lance@bcbsfl.com	4800 Deerwood Campus Pkwy	Bldg 100, 5th Floor	Jacksonville	FL	32246	12/05/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Emergency Part D Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9045259651					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Emergency Part D Contact (Secondary)	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	01/24/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Employer Waiver Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4thFloor	Jacksonville	FL	32246	04/04/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Encounter Data & Risk Adjustment Operations Contact	FBM Sr. Dir. RA Strategy & PM		Nair	Sudhir		2484175129					sudhir.nair@bcbsfl.com	4800 Deerwood Parkway		Jacksonville	FL	32246	02/18/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Enrollment Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	EOB Transfer Contact	Sr Director Member Contact		Gamble	LaTonya		9049052057				9043576121	latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	05/10/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Financial Audit Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Financial Reporting Contact	VP Medicare CFO		Dorsett	Kareen		9049051754					Kareen.Dorsett@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400	Jacksonville	FL	32246	08/20/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Formulary Contact	Medicare Clinical Pharmacist		Keaton	Stephanie		9049050114					stephanie.keaton@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	12/06/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/08/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	General Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	05/10/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Government Relations Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	05/10/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	HIPAA Privacy Officer	Sr. Counsel		Resnick	Steven		9049055025					steven.resnick@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	05/08/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	HIPAA Security Officer	VP Chief Information Security Officer		Raymond	Jason		9049050070					jason.raymond@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 600, 2nd Floor	Jacksonville	FL	32246	01/04/2019	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Hospice Contact	Sr. Manager Pharmacy		Adams	Tangela		9049050002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Interoperability Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th FL	Jacksonville	FL	32246	01/26/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	MA Appeals/Grievances Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	MA Claims Processing Contact for Public Website	FBM Dir. Claims		Stephens	Anquenette		2053353002					Anquenette.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Marketing Contact	FBM Spec.IV Product Operations		Lilly	Wanda		9043573900					wanda.lilly@bcbsfl.com	4800 Deerwood Campus Parkway	Building 400, 3rd Floor	Jacksonville	FL	32246	04/27/2023	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Medical Director	VP & CMO FBM	Dr.	Graf	Thomas		5704496647					Thomas.Graf@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	01/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Medicare Compliance Officer	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Medicare Coordinator	EVP, Medicare, Chief Innovation&Experience Officer	Mrs.	Harrison	Camille		9049051801					camille.harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	11/17/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists		Schons	Allison		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	07/19/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Medication Therapy Management Contact	Sr. Manager Pharmacy		Martinez	Diony		9049058882					Diony.Martinez@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	OffShore Subcontractor Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Online Enrollment Center Contact (Back-up)	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Online Enrollment Center Contact (Optional)	Sr. Manager Medicare Regulatory Ops		Stephens	Kate		9049055131					Kate.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 300 4th Flr	Jacksonville	FL	32246	08/04/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Online Enrollment Center Contact (Primary)			EMB Analysts	FBM Ops		9049051711					FB_Medicare_Ops_EMB_Analysts@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 2nd Floor	Jacksonville	FL	32246	05/06/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part C Application Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part C Reporting Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th floor	Jacksonville	FL	32246	04/11/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Appeals	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773736	56307			PPO - BBA		C	Dallas
H5434	Part D Appeals Contact (Secondary)	Spec IIIb Business Support		Barr	Shamika						9043011849	Shamika.Barr@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773636	54283			PPO - BBA		C	Dallas
H5434	Part D Application Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Benefits Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Claims Submission Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Exceptions Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773736	56307			PPO - BBA		C	Dallas
H5434	Part D Exceptions Contact (Secondary)	Regulatory Manager & Audit Response		Gonzales	Santiago						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55120	07/19/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	8006936651				PPO - BBA		C	Dallas
H5434	Part D Price File Contact (Back-up)	QA Analyst		Tastad	Emily		6127772557					emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/29/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Price File Contact (Optional)	Director Business Support		Chaney	Saraye		9049055878					saraye.chaney@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Price File Contact (Primary)	Business Support Specialist IIIb		Barr	Shamika		9049054283					Shamika.Barr@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Quality Assurance Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Part D Reporting Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th floor	Jacksonville	FL	32246	04/11/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Patient Safety Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Payment Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Pharmacy Director	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Pharmacy Network Management Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Pharmacy Network Management Contact (Secondary)	Sr. Dir, Network Client Services		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55122	07/19/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
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	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	8888776420				PPO - BBA		C	Dallas
H5434	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Member Services		Garza-Rodriguez	Melissa							MGarzarodriguez@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	07/30/2018	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active	2143366770				PPO - BBA		C	Dallas
H5434	Plan Directory Contact for Public Website			Mbr Svcs	Medicare		8009266565					Chrissy.This@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	05/05/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Plan to Plan Reconciliation Contact	Accounting Specialist		Williams	Lynn		9049054568					lynn.williams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	01/04/2019	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Processor Contact	FBM Dir. Claims		Stephens	Anquenette		2053353002					Anquenette.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Quality Contact	VP Medicare Quality		Neal	Leigh Anne		8037608701					leighanne.neal@bcbsfl.com	1388 Beechfern Circle		Elgin	SC	29045	07/11/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Reconciliation Contact	Medicare Actuary Director		Dougherty	Emily		9049053894					emily.dougherty@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Reconciliation Contact (Secondary)	Managing Actuary		Scott	Branson		9049054691					Branson.Scott2@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Recovery Audit Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Surveillance Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	System Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Third Party Administrator (TPA) Liaison	Sr. Manager Pharmacy		Adams	Tangela		9049050002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	User Access Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Utilization Management Contact	Sr. Manager - Case Management, Health Management		Wiggins	Dawn		9048858813					Dawn.Wiggins@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	11/10/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5434	Utilization Review Contact	Sr. Manager - Case Management, Health Management		Wiggins	Dawn		9048858813					Dawn.Wiggins@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	11/10/2025	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	Local CCP	Florida Blue	Local PPO		Guidewell Mutual Holding Corporation	594	Yes	Active					PPO - BBA		C	Dallas
H5435	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PFFS - Private Fee for Service		C	Boston
H5435	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PFFS - Private Fee for Service		C	Boston
H5435	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PFFS - Private Fee for Service		C	Boston
H5435	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	PFFS Terms and Conditions of Payment Contact for Public Website	VP, Product		Graham	Jennifer		9529314994					jennifer_graham@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PFFS - Private Fee for Service		C	Boston
H5435	Plan Directory Contact for Public Website			Customer Service	UHC		8665798774					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5435	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	PFFS	UnitedHealthcare	PFFS		UnitedHealth Group, Inc.	239	Yes	Active					PFFS - Private Fee for Service		C	Boston
H5439	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Medical Director	Chief Medical Officer	Dr.	Chen	Alex		8186766564					alex.y.chen@healthnet.com	21281 Burbank Blvd		Woodland Hills	CA	91367	03/30/2021	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H5439	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H5439	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H5439	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H5439	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H5439	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H5439	PHR Beneficiary Contact																	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8665498289				PPO - BBA		C	Denver
H5439	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5439	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/25/2024	2026	HEALTH NET LIFE INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5447	Agent/Broker Compensation Data Contact	Director, Government Programs		Gamboa	Brandie		2103586491					Dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Automated TrOOP Balance Transfer Contact	Operations Mgr. Enrollment & Elig.		Sherman	Mandy		9202214083				9202214583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/02/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Backup User Access Contact	Director, Infrastructure Services		Allen	Jeffrey		2105262301					Jallen@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Best Available Evidence Contact	Controller, Financial Accounting		Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Bid Audit Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Bid Primary Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	CAP Report Contact for Public Website	Interim Executive Director of Compliance		Morris	Stephanie		2105102611					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Scepanski	Theresa		2103586011					TScepanski@cfhp.com	12238 Silicon Drive	STE 100	SAN ANTONIO	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	CEO - Senior Official for Contracting	Chief Operating Officer	Ms.	Scepanski	Theresa		2103586011					tscepanski@cfhp.com	12238 Silicon Drive	STE 100	SAN ANTONIO	TX	78249	03/24/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	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		2103586013					DIsaac@cfhp.com	12238 Silicon Drive	STE 100	SAN ANTONIO	TX	78249	05/03/2021	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Chief Operating Officer	Chief Operating Officer	Ms.	Scepanski	Theresa		2103586011					TScepanski@cfhp.com	12238 Silicon Drive	STE 100	SAN ANTONIO	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Chief Information Officer	CIO, Security Officer	Mr.	Nyaribo	Kevin		2103586130					knyaribo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Chief Information Security Officer	CIO, Security Officer	Mr.	Nyaribo	Kevin		2103586130					knyaribo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	CMS Casework Communication Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Complaints Tracking Contact	Interim Executive Director of Compliance		Morris	Stephanie		2105102611					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Contact for Fraud Investigations			Cardona	Leticia		2105102456					SIURequests@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Coordination of Benefits Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Corporate Mailing						2103586396					JRazo@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	04/28/2022	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	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		2103586062					MGonzalez@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/30/2020	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	DIR Contact	Controller, Financial Accounting		Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	DIR Contact (Secondary)	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Discount Program Payment Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Electronic Health Record Contact	Interim Executive Director of Compliance		Morris	Stephanie		2105102611					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Dr. STE 100		San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Emergency Part D Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pFavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Emergency Part D Contact (Secondary)	Dir. Med. Mgmt & Pharmacy		Younts	Stephanie		2103586171					syounts@cfhp.com	12238 Silicon Drive, Suite 100		San Antonio	TX	78249	02/16/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Encounter Data & Risk Adjustment Operations Contact	CIO, Security Officer		Nyaribo	Kevin		2103586130					knyaribo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Enrollment Contact	Asst. Director, Enrollment Unit, Member Services		Gonzales	Thelma		2103586161					TGonzales2@cfhp.com	12238 Silicon Dr, STE 100		San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	EOB Transfer Contact	Director, Government Programs		Gamboa	Brandie		2103586491				2103586099	dl_governmentprograms@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Financial Audit Contact	Director, Financial Accounting	Ms.	Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/24/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Financial Reporting Contact	Controller, Financial Accounting		Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Formulary Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	04/27/2022	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	General Contact	Director, Government Programs		Gamboa	Brandie		2103586491					bgamboa@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/21/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Government Relations Contact	Director, Government Programs		Gamboa	Brandie		2103586491					bgamboa@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	04/16/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	HIPAA Privacy Officer	Interim Executive Director of Compliance		Morris	Stephanie		2105102611					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	HIPAA Security Officer	CIO, Security Officer		Nyaribo	Kevin		2103586130					knyaribo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Hospice Contact	VP, PHM		Chapa	Maria	E	2103586488					mchapa@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Interoperability Contact	CIO, Security Officer		Nyaribo	Kevin		2103586130					knyaribo@cfhp.com	12238 Silicon Drive		San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	MA Appeals/Grievances Contact	Interim Executive Director of Compliance		Morris	Stephanie		2105102611					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	MA Claims Processing Contact for Public Website	Executive Director, Claims		Padron	Meredith		2103586063				2103586014	mpadron@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Marketing Contact	Vice President, Experience & Growth		Razo	Judy		2103586396					JRazo@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Medical Director	Chief Medical Officer	Dr.	Yao	Jessica		2103586103					JYao@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/24/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Medicare Compliance Officer	Interim Executive Director of Compliance	Ms.	Morris	Stephanie		2105102611					smorris@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	11/24/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Medicare Coordinator	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Medicare Part D Opioid Overutilization Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Medication Therapy Management Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	OffShore Subcontractor Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr.	Suite 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Online Enrollment Center Contact (Back-up)	Vice President, Experience & Growth		Razo	Judy		2103586396					jRazo@cfhp.com	12238 Silicon Drive, STE 100		San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Online Enrollment Center Contact (Optional)	Government Programs Manager		Trevino	Michele		2103586489					DL_GovernmentPrograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Online Enrollment Center Contact (Primary)	Asst. Director, Enrollment Unit, Member Services		Gonzales	Thelma		2103586161					Tgonzales2@cfhp.com	12238 Silicon Dr, STE 100		San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part C Application Contact	Director, Government Programs		Gamboa	Brandie		2103586491					bgamboa@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	04/16/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part C Reporting Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Appeals	Supervisor, Grievance & Appeals		Blair	Rachel						8442689791	Rachel.Blair@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Appeals Contact (Secondary)	Executive Director, Pharmacy Services		Favila	Patricia							pfavila@cfhp.com	12238 Silicon Drive, Suite 100		San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	2103586402				HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Application Contact	Government Programs Director		Gamboa	Brandie		2103586491					DL_GovernmentPrograms@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	05/02/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Benefits Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/03/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Claims Submission Contact	Manager, Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/10/2020	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Exceptions Contact	Assoc. Director, Clinical Prior Authorization		LeClair	Christophe						9202214676	Christopher.LeClair@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/02/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Exceptions Contact (Secondary)	Executive Director, Pharmacy Services		Favila	Patricia							pfavila@cfhp.com	12238 Silicon Drive	Suite 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	2103586402				HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Price File Contact (Back-up)	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Price File Contact (Optional)			Plan Finder	Navitus		5122313140					Plan.Finder@navitus.com	361 Integrity Drive		Madison	WI	53717	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	361 Integrity Drive		Madison	WI	53717	04/03/2023	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Quality Assurance Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/03/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Part D Reporting Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Patient Safety Contact	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Payment Contact	Controller, Financial Accounting		Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Pharmacy Director	Executive Director, Pharmacy Services		Favila	Patricia		2103586402					pfavila@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	01/03/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Pharmacy Network Management Contact	VP, Network Management		Santos	Christina		6088204408					Christina.Santos@Navitus.com	361 Integrity Drive		Madison	WI	53717	04/02/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Pharmacy Network Management Contact (Secondary)	Executive Director, Pharmacy Services		Favila	Patricia		2103586402				2103586385	pfavila@cfhp.com	12238 Silicon Drive	Suite 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	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						9202214724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/07/2022	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H5447	Pharmacy Technical Help Desk Contact (Secondary)	Executive Director, Pharmacy Services		Favila	Patricia						2103586385	pfavila@cfhp.com	12238 Silicon Drive	Suite 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active	2103586402				HMO - Health Maintenance Organization		C	Dallas
H5447	Plan Directory Contact for Public Website	Vice President, Experience & Growth		Razo	Judy		2103586396					JRazo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Plan to Plan Reconciliation Contact	Controller, Financial Accounting		Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Processor Contact	CIO, Security Officer		Nyaribo	Kevin		2103586051					knyaribo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Quality Contact	Vice President. Chief Quality Officer		Eddy	Julie Anne		2103586472					jeddy@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	07/17/2024	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Reconciliation Contact	Controller, Financial Accounting		Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Recovery Audit Contact	Executive Director, Claims	Ms.	Padron	Meredith		2103586063					mpadron@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	SNP Application Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Drive	Ste. 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	SNP State Contact	Director, Government Programs		Gamboa	Brandie		2103586491					dl_governmentprograms@cfhp.com	12238 Silicon Drive	Suite 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Surveillance Contact	Interim Executive Director of Compliance		Morris	Stephanie		2105102611					DL_CFHP_Regulatory@cfhp.com	12238 Silicon Dr.	STE 100	San Antonio	TX	78249	11/06/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	System Contact	CIO, Security Officer		Nyaribo	Kevin		2103586130					knyaribo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Third Party Administrator (TPA) Liaison	Controller, Financial Accounting		Romero	Lorena		2103586181					lromero@cfhp.com	12238 Silicon Drive	STE 100	San Antonio	TX	78249	07/23/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	User Access Contact	CIO, Security Officer		Nyaribo	Kevin		2103586130					knyaribo@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	11/12/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Utilization Management Contact	VP, PHM		Chapa	Maria	E	2103586488					mchapa@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5447	Utilization Review Contact	VP, PHM		Chapa	Maria	E	2103586488					mchapa@cfhp.com	12238 Silicon Dr	STE 100	San Antonio	TX	78249	03/19/2025	2026	COMMUNITY FIRST HEALTH PLANS, INC.	Local CCP	Community First	HMO/HMOPOS		Bexar County Hospital District	751	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5453	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H5453	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H5453	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H5453	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H5453	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H5453	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H5453	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H5453	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5453	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5454	Agent/Broker Compensation Data Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Backup User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Bid Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Bid Audit Site Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Bid Primary Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Director	Ms.	Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Operating Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Information Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Information Security Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	CMMI Model Point of Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Complaints Tracking Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Contact for Fraud Investigations	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Corporate Mailing						8476968500					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway		Park Ridge	IL	60068	10/02/2025	2026	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	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	DIR Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	DIR Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Discount Program Payment Contact	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	Thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Emergency Part D Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Emergency Part D Contact (Secondary)	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact		Ms	Teibowei	Gladys		2142872625					gladys.teibowei@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Enrollment Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	EOB Transfer Contact			Lange	Tracie		8476968503				8008861082	tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Financial Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Formulary Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Formulary Contact (Secondary)	Pharmacy Director		Lopez	Eduardo		7542085867					elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	General Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	HIPAA Privacy Officer	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	HIPAA Security Officer	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539				8555158166	Eric.Annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Interoperability Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	MA Appeals/Grievances Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	MA Claims Processing Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Marketing Contact	VP of Marketing	Ms.	Branco	Margaret		7187957495					margaret.branco@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Medical Director	Medical Director	Dr.	Butt, MD	Tariq		3125458471					tariq.butt@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Coordinator	Compliance Specialist	Ms.	Wilcox	Hailey		8476968503					Hailey.wilcox@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Part D Opioid Overutilization Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Medication Therapy Management Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3304058084	Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	OffShore Subcontractor Contact		Mrs.	Lange	Tracie		8476968503				8476923225	Tracie.Lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 C Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 C Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Appeals			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H5454	Part D Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Benefits Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Claims Submission Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H5454	Part D Price File Contact (Back-up)			Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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 Price File Contact (Optional)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Price File Contact (Primary)			Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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 Quality Assurance Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Patient Safety Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Payment Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Director	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Network Management Contact			Perez	Felix		3053313044				3053313044	Felix.perez@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	10/02/2025	2026	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 Network Management Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H5454	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Bretten	Brad							bradley.betten@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH OF ILLINOIS, INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H5454	Physician Incentive Contact		Ms.	Wilcox-Lange	Tracie		8476968503				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	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	Plan Directory Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		2249855588				3124290194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Processor Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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	Quality Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	SNP Application Contact		Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	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	SNP State Contact		Ms.	Wilcox-Lange	Tracie		8476968502				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	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	Surveillance Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	System Contact	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539					eric.annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Third Party Administrator (TPA) Liaison	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Utilization Management Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Utilization Review Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Electronic Health Record Contact	Chief Information Officer	Mr.	Betancourt	Roger		3053419099					rbetancourt@simplyhealthcareplans.com	9250 W Flagler Street	Suite 600	Miami	FL	331743460	03/21/2017	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5471	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H5471	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5471	Part D Exceptions Contact (Secondary)	Product Management Director		Gray	Heather							heather.mckee@elevancehealth.com	5211 Pine Rockland Ave.		Lithia	FL	33547	05/14/2025	2026	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	9043474771				HMO - Health Maintenance Organization		C	Chicago
H5471	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5471	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5471	PHR Beneficiary Contact																	02/13/2019	2026	SIMPLY HEALTHCARE PLANS, INC.	Local CCP	Simply Healthcare Plans, Inc.	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H5471	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Staff VP Medicare Ops & Healthcare Management		Szabla	Sara		8135066000	11409			8135066236	HealthServices@freedomh.com	5411 Sky Center Drive		Tampa	FL	33607	05/14/2025	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Reconciliation Contact (Secondary)	Chief Financial Officer	Mrs	Prince	Holly		3059212610				3054085858	hprince@simplyhealthcareplans.com	9250 W. Flagler Street	Suite 600	Miami	FL	331743460	01/27/2016	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5472	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5472	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	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	Chicago
H5472	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5472	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	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	Chicago
H5472	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H5472	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			HMO - Health Maintenance Organization		C	Chicago
H5472	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5472	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	06/19/2025	2026	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	Chicago
H5472	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H5472	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				HMO - Health Maintenance Organization		C	Chicago
H5472	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5472	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5472	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	06/19/2025	2026	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	Chicago
H5472	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				HMO - Health Maintenance Organization		C	Chicago
H5472	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				HMO - Health Maintenance Organization		C	Chicago
H5472	PHR Beneficiary Contact																	06/19/2025	2026	ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC	Local CCP	Alignment Health Plan	HMO/HMOPOS	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				HMO - Health Maintenance Organization		C	Chicago
H5472	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H5472	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H5472	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5472	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H5475	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H5475	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5475	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5475	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5475	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H5475	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H5475	PHR Beneficiary Contact																	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H5475	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/08/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5475	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5493	Automated TrOOP Balance Transfer Contact	Regional Finance Director		Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Backup User Access Contact	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Bid Primary Contact	Regional Finance Director		Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	CAP Report Contact for Public Website	Executive Director		Gonzalez	Michele		3026603355				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	CEO - Senior Official for Contracting	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	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 Operating Officer	COO	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	04/28/2022	2026	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 Information Officer	Director Enterprise IT Operation	Mr.	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	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 Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083				3025758236	Preston.Jennings@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	11/27/2023	2026	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	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Complaints Tracking Contact	Quality Assurance and Compliance Part D Officer		Thomas	Clare	M	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Contact for Fraud Investigations	Quality Assurance and Compliance Part D Officer		Thomas	Clare	M	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	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	Ms.	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Corporate Mailing						3026603355				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	DIR Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Discount Program Payment Contact	Regional Finance Director	Ms.	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmingon	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Emergency Part D Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison st		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Emergency Part D Contact (Secondary)	Quality Assurance & Compliance Part D Officer	Ms	Thomas	Clare	M	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	10/25/2019	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Enrollment Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	EOB Transfer Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		3026603352				3025758236	Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Financial Audit Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Financial Reporting Contact	Regional Finance Director	Ms	Fuhrmeister	Nicole		3026603352				3025758236	Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2679917601				2679917618	joseph.garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	08/02/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	General Contact	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	HIPAA Security Officer	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Interoperability Contact	Enterprise Director IT Operations		Gillespie	Jeff		7343433079					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	MA Appeals/Grievances Contact	Quality Assurance & Compliance Part D Officer	Ms	Thomas	Clare	M	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	MA Claims Processing Contact for Public Website	Regional Finance Director	Ms	Fuhrmeister	Nicole		3026603352				3025758236	Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Marketing Contact	Director Marketing & Communications	Ms	Lark	Azia		9735182754					azia.lark@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	02/03/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Medical Director			Eisenhower	Michelle		3026603395				3025758238	Michelle.Eisenhower@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	05/14/2025	2026	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	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	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 Coordinator	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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 Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	04/02/2024	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	04/02/2024	2026	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 C Application Contact	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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 Appeals	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad St	Unit 3	Phildelphia	PA	19145	08/13/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H5493	Part D Appeals Contact (Secondary)	Director Quality & Compliance		Thomas	Clare							CThomas@trinity-health.org	1072 Justison St		Wilmington	DE	19801	09/03/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	3026603359				PACE - Nat		C	Philadelphia
H5493	Part D Application Contact	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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 Benefits Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	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 Claims Submission Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	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	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H5493	Part D Price File Contact (Back-up)	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	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 Price File Contact (Optional)	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352				6102714530	Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	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 Price File Contact (Primary)	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	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 Quality Assurance Contact	Quality Assurance & Compliance Part D Officer	Ms	Thomas	Clare	M	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	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 Reporting Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Patient Safety Contact	Quality Assurance & Compliance Part D Officer	Ms	Thomas	Clare	M	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Payment Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	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 Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	04/02/2024	2026	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 Network Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 South Broad Street		Philadelphia	PA	19145	04/02/2024	2026	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	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad St	Unit 3	Phildelphia	PA	19145	08/02/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H5493	Plan Directory Contact for Public Website	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Plan to Plan Reconciliation Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Processor Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Quality Contact	Quality Assurance & Compliance Part D Officer	Ms	Thomas	Clare	M	3026603359				3025758236	cthomas@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	09/03/2021	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Reconciliation Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Recovery Audit Contact	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Surveillance Contact	Executive Director	Ms	Gonzalez	Michele		3026603352				3025758236	Michele.Gonzalez@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	11/27/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Third Party Administrator (TPA) Liaison	Regional Director, Finance	Ms	Fuhrmeister	Nicole		3026603352					Nicole.Fuhrmeister@trinity-health.org	1072 Justison St		Wilmington	DE	19801	11/24/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Utilization Management Contact	Medical Director	Dr.	Eisenhower	Michelle		3026603395				3025758238	Michelle.Eisenhower@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	05/14/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5493	Utilization Review Contact	Medical Director	Dr	Eisenhower	Michelle		3026603395				3025758238	Michelle.Eisenhower@trinity-health.org	1072 Justison Street		Wilmington	DE	19801	05/14/2025	2026	LIFE AT ST. FRANCIS HEALTHCARE, INC.	National PACE	Saint Francis LIFE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H5496	Agent/Broker Compensation Data Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	12/07/2021	2026	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	Boston
H5496	Automated TrOOP Balance Transfer Contact	Senior Manager, Pharmacy Services		Cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Backup User Access Contact	Membership Manger Sr.		Flores	Alicia		6268385100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Best Available Evidence Contact	Membership Manger Sr.		Flores	Alicia		6268385100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Bid Audit Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Bid Audit Site Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Bid Primary Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	CAP Report Contact for Public Website	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	CEO - CMS Administrator Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	CEO - Senior Official for Contracting	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Chief Financial Officer	Chief Financial Officer	Mrs	Bindra	Meeta		6268385100	5155				Meeta.Bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Chief Operating Officer		Dr	TBD	TBD		6268385110				6265216028	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2026	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	Boston
H5496	Chief Information Officer	Vice President of IT and Revenue Integrity	Mr	Tay	Johnny		6268385100	750				Johnny.Tay@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/04/2023	2026	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	Boston
H5496	Chief Information Security Officer	Vice President of IT and Revenue Integrity	Mr	Tay	Johnny		6268385126	750				Johnny.Tay@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/04/2023	2026	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	Boston
H5496	CMS Casework Communication Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	Complaints Tracking Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	Contact for Fraud Investigations	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	Coordination of Benefits Contact	Membership Manger Sr.		Flores	Alicia		6268385100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Corporate Mailing						6267080333					pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2026	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	Boston
H5496	Customer Service Operations Contact	Membership Manger Sr.		Flores	Alicia		6268385100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	DIR Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	DIR Contact (Secondary)	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Discount Program Payment Contact	Accounting Manager	Ms	Luna	Thelma		6268385100	833				Thelma.Luna@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/04/2023	2026	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	Boston
H5496	Electronic Health Record Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Emergency Part D Contact	Senior Manager, Pharmacy Services		Cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Emergency Part D Contact (Secondary)	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Encounter Data & Risk Adjustment Operations Contact	Vice President of IT and Revenue Integrity	Mr	Tay	Johnny		6268385100					Johnny.Tay@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/04/2023	2026	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	Boston
H5496	Enrollment Contact	Membership Manger Sr.		Flores	Alicia		6268385100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	EOB Transfer Contact	Vice President of IT and Revenue Integrity	Mr	Tay	Johnny		6268385100				6265216028	Johnny.Tay@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/04/2023	2026	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	Boston
H5496	Financial Audit Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675				6265216028	eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	12/14/2021	2026	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	Boston
H5496	Financial Reporting Contact	Chief Financial Officer	Mrs	Bindra	Meeta		6268385100	818			6265216028	meeta.bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/04/2023	2026	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	Boston
H5496	Formulary Contact	Senior Manager, Pharmacy Services		Cho	Evelyn		6267270465				6265216028	evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Formulary Contact (Secondary)	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	General Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	Government Relations Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	HIPAA Privacy Officer	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	HIPAA Security Officer	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	Hospice Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Interoperability Contact	VP of IT & Revenue Integrity		Tay	Johnny		6267151830					Johnny.Tay@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	05/31/2024	2026	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	Boston
H5496	MA Appeals/Grievances Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	MA Claims Processing Contact for Public Website		Dr	TBD	TBD		6267558831				6265216028	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	02/10/2020	2026	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	Boston
H5496	Marketing Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Medical Director	Medical Director	Dr	Vaidyaraman	Muthukumar		5625671911					Muthukumar.Vaidyaraman@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	07/02/2024	2026	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	Boston
H5496	Medicare Compliance Officer	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	10/25/2021	2026	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	Boston
H5496	Medicare Coordinator	Membership Manger Sr.		Flores	Alicia		6268385100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Medicare Part D Opioid Overutilization Contact	Senior Manager, Pharmacy Services		cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Medication Therapy Management Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	OffShore Subcontractor Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Online Enrollment Center Contact (Back-up)	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Online Enrollment Center Contact (Optional)	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Online Enrollment Center Contact (Primary)	Membership Manger Sr.		Flores	Alicia		6268385100	416				Alicia.Munoz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Part C Application Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Part C Reporting Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Part D Appeals	Compliance Officer	Ms	Ruiz	Erica							eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	8008388271				HMO - Health Maintenance Organization		C	Boston
H5496	Part D Appeals Contact (Secondary)	Appeals & Grievance Director		Dahlkamp	Sue						6263809049	sue.dahlkamp@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	8723330553				HMO - Health Maintenance Organization		C	Boston
H5496	Part D Application Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Part D Benefits Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Part D Claims Submission Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Part D Exceptions Contact	Senior Manager, Pharmacy Services		Cho	Evelyn							evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	8336673497				HMO - Health Maintenance Organization		C	Boston
H5496	Part D Exceptions Contact (Secondary)	Compliance Officer	Ms	Ruiz	Erica							eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	8008388271				HMO - Health Maintenance Organization		C	Boston
H5496	Part D Price File Contact (Back-up)	Medicare Part D Project Manager		Keller	Shanon		8587907104					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/01/2024	2026	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	Boston
H5496	Part D Price File Contact (Optional)	Senior Manager, Pharmacy Services		Cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Part D Price File Contact (Primary)	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Part D Quality Assurance Contact	Senior Manager, Pharmacy Services		cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Part D Reporting Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Patient Safety Contact	Senior Manager, Pharmacy Services		cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Payment Contact	CFO	Mrs	Bindra	Meeta		6268385100	5155			6265216028	meeta.bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Personal Health Record Contact	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Pharmacy Director	Senior Manager, Pharmacy Services		cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Pharmacy Network Management Contact	Senior Manager, Pharmacy Services	Dr	Cho	Evelyn		6267270465				6265216028	evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Pharmacy Network Management Contact (Secondary)	Compliance Officer	Ms	Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Pharmacy Technical Help Desk Contact	Dir. Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/01/2024	2026	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	8774036035				HMO - Health Maintenance Organization		C	Boston
H5496	Pharmacy Technical Help Desk Contact (Secondary)	Compliance Officer	Ms	Ruiz	Erica							eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Imperial Health Plan of California, Inc.	HMO/HMOPOS		Imperial Health Plan of California	667	Yes	Active	8008388271				HMO - Health Maintenance Organization		C	Boston
H5496	Plan Directory Contact for Public Website	Compliance Officer		Ruiz	Erica		8007087903					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Plan to Plan Reconciliation Contact	Controller	Mrs	Bindra	Meeta		6268385100	5155			6265216028	meeta.bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Processor Contact	Senior Manager, Pharmacy Services		cho	Evelyn		6267270465					evelyn.cho@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	01/01/2024	2026	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	Boston
H5496	Quality Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Reconciliation Contact	Compliance Officer		Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Reconciliation Contact (Secondary)	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Recovery Audit Contact	Controller	Mrs	Bindra	Meeta		6268385100	5155				meeta.bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	12/07/2021	2026	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	Boston
H5496	SNP Application Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	SNP State Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Surveillance Contact	Compliance Officer		Ruiz	Erica		5622395675					eruiz@imperialhealthplan.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	System Contact	Vice President of IT and Revenue Integrity	Mr	Tay	Johnny		6268385100				6265216028	Johnny.Tay@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	10/04/2023	2026	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	Boston
H5496	Third Party Administrator (TPA) Liaison	CFO	Mrs	Bindra	Meeta		6268385100	5155			6265216028	meeta.bindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	User Access Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Utilization Management Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5496	Utilization Review Contact	CEO	Dr	Bindra	Pavel		6268385110				6262834175	pbindra@imperialhealthholdings.com	1100 East Green Street		Pasadena	CA	91106	11/06/2025	2026	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	Boston
H5521	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H5521	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H5521	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H5521	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H5521	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H5521	PHR Beneficiary Contact																	11/15/2012	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				PPO - BBA		C	Atlanta
H5521	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5521	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H5522	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H5522	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H5522	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H5522	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H5522	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5522	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H5525	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H5525	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024989871				PPO - BBA		C	Kansas City
H5525	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H5525	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024682494				PPO - BBA		C	Kansas City
H5525	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8008658715				PPO - BBA		C	Kansas City
H5525	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5025800475				PPO - BBA		C	Kansas City
H5525	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5525	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5526	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/18/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/21/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/03/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/10/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	12/22/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/22/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/21/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	06/03/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Corporate Mailing						4125447031					Thomas.Boettler@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/23/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5182205661				5184232294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/02/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Encounter Data & Risk Adjustment Operations Contact	Director, Actuarial Services	Mr.	DelPrince	Vincent	M	4125443939					Vincent.Delprince@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Enrollment Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	EOB Transfer Contact	Manager, Claims	Ms.	Johannes	Karin		7168876875				7168876875	karin.johannes@highmark.com	257 West Genesee St.		Buffalo	NY	14202	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/15/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	10/06/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					Justine.Patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	11/08/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Interoperability Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	MA Appeals/Grievances Contact	Manager, Appeals & Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	MA Claims Processing Contact for Public Website	Manager, Claims	Ms.	Johannes	Karin		7168876875					Karin.Johannes@highmark.com	257 West Genesee St.		Buffalo	NY	14202	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	06/23/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Medical Director	VP, Executive Medical Director	Dr.	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	06/23/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing		Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part C Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125444579				PPO - BBA		C	Boston
H5526	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125441596				PPO - BBA		C	Boston
H5526	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	11/08/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite SPECARE	Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8006002227				PPO - BBA		C	Boston
H5526	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	9013817109				PPO - BBA		C	Boston
H5526	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets	Ms	Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	11/09/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Payment Contact	Vice President, Accounting & Reporting	Mr	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	03/12/2024	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		Buffalo	NY	14203	02/14/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Pharmacy Network Management Contact	Network Account Director, Retail Strategy&Contract		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/30/2016	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	11/08/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
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	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8009221557				PPO - BBA		C	Boston
H5526	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active	5705783579				PPO - BBA		C	Boston
H5526	PHR Beneficiary Contact																	10/28/2021	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO	Highmark Western and Northeastern New York Inc	Highmark Health	123	Yes	Active	8003292792				PPO - BBA		C	Boston
H5526	Physician Incentive Contact	VP Prov Reimbursement & Network	Mr.	McDonald	Brendan		4125446611					brendan.mcdonald@highmarkhealth.org	120 5th Avenue Place		Pittsburgh	PA	152223099	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Plan Directory Contact for Public Website			Service	Customer		8773271395					customerservice@bcbswny.com	PO Box 13599		Albany	NY	12212	02/21/2020	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Plan to Plan Reconciliation Contact	Manager, Operational Accounting		Stehr	Brett		7173022748					P2Precon@highmark.com	Highmark, Inc Attn: Cashier	PO Box 898820	Camp Hill	PA	17089	06/28/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Quality Contact	Director, Clinical Quality		Christian	Shari		7168878811					shari.christina@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/29/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/23/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/28/2025	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Utilization Management Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5526	Utilization Review Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	Local CCP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H5528	Agent/Broker Compensation Data Contact	Dir. Medicare Sales		Pappalardo	Kimberly		6464477024					kpappalardo@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Backup User Access Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Best Available Evidence Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Bid Audit Contact	Medicare Compliance Leader		Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Bid Audit Site Contact	Sr. Medicare Audit Spec.		Chan	Tat		6464470218					tchan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Bid Primary Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	CAP Report Contact for Public Website	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	CEO - CMS Administrator Contact	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	CEO - Senior Official for Contracting	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		6464476174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Chief Operating Officer	Chief Operating Officer	Mr.	MacMillan	Thomas		6464474401					tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Chief Information Officer	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Chief Information Security Officer	VP, Technology and CISO	Mr.	McDermott	Thomas	M	6464474110					tmcdermott@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	CMMI Model Point of Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	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	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Complaints Tracking Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Contact for Fraud Investigations	Director, Special Investigations		Lupo	Chris		6318442453					Clupo@EmblemHealth.com	395 North Service Road		Melville	NY	11747	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Coordination of Benefits Contact	AVP, Provider Claim Resolution		Maxwell	Christine		8606745751					cmaxwell@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Corporate Mailing						6464475000					Cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Customer Service Operations Contact	VP Customer Service		Tirado	Nicole		5184466981					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	DIR Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	DIR Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Discount Program Payment Contact	Financial Operations and Treasury		Czerczak	Ewelina		8606745716					egradka@emblemhealth.com	175 Scott Swamp Rd		New York	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Emergency Part D Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Emergency Part D Contact (Secondary)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Employer Waiver Contact	AVP, Product Dev., Admin., & Perf. Analysis		Averyanova	Nataliya		6464475044					naveryanova@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Encounter Data & Risk Adjustment Operations Contact	Dir., Enterprise Gov't Submissions		Guenther	Anne Marie		8606745847					aconnors@connecticare.com	175 Scott Swamp Rd		Farmington	CT	06034	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Enrollment Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	EOB Transfer Contact	Dir., Claims Operations		Salcedo	Clifford		2126150511				2125105319	csalcedo@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Financial Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Financial Reporting Contact	Dir., Financial Reporting		Nogajewski	Scott		7086461563					snogajewski@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Formulary Contact	Sr. Formulary Specialist		Sitilides Cimino	Irene		6864477926					isitilidescimino@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Formulary Contact (Secondary)	Director, Formulary Development & UM		Sandoval	Natalie		3479132921					nasandoval@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	General Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Government Relations Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	HIPAA Privacy Officer	VP, Corporate Compliance		Lurin	Joseph		6464475203					jlurin@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	HIPAA Security Officer	AVP, IT Governance		McDermott	Thomas		6464474110					TMcDermott@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Hospice Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Interoperability Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	MA Appeals/Grievances Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	MA Claims Processing Contact for Public Website	VP, Claims Operations		Henderson	Linda		6464476795					lhenderson@emblemhealth.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Marketing Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Medical Director	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Medicare Compliance Officer	Dir., Govt. Program Regulatory/MCO	Mr.	Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Medicare Coordinator	VP, Medicare	Mr.	Walsh	Eric		6464477893					ericwalsh@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Medicare Part D Opioid Overutilization Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Medication Therapy Management Contact	Clinical Pharmacy Program Leader		Mhajan	Ruby		6464477632					rumhajan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	OffShore Subcontractor Contact	Lead Admin., Regulatory Pgm.		Kelly	Veronica		6464477494					vkelly@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Online Enrollment Center Contact (Back-up)	Knowledge Manager, Enroll. & Bill.		Gonzalez	Gabriel		6464477722					gabriel.gonzalez@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Online Enrollment Center Contact (Optional)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com.com	55 water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Online Enrollment Center Contact (Primary)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part C Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part C Reporting Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Appeals	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A					2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active	6464477215				PPO - BBA		C	New York
H5528	Part D Appeals Contact (Secondary)	Mgr., G & A, Expedited Claims		Montana	Kim						2125108130	kgrace@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active	6464470523				PPO - BBA		C	New York
H5528	Part D Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Benefits Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Claims Submission Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Exceptions Contact	Pharmacy Client Ops Director		Der Weer	J'Nisha							jderweer@emblemhealth.com	55 Water street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active	6464477198				PPO - BBA		C	New York
H5528	Part D Exceptions Contact (Secondary)	Pharmacy Perf. Mgmt. Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active	4015251683				PPO - BBA		C	New York
H5528	Part D Price File Contact (Back-up)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Price File Contact (Optional)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Price File Contact (Primary)	Sr. Manager Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Quality Assurance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Part D Reporting Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Patient Safety Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Payment Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Personal Health Record Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Pharmacy Director	VP, Chief Pharmacy Officer		Smith	Jonalan		7858407007					jsmith@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Pharmacy Network Management Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Pharmacy Network Management Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	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	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active	8009221557	2			PPO - BBA		C	New York
H5528	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active	4015251683				PPO - BBA		C	New York
H5528	PHR Beneficiary Contact																	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO	EmblemHealth	EmblemHealth, Inc.	361	Yes	Active	8773447364				PPO - BBA		C	New York
H5528	Plan Directory Contact for Public Website	VP Customer Service		Tirado	Nicole		8773447364					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		6464473017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Processor Contact	AVP, Claims Operations		Gauthier	Kathleen	H	8604096435					kgauthier@connecticare.com	175 Scott Swamp Road	PO BOX 4050	Farmington	CT	06034	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Quality Contact	Data Analytics & Reporting Leader		Goldfarb	Julie		6315775110	65110				jgoldfarb@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Reconciliation Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Reconciliation Contact (Secondary)	Mgr., Enrollment & Billing		Roman	Erica		6464477125					eroman@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Recovery Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	SNP Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	SNP State Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Surveillance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	System Contact	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Third Party Administrator (TPA) Liaison	Dir., Treasury		Pastorello	Thomas		9172248582					tpastorello@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	User Access Contact	Lead Medicare Regulatory Spec.		Handy	Michelle		5184466949					mhandy@EmblemHealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Utilization Management Contact	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5528	Utilization Review Contact	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC.	Local CCP	EmblemHealth	Local PPO		EmblemHealth, Inc.	361	Yes	Active					PPO - BBA		C	New York
H5533	Agent/Broker Compensation Data Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Backup User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		8775393080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Bid Audit Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Bid Audit Site Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Bid Primary Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	CAP Report Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	CEO - CMS Administrator Contact	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	CEO - Senior Official for Contracting	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		4124545559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Chief Operating Officer	Chief Operating Officer	Ms.	Jenkins	Mary Beth	L	4124547764					jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	12/09/2015	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Chief Information Officer	Chief Information Officer	Mr.	McCallister	Ed		4124547711					mccallisterew@upmc.edu	USX Tower, 60th Floor	600 Grant Street	Pittsburgh	PA	15219	03/14/2016	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Chief Information Security Officer	Vice President, ISD	Mr	Haas	Scott		4124546162					haassm@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/14/2016	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Complaints Tracking Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Contact for Fraud Investigations	Sr. Director Fraud & Abuse		Workman	Craig		4124545524					workmanc@upmc.edu	USX Tower, 47th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Corporate Mailing						4124547500					upmchp@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		8775393080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2012	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	DIR Contact	Director, Pharmacy Finance		Bovier	Jacqueline		4124547584					bovierjd@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/18/2015	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	DIR Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Discount Program Payment Contact	Business Analyst III		Michalski	Jeff	K	4124545715				4124542110	michalskij@upmc.edu	USX Tower, 21st Floor	600 Grant Street	Pittsburgh	PA	15219	11/18/2024	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Emergency Part D Contact	Vice President, Customer Engagement & Enrollment		Palmerine	Anne		4129777828					palmerineac3@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Emergency Part D Contact (Secondary)	AVP, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	12/27/2023	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Encounter Data & Risk Adjustment Operations Contact	Director, Government Revenue		Plank	Tim		4124547747					planktm@upmc.edu	USX Tower, 36th Floor	600 Grant Street	Pittsburgh	PA	15219	10/28/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Enrollment Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	EOB Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Financial Audit Contact	AVP, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	08/14/2020	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Financial Reporting Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Formulary Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Formulary Contact (Secondary)	Manager, Clinical Pharmacy Medicare	Ms.	Ryan	Maggie		4124547086					ryanm7@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	05/13/2025	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	General Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	HIPAA Security Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		4124548589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Interoperability Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	02/16/2022	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	MA Appeals/Grievances Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	MA Claims Processing Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Marketing Contact	Director, Medicare Marketing		McVey	Alicia		4124545525					mcveyal@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	08/03/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Medical Director	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Medicare Coordinator	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Medicare Part D Opioid Overutilization Contact	Sr. Manager, Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Medication Therapy Management Contact	Sr. Manager Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Online Enrollment Center Contact (Back-up)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Online Enrollment Center Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Online Enrollment Center Contact (Primary)	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part C Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part C Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Appeals	Manager, C&G		Richards	Rebecca						4124547920	richardsr3@upmc.edu	USX Tower, 42nd Floor	600 Grant Street	Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active	4124540116				PPO - BBA		C	Dallas
H5533	Part D Appeals Contact (Secondary)	Manager, Pharmacy Compliance		Chaussinand	Matt							chaussinandm@upmc.edu	600 Grant St., USX, 12th Floor		Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active	4124545914				PPO - BBA		C	Dallas
H5533	Part D Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Benefits Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions		Dovico	Rosario		2012696398					rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	04/23/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active	8003964139				PPO - BBA		C	Dallas
H5533	Part D Price File Contact (Back-up)	Sr. Manager, Government Programs		Dolfi	Amanda		6147613606					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	01/12/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Price File Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Price File Contact (Primary)	Director, Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107 St. #11202		Overland	KS	66207	07/28/2020	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Quality Assurance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Part D Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Patient Safety Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Payment Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Personal Health Record Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Pharmacy Director	Sr. Director, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
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	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active	8009221557				PPO - BBA		C	Dallas
H5533	PHR Beneficiary Contact																	12/21/2007	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO	MyHealth	UPMC Health System	249	Yes	Active	4128032065				PPO - BBA		C	Dallas
H5533	Physician Incentive Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Plan Directory Contact for Public Website			Marketing	Medicare		8773813765					upmchp@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		4124545715				4124542110	medicarereporting@upmc.edu	US Steel Tower, 600 Grant Street, 9th Floor	c/o UPMC Health Plan Attn: Aunika Hall P2P - 09-257	Pittsburgh	PA	15219	08/11/2025	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Processor Contact	Sr Director - Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Quality Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Reconciliation Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Reconciliation Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Recovery Audit Contact	Sr. Director, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	SNP Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	SNP State Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Surveillance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	System Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Third Party Administrator (TPA) Liaison	Business Analyst III		Michalski	Jeff		4124545715				4124542110	michalskij@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	11/18/2024	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Utilization Management Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5533	Utilization Review Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH NETWORK, INC.	Local CCP	UPMC for Life	Local PPO		UPMC Health System	249	Yes	Active					PPO - BBA		C	Dallas
H5538	Automated TrOOP Balance Transfer Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Backup User Access Contact	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Best Available Evidence Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Bid Primary Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	CAP Report Contact for Public Website	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	CEO - Senior Official for Contracting	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	01/20/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Chief Financial Officer	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Chief Operating Officer	Chief Operating Officer	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	6113 Norma Jean Lane		Billings	MT	59101	06/16/2022	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Chief Information Officer	Director of IT Operations	Mr.	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	1201 Langhorne-Newtown Rd		Langhorne	PA	19047	02/26/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Chief Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083					Preston.Jennings@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	02/26/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	CMS Casework Communication Contact	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Complaints Tracking Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Contact for Fraud Investigations	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Coordination of Benefits Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Corporate Mailing						9177035808					antonio.dias@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	06/16/2022	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Customer Service Operations Contact	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	DIR Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Discount Program Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Emergency Part D Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Enrollment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	EOB Transfer Contact	Regional director Finance	Ms.	Fuhrmeister	Nicole		2157788707				9104834930	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Financial Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Financial Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Formulary Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 S. Broad Street	Unit 3	Philadelphia	PA	19145	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	General Contact	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Government Relations Contact	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Interoperability Contact	Enterprise Director of IT Operations		Gillespie	Jeff		6142348636					gillespj@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	10/25/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	MA Appeals/Grievances Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	MA Claims Processing Contact for Public Website	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Marketing Contact	Director Marketing and Communications	Ms.	Lark	Azia		9735182754					azia.lark@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	02/03/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Medical Director	Interim Medical Director	Dr	Amato	Alaina		8508060830					Alaina.Amato@mercylifeal.com	5020 Commerce Park Circle		Pensacola	FL	32505	09/29/2025	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Medicare Compliance Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Medicare Coordinator	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Part C Application Contact			Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	04/03/2022	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Part D Appeals	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.garbarino@mercyhealth.org	1930 S. Broad Street	Unit 3	Philadelphia	PA	19145	06/16/2022	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H5538	Part D Application Contact			Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	04/03/2022	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Part D Benefits Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Part D Claims Submission Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					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	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H5538	Part D Price File Contact (Back-up)	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Part D Price File Contact (Primary)	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Part D Quality Assurance Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Part D Reporting Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Patient Safety Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Payment Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Pharmacy Director	Manager Part D Compliance	Mr.	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 S. Broad Street	Unit 3	Philadelphia	PA	19145	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Pharmacy Network Management Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	1930 S. Broad Street	Unit 3	Philadelphia	PA	19145	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Pharmacy Technical Help Desk Contact	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Atlanta
H5538	PHR Beneficiary Contact																	06/16/2022	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE	Trinity Health PACE	Trinity Health Corporation	234	Yes	Active	9177035808				PACE - Nat		C	Atlanta
H5538	Plan Directory Contact for Public Website	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Plan to Plan Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Processor Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Quality Contact	Regional Director QI/Compliance	Ms	Baldwin	Diane		2512878426					diane.baldwin@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	10/28/2024	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Reconciliation Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Recovery Audit Contact	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707				2512878478	nicole.fuhrmeister@trinity-health.org	2900 Springhill Ave		Mobile	AL	36607	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Surveillance Contact	Executive Director	Mr.	Garrett	Travis		4172140524					travis.garrett@trinity-health.org	5020 Commerce Park Circle		Pensacola	FL	32505	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Third Party Administrator (TPA) Liaison	Regional Director Finance	Ms	Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	4508 Chestnut Street		Philadelphia	PA	19139	08/04/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Utilization Management Contact	Interim Medical Director	Dr	Amato	Alaina		8508060830					Alaina.Amato@mercylifeal.com	5020 Commerce Park Circle		Pensacola	FL	32505	09/29/2025	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5538	Utilization Review Contact	Interim Medical Director	Dr	Amato	Alaina		8508060830					Alaina.Amato@mercylifeal.com	5020 Commerce Park Circle		Pensacola	FL	32505	09/29/2025	2026	TRINITY HEALTH PACE OF PENSACOLA	National PACE	Trinity Health PACE of Pensacola	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Atlanta
H5549	Agent/Broker Compensation Data Contact	Vice President, Sales and Partnership Development	Mr.	Robinson	David		6466280096					David.Robinson@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Automated TrOOP Balance Transfer Contact	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		2127603147					Cheryl.Tang@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Backup User Access Contact	Vice President, Product Management		Tricomi	Michael		6464774885					michael.tricomi2@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	07/12/2024	2026	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		2127603147					Cheryl.Tang@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Bid Audit Contact	Executive Vice President and CFO	Mr.	Patterson	Keith		6469885391					Keith.Patterson@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	09/26/2024	2026	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	Bid Audit Site Contact	Executive Vice President and CFO	Mr.	Patterson	Keith		6469885391					Keith.Patterson@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	09/26/2024	2026	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	Bid Primary Contact	Associate Director, Product Management	Mr.	Powell	Jonathan	J	3479960153					Jonathan.Powell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	07/12/2024	2026	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	CAP Report Contact for Public Website	Director, Compliance & Regulatory Affairs		Lopez	Karina		6467455453					karina.lopez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	07/31/2025	2026	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	CEO - CMS Administrator Contact	President and Chief Executive Officer	Mr.	Savitt	Daniel		2126091520					Daniel.Savitt@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	06/16/2023	2026	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	CEO - Senior Official for Contracting	Executive Vice President, Chief of Health Plans	Mr.	Burke	John		6469463997					John.Burke@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	02/20/2024	2026	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		6469885391					Keith.Patterson@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	09/26/2024	2026	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 Operating Officer	Vice President, Product Management and Operations	Mr.	Tricomi	Michael		6464774885					Michael.Tricomi2@vnshealth.org	220 East 42nd Street		New  York	NY	10017	07/12/2024	2026	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 Information Officer	EVP, Science and Technology	Mr.	Peng	Timothy		2126095765					Timothy.Peng@vnshealth.org	220 East 42nd Street		New York	NY	10017	10/27/2023	2026	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 Information Security Officer	IT Security Policy Director	Mr.	Bain	Justin		2126095560					Justin.Bain@vnshealth.org	5 Penn Plaza	12th Floor	New York	NY	10001	08/15/2023	2026	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	CMMI Model Point of Contact	Director, Product Management	Ms.	Aquino	Josie		9177817999					Josie.Aquino@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/27/2023	2026	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	Director, Compliance & Regulatory Affairs		Lopez	Karina		6467455453					karina.lopez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	07/31/2025	2026	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	Complaints Tracking Contact	Vice President, Quality & Member Safety	Ms.	Brickner	Mihriban		2126091687					Mihriban.GursoyBrickner@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	05/09/2023	2026	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	Contact for Fraud Investigations	Director, Compliance Operations	Mr,	Mounic	Gerard		2126097332					Gerard.Mounic@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	10/27/2023	2026	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		2127603147					Cheryl.Tang@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Corporate Mailing						2126095641					Mariella.Rodriguez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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		2126268071					Nancy.Vitale@vnshealth.org	500 7th Avenue	11th Floor	New York	NY	10018	08/15/2023	2026	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	DIR Contact	Director, Actuarial Services	Mr.	Rong	Lei		3478863611					Lei.Rong@vnshealth.org	220 East 42nd Street	7th Floor	New York	NY	10017	03/07/2024	2026	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	DIR Contact (Secondary)	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557					Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Discount Program Payment Contact	Staff Accountant	Ms.	Jahan	Syeda		3476088579					Syeda.Jahan@vnshealth.org	220E 42nd Street	7th Floor	New York	NY	10017	07/23/2025	2026	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	Emergency Part D Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya		9174078732					Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Emergency Part D Contact (Secondary)	Associate Director, Pharmacy Services	Ms.	Devineni	Ramya		6462760482					Ramya.Devineni@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Employer Waiver Contact	Vice President, Product Management		Tricomi	Michael		6464774885					michael.tricomi2@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/05/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounter Reporting and Risk Adjustment		Edmudson	Ben		3473228132					BEN.EDMUDSON@vnshealth.org	220 East 42nd Street, 3rd floor		New York	NY	10017	08/15/2023	2026	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	Enrollment Contact	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		2127603147					Cheryl.Tang@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	EOB Transfer Contact	Director, Service Operations	Mr.	Nunez	Ramennis		2126097474				6464597725	Ramennis.Nunez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Financial Audit Contact	Vice President and Corporate Controller	Ms.	Guilfoyle	Jacqueline		2126094162					Jacqueline.Guilfoyle@vnshealth.org	220 East 42nd Street	7th Floor	New York	NY	10017	08/15/2023	2026	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	Financial Reporting Contact	Vice President and Corporate Controller	Ms.	Guilfoyle	Jacqueline		2126094162					Jacqueline.Guilfoyle@vnshealth.org	220 East 42nd Street	7th Floor	New York	NY	10017	08/15/2023	2026	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	Formulary Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557					Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Formulary Contact (Secondary)	Manager, Formulary Ops & Analysis	Ms.	Nyawabila	Christina		8587906297					FAS@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/10/2024	2026	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	General Contact	Director, Compliance & Regulatory Affairs		Lopez	Karina		6467455453					karina.lopez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	07/31/2025	2026	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		2126091514					Dan.Lowenstein@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	08/15/2023	2026	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	HIPAA Privacy Officer	SVP, Chief Compliance & Privacy Officer	Ms.	Griggs Pauly	Leah		2122906425				6464597729	Leah.GriggsPauly@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	08/07/2025	2026	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	HIPAA Security Officer	IT Security Policy Director	Mr.	Bain	Justin		2126095560					Justin.Bain@vnshealth.org	5 Penn Plaza	12th Floor	New York	NY	10001	08/15/2023	2026	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		2126091751					Ishrat.Rahman@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Interoperability Contact	VP, Software Engineering and Product Development	Mr.	Orlando	Robert		2126095471					Robert.Orlando@vnshealth.org	220 East 42nd Street		New York	NY	10017	11/07/2024	2026	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	MA Appeals/Grievances Contact	Vice President, Quality & Member Safety	Ms.	Brickner	Mihriban		2126091687					Mihriban.GursoyBrickner@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	05/09/2023	2026	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	MA Claims Processing Contact for Public Website	Director, Service Operations	Mr.	Nunez	Ramennis		2126097474					Ramennis.Nunez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Marketing Contact	Director, Marketing	Ms.	Sochurek	Tania		2126095455					Tania.Sochurek@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/07/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Frank	Jerry		5166505737					Jerry.Frank@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/07/2025	2026	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	Director, Compliance & Regulatory Affairs	Ms.	Lopez	Karina		6467455453					karina.lopez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	11/25/2025	2026	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 Coordinator	Associate Director, Product Management	Mr.	Powell	Jon		3479960153					Jonathan.Powell@vnshealth.org	220 East 42nd Street		New York	NY	10017	07/12/2024	2026	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 Part D Opioid Overutilization Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557				6462734885	Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Medication Therapy Management Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557				2122904855	Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	OffShore Subcontractor Contact	Mgr., Legal Support Services	Ms.	Abdel-Gleil	Karema		2126091754					karema.abdel-gleil@vnshealth.org	220 East 42nd Street		New York	NY	10017	08/15/2023	2026	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	Online Enrollment Center Contact (Back-up)	Reconciliation Specialist, MEU	Ms.	Castro	Annellys		2129469194					Annellys.Castro@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Online Enrollment Center Contact (Optional)	Reconciliation Specialist, MEU	Ms.	Castro	Annellys		2129469194					Annellys.Castro@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Online Enrollment Center Contact (Primary)	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		2127603147					Cheryl.Tang@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 C Application Contact	Vice President, Product Management		Tricomi	Michael		6464774885					michael.tricomi2@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/05/2023	2026	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 C Reporting Contact	Regulatory Data Validation Manager	Mr.	Wu	George		2129469286					George.Wu@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 Appeals	Vice President, Pharmacy Services	Ms.	Shell	Sofya							Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	2122906557				HMO - Health Maintenance Organization		C	New York
H5549	Part D Appeals Contact (Secondary)	Medicare Part D Manager	Ms.	Devineni	Ramya							Ramya.Devineni@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	2122906447				HMO - Health Maintenance Organization		C	New York
H5549	Part D Application Contact	Vice President, Product Management		Tricomi	Michael		6464774885					michael.tricomi2@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/05/2023	2026	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 Benefits Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557					Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 Claims Submission Contact	Director, Service Operations	Mr.	Nunez	Ramennis		2126097474					Ramennis.Nunez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	2122906557				HMO - Health Maintenance Organization		C	New York
H5549	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Services	Ms.	Devineni	Ramya							Ramya.Devineni@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	2122906447				HMO - Health Maintenance Organization		C	New York
H5549	Part D Price File Contact (Back-up)	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557					Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 Price File Contact (Optional)	Manager, Pharmacy Services	Ms.	Devineni	Ramya		2122906447					Ramya.Devineni@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 Price File Contact (Primary)	Program Manager	Ms.	Keller	Shanon		8587906455					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/30/2021	2026	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 Quality Assurance Contact	Vice President, Quality & Member Safety	Ms.	Brickner	Mihriban		2126091687					Mihriban.GursoyBrickner@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 Reporting Contact	Regulatory Data Validation Manager	Mr.	Wu	George		2129469286					George.Wu@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Patient Safety Contact	Vice President, Quality & Member Safety	Ms.	Brickner	Mihriban		2126091687					Mihriban.GursoyBrickner@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Payment Contact	Divisional Controller	Ms.	Wu	Amy		2126095715					Amy.Wu@vnshealth.org	220 East 42nd Street	7th Floor	New York	NY	10017	08/15/2023	2026	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	Personal Health Record Contact	Manager, Medical Records	Ms.	Denis	Maria		7185363109				6466402882	Maria.Denis@vnshealth.org	5 Penn Plaza	12th Floor	New York	NY	10001	08/15/2023	2026	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 Director	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557					Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 Network Management Contact	Vice President, Pharmacy Services	Ms.	Shell	Sofya		2122906557					Sofya.Shell@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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 Network Management Contact (Secondary)	Supervisor, Pharmacy Network Support	Ms.	Frey	Jessica		8582915348					Jessica.Frey@MedImpact.com	10181 Scripps Gateway CT		San Diego	CA	92131	07/30/2021	2026	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	2026	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	8886727205				HMO - Health Maintenance Organization		C	New York
H5549	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Contact Center Shared Services	Ms.	Coronado	Cristiana							Cristiana.coronado@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	10/05/2023	2026	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS		Visiting Nurse Service of New York	309	Yes	Active	8667831444				HMO - Health Maintenance Organization		C	New York
H5549	PHR Beneficiary Contact																	10/27/2023	2026	VNS CHOICE	Local CCP	VNS Health Medicare	HMO/HMOPOS	VNS CHOICE	Visiting Nurse Service of New York	309	Yes	Active	8667831444				HMO - Health Maintenance Organization		C	New York
H5549	Physician Incentive Contact	Sr. VP, Chief Quality & Performance Improvement	Ms.	Gursoy-Brickner	Mihriban		2126091687					Mihriban.GursoyBrickner@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Plan Directory Contact for Public Website	Director, Marketing	Ms.	Sochurek	Tania		8667831444					Tania.Sochurek@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/07/2025	2026	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	Plan to Plan Reconciliation Contact	Manager, Membership and Eligibility Unit	Ms.	Tang	Cheryl		2127603147					Cheryl.Tang@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Processor Contact	Director, Service Operations	Mr.	Nunez	Ramennis		2126091944					Ramennis.Nunez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Quality Contact	Vice President, Quality & Member Safety	Ms.	Brickner	Mihriban		2126091687					Mihriban.GursoyBrickner@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Reconciliation Contact	Executive Vice President and CFO	Mr.	Patterson	Keith		6469885391					Keith.Patterson@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	09/26/2024	2026	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	Reconciliation Contact (Secondary)	Director, Actuarial Services	Mr.	Rong	Lei		3478863611					Lei.Rong@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Recovery Audit Contact	Director, Compliance & Regulatory Affairs	Mr.	Lopez	Karina		6467455453					karina.lopez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/07/2025	2026	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	SNP Application Contact	Vice President, Product Improvement		Tricomi	Michael		6464774885					Michael.Tricomi2@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/05/2023	2026	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	SNP State Contact	Director, Compliance & Regulatory Affairs		Mendon	Priya		6467615745					Priya.Mendon@vnshealth.org	220 East 42nd Street	6th Floor	New York	NY	10017	08/15/2023	2026	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	Surveillance Contact	Director, Compliance & Regulatory Affairs		Lopez	Karina		6467455453					karina.lopez@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	07/31/2025	2026	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	System Contact	EVP, Science and Technology	Mr.	Peng	Timothy		2126095765					Timothy.Peng@vnshealth.org	220 East 42nd Street		New York	NY	10017	10/27/2023	2026	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	Third Party Administrator (TPA) Liaison	Vice President and Corporate Controller	Ms.	Guilfoyle	Jacqueline		2126094162					jacqueline.guilfoyle@vnshealth.org	220 East 42nd Street	7th Floor	New York	NY	10017	08/15/2023	2026	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	User Access Contact	Regulatory Data Validation Manager		Wu	George		2126094910					George.Wu@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	08/15/2023	2026	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	Utilization Management Contact	Vice President, Utilization Management	Ms.	Leacock-Bennett	Janice		3474529575					Janice.Leacock@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/27/2023	2026	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	Utilization Review Contact	Vice President, Utilization Management	Ms.	Leacock-Bennett	Janice		3474529575					Janice.Leacock@vnshealth.org	220 East 42nd Street	3rd Floor	New York	NY	10017	10/27/2023	2026	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
H5577	Agent/Broker Compensation Data Contact	Account Payable & Payroll VP		Serrano	Adriane		7877582500	2072				adrianes@medicalcardsystem.com	PO Box 191720		Hato Rey	PR	00919	04/15/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Automated TrOOP Balance Transfer Contact	Enrollment VP		Rios	Hector		7877582500	2874				hector.rios@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Backup User Access Contact	Compliance Director		Ramos	Kelsey		7877582500	5796				kramos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	05/04/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Best Available Evidence Contact	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Bid Audit Contact	Actuarial Senior VP		Kianes	Luis	F	7877582500	4590				lkianesr@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Bid Audit Site Contact	Actuarial Senior VP		Kianes	Luis	F	7877582500	4590				lkianesr@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Bid Primary Contact	Actuarial Senior VP		Kianes	Luis	F	7877582500	4590				lkianesr@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	CAP Report Contact for Public Website	SVP & Medicare Compliance Officer		Pastrana	Isis		7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/05/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	O'Drobinak	James	P	7877582500	5002			7872500380	jim.odrobinak@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Ninth Floor	San Juan	PR	00918	03/03/2016	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	O'Drobinak	James	P	7877582500	5002			7872500380	jim.odrobinak@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	03/03/2016	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Chief Financial Officer	Chief Financial Officer	Mr.	Aponte	Jose		7877582500	5022			7876222098	joseap@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Chief Operating Officer	Chief Operating Officer	Mr.	Torres	Roberto		7877582500	5380				roberto.torres@medicalcardsytem.com	MCS Plaza	255 Ponce de Leon Avenue, Ninth Floor	San Juan	PR	00918	12/04/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Chief Information Officer	Information Technology Senior VP	Mrs.	Ramos	Gannett		7877582500	5700				GRamosA@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	01/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Chief Information Security Officer	IT Security and Risk Management Vice President	Mr	Torres	Jorge		7876007580					JTorresV@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	CMMI Model Point of Contact	Product Development MA SVP		De Jesus	Carlos		7877582500	5221				carlos.dejesus@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	CMS Casework Communication Contact	Grievances & Appeals Director		Roman	Beatriz		7877582500	5799			7876207765	broman@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/15/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Complaints Tracking Contact	Grievances & Appeals Director		Roman	Beatriz		7877582500	5799			7876207765	broman@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/15/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Contact for Fraud Investigations	Special Investigation AVP		Roussel	Elizabeth		7877582500	2071			7872002862	elizabeth.roussel@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Coordination of Benefits Contact	Classicare Enrollment & Reconciliation AVP		Campos	Jose		7877582500	2939				jose.campos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon, Second Floor	San Juan	PR	00918	07/28/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Corporate Mailing						7877582500	2661			7872002862	maite.morales@medicalcardsystem.com	MCS Plaza	PO BOX 191720	San Juan	PR	009191720	09/15/2016	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Customer Service Operations Contact	Service Call Center AVP		Reyes  Ramos	Johalis		7877582500	3781			7876222463	jreyesra@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/12/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	DIR Contact	Financial Analysis Director		Vazquez	Jason		7877582500	2195			7876222098	jason.vazquez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	03/11/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	DIR Contact (Secondary)	Controller		Schaffer	David		7877582500	2920			7876222098	davids@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Discount Program Payment Contact	Controller		Schaffer	David		7877582500	2920			7876222098	davids@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Electronic Health Record Contact	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Emergency Part D Contact	Chief Pharmacy Officer		Rodriguez	Carolyn		7877582500	5746			7876222429	carodriguez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Emergency Part D Contact (Secondary)	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7874783428					isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Employer Waiver Contact	Finance SVP		Velez	Yumac		7877582500	5952			7876222098	yumac.velez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/15/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Encounter Data & Risk Adjustment Operations Contact	Encounter Data System AVP		Soler	Eva	Y	7877582500	2599				RAPS_EDS@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Enrollment Contact	Enrollment VP		Rios	Hector		7877582500	2874				hector.rios@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	EOB Transfer Contact	PBM Operations & Regulatory AVP		Castillo	Olgamarien		7877582500	2579			7876222429	Olgamarien.Castillo@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/03/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Financial Audit Contact	SVP & Medicare Compliance Officer	Mrs.	Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Financial Reporting Contact	Controller		Schaffer	David		7877582500	2920			7876222098	davids@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Formulary Contact	Pharmacy Formulary Management & Benefits Director		Amin	Aisha		7877582500	4132				PH_Formulary&Benefits@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/04/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Formulary Contact (Secondary)	Formulary Operations Clinical Pharmacist		Shaw	Andrea		4405038080					medicareformularyoperations@elixirsolutions.com	2181 E. Aurora Road		Twinsburg	OH	44087	07/22/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	General Contact	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Government Relations Contact	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	HIPAA Privacy Officer	Legal Affairs Specialist & Privacy Officer		Lourido	Gustavo		7877582500	5702				glourido@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/04/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	HIPAA Security Officer	IT Security and Risk Management Vice President	Mr.	Torres	Jorge		7876007580					JTorresV@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Hospice Contact	Pharmacy Utilization Management Director		Burgos	Grace		7877582500	5747				grace.burgos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Interoperability Contact	Information Technology Senior VP		Ramos	Gannett		7877582500	5700				GRamosA@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	01/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	MA Appeals/Grievances Contact	Grievances & Appeals Director		Roman	Beatriz		7877582500	5799			7876207765	broman@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/15/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	MA Claims Processing Contact for Public Website	Claims VP		Roque	Keila		7877582500	2621				keilar@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/11/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Marketing Contact	Marketing AVP		Agosto	Mariel		7877582500	5233				mariel.agosto@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Medical Director	Chief Medical Officer		Hernandez	Ines		7876164576				7876222442	irhernandez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Medicare Compliance Officer	SVP & Medicare Compliance Officer	Mrs.	Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Medicare Coordinator	Senior VP & Medicare Compliance Officer		Pastrana Lopez	Isis		7877582500	2040			7872002862	isispastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/12/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Medicare Part D Opioid Overutilization Contact	Pharmacy Quality & Clinical Programs Manager		Arriaga	Yolismarie		7877582500	2385				yarriaga@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/05/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Medication Therapy Management Contact	Pharmacy Clinical Service Director		Arroyo	Viviana		7877582500	5718				viviana.arroyo@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/04/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	OffShore Subcontractor Contact	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Online Enrollment Center Contact (Back-up)	Classicare Enrollment & Reconciliation AVP		Campos	Jose		7877582500	2939				jose.campos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Online Enrollment Center Contact (Optional)	Enrollment Manager		Hernandez	Limaris		7877582500	5825				limaris.hernandez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Online Enrollment Center Contact (Primary)	Enrollment VP		Rios	Hector		7877582500	2874				hector.rios@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part C Application Contact	Product Development MA SVP		De Jesus	Carlos		7877582500	5221				carlos.dejesus@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part C Reporting Contact	Auditing and Monitoring AVP		Reyes Villegas	Yarelis		7877582500	2774				yarelis.reyes@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/16/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Appeals	Pharmacy Utilization Management Director		Burgos	Grace							grace.burgos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	7875042233				HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Appeals Contact (Secondary)	Pharmacy Utilization Management & Specialty Progra		Ramos Marrero	Gladiany						7876222429	gramosm@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	08/19/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	7877582500	2414			HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Application Contact	Product Development MA SVP		De Jesus	Carlos		7877582500	5221				carlos.dejesus@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Benefits Contact	Pharmacy Clinical Operations - SVP		Rosado	Arelys		7877582500	5745			7876222429	arelys.rosado@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Claims Submission Contact	Chief Pharmacy Officer		Rodriguez	Carolyn		7877582500	5746			7876222429	carodriguez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Exceptions Contact	Pharmacy Utilization Management & Specialty		Ramos Marrero	Gladiany							gramos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	05/30/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	7877582500	2414			HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Exceptions Contact (Secondary)	Chief Pharmacy Officer		Rodriguez	Carolyn						7876222429	carodriguez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	7877582500	5746			HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Price File Contact (Back-up)	Rebate Analyst		Bentley	Rebecca		3308886988					rbentley@elixirsolutions.com	2181 E Aurora Rd #201		Twinsburg	OH	44087	08/18/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Price File Contact (Optional)	Pharmacy Formulary Management & Benefits Manager		Perez	Luis		7877582500	5744				luperez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/15/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Price File Contact (Primary)	Cost Management Director Pharmacy		Busquets Villegas	Rebecca		7877582500	2579				rbusquets@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/16/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Quality Assurance Contact	Chief Pharmacy Officer		Rodriguez	Carolyn		7877582500	5746			7876222429	carodriguez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Part D Reporting Contact	Auditing Monitoring and Reporting Director		Reyes	Yarelis		7877582500	2774				yarelis.reyes@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Patient Safety Contact	Pharmacy Formulary & Benefits Management Director		Arroyo	Viviana		7877582500	5718				viviana.arroyo@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/05/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Payment Contact	Controller		Schaffer	David		7877582500	2920			7876222098	davids@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Personal Health Record Contact	Legal Affair Specialist & Privacy officer		Lourido Rodriguez	Gustavo		7877582500	5702				glourido@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/12/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Pharmacy Director	Chief Pharmacy Officer		Rodriguez	Carolyn		7877582500	5746			7876222429	carodriguez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Pharmacy Network Management Contact	Pharmacy Regulations & Audit Monitoring Director		Izquierdo	Delmarie		7877582500	5719				dizquierdo@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/04/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Pharmacy Network Management Contact (Secondary)	Chief Pharmacy Officer		Rodriguez	Carolyn		7877582500	5746			7876222429	carodriguez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Pharmacy Technical Help Desk Contact	Pharmacy Utilization Management Director		Burgos	Grace							grace.burgos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	8446331064				HMO - Health Maintenance Organization		C	Dallas
H5577	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Coverage Determination Supervisor		Morales	Edna						7876222429	edna.morales@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/30/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active	8446331064				HMO - Health Maintenance Organization		C	Dallas
H5577	PHR Beneficiary Contact																	09/23/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS	Medical Card System	MHH Healthcare, L.P.	669	Yes	Active	8666278183				HMO - Health Maintenance Organization		C	Dallas
H5577	Physician Incentive Contact	Network Management Senior VP		Vazquez	Maritza		7877582500	4439				maritza.vazquez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	06/12/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Plan Directory Contact for Public Website	Network Operational Process Manager		Gonzalez	Deliannie		7877582500	3464				DGonzalezm@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/08/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Plan to Plan Reconciliation Contact	Financial Reporting Manager		Perez	Javier		7877582500	2604				javperez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Processor Contact	Claims VP		Roque	Keila		7877582500	2621				keilar@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/11/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Quality Contact	Quality Improvement VP		Lee	Linda		7877582500	2366				linda.lee@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	03/08/2013	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Reconciliation Contact	Finance SVP		Velez	Yumac		7877582500	5952			7876222098	yumac.velez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/15/2021	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Reconciliation Contact (Secondary)	Controller		Schaffer	David		7877582500	2920			7876222098	davids@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Recovery Audit Contact	SVP & Medicare Compliance Officer	Mrs.	Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	09/09/2024	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	SNP Application Contact	Quality Improvement VP		Lee	Linda		7877582500	2366				linda.lee@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	03/08/2013	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	SNP State Contact	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Surveillance Contact	SVP & Medicare Compliance Officer		Pastrana	Isis	C	7877582500	2040				isis.pastrana@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	12/01/2023	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	System Contact	Information Technology Senior VP	Mrs.	Ramos	Gannett		7877582500	5700				GRamosA@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	01/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Third Party Administrator (TPA) Liaison	Budget & Financial Analysis Lead		Marcano	Jomary		7877582500	3323				jomary.marcano@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	04/28/2022	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	User Access Contact	Compliance Director		Ramos Batiz	Kelsy		7877582500	5796				KRamos@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	05/23/2025	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Utilization Management Contact	Chief Medical Officer		Hernandez	Ines		7876164576				7876222442	irhernandez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5577	Utilization Review Contact	Chief Medical Officer		Hernandez	Ines		7876164576				7876222442	irhernandez@medicalcardsystem.com	MCS Plaza	255 Ponce de Leon Avenue, Second Floor	San Juan	PR	00918	07/27/2020	2026	MCS ADVANTAGE, INC.	Local CCP	MCS Classicare	HMO/HMOPOS		MHH Healthcare, L.P.	669	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5580	Agent/Broker Compensation Data Contact	Sales & Service Manager	Mr.	Nathe	Jeff		6024538341				6024317499	NatheJ@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Automated TrOOP Balance Transfer Contact	Director, Finance	Ms.	Wilson	Robyn		6026591424					WilsonR3@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Backup User Access Contact	Manager, Medicare Compliance		Jones	Wendy		6024147541					jonesW1@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	07/01/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Best Available Evidence Contact	Enrollment Services Manager	Ms.	Romero	Tammie		6024536054				6024147228	RomeroT@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Bid Audit Contact	Director Medicare Product	Mr.	Barrera	Noe		6024538010					barreran@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Bid Audit Site Contact	Director Medicare Product	Mr.	Barrera	Noe		6024538010					barreran@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Bid Primary Contact	Director Medicare Product	Mr.	Barrera	Noe		6024538010					barreran@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	CAP Report Contact for Public Website	Director	Mrs.	Richardson	Shannon		6028261831					richardsons4@mercycareaz.org	4750 S. 44th Place,  Suite 150	Ste. 150	Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Gary	Tad		6024028106					GaryT@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	01/06/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Gary	Tad		6024028106					GaryT@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	01/06/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Chief Financial Officer	Chief Financial Officer	Mr.	Ek	Randell		6026591457					EkR@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Chief Operating Officer	Chief Operating Officer	Mr.	Hargens	Brad		6024147512					Hargensb@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Chief Information Officer	Chief Operating Officer	Mr.	Hargens	Brad		6024147512					Hargensb@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	07/01/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Chief Information Security Officer	Chief Operating Officer	Mr.	Hargens	Brad		6024147512					Hargensb@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	07/01/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	CMS Casework Communication Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Complaints Tracking Contact	Compliance Manager	Mrs.	Jones	Wendy		6024147541					jonesw1@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Contact for Fraud Investigations	SIU Team Leader	Ms.	Kielb	Tabitha		8606363319				8606362400	KielbTJ@aetna.com	151 E Farmington Ave		Hartford	CT	06156	10/24/2018	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Coordination of Benefits Contact	Accounting Manager	Mr.	Le	Tu		6024538345					LeT@mercycareaz.org	4755 S 44th Place	Suite 150	Phoenix	AZ	85040	06/12/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Corporate Mailing						6024538315					PattonJ@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Customer Service Operations Contact	Director Customer Service	Mr.	Sanchez	Luis		6023512317					sanchezl@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	DIR Contact	Accounting Manager	Mr.	Le	Tu		6024538345					LeT@mercycareaz.org	4755 S 44th Place	Suite 150	Phoenix	AZ	85040	06/12/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	DIR Contact (Secondary)	Director, Finance	Ms.	Wilson	Robyn		6026591424					WilsonR3@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Discount Program Payment Contact	Accounting Manager	Mr.	Le	Tu		6024538345					LeT@mercycareaz.org	4755 S 44th Place	Suite 150	Phoenix	AZ	85040	06/12/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Emergency Part D Contact	Pharmacy Director	Mrs	Pourarsalan	Hiva		4696793019					PourarsalanH@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Emergency Part D Contact (Secondary)	Pharmacy Director	Ms	Vergil	Gina		4026997768					VergilG@Aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Encounter Data & Risk Adjustment Operations Contact	Senior Project Manager	Mr.	Swartz	Harley		6024536187					Swartzh@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Enrollment Contact	Enrollment Services Manager	Ms.	Romero	Tammie		6024536054				6024147228	RomeroT@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	EOB Transfer Contact	Pharmacy Director	Mrs.	Pourarsalan	Hiva		4696793019				6027982713	pourarsalanh@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Financial Audit Contact	Chief Financial Officer	Mr.	Ek	Randell		6026591457					EkR@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Financial Reporting Contact	Chief Financial Officer	Mr.	Ek	Randell		6026591457					EkR@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Formulary Contact	Pharmacy Director	Ms.	Pourarsalan	Hiva		4696793019					PourarsalanH@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Formulary Contact (Secondary)	Pharmacy Director	Ms	Vergil	Gina		4026997768					VergilG@Aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	General Contact	Chief Operating Officer	Mr.	Hargens	Brad		6024147512					Hargensb@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	07/01/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Government Relations Contact	Chief Operating Officer	Mr.	Hargens	Brad		6024147512					Hargensb@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	HIPAA Privacy Officer	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	HIPAA Security Officer	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Hospice Contact	Director Medicare Product	Mr.	Barrera	Noe		6024538010					barreran@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Interoperability Contact	Director, Service Operations	Mr.	Vitaranyam	Senthil		4808624888					SenthilKumaran.Vitaranyam@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	MA Appeals/Grievances Contact	Director, G&A		Pierce-Byrd	Miral		6024147318					pierce-byrdm@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	07/01/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	MA Claims Processing Contact for Public Website	VP of Operations	Mr.	Vargas	David		8609006993					VargasD@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Marketing Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Medical Director	Chief Medical Officer	Dr.	Singh	Gagan		6024536001					SinghG16@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Medicare Compliance Officer	Director, Medicare Product	Mrs.	Richardson	Shannon		6028261831					richardsons4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Medicare Coordinator	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Medicare Part D Opioid Overutilization Contact	Pharmacy Director	Ms.	Pourarsalan	Hiva		4696793019					pourarsalanh@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Medication Therapy Management Contact	Pharmacy Director	Ms.	Pourarsalan	Hiva		4696793019					pourarsalanh@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	OffShore Subcontractor Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Online Enrollment Center Contact (Back-up)	Sr Eligibility Consultant	Ms.	Griffy	Kathleen		6024538336					GriffyK@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Online Enrollment Center Contact (Primary)	Enrollment Services Manager	Ms.	Romero	Tammie		6024536054				6024147023	RomeroT@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part C Application Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part C Reporting Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part D Appeals	Appeals Supervisor		Spencer	Tiffane						8552305544	SpencerT4@AETNA.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	8609004547				HMO - Health Maintenance Organization		C	New York
H5580	Part D Appeals Contact (Secondary)	Appeals Manager		Hung	Pam						8552305544	HungP@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	8609004547				HMO - Health Maintenance Organization		C	New York
H5580	Part D Application Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part D Benefits Contact	Pharmacy Director	Ms.	Pourarsalan	Hiva		4696793019					pourarsalanh@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part D Claims Submission Contact	Pharmacy Director	Ms.	Pourarsalan	Hiva		4696793019					pourarsalanh@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part D Exceptions Contact	Appeals Supervisor		Spencer	Tiffane						8552305544	SpencerT4@AETNA.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	8609004547				HMO - Health Maintenance Organization		C	New York
H5580	Part D Exceptions Contact (Secondary)	Manager		Hung	Pam							HungP@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	8609004547				HMO - Health Maintenance Organization		C	New York
H5580	Part D Price File Contact (Back-up)	Advisor		Loveland	Chet		8018363750					chet.loveland@cvshealth.com	9501 Shea Blvd	MC121	Scottsdale	AZ	85260	12/21/2021	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part D Price File Contact (Primary)	Sr. Manager	Ms.	Srauffer	Grace		4803181864					grace.stauffer@cvshealth.com	9501 Shea Blvd	MC121	Scottsdale	AZ	85260	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part D Quality Assurance Contact	Pharmacy Director	Ms.	Pourarsalan	Hiva		4696793019					pourarsalanh@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Part D Reporting Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Patient Safety Contact	Pharmacy Director	Ms.	Pourarsalan	Hiva		4696793019					pourarsalanh@aetna.com	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/11/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Payment Contact	Chief Financial Officer	Mr.	Ek	Randell		6026591457					EkR@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Pharmacy Director	Chief Pharmacist Medicaid	Ms.	Saba	Stephanie		6027982867					Stephanie.Saba@aetna.com	4750 S. 44th Place,  Suite 150	Bldg 1	Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Pharmacy Network Management Contact	Director, Network Systems & Standards		Lindsey	Lisa		8778647744					Lisa.lindsey@cvshealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	07/07/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Pharmacy Technical Help Desk Contact	Pharmacy Help Desk		Leverette	Miesha							Miesha.Leverette@cvshealth.com	750 W John Carpenter Fwy	Ste 1200	Irving	TX	75039	07/07/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	8555394721				HMO - Health Maintenance Organization		C	New York
H5580	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Help Desk	Mr.	Smith	Robert	W						Robert.Smith7@CVSHeath.com	750 W John Carpenter FWY	Ste 1200	Irving	TX	75039	07/07/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active	8555394721				HMO - Health Maintenance Organization		C	New York
H5580	Physician Incentive Contact	Chief Innovation Officer	Mrs.	Lundeen	Christi	J	4804382622					LundeenC1@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Plan Directory Contact for Public Website	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Plan to Plan Reconciliation Contact	Accounting Manager	Mr.	Le	Tu		6024538345					LeT@mercycareaz.org	4755 S 44th Place	Suite 150	Phoenix	AZ	85040	06/12/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Processor Contact	Director, Network Systems & Standards	Mr.	Ceklic	Vladimir		4802092887					vladimir.ceklic@cvshealth.com	9501 E Shea Blvd,	Mail Code 121	Scottsdale	AZ	85260	12/21/2021	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Quality Contact	Diretor Quality Management	Ms.	Boyd	Carson		7855968061					carson.boyd@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	12/03/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Reconciliation Contact	Director, Finance	Ms.	Wilson	Robyn		6026591424					WilsonR3@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Recovery Audit Contact	Director Medicare Product	Mr.	Barrera	Noe		6024538010					barreran@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	SNP Application Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/13/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	SNP State Contact	Medicaid Compliance Director	Mrs.	Brown	Heidi		4805094021					BrownH7@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Surveillance Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	System Contact	Director, IT	Mr.	Bangert	Sean		6024538402					BangertS@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/21/2023	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Third Party Administrator (TPA) Liaison	Accounting Manager	Mr.	Le	Tu		6024538345					LeT@mercycareaz.org	4755 S 44th Place	Suite 150	Phoenix	AZ	85040	06/12/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	User Access Contact	Director, Medicare Product	Mrs.	Richardson	Shannon		6024535592					RichardsonS4@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	11/12/2025	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Utilization Management Contact	VP Medical Management	Ms.	Parkinson	Caroline		6023292807					Parkinsonc@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	06/06/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5580	Utilization Review Contact	VP Medical Management	Ms.	Parkinson	Caroline		6023292807					Parkinsonc@mercycareaz.org	4750 S. 44th Place,  Suite 150		Phoenix	AZ	85040	06/06/2024	2026	MERCY CARE	Local CCP	Mercy Care Advantage	HMO/HMOPOS		Mercy Care	214	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5587	Agent/Broker Compensation Data Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Automated TrOOP Balance Transfer Contact	Sr Mgr Financial Reporting-VP Finance		Jones	Erin		6028644361					erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Backup User Access Contact	Vice President of Medicare Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Best Available Evidence Contact	Manager Operations Center- Call Center		Cruz Herrera	Elizabeth		4803034419				4807604708	Elizabeth.CruzHerrera@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Bid Audit Contact	Staff VP, Corp & Medicare Compliance		Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	04/01/2025	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Bid Audit Site Contact	Staff VP, Corp & Medicare Compliance		Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	04/01/2025	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Bid Primary Contact	Staff VP Health Plan Operations		Ladich	Matthew		4803034439					matthew.ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	CAP Report Contact for Public Website	Staff VP Health Plan Operations		Ladich	Matthew		4803034439					matthew.ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs	Carter	Heather		6028644211					heather.carter@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	07/01/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs	Carter	Heather		6028644211					heather.carter@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	07/01/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Chief Financial Officer	Chief Financial Officer	Ms	Magallanes	Tammy		5206097835					Tammy.Magallanes@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Chief Operating Officer	Staff VP Health Plan Operations	Mr	Ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Chief Information Officer	Director, Health Plan Systems	Mrs	Small	Melissa		4807604538					Melissa.Small@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	04/15/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Chief Information Security Officer	Information Technology	Mr	Matti	Firas		4803034424				4807842933	Firas.Matti@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	CMS Casework Communication Contact	Staff VP - Chief Medical Officer		Carroll	Mark		9282142175					Mark.carroll@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	02/05/2025	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Complaints Tracking Contact	Grievance Coordinator		Otter	Patti		4803502202					Patricia.Otter@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Contact for Fraud Investigations	Staff Vice President, Corp & Medicare Compliance		Moore	Veronica		6023367600				4807604784	veronica.moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Coordination of Benefits Contact	Manager, Provider Asst. Customer Service Ops Medic		Williams	Tammy		8003228670				4807604708	tammy.williams@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Corporate Mailing						4803034439				4807842933	Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Customer Service Operations Contact	Vice President of Operations Center - Call Center		Rajskub	Suzan		4803334507				4807604708	Suzan.Irmer@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	03/05/2025	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	DIR Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	DIR Contact (Secondary)	Sr Mgr Financial Reporting-VP Finance		Jones	Erin		6028644361					erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Discount Program Payment Contact	Financial Analyst/Sr. Accountant		Thompson	Nathan		6028293306					nathan.thompson@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	12/31/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Electronic Health Record Contact	Staff VP Health Plan Operations		Ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Emergency Part D Contact	HCP Pharmacist		Rodriguez	Leslie		6028194784					Leslie.Rodriguez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Emergency Part D Contact (Secondary)	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Encounter Data & Risk Adjustment Operations Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Enrollment Contact	Manager Operations Center- Call Center		Cruz Herrera	Elizabeth		4803034419				4807604708	Elizabeth.CruzHerrera@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	EOB Transfer Contact	Sr Mgr Financial Reporting-VP Finance		Jones	Erin		6028644361				4807604619	erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/12/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Financial Audit Contact	Sr Mgr Financial Reporting-VP Finance	Mrs	Jones	Erin		6028644361					erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Financial Reporting Contact	Sr Mgr Financial Reporting-VP Finance		Jones	Erin		6028644361					erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Formulary Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	General Contact			Services	Member		8006568991				4807842933	comments@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Government Relations Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	HIPAA Privacy Officer	Director of Legal and Privacy Officer		Schrock	Anne		6028644315					Anne.Schrock@azblue.com	8220 N 23rd Avenue		Phoenix	AZ	85021	03/16/2022	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	HIPAA Security Officer	Director, Chief Information Security Officer		Pencek	Michael		6029166728					Michael.Pencek@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/06/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Hospice Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Interoperability Contact			Quincey	Mark		6028642032					Mark.Quincey@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	03/16/2022	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	MA Appeals/Grievances Contact	Vice President of Reimbursement Services		Kingry	Matthew		4802661409				4807842933	Matthew.Kingry@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	MA Claims Processing Contact for Public Website	Vice President of Reimbursement Services		Kingry	Matthew		4802661409				4807842933	Matthew.Kingry@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Marketing Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Medical Director	Chief Medical Officer	Dr	Carroll	Mark		4807604611					Mark.Carroll@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Medicare Compliance Officer	Staff VP, Corporate & Medicare Compliance	Ms	Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	07/01/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Medicare Coordinator	Medicare Compliance Officer		Moore	Veronica		6023367600					veronica.moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	05/03/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Medication Therapy Management Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Online Enrollment Center Contact (Back-up)	Enrollment Coordinator		Cabrales	Lilia		4809686866				4807604708	Lilia.Cabrales@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Online Enrollment Center Contact (Optional)	Manager Operations Center- Call Center		Cruz Herrera	Elizabeth		4803034419				4807604708	Elizabeth.CruzHerrera@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Online Enrollment Center Contact (Primary)	Enrollment Supervisor		Grady	Michael		4809686866	5049			4807604708	Michael.Grady@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part C Application Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part C Reporting Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Appeals	HCP Pharmacist		Rodriguez	Leslie							Leslie.Rodriguez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	6028194784				HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Appeals Contact (Secondary)	Clinical Pharmacy Program Manager		Sanders	Stephanie						8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	5209063358				HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Application Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Benefits Contact	HCP Pharmacist		Rodriguez	Leslie		6028194784					Leslie.Rodriguez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Claims Submission Contact	HCP Pharmacist		Rodriguez	Leslie		6028194784					Leslie.Rodriguez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Exceptions Contact	HCP Pharmacist		Rodriguez	Leslie							Leslie.Rodriguez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	6028194784				HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Exceptions Contact (Secondary)	Clinical Pharmacy Program Manager		Sanders	Stephanie						8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	5209063358				HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Price File Contact (Back-up)	Senior Consultant		Loveland	Chet		4806064873				4013357984	Chet.Loveland@cvshealth.com	8801 E. Raintree Drive	MC121	Scottsdale	AZ	85260	04/02/2021	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Price File Contact (Optional)	Senior Consultant		Loveland	Chet		4806064873				4013357984	Chet.Loveland@cvshealth.com	8801 E. Raintree Drive	MC121	Scottsdale	AZ	85260	05/26/2020	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Price File Contact (Primary)	CVSHealth Sr. Manager		Schilcher	Sydney		6024057057				4803357984	Sydney.Schilcher@CVSHealth.com	8801 E. Raintree Drive	MC121	Scottsdale	AZ	85260	01/02/2020	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Quality Assurance Contact	HCP Pharmacist		Rodriguez	Leslie		6028194784					Leslie.Rodriguez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Part D Reporting Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358					Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Patient Safety Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Payment Contact	Sr Mgr Financial Reporting-VP Finance		Jones	Erin		6028644361					erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Pharmacy Director	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Pharmacy Network Management Contact	HCP Pharmacist		Rodriguez	Leslie		6028194784					Leslie.Rodriguez@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Pharmacy Network Management Contact (Secondary)	Pharmacy Benefit Analyst		Jackson	Eric		6028293361				8882914542	Eric.Jackson@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Pharmacy Technical Help Desk Contact	AVP, Caremark Member Operations (CMO) - Government		Jackson	Scott	A						Scott.Jackson@CVSHealth.com	CVS Health	1 CVS Drive	Woonsocket	RI	02895	01/01/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H5587	Plan Directory Contact for Public Website			Services	Member		8006568991				4807842933	comments@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Plan to Plan Reconciliation Contact	Sr Mgr Financial Reporting-VP Finance		Jones	Erin		6028644361					erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Processor Contact	Pharmacy Benefit Analyst		Jackson	Eric		6028293361				8882914542	Eric.Jackson@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Quality Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Reconciliation Contact	Clinical Pharmacy Program Manager		Sanders	Stephanie		5209063358				8889086747	Stephanie.Sanders@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Reconciliation Contact (Secondary)	Sr Mgr Financial Reporting-VP Finance		Jones	Erin		6028644361					erin.jones@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	09/11/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Recovery Audit Contact	Staff VP Health Plan Operations	Mr	Ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	SNP Application Contact	Staff VP Health Plan Operations		ladich	Matthew		4803034439					Matthew.Ladich@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/14/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	SNP State Contact	Chief Executive Officer	Mrs	Carter	Heather		6028644211					heather.carter@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	07/01/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Surveillance Contact	Staff VP, Corporate and Medicare Compliance		Moore	Veronica		6023367600					Veronica.Moore@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	07/01/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	System Contact	Director Information Systems		Small	Melissa		4807604538				4807842933	Melissa.Small@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	08/24/2023	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Third Party Administrator (TPA) Liaison	Financial Analyst/Sr. Accountant		Thompson	Nathan		6028293306					nathan.thompson@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	12/31/2024	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	User Access Contact	Information Security Svcs	Ms.	Herrington	Jennifer		6028644643					jennifer.herrington@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	04/15/2025	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Utilization Management Contact	Staff VP - Chief Medical Officer		Carroll	Mark		9282142175					Mark.carroll@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	02/05/2025	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5587	Utilization Review Contact	Staff VP - Chief Medical Officer		Carroll	Mark		9282142175					Mark.carroll@azblue.com	8220 N 23rd Ave		Phoenix	AZ	85021	02/05/2025	2026	HEALTH CHOICE ARIZONA, INC.	Local CCP	Blue Cross Blue Shield of Arizona Health Choice	HMO/HMOPOS		Blue Cross Blue Shield of Arizona	447	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5590	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/14/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H5590	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5590	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5590	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5590	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	09/30/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504411				HMO - Health Maintenance Organization		C	Denver
H5590	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504411				HMO - Health Maintenance Organization		C	Denver
H5590	PHR Beneficiary Contact																	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H5590	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5590	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	Bridgeway Health Solutions of Arizona, Inc.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5591	Agent/Broker Compensation Data Contact	Director, Medicare Sales		Cestaro	Connor		2077313136					connor.cestaro@martinspoint.org	P.O. Box 9746	891 Washington Ave.	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Backup User Access Contact	MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04014	10/24/2025	2026	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	Boston
H5591	Best Available Evidence Contact	Manager, Member Operations		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Bid Audit Contact			Ledbetter	Joe		2072536271					joe.ledbetter@martinspoint.org	331 Veranda Street		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Bid Audit Site Contact			Ledbetter	Joe		2072536271					joe.ledbetter@martinspoint.org	331 Veranda Street		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Bid Primary Contact			Ledbetter	Joe		2072536271					joe.ledbetter@martinspoint.org	331 Veranda Street		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	CAP Report Contact for Public Website	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	CEO - CMS Administrator Contact	President and Chief Executive Officer	Dr.	Kasuba	Paul		2077913710					paul.kasuba@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	CEO - Senior Official for Contracting	President and Chief Executive Officer	Dr.	Kasuba	Paul		2077913710					paul.kasuba@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Chief Financial Officer	Chief Financial Officer	Ms	Jackson	Amanda		2072536115					amanda.jackson@martinspoint.org	331 Veranda Street	P. O.  Box 9746	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Chief Operating Officer	MD	Mr	Kasuba	Paul		2077913710					paul.kasuba@martinspoint.org	331 Veranda Street - Building 4		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Chief Information Officer	VP Information Technology	Ms	Downs	Amie		2072536184					amie.downs@martinspoint.org	331 Veranda Street		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Chief Information Security Officer	MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04014	10/24/2025	2026	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	Boston
H5591	CMS Casework Communication Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Complaints Tracking Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	PO Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Contact for Fraud Investigations	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	PO Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Coordination of Benefits Contact	Manager, Member Operations		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Corporate Mailing						2077913710					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Customer Service Operations Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	DIR Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	DIR Contact (Secondary)	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Discount Program Payment Contact	Accountant III		Allard	Kathleen		2078282490					kathleen.allard@martinspoint.org	P. O. Box 9746		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Emergency Part D Contact	Manager, Pharmacy Operations		Theriault	Anne		2076500662					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Emergency Part D Contact (Secondary)	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Encounter Data & Risk Adjustment Operations Contact			Dockendorf	Megan		2072536250					megan.dockendorf@martinspoint.org	PO Box 9746		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Enrollment Contact	Manager, Member Operations		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	EOB Transfer Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535				2072536202	elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Financial Audit Contact	MCO	Ms	Loomis	Elizabeth		5182290535				2072536303	elizabeth.loomis@martinspoint.org	P.O. Box 9746		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Financial Reporting Contact	Corporate Controller	Ms.	Tsay	Tatiana		2072536106				2072536227	tatiana.tsay@martinspoint.org	P.O. Box 9746		Portland	ME	04103	10/24/2025	2026	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	Boston
H5591	Formulary Contact	Medicare Clinical Pharmacist		Brown	Nancy	J	4013333987	7941			8003730238	njbrown@pharmacare.com	695 George Washington Highway		Lincoln	RI	02865	10/24/2025	2026	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	Boston
H5591	Formulary Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	General Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Government Relations Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	HIPAA Privacy Officer	Interim Privacy Officer		True	Erica		2077913848					erica.true@martinspoint.org	331 Veranda Street		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	HIPAA Security Officer	MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Hospice Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	331 Veranda Street	PO Box 9746	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Interoperability Contact			Reburn	Sarah		2072536966					sarah.reburn@martinspoint.org	PO Box 9746		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	MA Appeals/Grievances Contact	MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	331 Veranda Street		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	MA Claims Processing Contact for Public Website	Sr Director, Claims and Payment Operations		Kumari	Shalini		2072536220					shalini.kumari@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Marketing Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Medical Director	VP Medical Director of Clinical Programs	Dr.	Virani	Avani		2072536245					avani.virani@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Medicare Compliance Officer	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Medicare Coordinator	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Medication Therapy Management Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Online Enrollment Center Contact (Back-up)	Supervisor Enrollment and Premium Biling		Whelan	James		2072742738					james.whelan@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Online Enrollment Center Contact (Optional)	Director Member Engagement		Reburn	Sarah		2072536966					sarah.reburn@martinspoint.org	PO Box 9746	891 Washington Ave	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Online Enrollment Center Contact (Primary)	Systems Analyst, Enrollment		Tucker	Thad		2072536398					thad.tucker@martinspoint.org	P.O. Box 9746	891 Washington Ave.	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Part C Application Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Part C Reporting Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Part D Appeals			Representative	Appeals							appealsmedicare@caremark.com	CVS Caremark	9501 E. Shea Blvd. MC 109	Scottsdale	AZ	85260	10/24/2025	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active	8668849479				HMO - Health Maintenance Organization		C	Boston
H5591	Part D Appeals Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne							anne.theriault@martinspoint.org	PO Box 9746	891 Washington Ave.	Portland	ME	04101	10/24/2025	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active	2077663144				HMO - Health Maintenance Organization		C	Boston
H5591	Part D Application Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Part D Benefits Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Part D Claims Submission Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Part D Exceptions Contact	Appeals Representative		Representative	Appeals							appealsmedicare@caremark.com	CVS Caremark	9501 E. Shea Blvd MC 109	Scottsdale	AZ	85260	10/24/2025	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active	8688849479				HMO - Health Maintenance Organization		C	Boston
H5591	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne							anne.theriault@martinspoint.org	PO Box 9746	891 Washington Ave.	Portland	ME	04101	10/24/2025	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active	2077663144				HMO - Health Maintenance Organization		C	Boston
H5591	Part D Price File Contact (Back-up)	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Part D Price File Contact (Primary)	Medicare Operations		Loveland	Chet		4806064873					Chet.Loveland@CVSHealth.com	CVS Caremark	9501 E. Shea Blvd.	Scottsdale	AZ	85260	10/24/2025	2026	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	Boston
H5591	Part D Quality Assurance Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Part D Reporting Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Patient Safety Contact	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Payment Contact	Corporate Controller	Ms	Tsay	Tatiana		2072536106					tatiana.tsay@martinspoint.org	P. O. Box 9746		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Pharmacy Director	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Pharmacy Network Management Contact	Director, Network Operations		Smith	Shawn		4803914844				4803146964	Shawn.Smith@caremark.com	CVS Caremark	9501 E. Shea Blvd. MC143	Scottsdale	AZ	85260	10/24/2025	2026	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	Boston
H5591	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	Pharmacy Technical Help Desk Contact	Manager, Vendor Management		Palmieri	Mike							mike.palmieri@caremark.com	CVS Caremark	2401 Cherahala Blvd. MC650	Knoxville	TN	37932	10/24/2025	2026	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	Local CCP	Martin's Point Generations Advantage	HMO/HMOPOS		Martin's Point Health Care, Inc.	287	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H5591	Plan Directory Contact for Public Website	Director Compliance & MCO	Ms	Loomis	Elizabeth		8887327364					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Plan to Plan Reconciliation Contact	Accountant II		Ayub	Rehema		2072536991					rehema.ayub@martinspoint.org	P. O. Box 9746	891 Washington Ave	Portland	ME	04103	10/24/2025	2026	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	Boston
H5591	Processor Contact	Sr Director, Claims and Payment Operations		Kumari	Shalini		2072536220					shalini.kumari@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Quality Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	PO Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Reconciliation Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Reconciliation Contact (Secondary)	Corporate Controller	Ms.	Tsay	Tatiana		2072536106					tatiana.tsay@martinspoint.org	P. O. Box 9746		Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Recovery Audit Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		8887327364					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Surveillance Contact	Director Compliance & MCO		Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	System Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535				2072536303	elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Third Party Administrator (TPA) Liaison	Manager, Pharmacy Operations		Theriault	Anne		2077663144					anne.theriault@martinspoint.org	P.O. Box 9746	891 Washington Ave	Portland	ME	04101	10/24/2025	2026	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	Boston
H5591	User Access Contact	Director Compliance & MCO	Ms	Loomis	Elizabeth		5182290535					elizabeth.loomis@martinspoint.org	P.O. Box 9746	331 Veranda Street Bldg 2	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Utilization Management Contact	Director, Clinical Programs		VanEtten	Sara		2072536989					sara.vanetten@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/24/2025	2026	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	Boston
H5591	Utilization Review Contact	Director, Clinical Programs		VanEtten	Sara		2072536989					sara.vanetten@martinspoint.org	P.O. Box 9746	891 Washington Avenue	Portland	ME	04104	10/24/2025	2026	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	Boston
H5593	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H5593	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/11/2018	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	SNP State Contact	Executive Director, National Duals Program		Hughes	Angelique		2482700990					hughesa1@aetna.com	2 Town Square, Suite 275		Southfield	MI	48076	12/09/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5593	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF IOWA INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5594	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072				PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	07/10/2024	2026	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	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	07/10/2024	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Chief Operating Officer	Staff VP Ops & System Solutions	Mr.	Setzer	Pete		2394780540				3054603907	peter.setzer@elevancehealth.com	11430 NW 20th Street		Miami	FL	33172	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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	Dir II GBD G&A		Rolle	Celeste		8135066000	11469			8135066151	crolle@freedomh.com	5411 Sky Center Dr		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Complaints Tracking Contact	Dir II GBD G&A		Rolle	Celeste		8135066000	11469			8135066151	crolle@freedomh.com	5411 Sky Center Dr		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	07/10/2024	2026	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	Manager II, Financial Ops Dept	Ms.	Fonseca	Idany		3054488100	262			3054449148	idany.fonseca@healthsun.com	9250 West Flager Street	Suite 600	Miami	FL	33174	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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		8135066000	1621755			8135066150	CMSMemberServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	01/22/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Discount Program Payment Contact	Finance Acctg Database Analyst Sr		Racine	Max		8058163930					Max.Racine@Anthem.com	120 S Via Merida	Mail Stop: CAT202-J003	Thousand Oaks	CA	91362	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Emergency Part D Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33604	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Emergency Part D Contact (Secondary)	Pharmacist Clinical Sr.		Parker	Suzi		8135645525					smparker@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33604	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Encounter Data & Risk Adjustment Operations Contact	Dir Reporting & Data Analysis		Shah	Parin		8135066000	11368				pshah@freedomh.com	5411 Skycenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Enrollment Contact	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	EOB Transfer Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Formulary Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Formulary Contact (Secondary)	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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		7274516800	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Interoperability Contact	Dir II Technology	Mr.	Kumbhani	Dev		8135066000	11146				cms@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	MA Appeals/Grievances Contact	Dir II GBD G&A		Rolle	Celeste		8135066000	11469				crolle@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	MA Claims Processing Contact for Public Website	VP of Finance	Mr	Caruso	David		8662455360				8135066236	CMSMemberServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Medical Director	Chief Medical Officer	Dr.	Rios, D.O.	Jeannette	M	7868310456				3054449148	jrios@simplyhealthcareplans.com	11430 NW 20th St	#300	Miami	FL	33172	08/20/2025	2026	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	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Medication Therapy Management Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	1621753			8134905338	bmarrocco@freedomh.com	5411 Sky Center Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Online Enrollment Center Contact (Back-up)	QM Acred/Reg Review Analyst		Barone-Raba	Michelle		8135066000	11444				CMSEnrollment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	08/20/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Pharmacy Clinical Ops		Marrocco	Brianna						8134905338	bmarrocco@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8135066000	1621753			HMO - Health Maintenance Organization		C	Chicago
H5594	Part D Appeals Contact (Secondary)	Pharmacist Clinical Sr.		Parker	Suzi						8134905338	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8135066000	1621401			HMO - Health Maintenance Organization		C	Chicago
H5594	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	07/10/2024	2026	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 Benefits Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072				PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	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 Claims Submission Contact	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072				PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	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	Dir II GBD G&A		Rolle	Celeste						8135066152	crolle@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8135066000	11469			HMO - Health Maintenance Organization		C	Chicago
H5594	Part D Exceptions Contact (Secondary)	Mgr I Grievance/Appleals		Anda	Diana						8135066152	diana.anda@wellpoint.com	11430 NW 20th St		Miami	FL	33172	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	3054488100				HMO - Health Maintenance Organization		C	Chicago
H5594	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	07/10/2024	2026	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 Price File Contact (Optional)	Director II Technology		KUMBHANI	DEVCHAND		8135066000	11146				CMSTechsupport@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					amanda.nicholson-sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	07/10/2024	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	07/10/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Payment Contact	Fin Acctg Database Analyst Sr	Mr.	Racine	Max	J	8058163930					Max.Racine@Anthem.com	2000 Corporate Center Drive	Mail Stop: CANP02-I001	Newbury Park	CA	91320	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	05/21/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Pharmacy Director	Manager Pharmacy Clinical Ops		Marrocco	Brianna		8135066000	66072			8135066152	PharmacyDepartment@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Road		Mason	OH	45040	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacey		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Drive		Woburn	MA	01801	07/10/2024	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Road		Mason	OH	45040	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5594	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy	M						amym.matthews@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5594	PHR Beneficiary Contact																	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS	Freedom Health, Inc.	Elevance Health, Inc.	1	Yes	Active	8004012740				HMO - Health Maintenance Organization		C	Chicago
H5594	Plan Directory Contact for Public Website	Director of Member Services		Doroteo	Carlos		8004012740					cms@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Plan to Plan Reconciliation Contact	P2P Contact		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd	Ste 100 Mailstop CA9304-R04H	Woodland Hills	CA	91367	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Quality Contact	Director Quality Management		Patel	Shetal		8135066000	11413				HealthServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	System Contact	Director II Technology	Mr	Kumbhani	Devchand		8135066000	11146				CMSTechsupport@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Third Party Administrator (TPA) Liaison	Finance Acctg Database Analyst Sr		Racine	Max		8058163930					Max.Racine@Anthem.com	120 S Via Merida	Mail Stop: CAT202-J003	Thousand Oaks	CA	91362	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Utilization Management Contact	Staff VP Medicare Ops & Healthcare Management		Szabla	Sara		8135066000	11409			8135066236	HealthServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5594	Utilization Review Contact	Staff VP Medicare Ops & Healthcare Management		Szabla	Sara		8135066000	11409			8135066236	HealthServices@freedomh.com	5411 SkyCenter Drive		Tampa	FL	33607	05/14/2025	2026	OPTIMUM HEALTHCARE, INC.	Local CCP	Optimum HealthCare, Inc.	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5599	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/18/2023	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	01/03/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	03/19/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					MedicareEnrollmentUnit@fideliscare.org	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	08/18/2023	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	08/18/2023	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	05/12/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	04/05/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Chief Information Officer	Executive VP, Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	03/19/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	CMS Casework Communication Contact	Manager, Complaints and Issues		Peters	John	M	6463860713					JPeters@fideliscare.org	2501 Jackson Ave		Long Island City	NY	11101	11/03/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Complaints Tracking Contact	Manager, Complaints and Issues		Peters	John	M	6463860713					JPeters@fideliscare.org	2501 Jackson Ave		Long Island City	NY	11101	11/03/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/28/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/31/2020	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/05/2022	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/29/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/30/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/30/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/07/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	EOB Transfer Contact	Plan Chief Financial Officer	Mr.	Meixner	Thomas		7183936172				7183936172	Thomas.Meixner@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	06/15/2022	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7676 Forsyth Blvd		Clayton	MO	63105	08/16/2021	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	08/04/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	08/04/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Hospice Contact	Director, Case Management		Ruffell	Jennifer		5854983094					jruffell@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	03/11/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	08/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Medical Director	Chief Medical Officer	Mr	Marchello	Vincent		7183936564					vmarchello@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	08/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63031	09/23/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Online Enrollment Center Contact (Optional)	Quality Specialist II		Lin	Qing		7186855273					qlin1@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	05/11/2022	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment		Bush	Serena		8175249641					Serena.Bush@CENTENE.COM	10624 Kootenai St		Ft. Worth	TX	76179	09/23/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Appeals	Manager, Clinical Pharmacy Operations	Ms.	Simmons	Jennifer							jennifer.simmons12@centene.com	8725 Henderson Rd		Tampa	FL	33634	04/12/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	7274608664				HMO - Health Maintenance Organization		C	Denver
H5599	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5599	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Benefits Contact	Director, Pharmacy	Mr.	Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	05/11/2022	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/22/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	09/03/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5599	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5599	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	04/05/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504593				HMO - Health Maintenance Organization		C	Denver
H5599	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/08/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504593				HMO - Health Maintenance Organization		C	Denver
H5599	PHR Beneficiary Contact																	09/27/2022	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8002471447				HMO - Health Maintenance Organization		C	Denver
H5599	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Plan Directory Contact for Public Website			Member Services	Fidelis		8002471447				8009778226	fidelis@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	03/26/2021	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Plan to Plan Reconciliation Contact	Manager, Reporting and Analytics		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	08/18/2023	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Processor Contact	Vice President, Enterprise Business Platforms, Ami	Ms.	Hurley	Claudia		7165646100				7165643645	churley1@CENTENE.COM	480 CrossPoint Parkway		Getzville	NY	14068	10/07/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	03/19/2024	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	CA	91367	12/06/2023	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/15/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5599	Utilization Review Contact	Sr. VP, Population Health Clinical Operations		Maginn	Mary Beth		7183936590					mmaginn@fideliscare.org	2501 Jackson Avenue		Long Island City	NY	11101	06/16/2022	2026	NEW YORK QUALITY HEALTHCARE CORPORATION	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5608	Agent/Broker Compensation Data Contact	Director of Insurance Products		Score	Natalie		3036027650				3036022099	Natalie.Score@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/03/2021	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Operations Supervisor		Distel	Chris		3302127994					PartDCAT@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/10/2024	2026	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	Backup User Access Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Bid Audit Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Bid Audit Site Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Bid Primary Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	CAP Report Contact for Public Website	Chief Compliance and Audit Officer		Palmer	Landon		3036027016					landon.palmer@dhha.org	601 Broadway	Mail Code 7776	Denver	CO	80204	12/12/2023	2026	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	CEO - CMS Administrator Contact	CEO/Executive Director	Mr.	McCarthy	Greg		3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	01/03/2025	2026	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	CEO - Senior Official for Contracting	CEO/Executive Director	Mr.	McCarthy	Greg		3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2017	2026	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.	Hassan	Ansar		3036027083					ansar.hassan@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	01/09/2025	2026	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 Operating Officer		Ms.	Chrissinger	Cailey		3033602242					Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	06/12/2025	2026	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 Information Officer	CEO/Executive Director	Mr.	McCarthy	Greg		3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	06/27/2017	2026	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 Information Security Officer	Cheif Information Security Officer	Mr.	Frietzsche	Randall		3036025005					Randall.Frietzsche@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	802044507	10/15/2018	2026	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	CMMI Model Point of Contact	Government Products Manager		Chrissinger	Cailey		3036022427					cailey.chrissinger@dhha.org	777 Bannock St.	MC6000	Denver	CO	80204	11/27/2024	2026	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		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/11/2022	2026	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	Complaints Tracking Contact	Grivance and Appeal Manager		Moes	Mark		3036024218					mark.moes@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	01/09/2025	2026	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	Contact for Fraud Investigations	Chief Compliance and Audit Officer		Palmer	Landon		3036027016					landon.palmer@dhha.org	601 Broadway	Mail Code 7776	Denver	CO	80204	12/12/2023	2026	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	Enrollment Services Manager		White	Christophe		3036022056				3036022094	Christopher.White@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	06/12/2025	2026	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	Corporate Mailing						3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	802044507	04/12/2018	2026	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	Government Products Manager		Chrissinger	Cailey		3036022427					Cailey.Chrissinger@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	06/12/2025	2026	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	DIR Contact	Finance Manager		Muschanow	Rhonda		3036022472				3036022094	rhonda.muschanow@dhha.org	777 Bannock	Mail Code 6000	Denver	CO	80204	02/19/2024	2026	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	DIR Contact (Secondary)	CEO/Executive Director	Mr.	McCarthy	Greg		3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/09/2021	2026	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	Discount Program Payment Contact	Sr. Financial Analyst		Wu	Connie		3036022007				3036022094	connie.wu@dhha.org	777 Bannock	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Emergency Part D Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Technician Supervisor		Chavez	Andrea		3036022074					Andrea.Chavez@dhha.org	777 Bannock St	Mail Code 6000	Denver	CO	80204	01/09/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Actuary		Wu	Sam		3036028706					Sam.Wu@dhha.org	777 Bannock Street	MC 6000	Denver	CO	80204	06/12/2025	2026	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	Enrollment Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	EOB Transfer Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Financial Audit Contact	Chief Compliance and Audit Officer	Mr.	Palmer	Landon		3036027016					landon.palmer@dhha.org	601 Broadway	Mail Code 7776	Denver	CO	80204	12/12/2023	2026	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	Financial Reporting Contact	CEO/Executive Director	Mr.	McCarthy	Greg		3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/09/2021	2026	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	Formulary Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	MC 6000	Denver	CO	80204	11/26/2025	2026	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	Formulary Contact (Secondary)	Manager, Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/10/2024	2026	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	General Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	HIPAA Privacy Officer	Privacy Officer		Grimpo	Michael		3036025115					Michael.Grimpo@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	802044507	10/15/2018	2026	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	HIPAA Security Officer	Privacy Officer		Grimpo	Michael		3036025115					michael.grimpo@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	802044507	09/09/2024	2026	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		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Interoperability Contact	Director of Information Systems		Wilson	Lucas		3036022029					lucas.wilson@dhha.org	777 Bannock St	MC 6000	Denver	CO	80204	12/09/2021	2026	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	MA Appeals/Grievances Contact	Grievance and Appeal Manager		Moes	Mark		3036024218					mark.moes@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	01/09/2025	2026	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	MA Claims Processing Contact for Public Website			Services	HealthPlan		3036022111					dhmpinfo@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/01/2025	2026	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	Marketing Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Medical Director	Interim Chief Medical Director	Dr.	Hammerly	Milton		3036029309					Milton.Hammerly@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	03/27/2025	2026	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	Compliance Manager	Mr.	Bean	Adam		3036022135					adam.bean@dhha.org	601 Broadway	Mail Code 7776	Denver	CO	80204	05/15/2024	2026	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 Coordinator	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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 Part D Opioid Overutilization Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St	MC 6000	Denver	CO	80204	11/26/2025	2026	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	Medication Therapy Management Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St	MC 6000	Denver	CO	80204	11/26/2025	2026	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	OffShore Subcontractor Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Online Enrollment Center Contact (Back-up)	Government Products Manager		Chrissinger	Cailey		3036022427					cailey.chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/01/2025	2026	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	Online Enrollment Center Contact (Optional)	Enrollment Services Manager		White	Chris		3036022056					Christopher.White@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/01/2025	2026	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	Online Enrollment Center Contact (Primary)	Government Products Manager		Chrissinger	Cailey		3036022427				3036022099	cailey.chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	11/27/2024	2026	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 C Application Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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 C Reporting Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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 Appeals	Grievance and Appeal Manager		Moes	Mark							mark.moes@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	01/09/2025	2026	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	3036024218				HMO - Health Maintenance Organization		C	Dallas
H5608	Part D Appeals Contact (Secondary)	Government Products Manager		Chrissinger	Cailey						3036022138	cailey.chrissinger@dhha.org	777 Bannock St., MC 6000		Denver	CO	802044507	06/12/2025	2026	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	3036022427				HMO - Health Maintenance Organization		C	Dallas
H5608	Part D Application Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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 Benefits Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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 Claims Submission Contact	Medicare Operations Supervisor		Distel	Chris		3302127994					PDE@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/10/2024	2026	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	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie							Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	3036020604				HMO - Health Maintenance Organization		C	Dallas
H5608	Part D Exceptions Contact (Secondary)	Dir PA & UM Programs		Emoto	Julianne							Julianne.emoto@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/10/2024	2026	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Dallas
H5608	Part D Price File Contact (Back-up)	Medicare Part D Project Manager		Keller	Shanon		8587907104					PlanFinderCommunications@medimpact.com	10181 Scripps Gateway Ct.,		San Diego	CA	92131	12/10/2024	2026	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 Price File Contact (Primary)	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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 Quality Assurance Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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 Reporting Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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	Patient Safety Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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	Payment Contact	CEO/Executive Director	Mr.	McCarthy	Greg		3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/09/2021	2026	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 Director	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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 Network Management Contact	Dir. Pharmacy Network Administration		Hunt	Brian		8587907092					Brian.Hunt@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/10/2024	2026	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 Network Management Contact (Secondary)	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St	MC6000	Denver	CO	80204	11/26/2025	2026	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	2026	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	8773919291				HMO - Health Maintenance Organization		C	Dallas
H5608	Pharmacy Technical Help Desk Contact (Secondary)	Director, Customer Contact Services		Brewer	Kathy							Customerservice@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/10/2024	2026	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS		Denver Health and Hospital Authority	77	Yes	Active	8773919291				HMO - Health Maintenance Organization		C	Dallas
H5608	PHR Beneficiary Contact																	11/27/2024	2026	DENVER HEALTH MEDICAL PLAN, INC.	Local CCP	Elevate Medicare Advantage	HMO/HMOPOS	Elevate Medicare Advantage	Denver Health and Hospital Authority	77	Yes	Active	8779562111				HMO - Health Maintenance Organization		C	Dallas
H5608	Physician Incentive Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Plan Directory Contact for Public Website			Services	HealthPlan		3036022111				3036022099	dhmpinfo@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	10/29/2019	2026	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	Plan to Plan Reconciliation Contact	Finance Manager		Muschanow	Rhonda		3036022472				3036022094	rhonda.muschanow@dhha.org	777 Bannock	Mail Code 6000	Denver	CO	80204	02/19/2024	2026	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	Processor Contact	Sr. VP, Government Programs		Scott	Helmus		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/01/2025	2026	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	Quality Contact	Director Senior, Heatlh Plan Pharmacy and Health O		Winters	Ruie		3036020604					Ruie.WintersIII@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/26/2025	2026	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	Reconciliation Contact	Finance Manager		Muchanow	Rhonda		3036022472				3036022094	rhonda.muschanow@dhha.org	777 Bannock	Mail Code 6000	Denver	CO	80204	02/19/2024	2026	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	Reconciliation Contact (Secondary)	CEO/Executive Director	Mr.	McCarthy	Greg		3036022001				3036022094	Greg.McCarthy@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/09/2021	2026	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	Recovery Audit Contact	Chief Compliance and Audit Officer	Mr.	Palmer	Landon		3036027016					landon.palmer@dhha.org	601 Broadway	Mail Code 7776	Denver	CO	80204	12/12/2023	2026	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	SNP Application Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	SNP State Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Surveillance Contact	Chief Compliance and Audit Officer		Palmer	Landon		3036027016					landon.palmer@dhha.org	601 Broadway	Mail Code 7776	Denver	CO	80204	12/12/2023	2026	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	System Contact	Government Products Manager		Chrissinger	Cailey		3036022427				3036022094	Cailey.Chrissinger@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	Third Party Administrator (TPA) Liaison	Sr. Financial Analyst		Wu	Connie		3036022007				3036022094	connie.wu@dhha.org	777 Bannock	Mail Code 6000	Denver	CO	80204	08/09/2022	2026	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	User Access Contact	Information Systems Manager		Novak	Robb		3036029844					Robb.Novak@dhha.org	777 Bannock Street	Mail Code 6000	Denver	CO	80204	12/30/2022	2026	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	Utilization Management Contact	UM Management Operations Manager		Culter	Corie		3036024313				3036023239	Corie.Culter@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/21/2022	2026	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	Utilization Review Contact	UM Management Operations Manager		Culter	Corie		3036024313				3036023239	Corie.Culter@dhha.org	777 Bannock St.	Mail Code 6000	Denver	CO	802044507	11/21/2022	2026	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 & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Backup User Access Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	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 & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Bid Primary Contact	Chief Operating Officer		Muszynski	Thomas		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	CAP Report Contact for Public Website	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active	8006106299	2012			PACE - Nat		C	Chicago
H5610	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs.	Smith	Kim		6169132011				6169132003	kimberly.smith@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	12/10/2024	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs.	Smith	Kim		6169132011				6169132003	kimberly.smith@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	12/10/2024	2026	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		6162355123				6169132003	steve.quist@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	02/24/2023	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Chief Operating Officer	Chief Operating Officer	Mr.	Muszynski	Tom		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Chief Information Officer	VP of Information Services	Mr.	Engle	Jeff		6162355272				6163564960	jeff.engle@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	04/29/2019	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Chief Information Security Officer	VP of Information Services	Mr.	Engle	Jeff		6162355272				6163564950	jeff.engle@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	04/29/2019	2026	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 & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Complaints Tracking Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Contact for Fraud Investigations	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Coordination of Benefits Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Corporate Mailing						6169132006				6169132005	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	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 & Compliance		Poeller	Dawn		6169132012				6169132005	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	08/23/2023	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	DIR Contact	Controller		Matro	Philip		6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	08/23/2023	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	DIR Contact (Secondary)	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Discount Program Payment Contact	Controller		Matro	Philip	J	6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook St SE Ste 300		Grand Rapids	MI	49546	02/27/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Emergency Part D Contact	Chief Operating Officer		Muszynski	Tom		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Emergency Part D Contact (Secondary)	Controller		Matro	Philip		6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook Avenue SE	Suite 300	Grand Rapids	MI	49546	01/12/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Encounter Data & Risk Adjustment Operations Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Enrollment Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	EOB Transfer Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Financial Audit Contact	Controller	Mr.	Matro	Philip		6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	08/23/2023	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Financial Reporting Contact	Controller		Matro	Philip		6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	04/27/2021	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Formulary Contact	Pharmacist		Hoholik	Aaron		6169132032				6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	General Contact	Director of Quality & Compliance		Poeller	Dawn		6169132006				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Government Relations Contact	CEO		Smith	Kim		6169132011				6169132003	kimberly.smith@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49506	02/14/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	HIPAA Privacy Officer	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	HIPAA Security Officer	VP of Information Systems		Engle	Jeff		6162355272				6163564950	jeff.engle@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49506	08/23/2023	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Interoperability Contact	COO		Muszynski	Tom		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	01/12/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	MA Appeals/Grievances Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	MA Claims Processing Contact for Public Website	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Marketing Contact	Community Outreach/Intake Supervisor		Horsley-Pettigrew	Veronica		6169132031				6169132003	veronica.horsley-pettigrew@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Medical Director	Medical Director		Chiavaras	James		6169133088				6169132037	james.chiavaras@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Medicare Compliance Officer	Director of Quality & Compliance	Ms.	Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Medicare Coordinator	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Medicare Part D Opioid Overutilization Contact	Pharmacist		Hoholik	Arron		6169132032				6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Medication Therapy Management Contact	Pharmacist		Hoholik	Aaron		6169132032				6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part C Application Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Appeals	Director of Quality & Compliance		Poeller	Dawn						6169132005	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active	8006106299	2012			PACE - Nat		C	Chicago
H5610	Part D Appeals Contact (Secondary)	COO		Muszynski	Tom						6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	01/04/2021	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active	6169130214				PACE - Nat		C	Chicago
H5610	Part D Application Contact	Chief Operating Officer		Muszynski	Thomas		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Benefits Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Claims Submission Contact	Chief Operating Officer		Muszynski	Thomas		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	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 & Compliance		Poeller	Dawn						6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active	8006106299	2012			PACE - Nat		C	Chicago
H5610	Part D Price File Contact (Back-up)	Pharmacist		Hoholik	Aaron		6169132032				6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Price File Contact (Optional)	Pharmacist		Hoholik	Aaron		6169132032				6169132005	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Price File Contact (Primary)	Chief Operating Officer	Mr.	Muszynski	Thomas		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Quality Assurance Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Part D Reporting Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Patient Safety Contact	Pharmacist		Hoholik	Aaron		6169132032				6169132003	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Payment Contact	Contoller		Matro	Philip		6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	04/27/2021	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Pharmacy Director	Pharmacist		Hoholik	Aaron		6169132032				6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Pharmacy Network Management Contact	Pharmacist		Hoholik	Aaron		6169132032				6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Pharmacy Network Management Contact (Secondary)	Pharmacist		Hoholik	Aaron		6169132032				6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	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						6169132037	aaron.hoholik@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active	1800610629				PACE - Nat		C	Chicago
H5610	Plan Directory Contact for Public Website	Community Outreach		Horsley-Pettigrew	Veronica		6169132031				6169132003	veronica.horsley-pettigrew@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Plan to Plan Reconciliation Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Processor Contact	COO		Muszynski	Tom		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Quality Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Reconciliation Contact	Controller		Matro	Philip		6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	02/14/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Reconciliation Contact (Secondary)	CFO		Quist	Steve		6162355123				6169132003	steve.quist@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	02/24/2023	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Recovery Audit Contact	Controller	Mr.	Matro	Philip		6162355090				6162355059	philip.matro@hollandhome.org	2100 Raybrook Ave SE	Suite 300	Grand Rapids	MI	49546	08/23/2023	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Surveillance Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	System Contact	Chief Operating Officer	Mr.	Muszynski	Thomas		6169132014				6169132003	tom.muszynski@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	11/04/2022	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Third Party Administrator (TPA) Liaison	Director of Quality & Compliance		Poeller	Dawn	M	6169132006				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	User Access Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Utilization Management Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5610	Utilization Review Contact	Director of Quality & Compliance		Poeller	Dawn		6169132012				6169132003	dawn.poeller@careresources.org	4150 Kalamazoo Avenue SE		Grand Rapids	MI	49508	05/20/2025	2026	CARE RESOURCES	National PACE	Care Resources	National PACE		Care Resources	267	Yes	Active					PACE - Nat		C	Chicago
H5619	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H5619	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H5619	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	ARCADIAN HEALTH PLAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H5619	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	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	VP, Finance & Reimbursement	Mrs	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Backup User Access Contact	VP	Ms.	Markert	Tracy		5024566200					tmarkert@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Best Available Evidence Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Bid Primary Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	CAP Report Contact for Public Website	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	CEO - CMS Administrator Contact	Executive Director of PACE Operations	Ms.	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	CEO - Senior Official for Contracting	CEO	Mr	Cook	David		5024566200					dcook@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Chief Financial Officer	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Chief Operating Officer	VP	Ms.	Markert	Tracy		5024566200					tmarkert@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Chief Information Officer	VP IT	Mr	Archibald	Josh		5024566200					jarchibald@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Chief Information Security Officer	VP IT	Mr	Archibald	Josh		5024566200					jarchibald@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	CMS Casework Communication Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Complaints Tracking Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	02/15/2024	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Contact for Fraud Investigations	VP, Compliance & Organizational Excellence	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	6200 Dutchmans Lane		Louisville	KY	40205	10/30/2025	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Coordination of Benefits Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Corporate Mailing						2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Customer Service Operations Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	DIR Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	DIR Contact (Secondary)	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Discount Program Payment Contact	Executive Director	Ms.	Parsons	Judith		2706002581					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	01/23/2024	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Emergency Part D Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Emergency Part D Contact (Secondary)	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Encounter Data & Risk Adjustment Operations Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Enrollment Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	EOB Transfer Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200				5025990175	lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Financial Audit Contact	Project Manager	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Financial Reporting Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Formulary Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	General Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Government Relations Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	HIPAA Privacy Officer	VP, Compliance & Organizational Excellence	Ms.	McGinty	Loretta		5024566200					lmcginty@everenthealth.org	6200 Dutchmans Lane		Louisville	KY	40205	10/30/2025	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	HIPAA Security Officer	VP IT	Mr	Archibald	Josh		5027194194					jarchibald@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	10/30/2025	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Interoperability Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	MA Appeals/Grievances Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	MA Claims Processing Contact for Public Website	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Marketing Contact	Executive Director of Marketing and Communication	Ms	Duncan	Dyan		5024566200					dduncan@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Medical Director	Medical Director	Dr	Borders	James		2706002580					jborders@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Medicare Compliance Officer	VP, Compliance & Organizational Excellence	Ms.	McGinty	Loretta		5027194194					lmcginty@everenthealth.org	6200 Dutchmans Lane		Louisville	KY	40205	10/30/2025	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Medicare Coordinator	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Medicare Part D Opioid Overutilization Contact	Executive Director	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	01/24/2024	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Medication Therapy Management Contact	Medical Director	Dr	Borders	James		2706002580					jborders@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part C Application Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part D Appeals	Executive Director of PACE Operations	Ms.	Parsons	Judith							jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active	2706002580				PACE - Nat		C	Atlanta
H5622	Part D Appeals Contact (Secondary)	Chief Legal Officer	Mrs	Fieldhouse	Lynn							lfieldhouse@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	02/15/2024	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active	5024566200				PACE - Nat		C	Atlanta
H5622	Part D Application Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part D Benefits Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part D Claims Submission Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part D Exceptions Contact	Executive Director of PACE Operations	Ms.	Parsons	Judith							jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active	2706002580				PACE - Nat		C	Atlanta
H5622	Part D Price File Contact (Back-up)	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part D Price File Contact (Primary)	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part D Quality Assurance Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	02/15/2024	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Part D Reporting Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Patient Safety Contact	Chief Legal Officer	Ms.	Fieldhouse	Lynn		5024566200					lfieldhouse@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	02/15/2024	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Payment Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Pharmacy Director	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Pharmacy Network Management Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Pharmacy Technical Help Desk Contact	Executive Director of PACE Operations	Ms.	Parsons	Judith							jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active	2706002580				PACE - Nat		C	Atlanta
H5622	Plan Directory Contact for Public Website	Executive Director of Marketing and Communication	Ms	Duncan	Dyan		5024566200					dduncan@hosparus.org	6200 Dutchman Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Plan to Plan Reconciliation Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Processor Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Quality Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	02/15/2024	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Reconciliation Contact	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Recovery Audit Contact	Executive Director of PACE Operations	Ms.	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Surveillance Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	System Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Third Party Administrator (TPA) Liaison	VP, Finance & Reimbursement	Ms.	Wilson	Lauren		5024566200					lwilson2@hosparus.org	6200 Dutchmans Lane		Louisville	KY	40205	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	User Access Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Utilization Management Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5622	Utilization Review Contact	Executive Director of PACE Operations	Ms	Parsons	Judith		2706002580					jparsons@careguidepartners.org	109 Buffalo Creek Drive		Elizabethtown	KY	42701	12/06/2023	2026	CARE GUIDE PARTNERS, INC.	National PACE	Care Guide Partners	National PACE		Hosparus Health Inc	824	Yes	Active					PACE - Nat		C	Atlanta
H5628	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H5628	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H5628	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5628	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H5628	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5628	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF UTAH, INC.	Local CCP	Molina Healthcare of Utah & Idaho	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5628	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		Bellar	Brittni		6196773927					bbellar@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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	Backup User Access Contact	IT Manager		Valladolid	Mark		6192396900					mvalladolid@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	04/14/2025	2026	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	Health Plan Manager		Bellar	Brittni		6196773927					bbellar@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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	Bid Primary Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	CAP Report Contact for Public Website	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	CEO - CMS Administrator Contact	VP of PACE/Executive Director	Mrs.	Castillon	Carol		6196773876					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	06/09/2025	2026	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	CEO - Senior Official for Contracting	VP of PACE Operations/Executive Director	Mrs.	Castillon	Carol		6196773876					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	09/05/2024	2026	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.	Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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 Operating Officer	Chief Operating Officer	Mr.	Cooper	Brian		6196773820					bcooper@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/27/2025	2026	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 Information Officer	IT Director	Mr.	Valladolid	Mark		6192396900					mvalladolid@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	03/01/2022	2026	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 Information Security Officer	IT Director	Mr.	Valladolid	Mark		6192396900					mvalladolid@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	03/01/2022	2026	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	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	Complaints Tracking Contact	Quality and Compliance Manager		Figueroa	Miriam		6196773852					mfigueroa@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	01/07/2025	2026	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	Contact for Fraud Investigations	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	Compliance Director		Cueva	Celeste		8775107223					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	Corporate Mailing						6196773800					ccueva@stpaulspace.org	328 Maple Street		San Diego	CA	92103	01/07/2025	2026	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	VP of PACE Operations		Castillon	Carol		6196773876					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	DIR Contact	Health Plan Manager		Bellar	Brittni		6196773927					bbellar@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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	DIR Contact (Secondary)	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Discount Program Payment Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Emergency Part D Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Emergency Part D Contact (Secondary)	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Enrollment Contact	VP of PACE Services/Executive Director		Castillon	Carol		6196773876					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/27/2025	2026	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	EOB Transfer Contact	Chief Financial Officer		Vieu	George		6196213351				6192391256	gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Financial Audit Contact	Chief Financial Officer	Mr.	Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Financial Reporting Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Formulary Contact	Chief Operating Officer	Mr.	Cooper	Brian		6196773820					bcooper@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/27/2025	2026	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	General Contact	Chief Operating Officer		Cooper	Brian		6196773820					bcooper@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/27/2025	2026	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	VP of PACE Operations		Castillon	Carol		6196773876					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	HIPAA Privacy Officer	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	HIPAA Security Officer	IT Director		Valladolid	Mark		6192396900					mvalladolid@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	04/14/2025	2026	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	Interoperability Contact	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	MA Appeals/Grievances Contact	Quality and Compliance Manager		Figueroa	Miriam		6196773852					mfigueroa@stpaulspace.org	3444 Camino del Rio North		San Diego	CA	92108	04/14/2025	2026	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	MA Claims Processing Contact for Public Website	Health Plan Manager		Bellar	Brittni		8775107223					bbellar@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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	Marketing Contact	Marketing Director		Romero	Jennifer		6192396900	3061				jenromero@stpaulspace.org	328 Maple Street		San Diego	CA	92103	04/17/2024	2026	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	Medical Director	Medical Director		Stull	Jamie		6196773811					jstull@stpaulspace.org	3444 Camino Del Rio North		San Diego	CA	92108	04/14/2025	2026	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	Compliance Director	Mrs.	Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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 Coordinator	VP of PACE Operations		Castillon	Carol		6196773876					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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 Part D Opioid Overutilization Contact	Quality and Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio North		San Diego	CA	92108	12/31/2024	2026	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	Medication Therapy Management Contact	Quality and Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio North		San Diego	CA	92108	12/31/2024	2026	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 C Application Contact	VP of PACE Operations		Castillon	Carol		6196773876					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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 Appeals	Quality and Compliance Manager		Figueroa	Miriam							mfigueroa@stpaulspace.org	3444 Camino Del Rio North		San Diego	CA	92108	01/07/2025	2026	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul s Episcopal Home	653	Yes	Active	6196773852				PACE - Nat		C	San Francisco
H5629	Part D Application Contact	VP of PACE Operations		Castillon	Carol		6196773876					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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 Benefits Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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 Claims Submission Contact	Health Plan Manager		Bellar	Brittni		6196773927					bbellar@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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	VP PACE Operations/Executive Director		Castillon	Carol							ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/27/2025	2026	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul s Episcopal Home	653	Yes	Active	8007352922				PACE - Nat		C	San Francisco
H5629	Part D Price File Contact (Back-up)	Health Plan Manager		Bellar	Brittni		6196773927					bbellar@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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 Price File Contact (Optional)	Chief Operating Officer		Cooper	Brian		6196773820					bcooper@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/27/2025	2026	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 Price File Contact (Primary)	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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 Quality Assurance Contact	Quality and Compliance Manager		Figueroa	Miriam		6196773852					mfigueroa@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	01/07/2025	2026	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 Reporting Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Patient Safety Contact	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	Payment Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Personal Health Record Contact	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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 Director	VP PACE Operation/Executive Director		Castillon	Carol		6196773811					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	01/07/2025	2026	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 Network Management Contact	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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 Network Management Contact (Secondary)	VP PACE Operations/Executive Director		Castillon	Carol		6196773811					ccastillon@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	01/07/2025	2026	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	Compliance Director		Cueva	Celeste							ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	COMMUNITY ELDERCARE OF SAN DIEGO	National PACE	St. Paul's PACE	National PACE		St. Paul s Episcopal Home	653	Yes	Active	8007352922				PACE - Nat		C	San Francisco
H5629	Plan Directory Contact for Public Website	Compliance Director		Cueva	Celeste		8775107223					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Processor Contact	Health Plan Manager		Bellar	Brittni		6196773927					bbellar@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	03/07/2025	2026	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	Quality Contact	Quality and Compliance Manager		Figueroa	Miriam		6196773852					mfigueroa@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	01/07/2025	2026	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	Reconciliation Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Surveillance Contact	Marketing Director		Romero	Jennifer		6192396900	3061				jenromero@stpaulspace.org	328 Maple Street		San Diego	CA	92103	04/17/2024	2026	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	System Contact	IT Director		Valladolid	Mark		6192396900					mvalladolid@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	04/14/2025	2026	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	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	User Access Contact	Compliance Director		Cueva	Celeste		6196773869					ccueva@stpaulspace.org	3444 Camino Del Rio N		San Diego	CA	92108	08/05/2024	2026	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	Utilization Management Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Utilization Review Contact	Chief Financial Officer		Vieu	George		6196213351					gvieu@stpaulseniors.org	328 Maple Street		San Diego	CA	92103	12/08/2023	2026	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	Agent/Broker Compensation Data Contact	Director, Individual Sales		Gehrke	Kimberly		9207201569					kgehrke@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Backup User Access Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Best Available Evidence Contact	Manager, Enrollment & Business Analysis Integratio		Crocker	Brian		9207201640					bcrocker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	06/26/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Bid Audit Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Bid Audit Site Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Bid Primary Contact	Manager, Actuarial Pricing		Lanier	Eric		9207201636				9207201912	elanier@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	CAP Report Contact for Public Website	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	CEO - CMS Administrator Contact	President & CEO	Mrs.	Dicus-Johnson	Coreen		9208259689					Coreen.DicusJohnson@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	CEO - Senior Official for Contracting	President & CEO	Mrs.	Dicus-Johnson	Coreen		2628259689					Coreen.DicusJohnson@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Chief Financial Officer	Chief Financial Officer	Mr	Ollech	Brian		9207201886					bollech@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Chief Operating Officer	Vice President, Operations	Ms.	Vander Zanden	Jessica		9207201652					jvanderz@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Chief Information Officer	Chief Information Officer	Mr	Riley	Timothy		9207201895					triley@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Chief Information Security Officer	Chief Information Security Officer	Mr	Bloedorn	Dave		9207201410					dbloedor@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	CMS Casework Communication Contact	Regulatory Support Administrator		Lee	Chia		9206287268					clee@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/08/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Complaints Tracking Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	08/04/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Contact for Fraud Investigations	VP, Risk Adjustment & Payment Integrity		Weisbrod	Josh		9207201461					jweisbro@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Coordination of Benefits Contact	Director, Pharmacy Benefits		Wheaton	Andy		9207201612				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Corporate Mailing						9207201200					nhcompliance@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Customer Service Operations Contact	Manager, Customer Service		Schwandner	Stacy		9207201309				9207201908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	DIR Contact	Medicare Pharmacist		Peterson Sanders	Anna		9207201672					apeterso@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	DIR Contact (Secondary)	Director, Pharmacy Benefits		Wheaton	Andy		9207201612					awheaton@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Discount Program Payment Contact	Senior Accountant		Cymerman	Tricia		9207201658					tcymerma@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Electronic Health Record Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Emergency Part D Contact	Director, Pharmacy Benefits		Wheaton	Andy		9202058528					awheaton@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Emergency Part D Contact (Secondary)	Medicare Pharmacist		Peterson Sanders	Anna		9207201672					apeterso@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/20/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Employer Waiver Contact	Director, Individual Sales		Gehrke	Kimberly		9207201569					kgehrke@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Encounter Data & Risk Adjustment Operations Contact	VP, Risk Adjustment & Payment Integrity		Weisbrod	Josh		9207201461					jweisbro@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Enrollment Contact	Manager, Enrollment & Business Analysis Integratio		Crocker	Brian		9207201640					bcrocker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	06/26/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	EOB Transfer Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Financial Audit Contact	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Financial Reporting Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Formulary Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Formulary Contact (Secondary)	Director, Pharmacy Benefits		Wheaton	Andy		9207201612				9207201906	awheaton@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/10/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	General Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Government Relations Contact	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	HIPAA Privacy Officer	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	HIPAA Security Officer	Chief Information Security Officer	Mr	Bloedorn	Dave		9207201410					dbloedor@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Hospice Contact	Pharmacy Benefits Program Manager		Kempfer	Amanda		9207201607					pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/13/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Interoperability Contact	Director, IT Development		Zirbel	Justin		9207201202					jzirbel@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/13/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	MA Appeals/Grievances Contact	Manager, Appeals and Grievances		Skinner	Jeanne		9207201382					jskinnner@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/20/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	MA Claims Processing Contact for Public Website	Manager, Claims		Adamick	Crystal		9207201547					cadamick@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Marketing Contact	VP of Marketing		Sengkhammee	David		9207201236				9207201912	dsengkha@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Medical Director	Chief Medical Officer	Dr.	Hassan	Mushir		2628259727					mhassan@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Medicare Compliance Officer	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Medicare Coordinator	Vice President, Operations		Vander Zanden	Jessica		9207201573				9207201912	jvanderz@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Medicare Part D Opioid Overutilization Contact	Staff Pharmacist		Coopman	Beth		9206287411					pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Medication Therapy Management Contact	Network Account Director, Retail Strategy & Contra		Muralidharan	Adrienne		3143131932					amuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	OffShore Subcontractor Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Online Enrollment Center Contact (Back-up)	Process Lead, Enrollment		Dessell	Tracy		9207201223				9207201912	tdessell@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Online Enrollment Center Contact (Optional)	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Business Analysis Integratio		Crocker	Brian		9207201640					bcrocker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	06/26/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part C Application Contact	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part C Reporting Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Appeals	Manager, Appeals and Grievances		Skinner	Jeanne						9207201382	jskinner@networkhealth.com	1570 Midway Place		Menasha	WI	54952	01/20/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active	8003785234				HMO - Health Maintenance Organization		C	Boston
H5644	Part D Appeals Contact (Secondary)	Vice President, Pharmacy Benefits		Regalia	Ted						9207201832	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active	8003785234				HMO - Health Maintenance Organization		C	Boston
H5644	Part D Application Contact	Compliance Officer		Jurmu	Michael		9207201893					mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Benefits Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Claims Submission Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Exceptions Contact	Sr. Manager - Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/27/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Boston
H5644	Part D Exceptions Contact (Secondary)	Vice President, Pharmacy Benefits		Regalia	Ted						9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active	8003785234				HMO - Health Maintenance Organization		C	Boston
H5644	Part D Price File Contact (Back-up)	Director, Pharmacy Benefits		Wheaton	Andy		9207201612				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Price File Contact (Optional)	Pharmacy Benefits Program Manager		Kempfer	Amanda		9207201607					pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/13/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Quality Assurance Contact	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Part D Reporting Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Patient Safety Contact	Medicare Pharmacist		Peterson Sanders	Anna		9207201672				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Payment Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Personal Health Record Contact	Vice President, Care Services		Dencker	Sarah		9207201694				9207201908	sdencker@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Pharmacy Director	Vice President, Pharmacy Benefits		Regalia	Ted		9207201654				9207201906	pharmacybenefits@networkhealth.com	1570 Midway Place	PO Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Pharmacy Network Management Contact			Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/19/2023	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H5644	PHR Beneficiary Contact																	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS	Network Health Insurance Corporation	Network Health, Inc.	670	Yes	Active	8003785234				HMO - Health Maintenance Organization		C	Boston
H5644	Physician Incentive Contact	Senior VP, Network Dev & Contract Management		Wille	Scott		2628259790					swille@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Plan Directory Contact for Public Website			Service	Customer		8003785234				9207201908	sschwand@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Plan to Plan Reconciliation Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Processor Contact	Director, Government Programs, MedicareMedicare		Steffen	Jeff		6363351729					jhsteffen@express-scripts.com	One Express Way		St Louis	MO	63121	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Quality Contact	VP, Quality and Clinical Integration		Willis	John		2628259783					jwillis@networkhealth.com	1570 Midway Place		Menasha	WI	54952	10/30/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Reconciliation Contact	Vice President, Finance		Leigh	Dennis		9207201837					FinanceReporting@networkhealth.com	1570 Midway  Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Reconciliation Contact (Secondary)	Senior Accountant		Cymerman	Tricia		9207201658					tcymerma@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Recovery Audit Contact	Compliance Officer	Mr.	Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	SNP Application Contact	Director, Care Management		Reinsch	Laura		9207201711					lreinsch@networkhealth.com	1570 Midway Pl	PO Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	SNP State Contact	Managed Care Policy Analyst	Ms.	Froelich	Brooke		6082677281					BrookeS.Froelich@dhs.wi.gov	1 Wilson Street, Room 350		Madison	WI	537010309	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Surveillance Contact	Compliance Officer		Jurmu	Michael		9207201893				9207201912	mjurmu@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/07/2025	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	System Contact	Manager, IT Infrastructure		Petersen	Chris		9207201445					cpeterse@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Third Party Administrator (TPA) Liaison	Senior Accountant		Cymerman	Tricia		9207201658					tcymerma@networkhealth.com	1570 Midway Place		Menasha	WI	54952	11/01/2022	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	User Access Contact	Information Security Risk Analyst		Pfefferle	Trish		9207201225					tpfeffer@networkhealth.com	1570 Midway Place	P.O. Box 120	Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Utilization Management Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5644	Utilization Review Contact	Vice President, Care Services		Dencker	Sarah		9207201694					sdencker@networkhealth.com	1570 Midway Place		Menasha	WI	54952	04/12/2024	2026	NETWORK HEALTH INSURANCE CORPORATION	Local CCP	Network Health Medicare Advantage Plans	HMO/HMOPOS		Network Health, Inc.	670	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5649	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H5649	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H5649	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5649	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H5649	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5649	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5649	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5649	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	Local CCP	Central Health Medicare Plan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5652	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H5652	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5652	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H5652	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H5652	Plan Directory Contact for Public Website			Customer Service	UHC		8663148188					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5652	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5692	Agent/Broker Compensation Data Contact	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Automated TrOOP Balance Transfer Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Backup User Access Contact	Compliance Director	Mr.	Markley	Ryan		8314301431					rmarkley@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Best Available Evidence Contact	Director of Medicare Operations	Ms.	Katz	Sherri	A	8314302571					skatz@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	04/21/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Bid Audit Contact	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Bid Primary Contact	Director of Medicare Operations	Ms.	Katz	Sherri	A	8314302571					skatz@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	04/21/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	CAP Report Contact for Public Website	Chief Compliance Officer	Ms.	Mandella	Jenifer		8314305624					jkugler@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Schrader	Michael		8314302501					mschrader@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Schrader	Michael		8314302501					mschrader@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Chief Financial Officer	Chief Financial Officer	Ms.	Ba	Lisa		8314302600					Lba@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Chief Operating Officer	Chief Operating Officer	Ms.	Wong	Van		8314304151					vwong@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Chief Information Officer	Chief Information Officer	Mr.	Newton	Cecil		8314301430					cnewton@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Chief Information Security Officer	Chief Information Officer	Mr.	Newton	Cecil		8314301430					cnewton@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	CMS Casework Communication Contact	Compliance Director	Mr.	Markley	Ryan		8314301431					rmarkley@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Complaints Tracking Contact	Grievance Supervisor	Ms.	Zuniga	Ruth		8314302542					ruzuniga@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	11/13/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Contact for Fraud Investigations	Compliance Director	Mr.	Markley	Ryan		8314301431					rmarkley@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Coordination of Benefits Contact	Member Data Supervisor	Ms.	Martinez	Veronica		2093815337					listcob@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Corporate Mailing						8314305636					rinlow@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Customer Service Operations Contact	Member Services Director	Ms.	Chagolla	Lilia		8317556020					lchagolla@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	DIR Contact	Chief Financial Officer	Ms.	Ba	Lisa		8314302600					Lba@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Discount Program Payment Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Emergency Part D Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Encounter Data & Risk Adjustment Operations Contact	EDI Manager	Ms.	Philllips	Kim		8314305648					kphillips@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Enrollment Contact	Director of Medicare Operations	Ms.	Katz	Sherri	A	8314302571					skatz@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	04/21/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	EOB Transfer Contact	Claims Manager	Ms.	White	Misty		8314305720				8314305858	mwhite@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	08/26/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Financial Audit Contact	Chief Financial Officer	Ms.	Ba	Lisa		8314302600					Lba@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Financial Reporting Contact	Director, Financial Planning & Analysis	Ms.	Lee	Anne		8314302664					alee@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Formulary Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	General Contact	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Government Relations Contact	Government Relations Director	Ms.	Carlson	Danita		8312121602					dcarlson@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Mandella	Jenifer		8314305624					jkugler@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	HIPAA Security Officer	Chief Information Officer	Mr.	Newton	Cecil		8314301430					cnewton@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Hospice Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Interoperability Contact	Chief Information Officer	Mr.	Newton	Cecil		8314301430					cnewton@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	MA Appeals/Grievances Contact	Grievance and Quality Manager	Ms.	Sanders	Sarah		8314305533					ssanders@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	White	Misty		8007003874	5503			8314305858	mwhite@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	08/26/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Marketing Contact	Marketing & Communications Director	Ms.	Gorman	Linda		8314304175					Lgorman@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Medical Director	Interim Chief Medical Officer	Dr.	Wang	Mike		8314304131					mwang@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	08/19/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Mandella	Jenifer		8314305624					jkugler@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Medicare Coordinator	Director of Medicare Operations	Ms.	Katz	Sherri	A	8314302571					skatz@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	04/21/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Medicare Part D Opioid Overutilization Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Medication Therapy Management Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Online Enrollment Center Contact (Back-up)	Director of Medicare Operations	Ms.	Katz	Sherri	A	8314302571					skatz@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	04/21/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Online Enrollment Center Contact (Primary)	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part C Application Contact	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part C Reporting Contact	Chief Compliance Officer	Ms.	Mandella	Jenifer		8314305624					jkugler@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Appeals	Pharmacy Director	Ms.	Sachdeva	Navneet							nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active	8314305802				HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Application Contact	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Rd, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Benefits Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Claims Submission Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Exceptions Contact	Pharmacy Director	Ms.	Sachdeva	Navneet							nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active	8314305802				HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Price File Contact (Back-up)	Clinical Pharmacist	Mr.	Cho	Sam		8314302612					scho@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Price File Contact (Optional)		Ms.	Keller	Shanon		8587906455					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	07/14/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Price File Contact (Primary)	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Quality Assurance Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Part D Reporting Contact	Chief Compliance Officer	Ms.	Mandella	Jenifer		8314305624					jkugler@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Patient Safety Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Payment Contact	Director, Financial Planning & Analysis	Ms.	Lee	Anne		8314302664					alee@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Personal Health Record Contact	Chief Compliance Officer	Ms.	Mandella	Jenifer		8314305624					jkugler@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Pharmacy Director	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Pharmacy Network Management Contact	Pharmacy Director	Ms.	Sachdeva	Navneet		8314305802					nsachdeva@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Pharmacy Technical Help Desk Contact	Director, Customer Service Contracts		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/19/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active	8003475841				HMO - Health Maintenance Organization		C	Dallas
H5692	Plan Directory Contact for Public Website	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	08/19/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Plan to Plan Reconciliation Contact	Financial Planning and Analysis Director	Ms.	Lee	Anne		8314302664					alee@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Processor Contact	SVP, Government Programs and Services	Mr.	Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/10/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Quality Contact	Quality Improvement and Population Health Director	Ms.	Swan	Andrea		2093815327					aswan@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Reconciliation Contact	Director, Financial Planning & Analysis	Ms.	Lee	Anne		8314302664					alee@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Recovery Audit Contact	Financial Planning and Analysis Director	Ms.	Lee	Anne		8314302664					alee@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	SNP Application Contact	Director of Medicare Operations	Ms.	Katz	Sherri	A	8314302571					skatz@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	04/21/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Surveillance Contact	Compliance Director	Mr.	Markley	Ryan		8314301431					rmarkley@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	System Contact	Chief Information Officer	Mr.	Newton	Cecil		8314301430					cnewton@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Third Party Administrator (TPA) Liaison	Executive Director, Medicare Programs	Mr.	Crawford	Scott		8314301478					scrawford@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	User Access Contact	Chief Compliance Officer	Ms.	Mandella	Jenifer		8314305624					jkugler@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Utilization Management Contact	Utilization Management Director	Ms.	Brass	Tammy		2093815325					tbrass@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5692	Utilization Review Contact	Utilization Management Director	Ms.	Brass	Tammy		2093815325					tbrass@thealliance.health	1600 Green Hill Road, Suite 101		Scotts Valley	CA	95066	02/06/2025	2026	SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDICAL CARE COMMISSION	Local CCP	Central California Alliance for Health	HMO/HMOPOS		SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	873	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5703	Agent/Broker Compensation Data Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Automated TrOOP Balance Transfer Contact	Business Systems Analyst		Murral	Karla		2672985899					kdmurray@performrx.com	PerformRx	200 Stevens Dr.	Philadelphia	PA	19113	06/18/2025	2026	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	Backup User Access Contact	Compliance Officer		Marks	Jeff		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Bid Audit Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Bid Audit Site Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Bid Primary Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	CAP Report Contact for Public Website	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms	Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Operating Officer	Chief Executive Officer	Ms	Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Information Officer		Mr	Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Information Security Officer		Mr	Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316373				5074447774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Complaints Tracking Contact	Grievance and Appeals Manager		Miller	Suzette		5074316373				5074447774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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	Contact for Fraud Investigations	Compliance Officer		Marks	Jeff		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Corporate Mailing						5074447770				5074447774	amcgregor@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	DIR Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	06/22/2022	2026	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	DIR Contact (Secondary)	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	02/18/2022	2026	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	Discount Program Payment Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	06/22/2022	2026	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	Emergency Part D Contact	Pharmacy Manager		Bailey	Sarah		5074315477				5074447774	sbailey@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Emergency Part D Contact (Secondary)	Director of Operations		Lewer	Cheryl		5074316377					clewer@mnscha.org	6380 West Frontage Road		Medford	MN	55049	01/23/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Schufman	Scott		5074316599				5074447770	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Enrollment Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	CLewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	EOB Transfer Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Financial Audit Contact	Chief Financial Officer	Mr	Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Financial Reporting Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Formulary Contact	Director of Clinical Services		Megargell	Lauren		2159374135					lmegargell@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	06/02/2021	2026	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	General Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	HIPAA Privacy Officer	Compliance Officer		Marks	Jeff		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	HIPAA Security Officer			Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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		5074316397				5074447774	kworrall@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Interoperability Contact			Hoenck	Matt		5074316391					mhoenck@mnscha.org	6380 West Frontage Road		Medford	MN	55049	04/11/2022	2026	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	MA Appeals/Grievances Contact	Grievance and Appeals Manager		Miller	Suzette		5074316373				5074447774	sumiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	MA Claims Processing Contact for Public Website	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Marketing Contact	Director of Community Engagement		Braaten	Kelly		5074316572				5074447774	kbraaten@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Medical Director	Chief Medical Director	Dr.	Miller	Timothy		5074316388				5074447774	tmiller@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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		5074316068				5074447774	jmarks@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Coordinator	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/22/2021	2026	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 Part D Opioid Overutilization Contact	Director Clinical Outcomes & Therapeutic Optimizat		McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Steven Dr.	Philadelphia	PA	19113	02/02/2023	2026	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	Medication Therapy Management Contact	Director Clinical Outcomes & Therapeutic Opt.		McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/02/2023	2026	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	Online Enrollment Center Contact (Back-up)	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Online Enrollment Center Contact (Primary)	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 C Application Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 C Reporting Contact	Compliance Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	05/27/2025	2026	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 Appeals	Director of Pharmacy Utilization Mgmt		Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H5703	Part D Appeals Contact (Secondary)	Clinical Pharmacist, Manager of Pharmacy Prior Aut		McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Chicago
H5703	Part D Application Contact	Compliance Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	05/27/2025	2026	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 Benefits Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 Claims Submission Contact	Director of Clinical Operations		Ortiz	Noel		2159375352					nortiz@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	05/26/2021	2026	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 Mgmt		Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H5703	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Mchale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Chicago
H5703	Part D Price File Contact (Back-up)	Medicard Part D Program Analyst		Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	07/30/2024	2026	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 Price File Contact (Optional)	Medicare Part D Program Analyst		Weihe	Heather		4127156363	1444				heather.weihe@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	06/18/2025	2026	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 Price File Contact (Primary)	Medicard Part D Program Analyst		West	Ariel		3133781225				2158635100	Ariel.West@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	07/30/2024	2026	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 Quality Assurance Contact	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 Reporting Contact	Compliance Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	05/27/2025	2026	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	Patient Safety Contact	Director Clinical Outcomes & Therapeutic Opt.		McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	02/02/2023	2026	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	Payment Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Personal Health Record Contact			Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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 Director	VP Clinical Programs, Pharmacy Clinical Services		Maiorini	Andrew		2159378565					Amaiorini@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/01/2016	2026	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 Network Management Contact	Vice President Network Strategy		Sullivan	Tim		6303303638					tim.sullivan@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	07/30/2024	2026	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	Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/11/2025	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H5703	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/11/2025	2026	SOUTH COUNTRY HEALTH ALLIANCE	Local CCP	South Country Health Alliance	HMO/HMOPOS		South Country Health Alliance	212	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H5703	Plan Directory Contact for Public Website	Communications Manager		Gartner	Chris		5074313021				5074447774	cgartner@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Plan to Plan Reconciliation Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Processor Contact	Director of Clinical Operations		Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	05/26/2021	2026	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	Quality Contact	Quality Manager		Smith	Justin		5074316387				5074447774	jsmith@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	Reconciliation Contact	Controller		Toquam	Erica		5074316591				5074447774	etoquam@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Reconciliation Contact (Secondary)	Chief Financial Officer		Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr	Schufman	Scott		5074316599				5074447774	sschufman@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	SNP Application Contact	Chief Executive Officer		Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	SNP State Contact	Chief Executive Officer		Lind	Leota		5074447772				5074447774	llind@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Surveillance Contact	Director of Community Engagement		Braaten	Kelly		5074316572				5074447774	kbraaten@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	01/23/2023	2026	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	System Contact	Director of IT and Analytics		Hoenck	Matt		5074316391				5074447774	mhoenck@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Third Party Administrator (TPA) Liaison	Director of Operations		Lewer	Cheryl		5074316377				5074447774	clewer@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	06/22/2022	2026	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	User Access Contact	Compliance and Government Relations Manager		Krenz	Kayla		5074316938				5074447774	kkrenz@mnscha.org	South Country Health Alliance	6380 West Frontage Road	Medford	MN	55049	10/26/2021	2026	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	Utilization Management Contact	Manager of Utilization Management		Beckel	Ashley		5074316583				2158635100	abeckel@mnscha.org	6380 West Frontage Road		Medford	MN	55049	01/23/2023	2026	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	Utilization Review Contact	Manager of Utilization Management		Beckel	Ashley		5074316583				2158635100	abeckel@mnscha.org	6380 West Frontage Road		Medford	MN	55049	01/23/2023	2026	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
H5718	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H5718	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H5718	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H5718	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H5718	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H5718	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H5718	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H5718	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5718	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H5734	Agent/Broker Compensation Data Contact	Director, Community Marketplace & Mbr Engagement		Ford	Vena		2099333696					vford@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Automated TrOOP Balance Transfer Contact	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Backup User Access Contact	Director, Compliance Operations		White	Toni		2098881775					twhite@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Best Available Evidence Contact	Senior Director Finance		Navarro	Christophe		2092795790					cnavarro@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Bid Audit Contact	Director, Medicare D-SNP		Pena	Cynthia		2092795821					cpena1@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Bid Audit Site Contact	Director, Medicare D-SNP		Pena	Cynthia		2092795821					cpena1@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Bid Primary Contact			Tangari	Jennifer		2035301418					jennifer@csteam.us	7751 S. Manthey Road		French Camp	CA	95231	01/10/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	CAP Report Contact for Public Website	Chief Regulatory Affairs and Compliance Officer	Ms.	Clark	Betty		2093170568					bclark@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	03/20/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Granados	Lizeth		2098002204					lgranados@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	CEO - Senior Official for Contracting	Chief Executive Officer	Ms	Granados	Lizeth		2098002204					lgranados@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Chief Financial Officer	Chief Financial Officer	Ms	Tetrault	Michelle		2098002174					mtetreault@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Chief Operating Officer	Chief Operations Officer	Ms	Le	Elizabeth		2092606795					ele@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Chief Information Officer	Chief Information Officer	Ms.	Worthy	Victoria		2099906355					vworthy@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Chief Information Security Officer	Chief Information Officer	Ms.	Worthy	Victoria		2099906355					vworthy@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	CMMI Model Point of Contact	Director, Medicare D-SNP		Pena	Cynthia		2092795821					cpena1@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	CMS Casework Communication Contact	Chief Regulatory Affairs and Compliance Officer	Ms.	Clark	Betty		2093170568					bclark@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	03/20/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Complaints Tracking Contact	Director, Medicare Compliance	Ms.	Chandra	Shirleen		2092795765					schandra@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	12/12/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Contact for Fraud Investigations	Director, Compliance Operations &Program Integrity		White	Toni		2098881775					twhite@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	12/12/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Coordination of Benefits Contact	Supervisor, Accounting Medical Programs		Giang	Quynh		2093373578					ggiang@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Corporate Mailing						8889367526					MedicareRAC@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Customer Service Operations Contact	Chief Operating Officer		Le	Liz		2092606795					ele@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	12/12/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	DIR Contact	Director, Financial Planning & Analysis		Navarro	Christophe		2092795790					cnavarro@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Discount Program Payment Contact	Senior Director Finance		Navarro	Christophe		2092795790					cnavarro@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Emergency Part D Contact	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Emergency Part D Contact (Secondary)	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Encounter Data & Risk Adjustment Operations Contact	Senior Director Finance		Navarro	Christophe		2092795790					cnavarro@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Enrollment Contact	Senior Director Finance		Navarro	Christophe		2092795790					cnavarro@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	EOB Transfer Contact	Director, Claims		Griffin	Aimee		2094698360				2094612555	agriffin@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Financial Audit Contact	Senior Director Finance	Mr.	Navarro	Christophe		2092795790					cnavarro@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Financial Reporting Contact	Controller		Sourng	Somatra		2096627950					ssourng@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Formulary Contact	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Formulary Contact (Secondary)	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	General Contact	Director, Medicare D-SNP		Pena	Cynthia		2092795821					cpena1@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Government Relations Contact	Chief Regulatory Affairs and Compliance Officer	Ms.	Clark	Betty		2093170568					bclark@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	03/20/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	HIPAA Privacy Officer	Chief Regulatory Affairs and Compliance Officer	Ms.	Clark	Betty		2093170568					bclark@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	03/20/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	HIPAA Security Officer	Director, Technology Operations & Security		Abbas	Mohammed		2098001468					mabbas@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Hospice Contact	Director, Case Management		Lee	Pamela		2093171913					plee@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Interoperability Contact	Chief Information Officer	Ms.	Worthy	Victoria		2099906355					vworthy@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	MA Appeals/Grievances Contact	Manager, Quality Improvement		Kaur	Ramanpreet		2092606526					rkaur@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	MA Claims Processing Contact for Public Website	Director, Claims		Griffin	Aimee		2094698360					agriffin@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Marketing Contact	Director, Community Marketplace & Mbr Engagement		Ford	Vena		2099333696					vford@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Medical Director	Medical Director	Dr.	Collins	Michael		2093097689					mcollins@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Medicare Compliance Officer	Chief Regulatory Affairs and Compliance Officer	Ms.	Clark	Betty		2093170568					bclark@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	03/20/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Medicare Coordinator	Director, Medicare D-SNP		Pena	Cynthia		2092795821					cpena1@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part C Application Contact			Tangari	Jennifer		2035301418					jennifer@csteam.us	7751 S. Manthey Road		French Camp	CA	95231	01/10/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part C Reporting Contact	Director, Medicare Compliance		Chandra	Shirleen		2092795765					schandra@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	06/11/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Appeals	Manager, QualityManagement		Kaur	Ramanpreet							rkaur@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	02/03/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active	8889367526				HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Application Contact			Tangari	Jennifer		2035301418					jennifer@csteam.us	7751 S. Manthey Road		French Camp	CA	95231	01/10/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Benefits Contact	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Claims Submission Contact	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Exceptions Contact	Manager, Clinical Pharmacy		Le	NhuAnh							nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	02/03/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active	8889367526				HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Price File Contact (Back-up)	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Price File Contact (Optional)	Supervisor, Pharmacy		Hang	Julie		2094254512					jhang@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Price File Contact (Primary)	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Quality Assurance Contact	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Part D Reporting Contact	Director, Medicare Compliance		Chandra	Shirleen		2092795765					schandra@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	06/11/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Patient Safety Contact	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Payment Contact	Supervisor, Accounting Medical Programs		Giang	Quynh		2093373578					ggiang@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Pharmacy Director	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Pharmacy Network Management Contact	Director, Pharmacy		Garrett	Matthew		2098006261					mgarrett@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Pharmacy Network Management Contact (Secondary)	Manager, Clinical Pharmacy		Le	NhuAnh		2093097578					nle@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Pharmacy Technical Help Desk Contact	Director, Customer Service		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps		San Diego	CA	92131	07/14/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active	8335460796				HMO - Health Maintenance Organization		C	Dallas
H5734	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy		Le	NhuAnh						2097624704	DSNP_Pharmacy@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	12/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active	8335460796				HMO - Health Maintenance Organization		C	Dallas
H5734	Physician Incentive Contact	Director, Delegate & Provider Relations		Aranda	Ana		2092668667					aaranda@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Plan Directory Contact for Public Website	Chief Regulatory Affairs and Compliance Officer	Ms.	Clark	Betty		2093170568					bclark@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	03/20/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Plan to Plan Reconciliation Contact	Supervisor, Accounting Medical Programs		Giang	Quynh		2093373578					ggiang@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Processor Contact	SVP, Government Programs, MedImpact		Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/01/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Quality Contact	Director, HEDIS & NCQA		Datziel	Kathleen		2098002406					kdatziel@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Reconciliation Contact	Senior Director Finance		Navarro	Christophe		2092795790					cnavarro@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/07/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Reconciliation Contact (Secondary)	Supervisor, Accounting Medical Programs		Giang	Quynh		2093373578					ggiang@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Recovery Audit Contact	Director, Claims	Ms.	Griffin	Aimee		2094698360					agriffin@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	SNP Application Contact	Director, Medicare D-SNP		Pena	Cynthia		2092795821					cpena1@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Surveillance Contact	Director, Community Marketplace & Mbr Engagement		Ford	Vena		2099333696					vford@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	System Contact	Chief Information Officer	Ms.	Worthy	Victoria		2099906355					vworthy@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Third Party Administrator (TPA) Liaison	Director, Claims		Griffin	Aimee		2094698360					agriffin@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	User Access Contact	Director, Compliance Operations		White	Toni		2098881775					twhite@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Utilization Management Contact	Director, Care & Utilizaton Management		Shook	Mike		2099425251					jshook@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5734	Utilization Review Contact	Director, Care & Utilizaton Management		Shook	Mike		2099425251					jshook@hpsj.com	7751 S. Manthey Road		French Camp	CA	95231	01/02/2025	2026	SAN JOAQUIN COUNTY HEALTH COMMISSION	Local CCP	Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO)	HMO/HMOPOS		SAN JOAQUIN COUNTY HEALTH COMMISSION	872	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Agent/Broker Compensation Data Contact	VP MA Sales and Promotions		Rivera	Carlos		7877494949	8324214				crivera1@ssspr.com	PO Box 363628		San Juan	PR	00936	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Automated TrOOP Balance Transfer Contact	MA Revenue Management Director	Mr	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Backup User Access Contact	Privacy Analyst	Ms	Mikasobe	Jessica		7877494949	8322443				jmikasobe@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Best Available Evidence Contact	MA Enrollment & Reconciliation Director		Toste	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Bid Audit Contact	Product Development  VP	Mrs	Rojas Sola	Marie	E	7877494949	8321325				marie.rojas@ssspr.com	PO Box 0363628		San Juan	PR	00936	10/17/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Bid Audit Site Contact	President for Triple S Salud	Mr	Muchnicki	Michael		7877494949	8322322			7876200939	michael.muchnicki@ssspr.com	P.O. Box 11320		San Juan	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Bid Primary Contact	Product Development VP	Mrs	Rojas Sola	Marie	E	7877494949	8321325				marie.rojas@ssspr.com	P.O. Box 363628		San Juan	PR	00936	10/17/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	CAP Report Contact for Public Website	Digital Marketing Manager	Mrs	Ruiz Martinez	Norma	J	7487494949	8321083				nruiz@ssspr.com	PO Box 363628		San Juan	PR	00936	02/11/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	CEO - CMS Administrator Contact	CEO & President, Triple-S Management	Mr	Justice	Thurman	R	7873099118					thurman.justice@ssspr.com	P O BOX 11320		San Juan	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	CEO - Senior Official for Contracting	CEO & President, Triple-S Management	Mr	Justice	Thurman	R	7873099118					thurman.justice@ssspr.com	P O BOX 11320		San Juan	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Chief Financial Officer	Chief Financial Officer	Mr.	Petruzzellis	Dave		7877494949					dave.petruzzellis@ssspr.com	P.O. Box 363628		San Juan	PR	009363628	11/11/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Chief Operating Officer	Chief Operating Officer	Ms	Rivera	Ixel		7879304298					ixel.arivera@ssspr.com	P.O BOX 11320		San Juan	PR	00922	10/14/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Chief Information Officer	Chief Information Technology Officer	Mr	Ruocco	Robert		7877494949	8320463				robert.ruocco@ssspr.com	PO Box 363628		San Juan	PR	00936	01/31/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Chief Information Security Officer	Sr Cyber Director	Mr.	Morris	Ken		7877494949				7877494949	Ken.Morris@ssspr.com	PO Box 363628		San Juan	PR	00936	10/22/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	CMS Casework Communication Contact	Appeals and Grievances Manager	Mrs	Martinez	Aixa		7877494949	8322307			7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Complaints Tracking Contact	Appeals and Grievances Manager	Mrs.	Martinez	Aixa		7877494949	8322307			7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Contact for Fraud Investigations	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Coordination of Benefits Contact	MA Enrollment & Reconcilliation Director	Mrs.	Toste	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Corporate Mailing						7877494949	8322438				jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Customer Service Operations Contact	Customer Service Manager	Mr	Jaxon	Harold		7876649288				7876200931	harold.jaxon@ssspr.com	PO Box 363628		San Juan	PR	00922	12/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	DIR Contact	Part D Reporting Analyst	Mrs	Cortes	Johannie		7879751365	8322448			7879933257	johannie@ssspr.com	PO Box 11320		San Juan	PR	00922	12/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	DIR Contact (Secondary)	MA Premium Management Manager	Mrs.	Ruiz Sanchez	Alexsandra		7877494949	8322185				alexsandra.ruiz@ssspr.com	PO Box 11320		San Juan	PR	00922	03/02/2021	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Discount Program Payment Contact	Part D Reporting Analyst	Mrs	Cortes	Johannie		7877494949	8322448			7876258717	johannie@sssapr.com	PO Box 11320		San Juan	PR	009229905	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Electronic Health Record Contact	Health VP Digital Solutions Delivery	Mr.	Saker	Alejandro		7877494949	8320585			7879933256	alejandro.saker@ssspr.com	PO Box 11320		San Juan	PR	00922	06/12/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Emergency Part D Contact	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 363628		San Juan	PR	00939	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Emergency Part D Contact (Secondary)	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero	Cindy		7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Employer Waiver Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Encounter Data & Risk Adjustment Operations Contact	MA Revenue Management Director	Mr.	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Enrollment Contact	MA Enrollment & Reconciliation Director	Mrs.	Toste Arana	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	01/30/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	EOB Transfer Contact	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8322461			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	00936	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Financial Audit Contact	Healthcare Finance VP	Mr	Marrero	Monica		7877494949					monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	00922	12/21/2021	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Financial Reporting Contact	Corporate Financial Reporting Director	Ms	Montes Santiago	Loyda	I	7877494949	8321967			7877494019	loyda.montes@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/18/2021	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Formulary Contact	Pharmacy Senior Manager		Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Formulary Contact (Secondary)	Clinical Pharmacist	Ms	Vargas	Viviana		7875231212	1171				viviana.vargas@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	01/19/2017	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	General Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Government Relations Contact	CCompliance Officer & VP   Compliance & Privacy Of	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	HIPAA Privacy Officer	Privacy Officer	Ms	Padilla	Lucy		7877494949	8322502			7879333260	lpadilla@sssadvantage.com	PO Box 11320		San Juan	PR	00922	03/09/2020	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	HIPAA Security Officer	Sr Cyber Director	Mr.	Morris	Ken		7877494949					Ken.Morris@ssspr.com	PO Box 363628		San Juan	PR	00936	10/22/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Hospice Contact	Health Management Programs Director	Mrs	Lliteras	Jeanniffer		7877494949	8322691				jeanieffer@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Interoperability Contact	VP Software Engineering & Delivery	Mr	Tummala	Srinivasa		7877494949	8320463				srinivasa.tummala@ssspr.com	PO Box 11320		San Juan	PR	00922	04/23/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	MA Appeals/Grievances Contact	Appeals and Grievances Manager	Mrs	Martinez	Aixa		7877494949	8322307			7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	MA Claims Processing Contact for Public Website	Claims Director	Mrs	Roldan-Marin	Francheska	M	7877494949	8324942				froldan@ssspr.com	PO Box 11320		San Juan	PR	00922	10/17/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Marketing Contact	Marketing Senior Director	Mrs.	Martin	Gabriela		7877494949	8321073			7877494060	gmartinb@ssspr.com	PO Box 363628		San Juan	PR	00936	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Medical Director	Chief Medical Officer	Dr.	Novoa	Jose		7877494949	8325171			0000000000	jnovoa@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Medicare Compliance Officer	Compliance Officer & VP   Compliance & Privacy Off	Mrs	Cardenas	Jenny	D	7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	009229905	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Medicare Coordinator	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Medicare Part D Opioid Overutilization Contact	Pharmacy Senior Manager	Mrs	Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Medication Therapy Management Contact	Pharmacy Senior Manager		Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	OffShore Subcontractor Contact	Privacy Officer		Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Online Enrollment Center Contact (Back-up)	MA Enrollment Manager	Mrs	Marcano	Zoe		7877494949	8322628			7875224307	zoem@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Online Enrollment Center Contact (Optional)	Enrollment Manager	Ms	Marcano	Zoe	C	7877494949	8322628				zoem@ssspr.com	PO Box 11320		San Juan	PR	009209905	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Online Enrollment Center Contact (Primary)	MA Enrollment & Reconciliation Director	Mrs	Toste	Maria		7877494949	8322541			7875224307	mtoste@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part C Application Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part C Reporting Contact	Compliance Audit and Monitoring Director	Ms	Marrero	Monica		7877494949	8322303				monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	009229905	03/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Appeals	Appeals and Grievances Manager	Mrs	Martinez	Aixa						7879933261	aixam@ssspr.com	PO Box 11320		San Juan	PR	00922	04/08/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8886201919	4047			HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Appeals Contact (Secondary)	Quality Improvement Medical Director	Mrs.	Carrion	Wanda						7879933261	wandavca@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8325107			HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Application Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Benefits Contact	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 11320		San Juan	PR	00922	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Claims Submission Contact	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8322461			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Exceptions Contact	Pharmacy Regulatory & Compliance Manager	Mrs	Cordero	Cindy	N					7875224004	cindy.cordero@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8321797			HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Exceptions Contact (Secondary)	Pharmacy Regulatory & Compliance Manager	Mrs	Cordero Miranda	Cindy	N					7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8321797			HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Price File Contact (Back-up)	Data Analyst II		De Jesus	Cesar		7875231212	1169				cesar.dejesus@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	09/03/2019	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Price File Contact (Optional)	Pharmacy Regulatory & Compliance Manager	Mrs.	Cordero Miranda	Cindy	N	7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Price File Contact (Primary)	Data Analyst II		Reed	Lindsay		8473466370	1125				lindsay.reed@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	09/03/2019	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Quality Assurance Contact	Pharmacy Regulatory & Compliance Manager	Mrs	Cordero Miranda	Cindy	N	7877494949	8321797			7875224004	cindy.cordero@ssspr.com	PO Box 363628		San Juan	PR	009363628	03/30/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Part D Reporting Contact	Compliance Audit and Monitoring Director	Ms	Marrero	Monica		7877494949	8322303				monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	009229905	03/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Patient Safety Contact	Pharmacy Senior Manager		Santos	Zoraida		7877494949	8324181			7875224004	zsantos@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Payment Contact	Revenue and Members Operation  Senior VP	Mrs	Reyes	Ivette		7877494949	8322419				ireyes@sssadvantage.com	PO Box 11320		San Juan	PR	00922	08/18/2020	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Personal Health Record Contact	Privacy Officer	Ms.	Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Pharmacy Director	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 11320		San Juan	PR	00922	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Pharmacy Network Management Contact	Director of Service Operations		Hernandez	Hector		7875231212	1123				hector.hernandez@abarcahealth.com	650 Avenida Mu oz Rivera	Suite 701	San Juan	PR	00918	01/04/2021	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Pharmacy Network Management Contact (Secondary)	Pharmacy Vice-president	Mrs	Muniz	Omarys		7877494949	8324535			7875224004	omaris.muniz@ssspr.com	PO Box 363628		San Juan	PR	00939	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Pharmacy Technical Help Desk Contact	Director of Service Operations		Hernandez	Hector						7877771372	hector.hernandez@abarcahealth.com	1606 Avenida Mu oz Rivera		San Juan	PR	00909	12/13/2023	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8559222722				HMO - Health Maintenance Organization		C	Dallas
H5774	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Vice-president	Mrs	Muniz	Omarys						7875224004	omaris.muniz@ssspr.com	PO Box 363628		San Juan	PR	00939	12/20/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	7877494949	8324535			HMO - Health Maintenance Organization		C	Dallas
H5774	PHR Beneficiary Contact																	01/11/2016	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS	Triple-S Advantage	Guidewell Mutual Holding Corporation	594	Yes	Active	8886201919				HMO - Health Maintenance Organization		C	Dallas
H5774	Physician Incentive Contact	Carepoint President SVP Network Strategy	Mr.	Molina Gonzalez	Yomaraly		7877494949	8320499			7877494949	yomaraly.molina@ssspr.com	PO Box 11320		San Juan	PR	00922	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Plan Directory Contact for Public Website	Carepoint President SVP Network Strategy	Mrs.	Molina	Yomaraly		7877494949	8320499			7876200939	yomaraly.molina@ssspr.com	PO Box 11320		San Juan	PR	00922	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Plan to Plan Reconciliation Contact	MA Revenue Management Director	Mr	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Processor Contact	Claims Director	Ms	Roldan	Francheska		7877494949	8324942				froldan@ssspr.com	PO Box 363628		San Juan	PR	009363628	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Quality Contact	Quality and Stars Director	Ms	Hernande	Patricia		7877494949	8322554			7879933256	patriciah@ssspr.com	P.O. Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Reconciliation Contact	MA Revenue Management Director	Mr	Rosich	Luis		7877494949	8321176			7879933257	lrosich@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Reconciliation Contact (Secondary)	Senior VP of Revenue and cost Management	Mrs	Reyes	Ivette		7877494949	8322419				ireyes@ssspr.com	P.O. Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Recovery Audit Contact	Compliance Audit and Monitoring Director	Ms	Marrero	Monica		7877494949	8322303				monica.marrero@ssspr.com	PO Box 11320		San Juan	PR	009229905	03/21/2022	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	SNP Application Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	SNP State Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Surveillance Contact	Compliance Officer & VP   Compliance & Privacy Off	Ms	Cardenas	Jenny		7877494949	8322438			7879933260	jennycar@ssspr.com	PO Box 11320		San Juan	PR	00922	04/10/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	System Contact	Privacy Officer	Ms.	Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Third Party Administrator (TPA) Liaison	Part D Reporting Analyst	Mrs.	Cortes	Johannie		7877494949	8322448			7876258717	johannie@ssspr.com	PO Box 11320		San Juan	PR	009229905	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	User Access Contact	Privacy Officer	Ms	Padilla	Lucy		7877494949	8322502			7879933260	lpadilla@ssspr.com	PO Box 11320		San Juan	PR	00922	04/18/2024	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Utilization Management Contact	Chief Operating Officer	MS	Rivera Caban	Ixel	A	7877494949					ixel.arivera@ssspr.com	PO Box 363628		San Juan	PR	009363628	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5774	Utilization Review Contact	Chief Operating Officer	Ms	Rivera Caban	Ixel	A	7877494949					ixel.arivera@ssspr.com	PO Box 363628		San Juan	PR	009363628	11/11/2025	2026	TRIPLE S ADVANTAGE, INC.	Local CCP	Triple S Advantage	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5779	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H5779	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H5779	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H5779	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H5779	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H5779	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H5779	PHR Beneficiary Contact																	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H5779	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5779	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H5793	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/29/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	09/15/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H5793	PHR Beneficiary Contact																	11/15/2012	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H5793	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/11/2015	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	SNP State Contact	Executive Director, National Duals Program		Hughes	Angelique		2482700990					hughesa1@aetna.com	2 Town Square, Suite 275		Southfield	MI	48076	12/09/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/29/2023	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5793	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (CT)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H5810	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H5810	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H5810	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5810	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H5810	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5810	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF CALIFORNIA	Local CCP	Molina Healthcare of California	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5810	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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 Health Plan, Quality and Compliance		Mitchell	Lisa		7852322044					lmitchell@midlandcc.org	200 SW Frazier Bldg A		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Backup User Access Contact	Director of PACE Operations		Webb-Cohen	Candace		7852322044					ccohen@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Best Available Evidence Contact	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Bid Primary Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	CAP Report Contact for Public Website	President/CEO		Sullivan	Shawn		7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/31/2020	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	CEO - CMS Administrator Contact	President/CEO		Sullivan	Shawn		7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/31/2020	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	CEO - Senior Official for Contracting	Chief Executive Officer		Sullivan	Shawn		7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/31/2020	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Chief Financial Officer	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Chief Operating Officer	Vice President/ Executive Director of PACE	Mrs.	Chaffee	Leanna		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Chief Information Officer	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Chief Information Security Officer	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	CMS Casework Communication Contact	VP/Executive Director of PACE		Chaffee	Leanna	E	7852322044				7852322044	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	01/08/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Complaints Tracking Contact	Director of Health Plan, Quality and Compliance	Mrs.	Mitchell	LIsa		7852322044	1054			7852325567	lmitchell@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Contact for Fraud Investigations	VP/Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Bldg A		Topeka	KS	66606	01/08/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Coordination of Benefits Contact	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Corporate Mailing						7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/31/2020	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Customer Service Operations Contact	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	DIR Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	DIR Contact (Secondary)	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Discount Program Payment Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Emergency Part D Contact	CEO/President		Sullivan	Shawn		7852322044	1054			7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/31/2020	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Emergency Part D Contact (Secondary)	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Encounter Data & Risk Adjustment Operations Contact	Vice President	Mrs.	Chaffee	Lea		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Enrollment Contact	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	EOB Transfer Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Financial Audit Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Financial Reporting Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Formulary Contact	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Formulary Contact (Secondary)	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	General Contact	VP / Executive Director of PACE		Chaffee	Leanna	E	7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	09/08/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Government Relations Contact	President/CEO		Sullivan	Shawn		7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/31/2020	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	HIPAA Privacy Officer	Vice President	Mrs.	Chaffee	Leanna		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	01/08/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	HIPAA Security Officer	Chief Administrative Officer		Mosinski	Kerri		7852322044				7852325567	kmosinski@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/02/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Interoperability Contact	Vice President	Mrs.	Chaffee	Leanna		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	01/08/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	MA Appeals/Grievances Contact	Vice President	Mrs.	Chaffee	Leanna		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	01/08/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	MA Claims Processing Contact for Public Website	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Marketing Contact	CEO	Mr.	Sullivan	Shawn		7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/15/2022	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Medical Director	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Medicare Compliance Officer	Vice President/ Executive Director of PACE	Mrs.	Chaffee	Leanna		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Medicare Coordinator	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	09/08/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Medicare Part D Opioid Overutilization Contact	PACE Medical Director	Dr.	Locke	Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	12/13/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Medication Therapy Management Contact	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Online Enrollment Center Contact (Back-up)	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Online Enrollment Center Contact (Optional)	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Online Enrollment Center Contact (Primary)	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part C Application Contact	CEO		Sullivan	Shawn		7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Appeals	PACE Medical Director		Locke	Dr. Erin						7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active	8663949600				PACE - Nat		C	San Francisco
H5822	Part D Appeals Contact (Secondary)	VP / Executive Director of PACE		Chaffee	Leanna						7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active	8004913691				PACE - Nat		C	San Francisco
H5822	Part D Application Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Benefits Contact	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Claims Submission Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Exceptions Contact	VP / Executive Director of PACE		Chaffee	Leanna						7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active	8004913691				PACE - Nat		C	San Francisco
H5822	Part D Price File Contact (Back-up)	Chief Medical Officer		Wiles	Dr. Mark	A	7852322044				7852325567	mwiles@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	02/16/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Price File Contact (Optional)	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Price File Contact (Primary)	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Quality Assurance Contact	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Part D Reporting Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Patient Safety Contact	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Payment Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Personal Health Record Contact	Vice President	Mrs.	Chaffee	Leanna		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	01/08/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Pharmacy Director	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Pharmacy Network Management Contact	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchafee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Pharmacy Network Management Contact (Secondary)	VP / Executive Director of PACE		Chaffee	Leanna		7852322044					lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Pharmacy Technical Help Desk Contact	VP / Executive Director of PACE		Chaffee	Leanna						7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active	7852322044				PACE - Nat		C	San Francisco
H5822	Pharmacy Technical Help Desk Contact (Secondary)	VP / Executive Director of PACE		Chaffee	Leanna						7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active	8004913691				PACE - Nat		C	San Francisco
H5822	PHR Beneficiary Contact																	04/06/2022	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE	Midland Care Connection	Midland Care Connection, Inc.	291	Yes	Active	8004913691				PACE - Nat		C	San Francisco
H5822	Plan Directory Contact for Public Website	CEO		Sullivan	Shawn		7852322044					ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Plan to Plan Reconciliation Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Processor Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Quality Contact	Director of Health Plan, Quality and Compliance	Mrs.	Mitchell	LIsa		7852322044	1054			7852325567	lmitchell@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	04/07/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Reconciliation Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Reconciliation Contact (Secondary)	PACE Medical Director		Locke	Dr. Erin		7852322044				7852325567	elocke@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	10/01/2024	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Recovery Audit Contact	CFO	Mr.	Lehman	Daniel	L	7852322044				7852325567	dlehman@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	07/24/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Surveillance Contact	CEO		Sullivan	Shawn		7852322044				7852325567	ssullivan@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	04/06/2022	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	System Contact	Vice President	Mrs.	Chaffee	Leanna		7852322044	1054			7852325567	lchaffee@midlandcc.org	200 SW Frazier Cir		Topeka	KS	66606	01/08/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Third Party Administrator (TPA) Liaison	CEO innermark TPA	Mr	Bailey	Patty		5739706303					pbailey@innermark.com	PO Box 21002		Eagan	MN	55121	04/21/2025	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	User Access Contact	VP / Executive Directtor of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Utilization Management Contact	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5822	Utilization Review Contact	VP / Executive Director of PACE		Chaffee	Leanna		7852322044				7852325567	lchaffee@midlandcc.org	200 SW Frazier Circle		Topeka	KS	66606	03/20/2023	2026	MIDLAND CARE CONNECTION	National PACE	Midland Care PACE	National PACE		Midland Care Connection, Inc.	291	Yes	Active					PACE - Nat		C	San Francisco
H5823	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H5823	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H5823	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5823	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H5823	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5823	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF WASHINGTON, INC.	Local CCP	Molina Healthcare of Washington, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5823	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Agent/Broker Compensation Data Contact	VP Community Engagement		Stevens	Melissa		2067317757				2065218834	melissa.stevens@chpw.org	1111 Third Ave, Suite 400		Seattle	WA	98101	07/21/2021	2026	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	Boston
H5826	Automated TrOOP Balance Transfer Contact	Senior Accountant		Slack	Lynne		2066527148				2065218834	Lynne.Slack@chpw.org	1111 Third Ave, Suite 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Backup User Access Contact	FWA Program Manager		Glew	Miles		2065157844				2065218834	miles.glew@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Best Available Evidence Contact	VP Customer Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Bid Audit Contact	VP Healthcare Econmics		DiGiuseppe	David		2066138946				2065218834	david.digiuseppe@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/03/2023	2026	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	Boston
H5826	Bid Audit Site Contact	VP Healthcare Econmics		DiGiuseppe	David		2066138946				2065218834	david.digiuseppe@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/03/2023	2026	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	Boston
H5826	Bid Primary Contact	Director Actuarial Services		Corrough	Elaine		2066138958				2065218834	elaine.corrough@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/06/2023	2026	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	Boston
H5826	CAP Report Contact for Public Website	VP, Compliance Officer	Ms	Zerda	Marie	A	2066135091				2066527017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Berge	Leanne		2066138828				2066135097	leanne.berge@chpw.org	1111 Third Ave, Suite 400		Seattle	WA	98101	01/22/2024	2026	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	Boston
H5826	CEO - Senior Official for Contracting	Chief Executive Officer	Ms	Berge	Leanne		2066138828				2066135097	leanne.berge@chpw.org	1111 Third Ave, Suite 400		Seattle	WA	98101	01/09/2017	2026	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	Boston
H5826	Chief Financial Officer	Chief Financial Officer	Mr	Battersby	Stuart		2066527205				2065218834	stuart.battersby@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	04/17/2024	2026	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	Boston
H5826	Chief Operating Officer	Chief Operations Officer	Mr	Lederman	Alan		2065154704				2066527001	alan.lederman@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/01/2018	2026	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	Boston
H5826	Chief Information Officer	VP Information Technology	Ms	Gleeson	Deborah		2065157990					Deb.Gleeson@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Chief Information Security Officer	Sr Director IT/CISO	Mr	Fahey	Michael		2065218833					michael.fahey@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/28/2024	2026	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	Boston
H5826	CMS Casework Communication Contact	VP Customer Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Complaints Tracking Contact	VP Customer Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Contact for Fraud Investigations	FWA Program Manager		Glew	Miles		2065157844				2065218834	miles. glew@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Coordination of Benefits Contact	VP Customer  Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Corporate Mailing						2066135091				2066527017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Customer Service Operations Contact	Director of Customer Service		Leibbrand	Julie		2066527268				2065218834	julie.leibbrand@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	DIR Contact	Chief Financial Officer	Mr	Battersby	Stuart		2066527205				2066528834	stuart.battersby@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	04/17/2024	2026	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	Boston
H5826	DIR Contact (Secondary)	Director Financial Reporting	Mrs	Catipon	Maria		2066138931				2065218834	maria.catipon@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	12/30/2020	2026	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	Boston
H5826	Discount Program Payment Contact	Senior Accountant		Slack	Lynne		2066527148				2065218834	Lynne.Slack@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Emergency Part D Contact	Sr. Director Pharmacy	Mr	Daoud	Omar		2066527185				2065218834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	01/22/2024	2026	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	Boston
H5826	Emergency Part D Contact (Secondary)	sr. Director of Pharmacy	Mr	Daoud	Omar		2064755779				2065218834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	01/22/2024	2026	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	Boston
H5826	Encounter Data & Risk Adjustment Operations Contact	Director Risk Adjustment	Mr	Dabney	Mark		2066135053				2065218834	Mark.Dabney@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/05/2024	2026	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	Boston
H5826	Enrollment Contact	VP Customer Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	EOB Transfer Contact	Senior Accountant		Slack	Lynne		2066527148				2065218834	Lynne.Slack@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Financial Audit Contact	VP Finance	Mrs	Faulring	Marie	A	2066138997				2065218833	marie.faulring@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Financial Reporting Contact	VP Finance	Mrs	Faulring	Marie	A	2066138997				2065218833	marie.faulring@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Formulary Contact	Director of Pharmacy		Daoud	Omar		2064755779				2065218834	Omar.Daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Formulary Contact (Secondary)	Director of Pharmacy	Mr	Daoud	Omar		2064755779				2065218834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	General Contact	VP Compliance Officer		Zerda	Marie		2067991406				2065218834	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/03/2023	2026	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	Boston
H5826	Government Relations Contact	VP Compliance Officer	Ms	Zerda	Marie	A	2067991406				2065218834	Marie.Zerda@chpw.org	1111 Third Ave Ste 400		Seattle	WA	98059	02/05/2024	2026	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	Boston
H5826	HIPAA Privacy Officer	VP, Compliance Officer	Ms	Zerda	Marie	A	2066135091				2066527017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	HIPAA Security Officer	Sr Director IT/CISO	Mr	Fahey	Michael		2065218833					michael.fahey@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/28/2024	2026	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	Boston
H5826	Hospice Contact	Director of Pharmacy		Daoud	Omar		2064755779				2065218834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Interoperability Contact	VP Information Technology	Ms	Gleeson	Deborah		2065157990				2065218834	deb.gleeson@chpw.org	1111 Third Ave	400	Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	MA Appeals/Grievances Contact	VP Customer Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	MA Claims Processing Contact for Public Website	VP Business Process Operations		Arcieri	Donna		2066138853				2065218834	donna.arcieri@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Marketing Contact	VP Community Engagement		Stevens	Melissa		2067317757				2065218834	melissa.stevens@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	07/21/2021	2026	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	Boston
H5826	Medical Director	Chief Medical/Health Officer		Malloy MD	Demetria		2066138875				2065218834	demetria.malloy@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/05/2024	2026	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	Boston
H5826	Medicare Compliance Officer	VP, Compliance Officer	Ms	Zerda	Marie	A	2066135091				2066527017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Medicare Coordinator	VP Customer Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Medicare Part D Opioid Overutilization Contact	Sr. Director of Pharmacy		Daoud	Omar		2064755779				2065218834	Omar.Daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	01/22/2024	2026	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	Boston
H5826	Medication Therapy Management Contact	Director - Clinical & Trend Solutions		Muralidharan	Adrienne		3143131932					amuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	05/11/2021	2026	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	Boston
H5826	OffShore Subcontractor Contact	Sr Director Medicare Operations		Graham	Kelly		2065157943				2065218834	kelly.graham@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/28/2024	2026	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	Boston
H5826	Online Enrollment Center Contact (Back-up)	Medicare Eligibility Coordinator		Warbington	Michael		2065157824				2065218834	michael.warbington@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Online Enrollment Center Contact (Optional)	Eligibility Specialist		Aceva	Casey		2066135088				2065218834	casey.aceva@chpw.org	1111 THird Ave, Ste 400		Seattle	WA	98101	09/21/2016	2026	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	Boston
H5826	Online Enrollment Center Contact (Primary)	VP Customer Experience	Ms	Norwood	Charyl		2066138885				2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Part C Application Contact	Sr Director Medicare Operations		Graham	Kelly		2065157943				2065218834	kelly.graham@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/28/2024	2026	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	Boston
H5826	Part C Reporting Contact	VP Information Technology	Ms	Gleeson	Deborah		2065157990				2065218834	deb.gleeson@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Part D Appeals	Manager	Mr	Campbell	Eric						2065218834	eric.campbell@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/05/2024	2026	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active	8009420247				HMO - Health Maintenance Organization		C	Boston
H5826	Part D Appeals Contact (Secondary)	VP Customer Experience	Ms	Norwood	Charyl						2065218834	charyl.norwood@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active	8009420247				HMO - Health Maintenance Organization		C	Boston
H5826	Part D Application Contact	Sr Director Medicare Operations		Graham	Kelly		2065157943				2065218834	kelly.graham@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/28/2024	2026	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	Boston
H5826	Part D Benefits Contact	Sr. Director of Pharmacy		Daoud	Omar		2064755779				2065218834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	01/22/2024	2026	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	Boston
H5826	Part D Claims Submission Contact	Director-Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					rosario_dovico@express-scripts.com	One Express Way		St Louis	MO	63121	05/24/2023	2026	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	Boston
H5826	Part D Exceptions Contact	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/05/2022	2026	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Boston
H5826	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/05/2022	2026	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Boston
H5826	Part D Price File Contact (Back-up)	Manager, Regulated Markets Products		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	05/24/2023	2026	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	Boston
H5826	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/24/2023	2026	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	Boston
H5826	Part D Quality Assurance Contact	VP Health Services		Hardman	Ma'ata		2066527207				2065218834	maata.hardman@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Part D Reporting Contact	VP Information Technology	Ms	Gleeson	Deborah		2065157990				2065218834	deb.gleeson@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Patient Safety Contact	Sr. Director of Pharmacy		Daoud	Omar		2064755779				2065218834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	01/22/2024	2026	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	Boston
H5826	Payment Contact	VP Finance	Mrs	Faulring	Marie	A	2066138997				2065218833	marie.faulring@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98059	12/30/2020	2026	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	Boston
H5826	Pharmacy Director	Director of Pharmacy		Daoud	Omar		2064755779				2065218834	omar.daoud@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy/Contracting		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	05/24/2023	2026	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	Boston
H5826	Pharmacy Network Management Contact (Secondary)	Sr Manager- Network Contracting		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	12/23/2015	2026	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	Boston
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	2026	COMMUNITY HEALTH PLAN OF WASHINGTON	Local CCP	Community Health Plan of WA Medicare Advantage	HMO/HMOPOS		Community Health Plan of Washington	275	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H5826	Physician Incentive Contact	Manager Healthcare Economics Analysis	Ms	Oswald	Gretchen		2066138890					gretchen.oswald@chpw.org	1111 Third Ave Ste 400		Seattle	WA	98059	02/05/2024	2026	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	Boston
H5826	Plan Directory Contact for Public Website	Customer Service Department		Care	Customer		8009420247				2065218834	CustomerCare@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Slack	Lynne		2066527148				2065218834	Lynne.Slack@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Processor Contact	VP BPO Operations		Arcieri	Donna		2066138853					donna.arcieri@chpw.org	1111 Third Ave, Suite 400		Seattle	WA	98101	12/30/2020	2026	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	Boston
H5826	Quality Contact	VP Health Services		Hardman	Ma'ata		2066527207				2065218834	maata.hardman@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Reconciliation Contact	Director Financial Reporting	Mrs	Catipon	Maria		2066138931				2065218834	maria.catipon@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	12/30/2020	2026	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	Boston
H5826	Reconciliation Contact (Secondary)	Senior Accountant	Ms.	Slack	Lynne		2066527148				2065218834	Lynne.Slack@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Recovery Audit Contact	VP, Compliance Officer	Ms	Zerda	Marie	A	2066135091				2066527017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	SNP Application Contact	Sr Director Medicare Operations		Graham	Kelly		2065157943				2065218834	kelly.graham@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/28/2024	2026	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	Boston
H5826	SNP State Contact	Sr Director Medicare Operations		Graham	Kelly		2065157943				2065218834	kelly.graham@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	02/28/2024	2026	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	Boston
H5826	Surveillance Contact	VP, Compliance Officer	Ms	Zerda	Marie	A	2066135091				2066527017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	System Contact	VP Information Technology	Ms	Gleeson	Deborah		2065157990					Deb.Gleeson@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	08/01/2023	2026	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	Boston
H5826	Third Party Administrator (TPA) Liaison	Senior Accountant	Ms.	Slack	Lynne		2066527148				2065218834	Lynne.Slack@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	User Access Contact	VP, Compliance Officer	Ms	Zerda	Marie	A	2066135091				2066527017	marie.zerda@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Utilization Management Contact	Sr Director Utilization Management		Fowler	Justin		2066138955				2065218834	justin.fowler@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5826	Utilization Review Contact	Sr Director Utilization Management		Fowler	Justin		2066138955				2065218834	justin.fowler@chpw.org	1111 Third Ave, Ste 400		Seattle	WA	98101	05/11/2021	2026	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	Boston
H5828	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/10/2020	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5828	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5828	PHR Beneficiary Contact																	02/10/2020	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H5828	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5828	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT TENNESSEE, INC.	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5843	Agent/Broker Compensation Data Contact	Senior Director, Government Programs Sales		Perry	Danielle		6024004768					Danielle.Perry@bannerhealth.com	2901 N Central Ave	Ste. 160	Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Backup User Access Contact	Sr. Government Programs Project Advisor		Croxon	Tracy		7752247134					buhpgovernmentprograms@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Best Available Evidence Contact	Director, Grievance and Appeals		Clayton	Natasha		5206673777				5208743462	natasha.clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	09/19/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Bid Audit Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Bid Audit Site Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Bid Primary Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	CAP Report Contact for Public Website	Interim Chief Executive Officer		Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	CEO - CMS Administrator Contact	Interim Chief Executive Officer	Mrs	Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	CEO - Senior Official for Contracting	Interim Chief Executive Officer	Mrs	Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Chief Financial Officer	Chief Financial Officer	Mr	Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Chief Operating Officer	Senior Director, Medicare Operations	Mr	McDonald	Kelly		4803905699					kelly.mcdonald@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	11/19/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Chief Information Officer	Executive Director, IT	Mr.	Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Chief Information Security Officer	Executive Director, IT	Mr.	Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	CMMI Model Point of Contact	Senior Director Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	CMS Casework Communication Contact	Director, Grievance and Appeals		Clayton	Natasha		6027478416				6023344683	Natasha.Clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Complaints Tracking Contact	Director, Grievance and Appeals		Clayton	Natasha		6027478416				6023344683	Natasha.Clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Contact for Fraud Investigations	Senior Director of Compliance		Dorazio	Terri		5208742847				5208747072	Theresa.Dorazio@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Coordination of Benefits Contact	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365					olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Corporate Mailing						5208745550				5208747083	silvia.parra@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	07/27/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Customer Service Operations Contact	Customer Care Director		Carrillo	Veronica		5208745349				5208747083	Veronica.Carrillo@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	DIR Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	DIR Contact (Secondary)	Director, Actuary		Marx	Blaiklen		4807208515					blaiklen.marx@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	07/24/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Discount Program Payment Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Electronic Health Record Contact	Executive Director, IT		Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Emergency Part D Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341				5208747083	Michael.Ramsey@bannerhealth.com	2901 N. Central Avenue		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Emergency Part D Contact (Secondary)	Executive Director Pharmacy		Jorn	Vincent		4023129969					Vincent.Jorn@bannerhealth.com	2901 N. Central Avenue		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Encounter Data & Risk Adjustment Operations Contact	Sr. Director Payment Integrity & Reimbursement		Horton	Tanner		4806845016					Tanner.Horton2@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Enrollment Contact	Associate Director, HP Operations Sales		Paredes	Nadya		5208745964				5208747083	Nadya.Paredes@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	EOB Transfer Contact	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365				5208747083	olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Financial Audit Contact	Chief Financial Officer	Mr	Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Financial Reporting Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Formulary Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Formulary Contact (Secondary)	Associate Director, Population Health Pharmacy		Pham	Vi		6027471125					vi.pham@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	09/12/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	General Contact	Sr. Director Compliance		Van Leeuwen	Kimberly		2132382980					kimberly.vanleeuwen@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	11/21/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Government Relations Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	HIPAA Privacy Officer	Senior Director of Compliance		Dorazio	Terri		5208742847				5208747072	Theresa.Dorazio@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	HIPAA Security Officer	Executive Director, IT		Hall	Matt		4802805577					Matt.Hall@bannerhealth.com	2901 N Central Ave, Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Hospice Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Interoperability Contact	Interoperability Healthcare Leader		Hall	Matt		4802805577					matt.hall@bannerhealth.com	2901 N Central Ave. Ste 160		Phoenix	AZ	85012	07/24/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	MA Appeals/Grievances Contact	Director, Grievance and Appeals		Clayton	Natasha		6027478416				6023344683	Natasha.Clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	MA Claims Processing Contact for Public Website	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365					olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Marketing Contact	Marketing Manager		Medina	AnaMaria		5208745082				5208747083	AnaMaria.Medina@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Medical Director	Chief Medical Officer	Dr	Ellis	Kevin		6027474000					kevin.ellis@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/05/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Medicare Compliance Officer	Sr. Director Compliance	Mrs	Van Leeuwen	Kimberly		2132382980					kimberly.vanleeuwen@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	11/21/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Medicare Coordinator	Interim Chief Executive Officer	Mrs	Chaydez	Myrna		6027474000					myrna.chaydez@bannerhealth.com	2901 N Central Ave., Ste 160		Phoenix	AZ	85012	10/03/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Medicare Part D Opioid Overutilization Contact	Express Scripts Director Clinical & Trend Solution		Muralidharan	Adrienne		3143131932					amuralidharan@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	12/21/2021	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Medication Therapy Management Contact	Director (Clinical & Trend Solutions)		Muralidharan	Adrienne		3143131932				8587906052	amuralidharan@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	12/21/2021	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	OffShore Subcontractor Contact	Sr. Director Compliance		Van Leeuwen	Kimberly		2132382980					kimberly.vanleeuwen@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	11/21/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Online Enrollment Center Contact (Back-up)	Senior Director, Government Programs Sales		Perry	Danielle		6024004768					Danielle.Perry@bannerhealth.com	2901 N Central Ave	Ste. 160	Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Online Enrollment Center Contact (Optional)	Enrollment Supervisor		Espinoza	Brianna		5208744192				5205855252	Brianna.Espinoza@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Online Enrollment Center Contact (Primary)	Associate Director, HP Operations Sales		Paredes	Nadya		5208745964				5208747083	Nadya.Paredes@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part C Application Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part C Reporting Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Appeals	Director, Grievance and Appeals		Clayton	Natasha						6023344683	natasha.clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	8668730029				HMO - Health Maintenance Organization		C	New York
H5843	Part D Appeals Contact (Secondary)	Director, Grievance & Appeals		Clayton	Natasha						6023344683	natasha.clayton@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	09/16/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	8668730029				HMO - Health Maintenance Organization		C	New York
H5843	Part D Application Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Benefits Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Claims Submission Contact	Director Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	Express Scripts	One Express Way	St Louis	MO	63121	01/30/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Exceptions Contact	Express Scripts Sr. Manager Pharmacy Prio Auth		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/14/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	New York
H5843	Part D Exceptions Contact (Secondary)	Director, Managed Pharmacy Solutions		Ramsey	Michael							michael.ramsey@bannerhealth.com	2901 N Central Ave Ste 160		Phoenix	AZ	85012	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	4806508341				HMO - Health Maintenance Organization		C	New York
H5843	Part D Price File Contact (Back-up)	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Price File Contact (Optional)	Express Scripts Manager, Regulated Markets		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	Express Scripts	4865 Dixie Hwy	Fairfield	OH	45014	03/26/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Price File Contact (Primary)	Express Scripts Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	Express Scripts	5151 Blazer Pkwy	Dublin	OH	43017	03/26/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Quality Assurance Contact	Sr. Director Quality Management		Robles Caraveo	Sandra		6233266425					sandra.roblescaraveo@bannerhealth.com	2901 N Central Ave		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Part D Reporting Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Patient Safety Contact	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Payment Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Personal Health Record Contact	Sr. Director Quality Management		Robles Caraveo	Sandra		6233266425					sandra.roblescaraveo@bannerhealth.com	2901 N Central Ave		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Pharmacy Director	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Pharmacy Network Management Contact	Express Scripts Network Accountant Director		Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	01/30/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Pharmacy Network Management Contact (Secondary)	Director, Managed Pharmacy Solutions		Ramsey	Michael		4806508341					Michael.Ramsey@bannerhealth.com	2901 N. Central Ave., Ste 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Pharmacy Technical Help Desk Contact	Senior Director, Customer Service		Sahs	Dale							dale.sahs@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/04/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H5843	Pharmacy Technical Help Desk Contact (Secondary)	Senior Manager		Perkins	Holly							hperkins@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/04/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H5843	PHR Beneficiary Contact																	06/14/2022	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS	Express Scripts	Banner Health	389	Yes	Active	3143131932				HMO - Health Maintenance Organization		C	New York
H5843	Physician Incentive Contact	Payer Account Program Sr. Manager		Ruiz	Marcela		5208745215				5208747083	Marcela.Ruiz@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Plan Directory Contact for Public Website	BMA Customer Care		Care	Customer		5208743930				5208743434	memberservicesinquiries@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	07/27/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Plan to Plan Reconciliation Contact	Financial Analyst		Best	Heather		4806845188					Heather.best@bannerhealth.com	PO BOX 16423		Mesa	AZ	85211	05/12/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Processor Contact	Supervisor, Senior Business Analyst		Greenway	Olga		8649341365					olga.greenway@BannerHealth.com	525 W Brown Rd		Mesa	AZ	85201	11/22/2023	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Quality Contact	Sr. Director Quality Management		Robles Caraveo	Sandra		6233266425					sandra.roblescaraveo@bannerhealth.com	2901 N Central Ave		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Reconciliation Contact	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Reconciliation Contact (Secondary)	Director, Actuary		Marx	Blaiklen		4807208515					blaiklen.marx@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	07/24/2025	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Recovery Audit Contact	Sr Director, Payment Intergrity & Reimb Finance	Mr	Horton	Tanner		4806845016					tanner.horton@bannerhealth.com	525 W Brown Rd		Mesa	AZ	85201	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	SNP Application Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	SNP State Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Surveillance Contact	Marketing Associate Director		Medina	AnaMaria		5208745082					AnaMaria.Medina@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	System Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Brady	Michael		4808613410					Michael.Brady@bannerhealth.com	2901 N Central Ave Ste. 160		Phoenix	AZ	85012	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	User Access Contact	Senior Director, Government Programs		Steward	Linda		5208742553					linda.steward@bannerhealth.com	5255 E Williams Circle, Ste 2050		Tucson	AZ	85711	11/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Utilization Management Contact	RN Director Utilization Management		Messing	Carla		6026171632					carla.messing@bannerhealth.com	525 W Brown Rd		Mesa	AZ	85201	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5843	Utilization Review Contact	Medical Management Associate Director		Wilson	Traci	R	4802702342					Traci.Wilson@bannerhealth.com	525 W Brown Rd		Mesa	AZ	85201	12/26/2024	2026	BANNER HEALTH PLAN, INC.	Local CCP	Banner Medicare Advantage	HMO/HMOPOS		Banner Health	389	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5852	Agent/Broker Compensation Data Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager	Ms.	Rivera-Aquino	Denisse		8582915269					denisse.rivera-aquino@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/05/2024	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Backup User Access Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Best Available Evidence Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Bid Audit Contact	Chief Financial Officer	Mr.	Honig Mojica	Lyle		3238605244				3239628513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	03/14/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Bid Audit Site Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Bid Primary Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	CAP Report Contact for Public Website	Compliance Officer	Ms.	Holzner	Sandra	E	3233379153					Sandra.Holzner@ahf.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	02/09/2024	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	3233379153				HMO - Health Maintenance Organization		C	Boston
H5852	CEO - CMS Administrator Contact	Chief of Managed Care	Ms.	Stidham	Donna	M	8056600703					donna.stidham@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	CEO - Senior Official for Contracting	President	Mr.	Weinstein	Michael	A	3238605200				3234678450	michael.weinstein@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/29/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Chief Financial Officer	Chief Financial Officer	Mr.	Honig Mojica	Lyle		3238605244				3239628513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	03/14/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Chief Operating Officer	Chief of Managed Care	Ms.	Stidham	Donna	M	8056600703					donna.stidham@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Chief Information Officer	Chief Information Officer	Mr.	Tychicus	Mohandoss		3238605360					mohandoss.tychicus@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/29/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Chief Information Security Officer	Director of Compliance, Deputy General Counsel	Mr.	Talukdar	Ashoke		3238605223				3234678450	ashoke.talukdar@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/29/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	CMMI Model Point of Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	CMS Casework Communication Contact	Risk Manager, Grievance & Appeals	Ms.	Beneche	Emelyne		9545223132	53292			8889657430	emelyne.beneche@aidshealth.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Complaints Tracking Contact	Risk Manager, Grievance & Appeals	Ms.	Beneche	Emelyne		9545223132	53292			8889657430	emelyne.beneche@aidshealth.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Contact for Fraud Investigations	SIU/Compliance Manager	Mr.	Flood	Robert		9545223132	53207				robert.flood@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	02/09/2024	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Coordination of Benefits Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Corporate Mailing						3234365000				3233379141	php@positivehealthcare.org	6255 W Sunset Blvd 21th Floor		Los Angeles	CA	90028	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Customer Service Operations Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	DIR Contact	Chief Financial Officer	Mr.	Honig Mojica	Lyle		3238605244				3239628513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	02/17/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	DIR Contact (Secondary)	Director of Finance - Finanical Compliance	Mr.	Vazquez	David		3238605260				3239628513	david.vazquez@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/29/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Discount Program Payment Contact	Director of Finance - Finanical Compliance	Mr.	Vazquez	David		3238605260				3239628513	david.vazquez@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/29/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Electronic Health Record Contact	Director of Care Coordination	Ms.	Jarrett	Tiffany		9545223132	3222			8889727976	tiffany.jarrett@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Emergency Part D Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		7143287404				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Emergency Part D Contact (Secondary)	Health Plan Administrator	Mr.	O'Malley	Michael		8186487834				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Employer Waiver Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Encounter Data & Risk Adjustment Operations Contact	Director of Risk Adjustment and Plan Revenue	Mr.	Twentyman	Thomas		3233379147					thomas.twentyman@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Enrollment Contact	Health Plan Administrator	Mr.	O'Malley	Michael		8002630067				8882358482	michael.omalley@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	EOB Transfer Contact	Assoc. Director Data and Information Architecture	Ms.	Adeli	Natalya		3238605317				8882358552	natalya.adeli@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Financial Audit Contact	Chief Financial Officer/Financial Services and Com	Mr.	Honig Mojica	Lyle		3238605244				3239628513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	03/14/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Financial Reporting Contact	Chief Financial Officer/Financial Services and Com	Mr.	Honig Mojica	Lyle		3238605244				3239628513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	03/14/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Formulary Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		3234365005				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Formulary Contact (Secondary)	Manager, Formulary Administration & Maitenance	Ms.	Nyawabila	Christina		8587906297					FAS@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	General Contact	Chief of Managed Care	Ms.	Stidham	Donna	M	8056600703					donna.stidham@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Government Relations Contact	Chief of Managed Care	Ms.	Stidham	Donna	M	8056600703					donna.stidham@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	HIPAA Privacy Officer	Director of Compliance, Deputy General Counsel	Mr.	Talukdar	Ashoke		3238605223				3234678450	ashoke.talukdar@aidshealth.org	6255 W. Sunset Blvd., 21st Floor		Los Angeles	CA	90028	03/10/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	HIPAA Security Officer	Director of Compliance, Deputy General Counsel	Mr.	Talukdar	Ashoke		3238605223				3234678450	ashoke.talukdar@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/29/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Hospice Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		3234365005				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Interoperability Contact	IT Project Manager	Mr.	Hayek	Joe		3237662176	56034				yousef.hayek@aidshealth.org	2146 W Adams Blvd		Los Angeles	CA	90018	04/28/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	MA Appeals/Grievances Contact	Risk Manager, Grievance & Appeals	Ms.	Beneche	Emelyne		9545223132	53292			8889657430	emelyne.beneche@aidshealth.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	MA Claims Processing Contact for Public Website	Health Plan Administrator	Mr	O'Malley	Michael		8886620626				8882359274	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Marketing Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Medical Director	Medical Director	Dr.	Howell	Scott	C	9175445619					scott.howell@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Medicare Compliance Officer	Compliance Officer	Ms.	Holzner	Sandra	E	3233379153					sandra.holzner@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Medicare Coordinator	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Medicare Part D Opioid Overutilization Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		3234365005				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Medication Therapy Management Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		7143287404				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	OffShore Subcontractor Contact	Chief of Managed Care	Ms.	Stidham	Donna	M	8056600703					donna.stidham@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Online Enrollment Center Contact (Back-up)	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Online Enrollment Center Contact (Optional)	Member Services Supervisor	Mr.	Ott	Eric		8002630067					eric.ott@ahf.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Online Enrollment Center Contact (Primary)	Director of Member Services	Ms.	Ramos	Melissa		3234365008				8882358552	melissa.ramos2@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part C Application Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part C Reporting Contact	Compliance Officer	Ms.	Holzner	Sandra	E	3233379153					Sandra.Holzner@ahf.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	02/09/2024	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Appeals	Pharmacy Director - Managed Care	Mr.	Dao	Anthony						8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	8885541334				HMO - Health Maintenance Organization		C	Boston
H5852	Part D Appeals Contact (Secondary)	Health Plan Administrator	Mr.	O'Malley	Michael						8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	8884365018				HMO - Health Maintenance Organization		C	Boston
H5852	Part D Application Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Benefits Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		3234365005				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Claims Submission Contact	Assoc. Director Data and Information Architecture	Ms.	Adeli	Natalya		3238605317					natalya.adeli@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Exceptions Contact	Pharmacy Director - Managed care	Mr.	Dao	Anthony						8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	8885541334				HMO - Health Maintenance Organization		C	Boston
H5852	Part D Exceptions Contact (Secondary)	Health Plan Administrator	Mr.	O'Malley	Michael						8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	8884365018				HMO - Health Maintenance Organization		C	Boston
H5852	Part D Price File Contact (Back-up)	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		3234365005				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90048	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Price File Contact (Optional)	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Price File Contact (Primary)	Medicare Part D Project Manager	Ms.	Niemi	Kirstin		8587906544					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Quality Assurance Contact	Director of Care Coordination	Ms.	Jarrett	Tiffany		9545223132	3222			8889727976	tiffany.jarrett@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Part D Reporting Contact	Medicare Part D Project Manager	Ms.	Scott	Susan		8587906565					medicarepartdprojectmanagers@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Patient Safety Contact	Director of Care Coordination	Ms.	Jarrett	Tiffany		9545223132	3222			8889727976	tiffany.jarrett@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Payment Contact	Associate Chief Financial Officer	Mr.	Honig Mojica	Lyle		3238605244				3239628513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Personal Health Record Contact	Director of Care Coordination	Ms.	Jarrett	Tiffany		9545223132	3222			8889727976	tiffany.jarrett@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Pharmacy Director	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		3234365005				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Pharmacy Network Management Contact	Pharmacy Director - Managed Care	Mr.	Dao	Anthony		3234365005				8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Pharmacy Network Management Contact (Secondary)	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Pharmacy Technical Help Desk Contact	Pharmacy Director - Managed care	Mr.	Dao	Anthony						8882382244	anthony.dao@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active	8885541334				HMO - Health Maintenance Organization		C	Boston
H5852	PHR Beneficiary Contact																	08/15/2019	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS	AIDS Healthcare Foundation	AIDS Healthcare Foundation	3	Yes	Active	8002630067				HMO - Health Maintenance Organization		C	Boston
H5852	Plan Directory Contact for Public Website	Health Plan Administrator	Mr.	O'Malley	Michael		3234365000				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Honig Mojica	Lyle		3238605244				3238605283	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	04/28/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Processor Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Quality Contact	Director of Care Coordination	Ms.	Jarrett	Tiffany		9545223132	3222			8889727976	tiffany.jarrett@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Reconciliation Contact	Chief Financial Officer	Mr.	Honig Mojica	Lyle		3238605244				3239628513	lyle.honig@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	04/28/2022	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Reconciliation Contact (Secondary)	Director of Finance	Mr.	Vazquez	David		3238605260				3239628513	david.vazquez@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/29/2020	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Recovery Audit Contact	Compliance Officer	Ms.	Holzner	Sandra	E	3233379153					Sandra.Holzner@ahf.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	02/09/2024	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	SNP Application Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172				8882358482	michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	SNP State Contact	Chief of Managed Care	Ms.	Stidham	Donna	M	8056600703					donna.stidham@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Surveillance Contact	Compliance Officer	Ms.	Holzner	Sandra	E	3233379153					Sandra.Holzner@ahf.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	02/09/2024	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	System Contact	Assoc. Director Data and Information Architecture	Ms.	Adeli	Natalya		3238605317					natalya.adeli@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Third Party Administrator (TPA) Liaison	Director of Finance - Finanical Compliance	Mr.	Vazquez	David		3238605260					david.vazquez@aidshealth.org	6255 W Sunset Blvd 21st Floor		Los Angeles	CA	90028	12/22/2023	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	User Access Contact	Health Plan Administrator	Mr.	O'Malley	Michael		3233379172					michael.omalley@aidshealth.org	1710 N. La Brea Ave.		Los Angeles	CA	90046	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Utilization Management Contact	Director of Care Coordination	Ms.	Jarrett	Tiffany		9545223132	3222			8889727976	tiffany.jarrett@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5852	Utilization Review Contact	Director of Care Coordination	Ms.	Jarrett	Tiffany		9545223132	3222			8889727976	tiffany.jarrett@ahf.org	700 SE 3rd Ave 4th Floor		Fort Lauderdale	FL	33316	07/11/2025	2026	AIDS HEALTHCARE FOUNDATION	Local CCP	AHF	HMO/HMOPOS		AIDS Healthcare Foundation	3	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5854	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5854	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H5854	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H5854	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H5854	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5854	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H5854	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM HEALTH PLANS, INC.	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H5854	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Agent/Broker Compensation Data Contact	Director of Medicare		Corbly	Jenna		5034163749				5034163723	corblyj@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97209	05/01/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Automated TrOOP Balance Transfer Contact	Director of Pharmacy - Operations		Corbett	Amber		5034168066					partdrx@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Backup User Access Contact	IS Application Systems Administrator		Crane	Randall		9713332638				5034161437	craner@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	11/15/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Best Available Evidence Contact	Enrollment Supervisor		Schulte	Rachel		5034168908				5034163723	schulter@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Bid Audit Contact	Chief Financial Officer		Learn	Teresa		5034161415				5034163721	learnt@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/21/2016	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Bid Audit Site Contact	Director of Medicare		Corbly	Jenna		5034163759				5034163723	corblyj@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/12/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Bid Primary Contact	Director of Medicare		Corbly	Jenna		5034163759					corblyj@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/12/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	CAP Report Contact for Public Website	VP Audit and Compliance	Mr.	Zorn	Christian		5034164700					zornc@careoregon.org	315 SW 5th Ave.	315 SW Fifth Avenue	Portland	OR	97204	02/04/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	8182036923				HMO - Health Maintenance Organization		C	Boston
H5859	CEO - CMS Administrator Contact	CEO	Mr.	Hunter	Eric		5034167788				5034164726	huntere@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	01/19/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	CEO - Senior Official for Contracting	CEO	Mr.	Hunter	Eric		5034167788				5034164726	huntere@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	01/02/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Chief Financial Officer	CFO	Ms.	Learn	Teresa		5034161415				5034168101	learnt@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	03/15/2018	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Chief Operating Officer	CEO	Mrs.	Dowd	Amy		5034164885				5034164726	dowda@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	03/18/2019	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Chief Information Officer	VP, Information Systems, Analytics	Mr.	Corley	Nathan		5034167919				5034168117	corleyn@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Chief Information Security Officer	VP  Audit and Compliance	Mr.	Zorn	Christian		5034164700				5034168117	zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	02/04/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	CMMI Model Point of Contact	Director of Medicare		Corbly	Jenna		5034163749				5034163723	corblyj@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97209	05/01/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	CMS Casework Communication Contact	Medicare Program Manager		Duran Rey	Whitney		5034168040				5034163720	duranreyw@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	07/15/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Complaints Tracking Contact	Medicare Program Manager		Duran Rey	Whitney		5034168040				5034163723	duranreyw@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	07/15/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Contact for Fraud Investigations	VP  Audit and Compliance		Zorn	Christian		5034164700				5034168117	zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	10/28/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Coordination of Benefits Contact	Enrollment Manager		Foster	Cody		5034167887				5034163723	COBServices@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/18/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Corporate Mailing						5034164279				5034163723	yanazzob@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/11/2018	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Customer Service Operations Contact	Customer Service Manager		Mattila	Karen		5034168033				5034163723	mattilak@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	08/19/2021	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	DIR Contact	Senior Accountant - Financial Reporting & Analysis		Lin	Echo		5034161414				5034168101	line@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	02/27/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	DIR Contact (Secondary)	Pharmacy Medicare Manager		Nguyen	Viet	V	5034161429				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Discount Program Payment Contact	Senior Accountant - Financial Reporting & Analysis		Lin	Echo		5034161414				5034168101	line@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	02/28/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Emergency Part D Contact	Director of Pharmacy - Operations		Corbett	Amber		5034168066					partdrx@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Emergency Part D Contact (Secondary)	Pharmacy Medicare Manager		Nguyen	Viet		5034161429				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Encounter Data & Risk Adjustment Operations Contact	Risk Asjustment Manager		Barnwell	Amy Jo		5034165753					barnwella@careoregon.org	315 SW 5th Ave		Portland	OR	97204	01/26/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Enrollment Contact	Enrollment Supervisor		Schulte	Rachel		5034168908				5034163723	schulter@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	EOB Transfer Contact	System Coordination Manager		Crace	Colleen		5034161722				5034163720	cracec@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Financial Audit Contact	Controller	Mr.	Jackson	Tony		5034168078				5034163720	jacksont@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/19/2019	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Financial Reporting Contact	CFO		Learn	Teresa		5034161415				5034163721	learnt@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue,	Portland	OR	97204	03/15/2018	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Formulary Contact	Pharmacy Medicare Manager		Nguyen	Viet		5034161429				5034161428	nguyent@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/22/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Formulary Contact (Secondary)	Lead Pharmacy Clinical Coordinator		Elliott	Analisa		5034164756					partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	05/02/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	General Contact	Director of Medicare		Corbly	Jenna		5034163749				5034163723	corblyj@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97209	05/01/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Government Relations Contact	Chief of Staff		Rigsby	Jeremiah		5034164699				5034163720	rigsbyj@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	HIPAA Privacy Officer	VP  Audit and Compliance		Zorn	Christian		5034164700				5034168117	zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	10/28/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	HIPAA Security Officer	VP  Audit and Compliance		Zorn	Christian		5034164700				5034168117	zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	10/28/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Hospice Contact	Pharmacy Medicare Manager		Nguyen	Viet		5034161429				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Interoperability Contact	VP, Information Systems, Analytics	Mr.	Corley	Nathan		5034167919				5034168117	corleyn@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	12/21/2021	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	MA Appeals/Grievances Contact	Quality Assurance Manager		Webb	Daron		5034163681					webbd@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	01/26/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	MA Claims Processing Contact for Public Website	Director, Claims		Villiarimo	Lynska		5034163733					villiarimol@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Marketing Contact	Medicare Program Manager		Duran Rey	Whitney		5034168040				5034163720	duranreyw@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	07/15/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Medical Director	Chief Medical Office		Shah, D.O.	Amit		5034161751				5034163713	shaha@careoregon.org	Health Plan of CareOregon, Inc.	315 SW Fifth Avenue	Portland	OR	97204	03/15/2018	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Medicare Compliance Officer	VP  Audit and Compliance	Mr.	Zorn	Christian		5034164700				5034168117	zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	02/27/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Medicare Coordinator	Medicare Program Manager		Duran Rey	Whitney		5034168040				5034168117	duranreyw@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	07/15/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Medicare Part D Opioid Overutilization Contact	Pharmacy Medicare Manager		Nguyen	Viet		5034161429				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Medication Therapy Management Contact	Pharmacy Medicare Manager		Nguyen	Viet		5034161429				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Online Enrollment Center Contact (Back-up)	Enrollment Coordinator		Watkins	Terri		5034163632				5034163723	watkinst@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Online Enrollment Center Contact (Optional)	Enrollment Coordinator		Bragg	Julie		5034165994				5034168117	braggj@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Online Enrollment Center Contact (Primary)	Enrollment Supervisor		Schulte	Rachel		5034168908				5034163723	schulter@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part C Application Contact	Director of Medicare		Corbly	Jenna		5034163749				5034163723	corblyj@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97209	05/01/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part C Reporting Contact	Medicare Program Specialist		Duran Rey	Whitney		5034168040				5034163720	duranreyw@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	07/15/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Appeals	Pharmacy Clinical Manager		Nguyen	Viet						5034161428	nguyent@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/22/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	5034161429				HMO - Health Maintenance Organization		C	Boston
H5859	Part D Appeals Contact (Secondary)	Pharmacy Clinical Coordinator Lead		Elliott	Analisa							partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	5034164756				HMO - Health Maintenance Organization		C	Boston
H5859	Part D Application Contact	Director of Medicare		Corbly	Jenna		5034163749				5034163723	corblyj@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97209	05/01/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Benefits Contact	Pharmacy Medicare Manager		Nguyen	Viet		5034161429				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Claims Submission Contact	Pharmacy Director		Corbett	Amber		5034168066					partdrx@careoregon.org	CareOregon Advantage	315 SW 5th Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Exceptions Contact	Pharmacy Medicare Manager		Nguyen	Viet						5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	5034161429				HMO - Health Maintenance Organization		C	Boston
H5859	Part D Exceptions Contact (Secondary)	Pharmacy Clinical Coordinator Lead		Elliott	Analisa							elliotta@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/22/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	5034164756				HMO - Health Maintenance Organization		C	Boston
H5859	Part D Price File Contact (Back-up)	SR Business Analyst		Lyman	Dorothy		6514955369					MedOps-Planfinder_DL@ds.uhc.com	OptumRx	1600 McConner Parkway	Schaumburg	IL	60173	11/30/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Price File Contact (Optional)	Pharmacy Medicare Manager		Nguyen	Viet		5034161429				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Price File Contact (Primary)	Director		Molberg	Brandi		6514945369					brandi.molberg@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	12/16/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Quality Assurance Contact	Director of Pharmacy - Operations		Corbett	Amber		5034168066				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Part D Reporting Contact	Director of Pharmacy - Operations		Corbett	Amber		5034168066				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Patient Safety Contact	Director of Pharmacy - Operations		Corbett	Amber		5034168066				5034161428	partdrx@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	06/18/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Payment Contact	Senior Accountant - Financial Reporting & Analysis		Lin	Echo		5034161414				5034168101	line@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	02/28/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Pharmacy Director	Vice President of Pharmacy		Slater	James		5034163633				5034161428	slaterj@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	08/19/2021	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Pharmacy Network Management Contact	Manager Retail Network Operations		Perez	Felix		3053313044					felix.perez@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/16/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Pharmacy Network Management Contact (Secondary)	Executive Director, Pharmacy		Slater	James		5034163633				5034161428	slaterj@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	02/01/2018	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prarie	MN	55344	12/16/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	8007887871				HMO - Health Maintenance Organization		C	Boston
H5859	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/15/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active	7633616109				HMO - Health Maintenance Organization		C	Boston
H5859	Physician Incentive Contact	VP  Value Based Contract		Mitchell	Angela		5034163425					mitchella@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue, Suite 900	Portland	OR	97204	08/19/2021	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Plan Directory Contact for Public Website	Medicare Program Manager		Duran Rey	Whitney		5034168040				5034163720	duranreyw@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	11/23/2022	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Plan to Plan Reconciliation Contact	Senior Accountant - Financial Reporting & Analysis		Lin	Echo		5034161414				5034168101	line@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	02/28/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Processor Contact	Senior Manager, Benefit Administration		Cassata	Mercedes		6307809152					mercedes.cassata@optum.com	1600 McConnor Pkwy		Schaumburg	IL	60173	08/19/2021	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Quality Contact	Vice President, Quality and Health Outcomes		Fife	Dave		5034168062					fifed@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	04/15/2025	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Reconciliation Contact	Senior Accountant - Financial Reporting & Analysis		Lin	Echo		5034161414				5034168101	line@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	02/27/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Reconciliation Contact (Secondary)	Director, Financial Reporting & Analysis		Yoshimori	Hiroshi		5034164935				5034168101	yoshimorih@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	02/28/2023	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Recovery Audit Contact	VP Audit and Compliance	Mr.	Zorn	Chris		5034164700				5034168117	zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	07/13/2021	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	SNP Application Contact	Director of Medicare		Corbly	Jenna		5034163749				5034163723	corblyj@careoregon.org	CareOregon Advantage 315 SW Fifth Avenue		Portland	OR	97209	05/01/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	SNP State Contact	Operations and Policy Analyst, Dual Eligibles	Ms.	Valentine	Jennifer		5039472328				5039455221	JENNIFER.B.VALENTINE@dhsoha.state.or.us	Division of Medical Assistance Programs (DMAP)	500 Summer Street NE, E-35	Salem	OR	97301	07/11/2019	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Surveillance Contact	VP Audit and Compliance		Zorn	Chris		5034164700					zornc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	12/02/2021	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	System Contact	VP, Information Systems, Analytics	Mr.	Corley	Nathan		5034167919				5034168117	corleyn@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue, Suite 900	Portland	OR	97204	09/09/2020	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Third Party Administrator (TPA) Liaison	Senior Accountant - Financial Reporting & Analysis		Lin	Echo		5034161414				5034168101	line@careoregon.org	315 SW Fifth Avenue		Portland	OR	97204	02/28/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	User Access Contact	IS Application Systems Administrator		Harlow	Craig		9719883768				5034161437	harlowc@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	11/12/2024	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Utilization Management Contact	Senior Manager of Care Management		Brink	Darin		5034161417				5034163713	brinkd@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/20/2016	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5859	Utilization Review Contact	Senior Manager of Care Management		Brink	Darin		5034161417				5034163713	brinkd@careoregon.org	CareOregon Advantage	315 SW Fifth Avenue	Portland	OR	97204	09/20/2016	2026	HEALTH PLAN OF CAREOREGON, INC.	Local CCP	CareOregon Advantage	HMO/HMOPOS		CareOregon, Inc.	48	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5883	Agent/Broker Compensation Data Contact	Manager	Mr.	Delaney	Brandon		3134482712					bdelaney@bcbsm.com	600 East Lafayette Blvd.	MC 520J	Detroit	MI	48226	03/16/2022	2026	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	Automated TrOOP Balance Transfer Contact	Manager	Mr.	Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1705	Detroit	MI	48226	10/08/2019	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Director	Mrs.	Love	Lonita		2482235350					LLove@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	12/03/2024	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2026	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	Bid Primary Contact	Manager		Wilkins	Shannon		2486654009					swilkins@bcbsm.com	600 East Lafayette	MC 1501	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	09/13/2021	2026	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	CEO - CMS Administrator Contact	President and Chief Executive Officer	Mrs.	Levine	Kathryn	G	2484553575				8668052405	KLevine@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	01/06/2025	2026	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	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms.	Keith	Tricia	A	3132250452					TKeith@bcbsm.com	600 East Lafayette	MC 2000	Detroit	MI	48226	05/05/2025	2026	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	3132256544					WHarris@bcbsm.com	600 E. Lafayette	MC 1800	Detroit	MI	48226	06/07/2021	2026	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 Operating Officer	President and Chief Executive Officer	Mrs.	Levine	Kathryn	G	2484553575				8668052405	KLevine@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	01/24/2024	2026	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 Information Officer	Vice President	Mr.	Cieszynski	Brent		3132258766					BCieszynski@bcbsm.com	600 East Lafayette Blvd.	MC S260	Detroit	MI	48226	11/15/2019	2026	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 Information Security Officer	Vice President	Mr.	Cieszynski	Brent		3132258766					BCieszynski@bcbsm.com	600 East Lafayette Blvd.	MC S260	Detroit	MI	48226	11/15/2019	2026	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	CMMI Model Point of Contact	Manager		Siess	Hac		3134480140					hsiess@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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		Smith	Brandon		2482235319					Bsmith@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	12/03/2024	2026	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	Complaints Tracking Contact	Senior Business Analyst, BCNA Enrollment		Surman	Daniel		2482235357				8666014392	dsurman@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	01/24/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48226	07/03/2025	2026	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, COB Payment Integrity		Besant	Tracy		3134485846					Tbesant@bcbsm.com	611 Cascade West Parkway, S.E.	G801	Grand Rapids	MI	49546	03/05/2024	2026	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	Corporate Mailing						2483955887					vpickens@bcbsm.com	600 East Lafayette Blvd.	MC TC1301	Detroit	MI	48226	01/23/2025	2026	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		3132255856					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2026	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	DIR Contact	Manager		Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette	TC1309	Detroit	MI	48226	03/04/2024	2026	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	DIR Contact (Secondary)	Senior Analyst		Desaraju	Vidhya		2486654514					vdesaraju@bcbsm.com	Tower 500 Renaissance Center	512A	Detroit	MI	48243	12/04/2024	2026	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	Discount Program Payment Contact	Director, Medicare Program Administration		Priebe	Scott		2486654472					spriebe@bcbsm.com	600 East Lafayette Blvd.	TC 1516	Detroit	MI	48226	02/01/2021	2026	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	Emergency Part D Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	12/27/2024	2026	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	Emergency Part D Contact (Secondary)	Director	Mrs.	Underhill	Molly		6163753398					MUnderhill@bcbsm.com	600 East Lafayette Blvd.	TC 1300	Detroit	MI	48226	12/28/2020	2026	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	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		King	Aleesha		9194303434					aking12@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	03/17/2025	2026	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	Enrollment Contact	Manager		Smith	Brandon		2482235319					Bsmith@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	12/03/2024	2026	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	EOB Transfer Contact	Manager	Mrs.	Rawson	Lori		6169565796				8773459942	lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	11/24/2021	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	Director, Finance	Mr.	Bluhm	Ken		3132259095					kbluhm@bcbsm.com	600 East Lafayette Blvd.	MC 0801	Detroit	MI	48226	11/16/2020	2026	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	Formulary Contact	Manager		Siess	Hac		3134480140					hsiess@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	Formulary Contact (Secondary)	Supervisor		Lota	Amardeep		2486654537					alota@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	General Contact	Compliance Consultant	Ms.	White	Jasmin		2486654235					jwhite4@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/04/2024	2026	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	Managing Director	Ms.	Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	02/23/2024	2026	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	HIPAA Privacy Officer	VP, Enterprise Compliance and Privacy Official	Ms.	Lange	Kelly		3132258554					KLange@bcbsm.com	600 E Lafayette East	MC 1304	Detroit	MI	48226	12/27/2021	2026	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	HIPAA Security Officer	Vice President	Mr.	Cieszynski	Brent		3132258766					BCieszynski@bcbsm.com	600 E. Lafayette Blvd.	MC S260	Detroit	MI	48226	11/15/2019	2026	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		6169565796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Interoperability Contact	Director	Mr.	Kett	James		3132250224					jkett@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	02/11/2022	2026	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	MA Appeals/Grievances Contact	Manager	Mr.	McCarty	Kevin		2483507488				8665227345	KMcCarty@bcbsm.com	P.O. Box 284		Southfield	MI	48086	02/03/2023	2026	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	MA Claims Processing Contact for Public Website	Manager		Shippy	Karen		6169565890				8004503680	KShippy@bcbsm.com	611 Cascade West Parkway, S.E.	G804	Grand Rapids	MI	49546	03/04/2024	2026	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	Marketing Contact	Director		Parrish	Loralie		3135007876					Lparrish1@bcbsm.com	600 East Lafayette Blvd.	MC 1401	Detroit	MI	48226	03/05/2024	2026	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	Medical Director	Senior Medical Director	Dr.	Yende	Namita		3132259513					nyende@bcbsm.com	600 East Lafayette Blvd.	MC 516D	Detroit	MI	48226	03/17/2025	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	09/13/2021	2026	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 Part D Opioid Overutilization Contact	Manager		Mates	Bianca		8002874163				8778958667	MedicarePartDOverutilizationMonitoring@bcbsm.com	600 East Lafayette Blvd.	512J	Detroit	MI	48226	12/11/2025	2026	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	Medication Therapy Management Contact	Manager		Pallisco	Amy		2486654777					Apallisco@bcbsm.com	600 East Lafayette	MC 512J	Detroit	MI	48226	07/14/2025	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	10/16/2019	2026	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	Online Enrollment Center Contact (Back-up)	Team Lead II	Ms.	Gaither	Tia		2482235335					TGaither@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	01/24/2024	2026	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	Online Enrollment Center Contact (Optional)	Project Consultant		Shiemke	Leanne	L	2486654586					lshiemke@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	04/28/2025	2026	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	Online Enrollment Center Contact (Primary)	Manager		Smith	Brandon		2482235319					Bsmith@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	12/03/2024	2026	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 C Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 C Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Appeals	Manager		Lewis	Letoretoys						8004598027	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1408	Detroit	MI	48226	03/04/2024	2026	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8004373803				HMO - Health Maintenance Organization		C	Chicago
H5883	Part D Appeals Contact (Secondary)	Senior Business Analyst		Plain	Sheree						8666014392	splain@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	01/24/2024	2026	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	2482235241				HMO - Health Maintenance Organization		C	Chicago
H5883	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Manager	Mrs.	Rawson	Lori		6169565796					lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	11/15/2019	2026	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 Claims Submission Contact	Manager		Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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		Lewis	Letoretoys						8004598027	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1408	Detroit	MI	48226	03/04/2024	2026	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8004373803				HMO - Health Maintenance Organization		C	Chicago
H5883	Part D Exceptions Contact (Secondary)	Supervisor	Ms.	Agnew	Amber						2484553692	dramspriorauthmedicared@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8004373803				HMO - Health Maintenance Organization		C	Chicago
H5883	Part D Price File Contact (Back-up)	Senior Health Care Analyst		McGuire	Donald		2486654548					dmcguire2@bcbsm.com	500 Renaissance Center	512A	Detroit	MI	48243	02/26/2025	2026	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 Price File Contact (Optional)	Senior Healthcare Analyst	Ms.	Desaraju	Vidhya		2486654514					vdesaraju@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	12/28/2022	2026	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 Price File Contact (Primary)	Manager	Mr.	Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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 Quality Assurance Contact	Director	Ms.	Underhill	Molly		2483955505					munderhill@bcbm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/16/2020	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Director		Connelly	Theresa		2483955529					Tconnelly@bcbsm.com	500 Renaissance Center	505A	Detroit	MI	48243	12/04/2024	2026	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	Payment Contact	Director		Priebe	Scott		2486654472					spriebe@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	01/23/2025	2026	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 Director	Director	Ms.	Underhill	Molly		6163753398					munderhill@bcbm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/18/2021	2026	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 Network Management Contact	Director		Underhill	Molly		2483955505					munderhill@bcbsm.com	600 East Lafayette Blvd.	TC1308	Detroit	MI	48226	03/04/2024	2026	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 Network Management Contact (Secondary)	Manager	Mrs.	Rawson	Lori		6169565796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Manager	Mr.	Nalamolu	Chandra							hnalamolu@bcbsm.com	600 East Lafayette Blvd	MC 1309	Detroit	MI	48226	12/10/2025	2026	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8558100007				HMO - Health Maintenance Organization		C	Chicago
H5883	Pharmacy Technical Help Desk Contact (Secondary)	Manager	Ms.	Rawson	Lori							lrawson@bcbsm.com	600 East Lafayette Blvd	TC 1309	Detroit	MI	48226	12/10/2025	2026	BLUE CARE NETWORK OF MICHIGAN	Local CCP	Blue Care Network	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8558100007				HMO - Health Maintenance Organization		C	Chicago
H5883	Physician Incentive Contact	Vice President	Mr.	Coscione	Robert		3134480083					RCoscione@bcbsm.com	600 East Lafayette Blvd.	MC 511E	Detroit	MI	48226	10/16/2019	2026	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	Plan Directory Contact for Public Website	Director	Ms.	Judson	Johanna		8003448525					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2026	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	Plan to Plan Reconciliation Contact	Manager		Ellis	Carol		3132257492					bcnp2padmin@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	07/08/2025	2026	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	Processor Contact	Manager	Mrs.	Rawson	Lori		6169565796					LRawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Quality Contact	Director	Ms.	Bolton	Belinda		2484552773					BBolton@bcbsm.com	500 Renaissance Ctr.	507K	Detroit	MI	48243	03/04/2024	2026	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	Reconciliation Contact	Director		Priebe	Scott		2486654472					spriebe@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	01/23/2025	2026	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	Reconciliation Contact (Secondary)	Project Consultant		Shiemke	Leanne		2486654586					lshiemke@bcbsm.com	441 E. Jefferson	J210	Detroit	MI	48226	03/05/2025	2026	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	Recovery Audit Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2026	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	SNP Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Surveillance Contact	Director		Crawford	Constance		2486654231					ccrawford@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	06/17/2022	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Project Consultant		Shiemke	Leanne	L	2486654586					lshiemke@bcbsm.com	441 E. Jefferson		Detroit	MI	48226	04/10/2025	2026	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	User Access Contact	Analyst	Mr.	Teklinski	Greg		2486654284					gteklinski@bcbsm.com	600 East Lafayette Blvd.	MC S140	Detroit	MI	48226	03/16/2022	2026	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	Utilization Management Contact	Director	Mrs.	Szydlowski	Taryn		2487996453					TSzydlowski@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/04/2024	2026	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	Utilization Review Contact	Director	Mrs.	Szydlowski	Taryn		2487996453					Tszydlowski@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/04/2024	2026	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	Agent/Broker Compensation Data Contact	Director, Finance Operations		Hoeg	Andrea		5153764509					commissioninquiry@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	02/16/2021	2026	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	Automated TrOOP Balance Transfer Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2026	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	Bid Primary Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director		Pickens	Veronica		2483955887					vpickens@bcsbm.com	600 East Lafayette	TC 1301	Detroit	MI	48826	03/05/2024	2026	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	CEO - CMS Administrator Contact	Plan President	Ms.	Winright	Krischa	K	2486654048					kwinright@bcbsm.com	1000 Town Center		Southfield	MI	48075	01/06/2025	2026	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	CEO - Senior Official for Contracting	Plan President	Ms.	Winright	Krischa	K	2486654048					kwinright@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/20/2023	2026	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		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/11/2021	2026	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 Operating Officer	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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 Information Officer	IT Director II	Mrs.	Krause	Amy		3132256638					akrause@bcbsm.com	600 East Lafayette Blvd. MC 0506		Detroit	MI	48826	06/17/2022	2026	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 Information Security Officer	VP Chief Information Security Officer	Mr.	Cieszynski	Brent		3132258766					bcieszynski@bcbsm.com	600 Lafayette East		Detroit	MI	48226	08/22/2022	2026	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	CMMI Model Point of Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Complaints Tracking Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Corporate Mailing						5152012513					briggs.hamor@wellmarkadvantagehealthplan.com	1331 Grand Avenue		Des Moines	IA	50309	03/31/2022	2026	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		3132250555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	11/15/2021	2026	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	DIR Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/07/2025	2026	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	DIR Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2025	2026	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	Discount Program Payment Contact	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	Electronic Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Emergency Part D Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	01/04/2023	2026	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	Emergency Part D Contact (Secondary)	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Employer Waiver Contact	Director		Nelson	Jessica		2483209946					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		King	Aleesha		9194303434					aking12@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	04/10/2025	2026	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	Enrollment Contact	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	EOB Transfer Contact	Director		Clark	Erica		6167580917				8556337633	eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	SVP, Controller	Mr.	Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/11/2021	2026	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	Formulary Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Formulary Contact (Secondary)	Manager		Jones	Marini		3135706777					Marini.Jones@emergient.com	1000 Town Center		Southfeld	MI	48075	03/05/2024	2026	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	General Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	HIPAA Privacy Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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	HIPAA Security Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Interoperability Contact	Manager, Functional Operations		Kingsley	Chris		2484444160					Christopher.kingsley@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	MA Appeals/Grievances Contact	Chief Operating Officer		Hower	Johanna		8048594034					Johanna.Hower@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	MA Claims Processing Contact for Public Website	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Marketing Contact	Marketing Manager		Swanson	Emily		5153764758					SwansonE@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	10/09/2025	2026	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	Medical Director	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	02/09/2022	2026	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 Part D Opioid Overutilization Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Medication Therapy Management Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	09/11/2024	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	02/09/2022	2026	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	Online Enrollment Center Contact (Back-up)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Online Enrollment Center Contact (Optional)	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	Online Enrollment Center Contact (Primary)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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 C Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 C Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Appeals	Manager		Moran	Vickie							Vickie.Moran@CVSHealth.com	620 Epsilon Dr		Pittsburgh	PA	15238	04/26/2022	2026	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	4125263320				PPO - BBA		C	Chicago
H5900	Part D Appeals Contact (Secondary)	Director		Christensen	Ann							Ann.Christensen@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	04/26/2022	2026	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	6023883829				PPO - BBA		C	Chicago
H5900	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Claims Submission Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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		Clark	Erica							eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	6167580917				PPO - BBA		C	Chicago
H5900	Part D Exceptions Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	8553440930				PPO - BBA		C	Chicago
H5900	Part D Price File Contact (Back-up)	Manager		Jones	Marini		3135706777					Marini.Jones@emergient.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Price File Contact (Optional)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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 Price File Contact (Primary)	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Quality Assurance Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Payment Contact	SVP, Controller	Mr.	Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/11/2021	2026	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	Personal Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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 Director	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Network Management Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Network Management Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Manager, Pharmacy Operations		Zylstra	Jennifer							Jennifer.Zylstra@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/11/2023	2026	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	8006008065				PPO - BBA		C	Chicago
H5900	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Operations		Jones	Marini							Marini.Jones@emergient.com	1000 Town Center		Southfield	MI	48075	12/11/2023	2026	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	8006008065				PPO - BBA		C	Chicago
H5900	Physician Incentive Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Plan Directory Contact for Public Website	Director		Nelson	Jessica		8557162556					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Plan to Plan Reconciliation Contact	SVP, Controller	Mr.	Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/11/2021	2026	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	Processor Contact	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Quality Contact	Corporate Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Reconciliation Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Recovery Audit Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP State Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Surveillance Contact	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	User Access Contact	Administrative Assistant		Eddy	Chris		3132683879					CEddy@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/03/2024	2026	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	Utilization Management Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Utilization Review Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Backup User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Bid Primary Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	CAP Report Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Operating Officer	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Information Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Complaints Tracking Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Contact for Fraud Investigations	Executive Director	Ms	Miloro	Roxanne		8149432273	27004			8142487902	SLEDirectors@seniorlifeebensburg.com	2891 Fairway Drive		Altoona	PA	16602	08/26/2024	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Corporate Mailing						8145356000	22101			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	DIR Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Discount Program Payment Contact	CFO		Dodson	David	M	8145356000	22102				Ddodson@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/14/2025	2026	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	Emergency Part D Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	10/18/2019	2026	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	Enrollment Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	EOB Transfer Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Formulary Contact			N/A	N/A		1234567890	123				N/A@n/a.com	N/A		N/A	PA	15906	01/22/2013	2026	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	General Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	HIPAA Privacy Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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	Interoperability Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	MIrwin@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	02/16/2022	2026	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	MA Appeals/Grievances Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Marketing Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Medical Director	Medical Director		Ratchford	Donald		8145356000	26007				DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	02/26/2018	2026	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		8144726060	27004				SLEDirectors@seniorlifeebensburg.com	429 Manor Drive		Ebensburg	PA	15931	08/26/2024	2026	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 Coordinator	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Part D Opioid Overutilization Contact	Medical Director		Ratchford	Donald		8145356000	26007				DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	10/31/2018	2026	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	Medication Therapy Management Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/13/2019	2026	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 C Application Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Appeals	Chief Financial Officer	Mr	Dodson	David						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H5902	Part D Appeals Contact (Secondary)	Chief Executive Officer	Mr.	i	Mark						8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	12/29/2020	2026	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active	8145356000	22101			PACE - Nat		C	Philadelphia
H5902	Part D Application Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Benefits Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Claims Submission Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H5902	Part D Price File Contact (Back-up)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Price File Contact (Primary)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	01/22/2013	2026	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 Quality Assurance Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Patient Safety Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Payment Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Director			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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 Network Management Contact			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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	2026	SENIOR LIFE ALTOONA, INC.	National PACE	Senior LIFE Altoona / Ebensburg / Indiana	National PACE		Senior LIFE Altoona, Inc.	542	Yes	Active	7242751203	219			PACE - Nat		C	Philadelphia
H5902	Plan Directory Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Processor Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	11/13/2025	2026	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	Quality Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@paceconsultingsolutions.com	401 Broad Street		Johnstown	PA	15906	10/03/2016	2026	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	Reconciliation Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Recovery Audit Contact	CFO	Mr	Dodson	David	M	8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Surveillance Contact			Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	System Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Third Party Administrator (TPA) Liaison	VP Grane PBM		Baker	John		3306968345					jebaker@granepbm.com	209 Sigma Drive		Pittsburgh	PA	15238	03/14/2025	2026	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	User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Utilization Management Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Utilization Review Contact	ChieExecutive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H5926	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H5926	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5926	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H5926	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5926	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF MICHIGAN, INC.	Local CCP	Molina Healthcare of Michigan	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5926	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Agent/Broker Compensation Data Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		8182286374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Backup User Access Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Best Available Evidence Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/05/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Bid Audit Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Bid Audit Site Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Bid Primary Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	CAP Report Contact for Public Website	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	CEO - CMS Administrator Contact	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	CEO - Senior Official for Contracting	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Chief Financial Officer	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Chief Operating Officer	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Chief Information Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Chief Information Security Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Complaints Tracking Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Contact for Fraud Investigations	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Coordination of Benefits Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/05/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Corporate Mailing						5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Customer Service Operations Contact	Director		Mathews	Carolyn		5626135004					Carolyn.Mathews@blueshieldca.com	3021 Reynolds Ranch Pkwy		Lodi	CA	95240	09/07/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	DIR Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	DIR Contact (Secondary)	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Discount Program Payment Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Electronic Health Record Contact	Compliance Manager		Martinez	Jesus		3238896638	3326				Jesus.Martinez@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	12/27/2018	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Emergency Part D Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Emergency Part D Contact (Secondary)	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Employer Waiver Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland HIlls	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Actuary		Rodgers	John		3107442643					John.Rodgers@blueshieldca.com	100 N. Sepulveda Boulevard		El Segundo	CA	90245	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Enrollment Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/05/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	EOB Transfer Contact	Medicare Project & Program Manager		Zuehlke	Erica		2093713036				8558953519	zuehlke@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/07/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Financial Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Financial Reporting Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Formulary Contact	Director, Formulary Strategy and P&T		Nguyen	Nhi		9168410342					Nhi.Nguyen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Formulary Contact (Secondary)	Principal Pharmacist, Formulary Management		Trinh	Andy		3238276322					Andy.Trinh@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	General Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Government Relations Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	HIPAA Privacy Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	HIPAA Security Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Hospice Contact	Senior Program Manager		Fields	Torrie		4152295839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	02/12/2018	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Interoperability Contact	VP Enterprise Digital Growth		Grimm	David		6196864233					david.grimm@blueshieldca.com	2275 Rio Bonito Way	Suite 250	San Diego	CA	92108	02/15/2022	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	MA Appeals/Grievances Contact	Supervisor, Medicare Appeals and Grievances		Lopez	Celina		8182286183				9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	07/14/2020	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	MA Claims Processing Contact for Public Website	Senior Manager, Medicare Operations		Halley	Derek		8182286374					Derek.Halley@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Marketing Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Medical Director	Medicare Medical Director	Dr.	Siddiq	Khaliq		5627137953					Khaliq.Siddiq@blueshieldca.com	555 Anton Boulevard	Suite 800	Costa Mesa	CA	92626	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Medicare Coordinator	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Medicare Part D Opioid Overutilization Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					OpioidDUR@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/13/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Medication Therapy Management Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					Dawn.Becker-Ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	OffShore Subcontractor Contact	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Online Enrollment Center Contact (Back-up)	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Online Enrollment Center Contact (Optional)	IT Product Manager, Consultant		Skuta	Paul		9168660922					Paul.Skuta2@blueshieldca.com	601 12th Street		Oakland	CA	94607	10/02/2024	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Online Enrollment Center Contact (Primary)	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/05/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part C Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part C Reporting Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Appeals	Supervisor, Medicare Appeals and Grievances		Lopez	Celina						9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	07/14/2020	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Appeals Contact (Secondary)	Senior Manager, Operations		Salam	Shahid							Shahid.Salam@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Benefits Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Claims Submission Contact	Lead Medicare Rx Benefits & Claims Specialist		Campbell	Leslie		5306263838					leslie.campbell@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Exceptions Contact (Secondary)	Senior Manager, Medicare Compliance		Mata	Marcos							Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8007764466				HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Price File Contact (Back-up)	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Price File Contact (Optional)	Business Analyst, Rx Benefit/Claims Implementation		Ng	Alvin		5106072964					alvin.ng@blueshieldca.com	601 12th Street		Oakland	CA	94105	01/14/2020	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Price File Contact (Primary)	Business Analyst, Rx Benefit/Claims Implementation		Ng	Alvin		5106072964					Alvin.Ng@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Quality Assurance Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Part D Reporting Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Patient Safety Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					dawn.becker-ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	07/14/2020	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Payment Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Pharmacy Director	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Pharmacy Network Management Contact (Secondary)	Senior Program Manager, Medicare Rx Compliance		Nelson	Kimberly	C	5106073281					Kim.Nelson@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/20/2024	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	8003757924				HMO - Health Maintenance Organization		C	Dallas
H5928	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager		Nordby	Christina							cnordb01@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/30/2024	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active	5626135252				HMO - Health Maintenance Organization		C	Dallas
H5928	Physician Incentive Contact	Director, Provider Services - Network		Gonzalez	Maria		3238534445					Maria.Gonzalez2@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Plan Directory Contact for Public Website			Services	Member		8007764466					membersvcs@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Plan to Plan Reconciliation Contact	Supervisor Accounts Payable/Receivable		Perez	Cheryl		9167024442					BSCP2PRecon@blueshieldca.com	3021 Reynolds Ranch Parkway		Lodi	CA	95240	02/22/2024	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Processor Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106073281					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Quality Contact	Director, Case Management		Taylor	Christy		6197194536					christy.taylor@blueshieldca.com	313 Camino Del Rio	North, Ste. 1300	San Diego	CA	92108	12/16/2022	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Reconciliation Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Reconciliation Contact (Secondary)	Senior Director, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Recovery Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	SNP Application Contact			Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Surveillance Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	System Contact	Sr. Director, IT Product Management		Chambers	Shelley		1916866073					Shelley.Chambers@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	09/07/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Third Party Administrator (TPA) Liaison	Director, Actuary		Shah	Dimple		5109068189					dimple.shah@blueshieldca.com	50 Beale Street		Oakland	CA	94105	12/04/2024	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	User Access Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Utilization Management Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5928	Utilization Review Contact	Senior Director, Utilization & Medical Review		Albertsen	Mirela		9168410418					Mirela.Albertsen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	California Physicians' Service	Local CCP	Blue Shield of California	HMO/HMOPOS		California Physicians' Service	30	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5929	Part C Application Contact			Rutter	Jeremy		3157244959					jrutter@cwpinc.org	110 Utica Road		Clinton	NY	13323	11/03/2025	2026	LUTHERAN HOMES MANAGEMENT SERVICES, INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H5929	Part D Application Contact			Rutter	Jeremy		3157244959					jrutter@cwpinc.org	110 Utica Road		Clinton	NY	13323	11/03/2025	2026	LUTHERAN HOMES MANAGEMENT SERVICES, INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H5932	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Automated TrOOP Balance Transfer Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/14/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Best Available Evidence Contact	Senior Director,Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	01/03/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/25/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/21/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Chief Information Officer	VP, Information Technology	Mr.	Putila	Matt		4122554163					mputila@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/08/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	CMMI Model Point of Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					Aaron.Laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	08/02/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	CMS Casework Communication Contact	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	05/13/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Complaints Tracking Contact	Sr. Quality Analyst, A&G	Ms.	Barbagallo	Toni Marie		4122557287					tbarbagallo@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Contact for Fraud Investigations	Director, Fraud, Waste and Abuse	Dr.	Berdell	Melissa		4126907432					mberdell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Coordination of Benefits Contact	Sr. Director, Operations	Ms.	Magliocco	Michelle		4122554810					COB-TPLMedicare@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Corporate Mailing						4122554640					medicareassured@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Customer Service Operations Contact	Manager Business Operations	Mr.	Hartman	Josh		8006855209					jhartman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	DIR Contact	Vice President, Accounting & Reporting		Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	03/12/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/19/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Discount Program Payment Contact	Manager		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Emergency Part D Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4122558830				8889188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Emergency Part D Contact (Secondary)	Senior Compliance Analyst	Mr.	Woods	Shane		4129188763					Shane.Woods@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	09/18/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Encounter Data & Risk Adjustment Operations Contact	Senior Encounters Analyst	Mr.	McKay	Douglas		4129188447					GHP_Medicare_Encounters@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Enrollment Contact	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	EOB Transfer Contact	SVP, Operations	Mr.	Burgess	James		4122551318				4122551318	jburgess@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	09/24/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Formulary Contact	Pharmacy Relations & Formulary Specialist	Ms.	Stein	Victoria		1412255725					vstein@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Formulary Contact (Secondary)			McDonnell	Kallyn		4129188692					KMcDonnell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					justine.patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Hospice Contact	Supervisor, Pharmacy Call Center	Mr.	Woods	Shane		4129188763					SWoods2@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Interoperability Contact	VP,  Data Analytics & Strategy	Mr.	Castle	Brian		4129188449					bcastle@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	MA Appeals/Grievances Contact	Senior Director, Operations		Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	05/13/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	MA Claims Processing Contact for Public Website	SVP, Operations	Mr.	Burgess	James		4122551318					jburgess@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Medical Director	Senior Medical Director	Dr.	Reddy	Lakshmi		4124206517					lakshmi.reddy@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/08/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	01/03/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Medicare Part D Opioid Overutilization Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Medication Therapy Management Contact	Senior Director,  Stars Quality	Dr.	Serrano	Daniel	N	4129188572					dserrano@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Online Enrollment Center Contact (Back-up)	Manager, Enrollment, Systems Admin/Enrollment	Ms.	Blumentritt	Kristen		4122554172					KBlumentritt@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	08/02/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Online Enrollment Center Contact (Primary)	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part C Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	07/02/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/29/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Appeals	Supervisor, Medicare Appeals		Earlewine	Melissa							mearlewine@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	4122557203				HMO - Health Maintenance Organization		C	Boston
H5932	Part D Appeals Contact (Secondary)	Manager, Appeals		Wright	Kristie							kwright@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	11/01/2022	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	4124206431				HMO - Health Maintenance Organization		C	Boston
H5932	Part D Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/03/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Benefits Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				8882452049	EYarnell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Claims Submission Contact	Dir Initiative Mgt	Mr.	Smith	Cory		4129188825					csmith@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Exceptions Contact	VP, Pharmacy	Mr.	Yarnell	Eric						8882452049	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	4129188830				HMO - Health Maintenance Organization		C	Boston
H5932	Part D Exceptions Contact (Secondary)	Director, Pharmacy Clinical Operations	Ms.	Nogrady	Lisa							lnogrady@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	4122554256				HMO - Health Maintenance Organization		C	Boston
H5932	Part D Price File Contact (Back-up)	Director,  Pharmacy Business Operations	Ms.	Funkhouser	Christina		4122157123					cfunkhouser@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Price File Contact (Optional)	Program Manager, Pharmacy Quality		Michael	Alisa		4126907028					Alisa.Michael@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	01/23/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Price File Contact (Primary)	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Quality Assurance Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsbugh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/29/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Patient Safety Contact	Vice President, Pharmacy Business Administration	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Payment Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	03/12/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Pharmacy Director	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Pharmacy Network Management Contact	Director,  Pharmacy Business Operations	Ms.	Funkhouser	Christina		4122157123					cfunkhouser@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Pharmacy Network Management Contact (Secondary)	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	CVS								Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	11/21/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H5932	Pharmacy Technical Help Desk Contact (Secondary)	VP, Pharmacy		Yarnell	Eric						4129188830	eric.yarnell@highmark.com	Four Gateway Center	444 Liberty Ave, Ste 2100	Pittsburgh	PA	15222	04/11/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active	8006855209				HMO - Health Maintenance Organization		C	Boston
H5932	Physician Incentive Contact	Senior Director, Stars Quality	Mr.	O'Donnell	William		4129188572					wodonnell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Plan Directory Contact for Public Website	Manager Business Operations	Mr.	Hartman	Josh		8006855209					jhartman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Plan to Plan Reconciliation Contact	Manager, Operational Accounting		Stehr	Brett		7173022748					P2PRecon@highmark.com	Attn: Cashier	PO Box 898820	Camp Hill	PA	17089	11/18/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Processor Contact	Director, Claims Processing	Ms.	Goheen	Theresa		4129188706					tgoheen@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Quality Contact	Interim Director, Quality Improvement	Ms.	Uncapher	Patricia		4129188790					puncapher@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Reconciliation Contact	VP, Controller		Cogan	Chris		4122554693					CCogan@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Recovery Audit Contact	Director, Fraud, Waste and Abuse	Dr.	Berdell	Melissa		4126907432					mberdell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	SNP Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	07/02/2024	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	SNP State Contact	Senior Risk Partner	Ms.	Bach	Vicki		4125441549					Vicki.Bach@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	01/27/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Third Party Administrator (TPA) Liaison	Senior Financial Analyst		Trautvetter	Jill		4122557132					Jill.Trautvetter@highmarkhealth.org	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/12/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Utilization Management Contact	Director, Clinical Operations	Ms.	Layman	Katrina		4122554173					klayman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5932	Utilization Review Contact	Director, Clinical Operations	Ms.	Layman	Katrina		4122554173					klayman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	06/15/2023	2026	GATEWAY HEALTH PLAN, INC.	Local CCP	Highmark Wholecare Medicare Assured	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5934	Automated TrOOP Balance Transfer Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Backup User Access Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Best Available Evidence Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Bid Primary Contact	Director of Accounting		Iffland	Bill		2394824673				2399856411	bill.iffland@hopehcs.org	9470 HealthPark Circle		Ft. Myers	FL	33908	07/28/2015	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	CAP Report Contact for Public Website	Manager, Quality		Vazquez	Delamliz		2399856402					Lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Ft. Myers	FL	33901	04/24/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	White	Rhonda		8632421215					rwhite@chaptershealth.org	12470 Telecom Drive Suite 301		Tampa	FL	33637	03/04/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	CEO - Senior Official for Contracting	Chief Operating Officer	Ms.	White	Rhonda		8632421215					rwhite@chaptershealth.org	12470 Telecom Drive Suite 301		Tampa	FL	33637	03/04/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Chief Financial Officer	CFO	Ms.	Lampley	Jill	S	2394824673				2394827298	jill.lampley@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33908	02/01/2008	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Chief Operating Officer	COO	Dr.	El-Menshawi	Marwa		9168739281					melmenshawi@chaptershealth.org	2668 Winkler Avenue		Fort Myers	FL	33901	09/16/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Chief Information Officer	CIO	Ms.	Stobel	Sheri		4146883245					strobels@chaptershealth.org	12470 Telecom Drive Suite 301		Temple Terrace	FL	33637	04/15/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Chief Information Security Officer	Director, IT Security CISO	Mr	Parkin	Mike		8133575137					ParkinM@chaptershealth.org	12470 Telecom Drive Suite 301		Temple Terrace	FL	33637	02/04/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	CMS Casework Communication Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Complaints Tracking Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/24/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Contact for Fraud Investigations	CFO	Ms.	Lampley	Jill	S	2394824673				2394827298	jill.lampley@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33908	05/04/2018	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Coordination of Benefits Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/24/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Corporate Mailing						2394824673				2394827298	samira.beckwith@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33908	02/01/2008	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Customer Service Operations Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	DIR Contact	Director of Accounting		Iffland	Bill		2399857767				2394259800	Bill.Iffland@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33901	03/15/2012	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Discount Program Payment Contact	Director, PACE Finance & Health Plan Services		Iffland	Bill		2399857767					ifflandb@chaptershealth.org	2668 Winkler Avenue		Fort Myers	FL	33901	03/31/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Emergency Part D Contact	CFO	Ms.	Lampley	Jill	S	2394824673				2394827298	jill.lampley@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33908	12/22/2014	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Encounter Data & Risk Adjustment Operations Contact	Director of Pace		Vazquez	Delmaliz		2399856402					Lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Ft. Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Enrollment Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	EOB Transfer Contact			Vazquez	Delmaliz		2399856402				8666597223	lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Financial Audit Contact	Director of Accounting	Mr.	Iffland	Bill		2399857767				2394259800	Bill.Iffland@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33901	03/15/2012	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Financial Reporting Contact	Director of Accounting		Iffland	Bill		2394824673				2399856411	bill.iffland@hopehcs.org	9470 HealthPark Circle		Ft. Myers	FL	33908	07/28/2015	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Formulary Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	General Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Government Relations Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/24/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	HIPAA Privacy Officer	VP, Risk, Quality and Compliance		DeLeon	Juan		7273664144					deleonj@chaptershealth.org	12470 N. Telecom Drive		Temple Terrace	FL	33637	02/04/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	HIPAA Security Officer	Chief Compliance Officer		Zolman	Valerie		3527426890					vzolman@chaptershealth.org	12470 N. Telecom Drive		Temple Terrace	FL	33637	02/03/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Interoperability Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	MA Appeals/Grievances Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/03/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	MA Claims Processing Contact for Public Website			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/24/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Marketing Contact			Hantz	Jordan		2399856400				2394827298	HantzJ@chaptershealth.org	2668 Winkler Ave		Ft. Myers	FL	33901	02/04/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Medical Director	Medical Director	Dr.	El-Menshawi	Marwa		9168739281					melmenshawi@chaptershealth.org	2668 Winkler Ave.		Fort Myers	FL	33901	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Medicare Compliance Officer		mrs	Zolman	Valerie		3527426890				2399856411	vzolman@chaptershealth.org	12470 Telecom Dr Suite 301		Tampa	FL	33637	09/05/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Medicare Coordinator			Iffland	Bill		2399857767					ifflandb@chaptershealth.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/17/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	El-Menshawi	Marwa		9168739281					melmenshawi@chaptershealth.org	2668 Winkler Ave.		Fort Myers	FL	33901	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Medication Therapy Management Contact	Medical Director	Dr.	El-Menshawi	Marwa		9168739281					melmenshawi@chaptershealth.org	2668 Winkler Ave.		Fort Myers	FL	33901	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Online Enrollment Center Contact (Back-up)	Senior Director Pace		Vazquez	Delmaliz		2399856400					vazquezd@chaptershealth.org	2668 Winkler Ave		Fort Myers	FL	33901	11/18/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part C Application Contact	Pace Director		Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Appeals	Pace Director		Vazquez	Delmaliz							lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active	8666597223				PACE - Nat		C	Atlanta
H5934	Part D Application Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Benefits Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Claims Submission Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Exceptions Contact			Vazquez	Delmaliz							lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active	8666597223				PACE - Nat		C	Atlanta
H5934	Part D Price File Contact (Back-up)			Vazquez Ayala	Lissie		2399856405					lissie.vazquesayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/15/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Price File Contact (Primary)			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Quality Assurance Contact			Vazquez Ayala	Lissie		2399856400				2399856411	lissie.vazquesayala@hopehcs.org	2668 Winkler Ave		Fort Myers	FL	33901	05/01/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Part D Reporting Contact	Director of Accounting		Iffland	Bill		2394824673	17767			2399856411	bill.iffland@hopehcs.org	9470 HealthPark Circle		Ft. Myers	FL	33908	03/04/2016	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Patient Safety Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/24/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Payment Contact	Director of Accounting		Iffland	Bill		2399857767				2394259800	Bill.Iffland@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33901	05/03/2013	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Pharmacy Director			Murphy	Brenna		8568404854					bmurphy@careventionhc.com	228  Strawbridge Drive		Moorestown	NJ	08057	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Pharmacy Network Management Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Pharmacy Technical Help Desk Contact			Murphy	Brenna							bmurphy@careventionhc.com	228  Strawbridge Drive		Moorestown	NJ	08057	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active	8568404854				PACE - Nat		C	Atlanta
H5934	PHR Beneficiary Contact																	02/06/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE	Hope HealthCare Services	Chapters Health System, Inc.	878	Yes	Active	8008351673				PACE - Nat		C	Atlanta
H5934	Plan Directory Contact for Public Website			Vazquez	Delmaliz		2399856400					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	03/31/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Plan to Plan Reconciliation Contact		Mr.	Iffland	Bill		2399857767					bill.iffland@hopehcs.org	9470 HealthPark Circle		Fort Myers	FL	33908	03/03/2017	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Processor Contact			Vazquez	Delmaliz		2399856400					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	03/31/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Quality Contact			Vazquez	Delmaliz		8554543104					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Ft. Myers	FL	33901	04/24/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Reconciliation Contact	Director of Accounting		Iffland	Bill		2399857767				2394259800	Bill.Iffland@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33901	03/15/2012	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Recovery Audit Contact	Director of Accounting	Mr.	Iffland	Bill		2399857767				2394259800	Bill.Iffland@hopehospice.org	9470 HealthPark Circle		Fort Myers	FL	33901	03/15/2012	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Surveillance Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	System Contact	Pace Director		Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	02/19/2024	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Third Party Administrator (TPA) Liaison	Director PACE Finance and Health Plan Management		Iffland	Bill		2399857767					bill.iffland@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	05/16/2025	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	User Access Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Utilization Management Contact			Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5934	Utilization Review Contact		Mr.	Vazquez	Delmaliz		2399856402					lissie.vazquezayala@hopehcs.org	2668 Winkler Avenue		Fort Myers	FL	33901	04/19/2023	2026	HOPE HOSPICE AND COMMUNITY SERVICES, INC.	National PACE	Hope PACE	National PACE		Chapters Health System, Inc.	878	Yes	Active					PACE - Nat		C	Atlanta
H5937	Agent/Broker Compensation Data Contact	Vice President Strategy & Product Management		Hounchell	Dan		6126763530					dhounchell@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Automated TrOOP Balance Transfer Contact	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Backup User Access Contact	Medicare Policy Specialist		Paciorek	Joshua		6122945225					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Best Available Evidence Contact	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					ldolan@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Bid Audit Contact	Corporate Actuary		Uding	Chris		6126763372					cuding@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Bid Audit Site Contact	Corporate Actuary		Uding	Chris		6126763372					cuding@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Bid Primary Contact	Corporate Actuary		Uding	Chris		6126763372					bids@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	CAP Report Contact for Public Website	Regulatory Audit Manager		Bons	Nicole		6122945889					nbons@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Marden-Resnik	Ms. Hilary		6126763302					hmarden-resnik@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Marden-Resnik	Ms. Hilary		6126763302					hmarden-resnik@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	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		6126763217				6126766501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Chief Operating Officer	SVP and Chief Administrative Officer	Ms.	Schmitt	Pat		6126763460					pschmitt@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Chief Information Officer	Chief Information Officer	Mr	McDonald	Darin		9493098524					dmcdonald@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Chief Information Security Officer	Chief Information Security Officer, Director	Mr	Wiech	Justin		6126765218					jwiech@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	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 Senior Manager		Randolph	Takeisha		6122945906					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Complaints Tracking Contact	A&G Senior Manager		Randolph	Takeisha		6122945906					trandolph@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Contact for Fraud Investigations	SIU Senior Manager		Monson	Peter		6126763373					pmonson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Coordination of Benefits Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Corporate Mailing						6126766500				6126766501	sschwartz@ucare.org	UCare	500 Stinson Boulevard NE	Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Customer Service Operations Contact	Business Analyst		Pena	Jennifer		6122945251					jstromquist@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	DIR Contact	Actuarial Services Manager		Ordansky	Nathan		6122945999					nordansky@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	DIR Contact (Secondary)	Principal Analyst		Litzow	Jina		6122943344					jlitzow@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Discount Program Payment Contact	Accountant Senior		Ly	Tong		6126277157					tly@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Emergency Part D Contact	Business Analyst		Pena	Jennifer		6122945251					jstromquist@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Emergency Part D Contact (Secondary)	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030					anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment & Revenue Associate Director		Olberding	Milissia		6126763205					molberding@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Enrollment Contact	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					ldolan@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	EOB Transfer Contact	Business Analyst		Pena	Jennifer		6122945251				6128842145	jstromquist@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Financial Audit Contact	Controller	Mr.	Marshall	Greg		6126763213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Financial Reporting Contact	Controller		Marshall	Greg		6126763213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Formulary Contact	Pharmacy Formulary Manager		Merk	Zachariah		6126763483					zmerk@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Formulary Contact (Secondary)	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	General Contact	Medicare Policy Specialist		Wood	Nakia		6122945668					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Government Relations Contact	Medicare Policy Specialist Senior		Vang	Julie		6122945654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	HIPAA Privacy Officer	Associate General Counsel - Privacy Officer		Heacox	Katie		5073408378					kheacox@ucare.org	500 Stinson Boulevard NE		Minneapolos	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	HIPAA Security Officer	Chief Information Security Officer, Director		Wiech	Justin		6122945218					jwiech@ucare.org	500 Stinson Boulevard NE		Minneapolos	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Hospice Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030					anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Interoperability Contact	Associate General Counsel		Roller	Melissa		6126763616					mroller@ucare.org	500 Stinson Blvd NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	MA Appeals/Grievances Contact	A&G Senior Manager		Randolph	Takeisha		6122945906					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	MA Claims Processing Contact for Public Website	CCO Audit & Compliance Manager		Tenhoff	Reed		6126763664					rtenhoff@ucare.og	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Marketing Contact	Government Relations Materials Coordinator Senior		Morales	Ana Sophia		6122945641					amorales@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Medical Director	Senior VP Chief Medical Officer		Emiru	Tenbit		6122945865					temiru@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Medicare Compliance Officer	VP, Dep General Counsel & Chief Compliance Officer	Mrs.	Slaughter	Angela		6122945934					aslaughter@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Medicare Coordinator	Medicare Team Manager		Berglund	Marie		6126763598					mberglund@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacy Manager		Nelson	Adam		6122945030					anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Medication Therapy Management Contact	Pharmacy Quality Manager		Bower	Erika		6122945800				6128842321	ebower@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	OffShore Subcontractor Contact	Medicare Policy Specialist		Paciorek	Joshua		6122945225					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Online Enrollment Center Contact (Back-up)	MBE Operations Director		Rooney	Courtney		6126763468					crooney@ucare.org	500 Stinson Blvd NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Online Enrollment Center Contact (Primary)	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					ldolan@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part C Application Contact	Medicare Team Manager		Berglund	Marie		6126763598					mberglund@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part C Reporting Contact	Regulatory Audit Manager		Bons	Nicole		6122945889					nbons@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Appeals	A&G Senior Manager		Randolph	Takeisha							cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	6122945906				HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Appeals Contact (Secondary)	Supervisor Appeals & Grievances		Johnsen	Sarah							sjohnsen@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	6122945292				HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Application Contact	Medicare Team Manager		Berglund	Marie		6126763598					mberglund@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Benefits Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Claims Submission Contact	Financial Analyst		Jackson	Lyndsey		6126073663					ljackson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Exceptions Contact	Clinical Pharmacy Associate Director		Nelson	Adam						6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	6122945030				HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Exceptions Contact (Secondary)	Clinical Pharmacy Manager		Nelson	Adam						6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	6122945030				HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Price File Contact (Back-up)	Pharmacy Operations Manager Sr.		Lex	Brian		6122945907				6128842263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Price File Contact (Optional)	Medicare Policy Specialist Senior		Vang	Julie		6122945654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Price File Contact (Primary)	Government Programs		Noel	Bailee		5122313140					plan.finder@navitus.com	361 Integrity Drive		Madison	WI	53717	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Quality Assurance Contact	Vice President Pharmacy Management		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Part D Reporting Contact	Regulatory Audit Manager		Bons	Nicole		6122945889					nbons@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Patient Safety Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Payment Contact	Chief Financial Officer		Monsrud	Beth		6126763217				6126766501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Pharmacy Director	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Pharmacy Network Management Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Pharmacy Technical Help Desk Contact	Sr Manager Customer Care Accounts		Nett	Danielle							Danielle.Nett@Navitus.com	1025 West Navitus Dr		Appleton	WI	54913	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	8338374300				HMO - Health Maintenance Organization		C	Chicago
H5937	Pharmacy Technical Help Desk Contact (Secondary)	Sr Director Customer Care		Visco	Victoria							victoria.visco@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active	8338374300				HMO - Health Maintenance Organization		C	Chicago
H5937	PHR Beneficiary Contact																	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS	UCare	UCare Minnesota	238	Yes	Active	8775231515				HMO - Health Maintenance Organization		C	Chicago
H5937	Physician Incentive Contact	Senior VP Chief Medical Officer		Emiru	Tenbit		6122945865					temiru@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Plan Directory Contact for Public Website	Business Analyst		Pena	Jennifer		8559314851					providerassistancecenterMA@aspirushealthplan.com	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		6126763213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Processor Contact	Pharmacy Operations Manager Sr		Lex	Brian		6122945907				6128842263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Quality Contact	Vice President Quality Management		Hanley	Greg		6122945296					ghanley@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Reconciliation Contact	Actuarial Services Manager		Ordansky	Nathan		6122945999					nordansky@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Reconciliation Contact (Secondary)	Principal Analyst		Litzow	Jina		6122943344					jlitzow@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Recovery Audit Contact	Chief Reg Internal Audit Off & Comp Director	Mr.	Schach	Steve		6126763562					sschach@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	554132615	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	SNP Application Contact	Medicare Team Manager		Berglund	Marie		6126763598					MedicareGRLeadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	SNP State Contact	Medicare Team Manager		Berglund	Marie		6126763598					MedicareGRLeadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Surveillance Contact	Medicare Policy Specialist Senior		Vang	Julie		6122945654					MedicareGRLeadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	System Contact	Chief Information Security Officer, Director		Wiech	Justin		6122945218					jwiech@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Third Party Administrator (TPA) Liaison	Accountant Senior		Ly	Tong		6126277157					tly@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	User Access Contact	Medicare Policy Specialist		Wood	Nakia		6122945668					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Utilization Management Contact	Director, Utilization Management		Williams	Amanda		6122945527					awilliams4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5937	Utilization Review Contact	Clinical Regulatory Lead		Brown	Julie	B	6126763433					jbbrown@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	UCARE MINNESOTA	Local CCP	UCare	HMO/HMOPOS		UCare Minnesota	238	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5938	Agent/Broker Compensation Data Contact	Director of Sales & Account Management	Mr.	Hicks	Mark	S	8503833540					mshicks@chp.org	PO Box 15349		Tallahassee	FL	32317	09/25/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations	Mrs.	Cain	Christina		6127771330				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Backup User Access Contact	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Best Available Evidence Contact	Director of Enrollment	Mr.	Sanquintin	Gabe	A	8503833502					gasanquintin@chp.org	P.O. Box 15349		Tallahassee	FL	32317	09/25/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Bid Audit Contact	CFO	Mr.	Bedenbaugh	Jeff	Y	8503833306				8503833441	jybedenbaugh@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Bid Audit Site Contact	CFO	Mr.	Bedenbaugh	Jeff	Y	8503833306				8503833441	jybedenbaugh@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Bid Primary Contact	CFO	Mr.	Bedenbaugh	Jeff	Y	8503833306				8503833441	jybedenbaugh@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	CAP Report Contact for Public Website	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	CEO - CMS Administrator Contact	President & Chief Executive Officer	Mr.	Bass	Sabin	C	8503833492				8503833497	scbass@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	CEO - Senior Official for Contracting	President & Chief Executive Officer	Mr.	Bass	Sabin	C	8503833492				8503833497	scbass@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Chief Financial Officer	CFO	Mr.	Bedenbaugh	Jeff	Y	8503833306				8503833441	jybedenbaugh@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Chief Operating Officer	President and Chief Operating Officer	Mr.	Bass	Sabin	C	8503833492				8503833497	scbass@chp.org	P O Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Chief Information Officer	Sr VP Chief Information Officer	Mr	Smith	Eric	M	8503833431				8503833441	emsmith@chp.org	P .O. Box 15349		Tallahassee	FL	32317	01/25/2016	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Chief Information Security Officer	Sr VP Chief Information Officer	Mr.	Smith	Eric	M	8503833431				8503833441	emsmith@chp.org	P O Box15349		Tallahassee	FL	32317	03/14/2016	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	CMS Casework Communication Contact	Director, Member Services	Ms.	Mackey	Felecia		8505237302				8503833339	ffmackey@chp.org	PO Box 15349		Tallahassee	FL	32317	08/15/2011	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Complaints Tracking Contact	Member Services Director	Ms	Mackey	Felecia		8505237302				8503833339	ffmackey@chp.org	P.O. Box 15349		Tallahassee	FL	32308	05/11/2015	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Contact for Fraud Investigations	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	PO Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Coordination of Benefits Contact	Director, PBM Operations	Mrs.	Cain	Christina		6127771330				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	12/31/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Corporate Mailing						8503833311				8503833339	tpglennon@chp.org	P.O. Box 15349		Tallahassee	FL	32317	01/26/2017	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Customer Service Operations Contact	Director, Member Services	Ms.	Mackey	Felecia		8503833311				8503833338	ffmackey@chp.org	P.O. Box 15349		Tallahassee	FL	32317	12/05/2019	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	DIR Contact	Actuarial Services Director	Ms.	Cornman	Adriel	W	8505237481				8503833441	awcornman@chp.org	P.O. 15349		Tallahassee	FL	32317	07/17/2023	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	DIR Contact (Secondary)	Actuarial Analyst	Ms	Dolly	Elaine	M	8505235619				8505237326	emdolly@chp.org	P O Box 15349		Tallahassee	FL	32317	03/13/2017	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Discount Program Payment Contact	Controller		Bawek	Paul	A	8503833427				8503833441	pabawek@chp.org	P.O. Box 15349		Tallahassee	FL	32308	12/13/2018	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Electronic Health Record Contact	Associate Medical Director	Dr	Omotayo	Adekunle	F	8505237242				8503833497	afomotayo@chp.org	P. O. Box 15349		Tallahassee	FL	32317	08/04/2014	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Emergency Part D Contact	Pharmacist		Nacin	Renee		8503833506					crnacin@chp.org	PO Box 15349		Tallahassee	FL	32317	12/31/2020	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Emergency Part D Contact (Secondary)	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	02/05/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Data Services Manager	Ms	Grabowski	Rebecca	A	8505235610				8503833441	ragrabowski@chp.org	P.O.Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Enrollment Contact	Director of Enrollment	Mr.	Sanquintin	Gabe	A	8503833502					gasanquintin@chp.org	P.O. Box 15349		Tallahassee	FL	32317	09/25/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	EOB Transfer Contact	Manager, PBM Operations	Mrs.	Cain	Christina		6127771330				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Financial Audit Contact	Director of Internal Audit	Mrs.	Snyder	Janet	E	8505237288					jesnyder@chp.org	P.O. Box 15349		Tallahassee	FL	32317	09/25/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Financial Reporting Contact	Comptroller	Mr.	Bawek	Paul		8503833427				8503833441	pabawek@chp.org	P.O. Box 15349		Tallahassee	FL	32317	04/13/2009	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Formulary Contact	Pharmacist		Nacin	Renee		8503833506					crnacin@chp.org	PO Box 15349		Tallahassee	FL	32317	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	General Contact	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	PO Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Government Relations Contact	President and Chief Executive Officer	Mr.	Bass	Sabin	C	8503833492				8503833497	scbass@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	HIPAA Privacy Officer	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	03/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	HIPAA Security Officer	Sr. Vice President, Chief Information Officer	Mr.	Smith	Eric		8503833431				8503833441	emsmith@chp.org	P.O. Box 15349		Tallahassee	FL	32317	04/13/2009	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Hospice Contact	Manager Medication Management Services	Mrs.	Duncan	Anne	A	8505235648				8503833413	amduncan@chp.org	PO BOX 15349		Tallahassee	FL	32317	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Interoperability Contact	Compliance and Privacy Officer	Mr.	Kaminski	Frank		8505237304					fckaminski@chp.org	PO Box 15349		Tallahassee	FL	32317	04/13/2022	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	MA Appeals/Grievances Contact	Grievance and Appeals Manager	Ms.	Alexander	Suzie	M	8505235680				8503833413	appeals@chp.org	P.O. Box 15349		Tallahassee	FL	32317	10/23/2018	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	MA Claims Processing Contact for Public Website	CFO	Mr.	Bedenbaugh	Jeff	Y	8503833306				8503833441	jybedenbaugh@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Marketing Contact	Director of Sales & Account Management	Mr.	Hicks	Mark	S	8503833540					mshicks@chp.org	P.O. Box 15349		Tallahassee	FL	32317	09/25/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Medical Director	Medical Director	Dr.	Omotayo	Adekunle	F	8505237242				8503833497	afomotayo@chp.org	P.O. Box 15349		Tallahassee	FL	32317	10/03/2017	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Medicare Compliance Officer	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Medicare Coordinator	Compliance and Privacy Officer	Mr	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	12/30/2022	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Medication Therapy Management Contact	Supervisor MTM Case/Care Management	MR.	Helbling	Matthew		8666862223				8666862220	MTM.leadership@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55120	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Online Enrollment Center Contact (Back-up)	Sr. Enrollment Rep	Ms.	Dorsey	Ossie		8503833459				8505237369	ohdorsey@chp.org	P.O. Box 15349		Tallahassee	FL	32317	04/13/2009	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Online Enrollment Center Contact (Primary)	Director of Enrollment	Mr.	Sanquintin	Gabe	A	8503833502					gasanquintin@chp.org	P.O. Box 15349		Tallahassee	FL	32317	09/25/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part C Application Contact	Sr. VP Marketing and Admin Services	Mr	Glennon	Tom		8503833393				8505237261	tpglennon@chp.org	PO Box 15349		Tallahassee	FL	32317	01/12/2015	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part C Reporting Contact	Compliance & Privacy Officer	Mr.	Kaminski	Frank	C	8505237304					fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	09/25/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Appeals	Regulatory Pharmacist		Emerson	Kimberly						8006936703	Clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55120	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Keiser	Katrina						8006936703	Clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55120	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Application Contact	Sr. VP Marketing and Admin Services	Mr	Glennon	Tom		8503833393				8505237261	tpglennon@chp.org	PO Box 15349		Tallahassee	FL	32317	01/12/2015	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Benefits Contact	Sr. Director, Benefits Operations	Mrs.	Icaza	Ashley		5073018360					Ashley.icaza@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Claims Submission Contact	Functional Business Consultant-Government Programs	Mr.	Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2022	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Exceptions Contact	Regulatory Director		Davis	Megan						8006936703	Clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	Clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55120	12/30/2022	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr.	Mrs.	Trudeau	Ashley		6127771338					Ashley.trudeau@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	12/30/2022	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Price File Contact (Optional)	Price File Analyst	Mrs.	Tastad	Emily		6127771699					emily.tastad@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Price File Contact (Primary)	Compliance Officer	Mr.	Kaminski	Frank		8505237304					fckaminski@chp.org	PO Box 15349		Tallahassee	FL	32317	03/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Quality Assurance Contact	Pharmacist		Nacin	Renee		8503833506					crnacin@chp.org	PO Box 15349		Tallahassee	FL	32317	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Part D Reporting Contact	Manager Medication Management Services	Mrs.	Duncan	Annne	M	8505235648					amduncan@chp.org	P.O. Box 15349		Tallahassee	FL	32317	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Patient Safety Contact	Pharmacist		Nacin	Renee		8503833506					crnacin@chp.org	PO Box 15349		Tallahassee	FL	32317	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Payment Contact	CFO	Mr.	Bedenbaugh	Jeff	Y	8503833306				8503833441	jybedenbaugh@chp.org	P.O. Box 15349		Tallahassee	FL	32317	06/04/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Pharmacy Director	Pharmacist		Nacin	Renee		8503833506					crnacin@chp.org	PO Box 15349		Tallahassee	FL	32317	12/31/2020	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Pharmacy Network Management Contact	VP Network  Management	Ms.	Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Pharmacy Network Management Contact (Secondary)	Senior Director Network Client Services	Ms.	Hanley	Megan		6127773969					megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	12/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Pharmacy Technical Help Desk Contact	Sr. Director Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8665903010				HMO - Health Maintenance Organization		C	Dallas
H5938	Pharmacy Technical Help Desk Contact (Secondary)	Director Member Services	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	01/06/2025	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active	8665903010				HMO - Health Maintenance Organization		C	Dallas
H5938	Physician Incentive Contact	Medical Director	Dr.	Omotayo	Adekunle	F	8505237242				8503833497	afomotayo@chp.org	P.O. Box 15349		Tallahassee	FL	32317	05/13/2019	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Plan Directory Contact for Public Website	Network Services Supervisor	Ms.	Maige	Beth		8505237307				8503833413	emmaige@chp.org	P.O. Box 15349		Tallahassee	FL	32317	04/13/2009	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Plan to Plan Reconciliation Contact	Actuarial Services Director	Ms.	Cornman	Adriel	W	8505237481				8503833441	awcornman@chp.org	P.O. 15349		Tallahassee	FL	32317	10/19/2023	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Processor Contact	Director, PBM Operations	Mrs.	Allie	Cindy		6127776722				6127776706	Medicareclaimresearch@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	12/30/2022	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Quality Contact	Director, Quality Improvement	Ms	Goble	Mary	A	8503833498				8505237320	magoble@chp.org	P.O. Box 15349		Tallahassee	FL	32317	12/27/2018	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Reconciliation Contact	Actuarial Services Director	Ms.	Cornman	Adriel	W	8505237481				8503833441	awcornman@chp.org	P. O. Box  15349		Tallahassee	FL	32317	02/16/2024	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Reconciliation Contact (Secondary)	Actuarial Analyst ll	Ms	Dolly	Elaine	M	8505235619				8503833441	emdolly@chp.org	P O Box 15349		Tallahassee	FL	32317	03/13/2017	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Recovery Audit Contact	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Surveillance Contact	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	System Contact	Sr. Vice President, Chief Information Officer	Mr.	Smith	Eric		8503833431				8503833441	emsmith@chp.org	P.O. Box 15349		Tallahassee	FL	32317	04/13/2009	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Third Party Administrator (TPA) Liaison	Accountant	Ms	Williams	Camise	Q	8505237253				8503833441	cqwilliams@chp.org	P. O . Box 15349		Tallahassee	FL	32317	09/27/2018	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	User Access Contact	Compliance and Privacy Officer	Mr.	Kaminski	Frank	C	8505237304				8505237419	fckaminski@chp.org	P.O. Box 15349		Tallahassee	FL	32317	11/15/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Utilization Management Contact	Director Care Coordination	Mrs.	Davis	Brenda	G	8505237301				8503833310	bgdavis@chp.org	P.o. Box 15349		Tallahassee	FL	32317	03/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5938	Utilization Review Contact	Director Care Coordination	Mrs.	Davis	Brenda	G	8505237301				8503833310	bgdavis@chp.org	P.o. Box 15349		Tallahassee	FL	32317	03/30/2021	2026	CAPITAL HEALTH PLAN	Local CCP	Capital Health Plan	HMO/HMOPOS		Guidewell Mutual Holding Corporation	594	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5943	Agent/Broker Compensation Data Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Best Available Evidence Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/28/2019	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	CEO - CMS Administrator Contact	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	CEO - Senior Official for Contracting	Chief Executive Officer	Dr.	Jain	Sachin		5629898314				5629895225	sjain@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/30/2020	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Chief Financial Officer	Chief Financial Officer	Mr	Plumb	Michael		5629971589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/02/2020	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Chief Information Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	CMS Casework Communication Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Complaints Tracking Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2012	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	05/27/2014	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459				5629890101	tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/03/2016	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	DIR Contact (Secondary)	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/27/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/31/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/21/2022	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Employer Waiver Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Encounter Data & Risk Adjustment Operations Contact	Chief Data Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	04/17/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Enrollment Contact	Director, Enrollment & Reconciliation		Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/28/2019	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Financial Audit Contact	Regulatory Audits, Lead	Mrs.	Mendoza	Kirsten		5623084363	4363			5629895120	kascio@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/04/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2012	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/21/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	General Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Government Relations Contact	VP of Government Relations		Kazan	Matt		8005593500				5629899439	m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	MA Appeals/Grievances Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/02/2021	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Medical Director	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Medicare Compliance Officer	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/19/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195					c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	OffShore Subcontractor Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/31/2015	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/09/2022	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part C Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part C Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Appeals	Sr. Director of Grievances and Appeals		Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active	5626371290	1290			HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization		Herbert	Joshua						5629890958	Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	1290			HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	04/29/2021	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	12/01/2021	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4348			5629973196	a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/01/2021	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Part D Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2012	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/23/2023	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H5943	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/03/2020	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/09/2019	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Processor Contact	Senior Director Government Programs, Medicare	Ms.	Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/03/2018	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/02/2015	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Recovery Audit Contact	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131	3131			5629895120	ECordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	SNP Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	SNP State Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Surveillance Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/17/2018	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	User Access Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5943	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN	Local CCP	VillageHealth	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5945	Agent/Broker Compensation Data Contact	Vice President of Medicare Sales	Mr.	Tolle	Rob		4699997675					Rob.Tolle@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Manosca	Nova		8587905873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Backup User Access Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Best Available Evidence Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Bid Audit Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Bid Audit Site Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Bid Primary Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	CAP Report Contact for Public Website	VP, Compliance & Risk Management		von Arx	Michael	A	7757709348					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	7757709348				HMO - Health Maintenance Organization		C	Boston
H5945	CEO - CMS Administrator Contact	CEO	Mr	Jemmoua	Kamal		7757709325					kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	CEO - Senior Official for Contracting	CEO	Mr.	Jemmoua	Kamal		7757709325					kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Chief Financial Officer	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Chief Operating Officer	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Chief Information Officer		Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Chief Information Security Officer	CISO - UHS	Mrs.	Sassaman	Kim		6103824858					kim.sassaman@uhsinc.com	367 S Gulph RD		King of Prussia	PA	19406	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	CMMI Model Point of Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	CMS Casework Communication Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Complaints Tracking Contact	Director of Operations		Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Contact for Fraud Investigations	SIU Investigator	Mrs.	Kast	Shannon		7754204840					Shannon.Kast@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Coordination of Benefits Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Corporate Mailing						7757709245					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Customer Service Operations Contact	Chief Operating Officer		Koltz	Patrick		7757709240					patrick.koltz@uhsinc.com	1510 Meadow Wood Ln		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	DIR Contact	CEO	Mr	Jemmoua	Kamal		6109924579				7757709360	kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	DIR Contact (Secondary)	Director Pharmacy	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Discount Program Payment Contact	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89052	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Electronic Health Record Contact	Director Health Services		Estipona	Steve		7757709462					steve.estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Emergency Part D Contact	Director Pharmacy	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Emergency Part D Contact (Secondary)	Pharmacy Liaison - Compliance		Harvey	Jonathan		7242945245					jonathan.harvey@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Employer Waiver Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Encounter Data & Risk Adjustment Operations Contact	Director of Quality Improvement		Martinez	Johanna		7757709524					johanna.martinez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	01/10/2025	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Enrollment Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	EOB Transfer Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240				9999999999	Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Financial Audit Contact	Compliance Analyst	Mrs	Cortez	Adrienne		7757709300					phpregulatory@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	09/25/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Financial Reporting Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Formulary Contact	Sup Formulary Operations		Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Formulary Contact (Secondary)	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	General Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Government Relations Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	HIPAA Privacy Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	HIPAA Security Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Hospice Contact	Health Services Director		Estipona	Steve		7757709462					Steve.Estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Interoperability Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	MA Appeals/Grievances Contact	Director of Operations		Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	MA Claims Processing Contact for Public Website	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Marketing Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Medical Director	Chief Medical Director	Dr.	Biondi	Traci		7757701510					traci.biondi@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Medicare Compliance Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Medicare Coordinator	Compliance Analyst	Mrs.	Cortez	Adrienne		7757709300					PHPCompliance@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	10/01/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Medicare Part D Opioid Overutilization Contact	Audit Team		Audit Team	FA Part D		8587905846					FA_Part_D_Audit@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/11/2025	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Medication Therapy Management Contact	Clinical Solutions Mgr II		Nguyen	Linh		8587906627					MTMP@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	OffShore Subcontractor Contact	VP Compliance and Risk Management	Mr.	von Arx	Michael		7757709245					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Online Enrollment Center Contact (Back-up)	Director of Medicare Sales	Ms.	Saintil	Adrienne		7757701564					Adrienne.Saintil@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Online Enrollment Center Contact (Optional)	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Online Enrollment Center Contact (Primary)	Vice President of Medicare Sales	Mr.	Tolle	Rob		4699997675					Rob.Tolle@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part C Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part C Reporting Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part D Appeals	Part D Appeals 1		and Grievances Team	Appeals							appealgrievancesmanagement@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587906584				HMO - Health Maintenance Organization		C	Boston
H5945	Part D Appeals Contact (Secondary)	Part D Appeals 2		Redd Guinto	Karen							karen.reddguinto@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587906584				HMO - Health Maintenance Organization		C	Boston
H5945	Part D Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part D Benefits Contact	Director of Pharmacy		Huang	David		3177528432					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part D Claims Submission Contact	Supervisor, GPS Operations		Distel	Chris		3302127994					PDE@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part D Exceptions Contact	Director Prior Authorization and Utilization Mgmt		Emoto	Junianne							Julianne.Emoto@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Boston
H5945	Part D Exceptions Contact (Secondary)	Pharmacist in Charge		deGuzman	Edwin							Edwin.deGuzman@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8582915494				HMO - Health Maintenance Organization		C	Boston
H5945	Part D Price File Contact (Back-up)	Medicare Part D Program MGR I		Niemi	Kristin		8587906455					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part D Price File Contact (Primary)	Medicare Part D Program Manager II		Keller	Shannon		8587907104					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part D Quality Assurance Contact	Director Pharmacy		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Part D Reporting Contact	Medicare Part D Project Manager		Scott	Susan		8587906565					MedicarePartDProjectManagers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Patient Safety Contact	Pharmacy Director	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Ren	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Payment Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Pharmacy Director	Pharmacy Director	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Ren	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Pharmacy Network Management Contact	Supervisor, Carrier Configuration		Montes	Melissa		6195995938					Melissa.Montes@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Pharmacy Network Management Contact (Secondary)	Manager, PNS & Claims Operations		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/29/2025	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8445877389				HMO - Health Maintenance Organization		C	Boston
H5945	Pharmacy Technical Help Desk Contact (Secondary)	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	01/29/2025	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8445877389				HMO - Health Maintenance Organization		C	Boston
H5945	Physician Incentive Contact	Director of Network Management	Jr	Maronde	James		7757709300					james.marondejr@uhsinc.com	639 Isbell Road Ste. 400		Reno	NV	89509	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Plan Directory Contact for Public Website	Marketing Director		Koltz	Danielle		7757709302					Danielle.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Processor Contact	Director, Medicare Programs		Davis-Jones	DeLona		8587906229					DeLona.Davis-Jones@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Quality Contact	Director of Quality Improvement		Martinez	Johanna		7757709524					johanna.martinez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Reconciliation Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Reconciliation Contact (Secondary)	Chief Finance Officer	Mr.	Hsieh	David		6103824858					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Recovery Audit Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	SNP Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	SNP State Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Surveillance Contact	Director of Operations	Ms.	Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	System Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Third Party Administrator (TPA) Liaison	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89052	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	User Access Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Utilization Management Contact	Manager, QA & Client Services		Nguyen	Quan		8587907151					Quan.nguyen@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5945	Utilization Review Contact	Dir PA Clinical Programs		McGurran	Shawn		8587906682					Shawn.McGurran@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	08/15/2024	2026	PROMINENCE HEALTHFIRST	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5959	Agent/Broker Compensation Data Contact	Mgr Sales Commission & Analytics		Bruggemann	Brad		6516623870					bradford.bruggemann@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/02/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management		Chesling	Beth		6127776722				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Backup User Access Contact	Compliance		Nordwall	Darlene		6516628745					darlene.nordwall@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/30/2024	2026	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		6516623468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/03/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Bid Audit Contact	Asst. Actuary		Zeterlu	Angela		6516620420					angela.zeterlu@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Bid Audit Site Contact	Asst. Actuary		Zeterlu	Angela		6516620420					angela.zeterlu@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Bid Primary Contact	Asst. Actuary		Zeterlu	Angela		6516620420					angela.zeterlu@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	CAP Report Contact for Public Website	Government Compliance Officer		Hogan	Carrie		6516621900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	CEO - CMS Administrator Contact	President & Chief Executive Officer	Ms.	Erickson	Dana		6516621000					Dana.erickson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	CEO - Senior Official for Contracting	VP Medicare	Mr.	Boles	Chris		6516628340					Chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/31/2024	2026	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		6516629501					John.Uribe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	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 Operating Officer	Chief Operating Officer	Mr.	Im	David		6516629275					David.im@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/10/2025	2026	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 Information Officer	Chief Information Officer	Mr	Flicek	Melissa		6516629995					melissa.flicek@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	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 Information Security Officer	VP Digital Platforms & Cybersecurity	Mr	Groshong	Chris		6516628786					Christopher.Groshong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/12/2023	2026	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 Appeals & Grievances		Bazzarre	Tom		6516629643					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/14/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Complaints Tracking Contact	Manager Appeals & Grievances		Bazzarre	Tom		6516629643					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/14/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Contact for Fraud Investigations	Director Operational Risk Management Performance		Dickinson	Richard	A	6516623532					richard.dickinson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	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		6516623468					government.program.service.request@bcbsmn.com	3400 Yankee Dr		Eagan	MN	55121	01/27/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Corporate Mailing						8663408654					contact@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/16/2018	2026	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		6516628864					denise.hovick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	DIR Contact	Managing Actuary-Actuarial		Santa	Tyler		6516628362					Tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/15/2024	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	DIR Contact (Secondary)	Financial Analyst, Sr		Voves	Alex		6516623606					alex.voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Discount Program Payment Contact	Financial Analyst Sr		Voves	Alex		6516623606					Alex.Voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Electronic Health Record Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Emergency Part D Contact	Director, Pharmacy Ops Support		Ibrahim	Sonya		6516627412					sonya.ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Mitchell	Angela		6516623607					angela.mitchell@clearstonesolutions.com	3400 Yankee Drice		Eagan	MN	55121	12/29/2019	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Employer Waiver Contact	Director Gov't Program Management for Medicare		Hower	Sara		6516624156					sara.hower@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/04/2019	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Encounter Data & Risk Adjustment Operations Contact	VP Medicare	Mr.	Boles	Chris		6516628340					Chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Enrollment Contact	Mgr Business Infrastructure Services		McWaters	Alisha		6516621755					alisha.mcwaters@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	EOB Transfer Contact	Mgr Project & Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Financial Audit Contact	Manager, Regulatory Internal Audit	Mr	Haile-Selassie	Moguss		6516628966					moguss.haile-selassie@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/09/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Financial Reporting Contact	Dir Sr Corporate Controller		Long	Darlene		6516621704					Darlene.Long@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Formulary Contact	Pharmacist Business Segment Director		Boreen	Donna		6516621264					donna.boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/29/2018	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	General Contact	VP Medicare		Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	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	Chief Lobbyist		Nelson	Lin		6516627123					lin.nelson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	HIPAA Privacy Officer	Privacy Director		Armstrong	Rebecca		6516621865					rebecca.armstrong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/13/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	HIPAA Security Officer	VP Digital Platforms & Cybersecurity	Mr.	Groshong	Chris		6516628786					chris.groshong@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	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		6516629644					beth.dick@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/19/2019	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Interoperability Contact	Chief Information Officer		Flicek	Melissa		6516629995					melissa.flicek@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/21/2024	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	MA Appeals/Grievances Contact	Manager Appeals & Grievances		Bazzarre	Tom		6516623532					Tom.bazzarre@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/13/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	MA Claims Processing Contact for Public Website	Manager, Business Services		Daniels	Cassandra		6516623468					cassandra.daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Marketing Contact	Compliance Manager- Enterprise Ethics & Compliance		Danisch	Gary		6516622072					Medicare.materials@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/08/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Medical Director	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	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		6516621900					carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	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 Coordinator	Manager, Business Services		Daniels	Cassandra		6126623468					Cassandra.Daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/22/2025	2026	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 Part D Opioid Overutilization Contact	Supv Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/07/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Medication Therapy Management Contact	Mgr. Pharmacy Services		Aderinkomi	Anita		6516629221					anita.aderinkomi@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/31/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	OffShore Subcontractor Contact	Government Compliance Officer		Hogan	Carrie		6516621900					Carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/26/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Online Enrollment Center Contact (Back-up)	Manager, Business Services		Daniels	Cassandra		6516623468				6516623500	cassandra.daniels@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Online Enrollment Center Contact (Primary)	Mgr Business Infrastructure Services		McWaters	Alisha		6516621755					alisha.mcwaters@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	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 C Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/07/2022	2026	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 C Reporting Contact	Operations Business Analyst Pr		Littrell	Sue		6516622670					sue.littrell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	05/12/2025	2026	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 Appeals	Regulatory Pharmacist Sr		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	8006936703				PPO - BBA		C	Chicago
H5959	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	5073018360				PPO - BBA		C	Chicago
H5959	Part D Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/07/2022	2026	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 Benefits Contact	Regulatory Pharmacist Sr		Icaza	Ashley		5083018360					ashley.icaza@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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 Claims Submission Contact	Health Data Analyst Sr.		Brooke	Lance		4026862603				4029702545	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	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	Regulatory Pharmacist Sr		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	8006936651				PPO - BBA		C	Chicago
H5959	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	8006936651				PPO - BBA		C	Chicago
H5959	Part D Price File Contact (Back-up)	Business Solution Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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 Price File Contact (Optional)	Price File Analyst		Tastad	Emily		6517771699					emily.tastad@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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 Price File Contact (Primary)	PBM Operations Analyst		Aschoff	Ted		6516628777					theodore.aschoff@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	04/22/2025	2026	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 Quality Assurance Contact	Director, Pharmacy Ops Support		Ibrahim	Sonya		6516627412					Sonya.Ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/29/2019	2026	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 Reporting Contact	Operations Business Analyst Pr		Littrell	Sue		6516622670					sue.littrell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/05/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Patient Safety Contact	Pharmacist Business Segment Director		Boreen	Donna		6516621264					donna.boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/13/2020	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Payment Contact	Dir Sr Corporate Controller		Long	Darlene		6516621704					Darlene.Long@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	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 Director	Pharmacist Business Segment Director		Boreen	Donna		6516621264					Donna.Boreen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/29/2018	2026	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 Network Management Contact	VP Network Management		Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	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 Network Management Contact (Secondary)	AVP Network Relations		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	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	Sr Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Rd	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	8006482778				PPO - BBA		C	Chicago
H5959	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active	8554571209				PPO - BBA		C	Chicago
H5959	PHR Beneficiary Contact																	07/17/2019	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO	Blue Cross and Blue Shield of Minnesota	Aware Integrated, Inc.	642	Yes	Active	8003822000				PPO - BBA		C	Chicago
H5959	Physician Incentive Contact	Dir. Product Mgmt		Hower	Sara		6516624156					Sara.Hower@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/03/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Plan Directory Contact for Public Website	Digital Content Strategist		Cosgrove	Patrick		6516623727					patrick.cosgrove@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/02/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Plan to Plan Reconciliation Contact	Manager, Financial Reporting		Harrelson	Michael		6516628490				6516622200	Michael.Harrelson@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722				6127777606	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/21/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Quality Contact	VP Medicare	Mr.	Boles	Chris		6516628340					chris.boles@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	09/30/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Reconciliation Contact	Managing Actuary-Actuarial		Santa	Tyler		6516628362					Tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/15/2024	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Reconciliation Contact (Secondary)	Healthcare Analyst Principle-Actuarial		Kieffer	Ryan		6516624405					Ryan.kieffer@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	10/26/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Recovery Audit Contact	Government Compliance Officer	Ms.	Hogan	Carrie		6516624405					Carrie.hogan@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/05/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	SNP Application Contact	Product Consultant, Pr		Snyder	Amanda		6516623774					Amanda.Snyder@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/07/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	SNP State Contact	Manager, Special Needs Plan		Kosel	Karla		6516624166					Karla.Kosel@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/03/2022	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Surveillance Contact	manager sales compliance & oversight		Moomey	Kristina		6516621707					kristina.moomey@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/22/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	System Contact	VP Digital Project Engineering	Mr.	Young	Jeffrey		6516626767					Jeffrey.young@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/10/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Third Party Administrator (TPA) Liaison	Financial Analyst Senior		Voves	Alex		6516623606					Alex.Voves@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	08/21/2023	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	User Access Contact	Compliance Manager- Enterprise Ethics & Compliance		Danisch	Gary		6516622072					Gary.danisch@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	05/12/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Utilization Management Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5959	Utilization Review Contact	Chief Medical Officer	Dr	Steffen	Mark		6516623568					mark.steffen@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/08/2025	2026	BCBSM, Inc.	Local CCP	Blue Cross and Blue Shield of Minnesota	Local PPO		Aware Integrated, Inc.	642	Yes	Active					PPO - BBA		C	Chicago
H5965	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H5965	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H5965	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H5965	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H5965	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H5965	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H5965	PHR Beneficiary Contact																	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H5965	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5965	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H5969	Agent/Broker Compensation Data Contact	Sr. Manager of Sales and Business Development	Ms	De Silva	Vicki		8089732479				8089730726	vdesilva@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Automated TrOOP Balance Transfer Contact	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Backup User Access Contact	Compliance Manager	Ms.	Kalawa	Pua		8089731653					pkalawa@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	07/01/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Best Available Evidence Contact	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Bid Audit Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise		8138466424				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Bid Audit Site Contact	Chief Operations Officer	Mr.	Brennan	Patrick		8089731655				8089732625	pbrennan@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Bid Primary Contact	Chief Operations Officer	Mr.	Brennan	Patrick		8089731655				8089732625	Jluper@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	CAP Report Contact for Public Website	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	CEO - CMS Administrator Contact	Chief Operations Officer	Mr.	Brennan	Patrick		8089731655				8089732625	pbrennan@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Culley-Trotman	Francoise	E	8138466424				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Chief Financial Officer	Chief Executive Officer	Ms.	Culley-Trotman	Francoise		8138466424				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Chief Operating Officer	Chief Operations Officer	Mr.	Brennan	Patrick		8089731655				8089732625	pbrennan@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Chief Information Officer	Chief Information Officer	Mr.	Morgan	Todd		8089731711					tmorgan@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Chief Information Security Officer	Chief Information Officer	Mr.	Morgan	Todd		8089731711					tmorgan@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	CMMI Model Point of Contact	Chief Operations Officer	Mr.	Brennan	Patrick		8089731655				8089732632	pbrennan@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	CMS Casework Communication Contact	Sr. VP of Compliance and Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Complaints Tracking Contact	Grievance and Appeals Manager	Ms.	Kamahiai-Macloves	Malia		8089731814				8089732632	mkamahiai-macloves@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Contact for Fraud Investigations	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Coordination of Benefits Contact	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Corporate Mailing						8089732476				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/13/2021	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Customer Service Operations Contact	Senior. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	DIR Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise		8138466424				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	DIR Contact (Secondary)	Financial Planning and Analysis		Team	FPA		8089737481				8089737404	fp&a@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/23/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Discount Program Payment Contact	Director of Financial Operations	Ms.	Miller	Kayla		8089730803				8089737410	Kmiller@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/06/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Emergency Part D Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8082109847				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Emergency Part D Contact (Secondary)	Sr. Pharmacy Manager of Clinical Programs	Ms.	Chock	Evelyn		8087818072				8089736327	echock@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Employer Waiver Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise	E	8089732476				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Encounter Data & Risk Adjustment Operations Contact	Financial Planning and Analysis		Team	FPA		8089737481				8089737404	fp&a@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/23/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Enrollment Contact	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	EOB Transfer Contact	Sr. Claims Manager	Mr	Takamine	Davin		8089730727				8089732140	dtakamine@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Financial Audit Contact	Sr. VP of Compliance and Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Financial Reporting Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise		8138466424				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Formulary Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Formulary Contact (Secondary)	Formulary Analyst	Ms.	Maloney	Julia		2242312718					Julia.Maloney@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	General Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise	E	8089732476				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Government Relations Contact	VP of External Affairs	Ms	Arcena	Paula		8089736426				8089730204	parcena@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	HIPAA Privacy Officer	Sr. VP of Compliance and Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	HIPAA Security Officer	Sr. Systems Architect	Mr.	Rushworth	Robert		8089731567				8089730726	rrushworth@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Hospice Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Interoperability Contact	Chief Information Officer	Mr.	Morgan	Todd		8089731711					tmorgan@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	MA Appeals/Grievances Contact	Grievance and Appeals Manager	Ms	Kamahiai-Macloves	Malia		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	MA Claims Processing Contact for Public Website	Sr. Claims Manager	Mr	Takamine	Davin		8089730727				8089732140	dtakamine@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Marketing Contact	VP of External Affairs	Ms.	Arcena	Paula		8089736426				8089730204	parcena@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Medical Director	Chief Medical Officer	Dr	Okamoto	Gary		8089731564				8089730726	gokamoto@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Medicare Compliance Officer	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Medicare Coordinator	Compliance Manager	Ms.	Kalawa	Pua		8089731653					pkalawa@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr	Okamoto	Gary		8089731564				8089730726	gokamoto@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Medication Therapy Management Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	OffShore Subcontractor Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise	E	8089732476				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Online Enrollment Center Contact (Back-up)	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Online Enrollment Center Contact (Optional)	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Online Enrollment Center Contact (Primary)	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part C Application Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise	E	8089732476				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part C Reporting Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Appeals	Grievance and Appeals Manager	Ms.	Kamahiai-Macloves	Malia						8089732140	mkamahiai-macloves@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	02/12/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active	8089730814				HMO - Health Maintenance Organization		C	Boston
H5969	Part D Appeals Contact (Secondary)	Senior VP of Operations	Mr.	Janicek	Jerome						8089732140	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active	8089736320				HMO - Health Maintenance Organization		C	Boston
H5969	Part D Application Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise	E	8089732476				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Benefits Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Claims Submission Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Exceptions Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh						8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active	8669737418				HMO - Health Maintenance Organization		C	Boston
H5969	Part D Exceptions Contact (Secondary)	Senior Pharmacy Director	Ms.	Bannister	Hanh						8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active	8669737418				HMO - Health Maintenance Organization		C	Boston
H5969	Part D Price File Contact (Back-up)	Plan Finder Analyst	Ms.	Dang-Chau	Diana		7633303252					diana.dang@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Price File Contact (Optional)	Business Change Manager	Ms.	Mendez	Daniela		3232193390				3232193390	daniela.mendez@carelon.com	1723 Loma Road		Montebello	CA	90640	02/08/2023	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Price File Contact (Primary)	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Quality Assurance Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Part D Reporting Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Patient Safety Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Payment Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise		8138466424				8089732625	JLuper@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Pharmacy Director	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Pharmacy Network Management Contact	Senior Pharmacy Director	Ms.	Bannister	Hanh		8089736843				8089736327	hbannister@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Pharmacy Network Management Contact (Secondary)	Chief Medical Officer	Dr	Okamoto	Gary		8089731564				8089730726	gokamoto@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Pharmacy Technical Help Desk Contact	Sr. Manager	Mr.	Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	02/19/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active	8003830589				HMO - Health Maintenance Organization		C	Boston
H5969	Physician Incentive Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Plan Directory Contact for Public Website			Customer Service	AlohaCare		8089736395				8089737410	info@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Plan to Plan Reconciliation Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise		8138466424				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Processor Contact	Sr. Claims Manager	Mr	Takamine	Davin		8089730727				8089732140	dtakamine@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	10/29/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Quality Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	Jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Reconciliation Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise		8138466424				8089732625	JLuper@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	11/28/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Reconciliation Contact (Secondary)	Financial Planning & Analysis		Team	FPA		8089737481				8089737404	fp&a@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/23/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Recovery Audit Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	SNP Application Contact	Chief Executive Officer	Ms.	Culley-Trotman	Francoise	E	8089732476				8089732625	fculley-trotman@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	03/03/2022	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	SNP State Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Surveillance Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	System Contact	Sr. Systems Architect	Mr.	Rushworth	Robert		8089731567				8089730726	rrushworth@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Third Party Administrator (TPA) Liaison	Sr. VP of Operations	Mr.	Janicek	Jerome		8089736320				8089733810	jjanicek@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	User Access Contact	Sr. VP of Compliance & Quality	Ms.	Mellor	June		8089730690				8089737410	jmellor@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	06/05/2024	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Utilization Management Contact	Chief Medical Officer	Mr.	Okamoto	Dr. Gary		8089731564				8089730726	gokamoto@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5969	Utilization Review Contact	Chief Medical Officer	Mr.	Okamoto	Dr. Gary		8089731564				8089730726	gokamoto@alohacare.org	1357 Kapiolani Blvd., Suite G101		Honolulu	HI	96814	08/12/2025	2026	ALOHACARE	Local CCP	AlohaCare	HMO/HMOPOS		AlohaCare	10	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H5970	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H5970	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024989871				PPO - BBA		C	Kansas City
H5970	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H5970	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024682494				PPO - BBA		C	Kansas City
H5970	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8008658715				PPO - BBA		C	Kansas City
H5970	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5025800475				PPO - BBA		C	Kansas City
H5970	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H5970	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Backup User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Bid Primary Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	CAP Report Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Operating Officer	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Information Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Complaints Tracking Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Contact for Fraud Investigations	Executive Director	Mr	Sauers	Robert		6109545433	31167				SLLVDirectors@seniorlifelehighvalley.com	3365 High Point Blvd		Bethlehem	PA	18017	08/26/2024	2026	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		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Corporate Mailing						8145356000	22101			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	DIR Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Discount Program Payment Contact	CFO		Dodson	David	M	8145356000	22102				Ddodson@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/14/2025	2026	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	Emergency Part D Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	10/18/2019	2026	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	Enrollment Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	EOB Transfer Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Formulary Contact			N/A	N/A		1234567890	123				N/A@n/a.com	N/A		N/A	PA	15906	03/24/2014	2026	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	General Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	HIPAA Privacy Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Rankin	Seth		4129630700	144				SRankin@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	10/27/2025	2026	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	Interoperability Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	MIrwin@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	02/16/2022	2026	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	MA Appeals/Grievances Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Marketing Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Medical Director	Medical Director		Collier	AnnElise		6109545433	100				Acollier@PhysicianSolutionsGRP.com	3365 High Point Blvd		Bethlehem	PA	18017	04/19/2023	2026	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		6109545433	31167				SLLVDirectors@seniorlifelehighvalley.com	3365 High Point Boulevard		Bethlehem	PA	18017	08/26/2024	2026	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 Coordinator	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Part D Opioid Overutilization Contact	Medical Director		Collier	AnnElise		6109545433	100				Acollier@PhysicianSolutionsGRP.com	3365 High Point Blvd		Bethlehem	PA	18017	04/19/2023	2026	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	Medication Therapy Management Contact	Chief Executive Officer	Mr.	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/13/2019	2026	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 C Application Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Appeals	Chief Financial Officer	Mr	Dodson	David						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H5978	Part D Appeals Contact (Secondary)	Chief Executive Officer	Mr.	Irwin	Mark						8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	12/29/2020	2026	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active	8145356000	22101			PACE - Nat		C	Philadelphia
H5978	Part D Application Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Benefits Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Claims Submission Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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						8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active	8145356000	22102			PACE - Nat		C	Philadelphia
H5978	Part D Price File Contact (Back-up)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	03/24/2014	2026	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 Price File Contact (Primary)			N/A	N/A		1234567890	123				N/A@N/A.com	N/A		N/A	PA	15906	03/24/2014	2026	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 Quality Assurance Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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 Reporting Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Patient Safety Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Payment Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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 Director			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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 Network Management Contact			Rowland	Bob		7242751203	219				Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	10/03/2016	2026	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	2026	SENIOR LIFE LEHIGH VALLEY, INC.	National PACE	Senior LIFE Lehigh Valley / Reading	National PACE		Senior LIFE Lehigh Valley, Inc.	562	Yes	Active	7242751203	219			PACE - Nat		C	Philadelphia
H5978	Plan Directory Contact for Public Website	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Processor Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	11/13/2025	2026	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	Quality Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Reconciliation Contact	CFO		Dodson	David		8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Recovery Audit Contact	CFO	Mr	Dodson	David	M	8145356000	22102				Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Surveillance Contact			Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	System Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Third Party Administrator (TPA) Liaison	VP Grane PBM		Baker	John		3306968345					jebaker@granepbm.com	209 Sigma Drive		Pittsburgh	PA	15238	03/14/2025	2026	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	User Access Contact	Chief Financial Officer	Mr	Dodson	David		8145356000	22102			8142487902	Ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	01/20/2021	2026	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	Utilization Management Contact	Chief Executive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Utilization Review Contact	ChieExecutive Officer	Mr	Irwin	Mark		8145356000	22101			8142487902	Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	02/23/2017	2026	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	Agent/Broker Compensation Data Contact	VP, Associate General Counsel	Ms.	Jan	Munizeh		6467675166					mjan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Backup User Access Contact	Manager, LTC Programs	Ms.	Duker	Stephanie		3324554464					sduker@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Bid Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Bid Audit Site Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Bid Primary Contact	Director, Medicare Strategy	Ms.	Wheeler	Jillian		2073222422					jiwheeler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	CAP Report Contact for Public Website	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	CEO - CMS Administrator Contact	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	CEO - Senior Official for Contracting	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Chief Financial Officer	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Chief Operating Officer	SVP, Operations	Ms.	Weinseiss	Karen		6466773595					kweinseiss@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Chief Information Officer	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Chief Information Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	CMS Casework Communication Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Complaints Tracking Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Contact for Fraud Investigations	VP, Associate General Counsel	Mr.	Kianovsky	Nahum		2128013240					nkianovsky@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		9176982415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Corporate Mailing						6463138967					clogreira@healthfirst.org	Healthfirst Medicare Plan	100 Church Street, 18th Floor	New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		2128011639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	DIR Contact	Manager, Pharmacy Finance	Mr.	Sheridan	Justin		2124535509					jsheridan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	DIR Contact (Secondary)	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					Tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Discount Program Payment Contact	VP, Controller	Mr.	Barattin	Craig		2125191780					cbarattin@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Emergency Part D Contact	VP, Pharmacy	Mr.	Modi	Bhavesh		2122096442					bmodi@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Emergency Part D Contact (Secondary)	Director, Pharmacy Regulatory & Compliance	Ms.	Andreu	Kim		6462732839					kandreu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters	Mr.	Miller	Robert		2125193011					rmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Enrollment Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	EOB Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753				6463134645	jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Financial Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Financial Reporting Contact	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Formulary Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Formulary Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	General Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	HIPAA Privacy Officer	AVP, Chief Privacy Officer	Ms.	Radler	Laurie		9172863902					lradler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	HIPAA Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Hospice Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Interoperability Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	MA Appeals/Grievances Contact	VP, Appeals & Grievances	Ms.	Johnston	Meredith		6467674748					mjohnston@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	MA Claims Processing Contact for Public Website	VP Application Development	Mr.	Brexel	CJ		2128232481					cbrexel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/08/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Marketing Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Medical Director	Chief Clinical Officer	Dr.	Schechtman	Jay		2128016170					jschechtman@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		2124534495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Medicare Coordinator	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Benefits	Ms.	Baja	Melody		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/22/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Medication Therapy Management Contact	Pharmacy Manager	Ms.	Ziu	Rezarta		6463134678					rziu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Online Enrollment Center Contact (Primary)	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part C Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part C Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Appeals	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	3013464234				HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Appeals Contact (Secondary)	Sr. Manager, Pharmacy Regulatory & Compliance	Ms.	Alenkina	Karolina							kalenkina@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Benefits Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Claims Submission Contact	Manager, Pharmacy Benefits	Ms.	Grodzitsky	Janet		6467675231					jparedes@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Exceptions Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Exceptions Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie							mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8882601010				HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Price File Contact (Back-up)	Sr. Manager, Financial Operations	Ms.	Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	CVS Health	9501 E. Shea Blvd, MC121	Scottsdale	AZ	85260	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Price File Contact (Optional)	Advisor, Med D Finance	Mr.	Pertgen	Richard		8045258502					richard.pertgen@cvshealth.com	CVS Health	9501 E Shea Blvd, MC121	Scottsdale	AZ	85260	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Price File Contact (Primary)	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Quality Assurance Contact	AVP, Pharmacy	Ms.	Kourlas	Helen		2122096456					hkourlas@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Part D Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Patient Safety Contact	Manager, Pharmacy	Ms.	Gandara Rodriguez	Alexandra		2124792775					agandararodriguez@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Payment Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Pharmacy Director	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Pharmacy Network Management Contact	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist	Ms.	An	Diana		3476911405					dan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Pharmacy Technical Help Desk Contact	AVP Customer Care	Mr.	Jackson	Scott							scott.jackson@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H5989	Plan Directory Contact for Public Website			Services	Provider		8888011660					hfprovsrvs@healthfirst.org	P.O. Box 5168		New York	NY	102745168	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					P2P@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Processor Contact	Executive Director	Mr.	Mangin	Marty		3124981167					martin.mangin@cvshealth.com	CVS Health	3100 Sanders Rd	Northbrook	IL	60062	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Quality Contact	VP, Clinical Quality	Ms.	Washington	Laisha		2128016186					lawashington@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Reconciliation Contact	VP, Actuarial Services	Ms.	Liang	Angela		2124535538					aliang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Recovery Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	SNP Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	SNP State Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Surveillance Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	System Contact	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Third Party Administrator (TPA) Liaison	Sr. Manager, Accounting	Ms.	Tyme	Denise		6462732814					dtyme@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	User Access Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Utilization Management Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5989	Utilization Review Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST HEALTH PLAN, INC.	Local CCP	Healthfirst Medicare Plan	HMO/HMOPOS		Healthfirst, Inc.	391	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H5990	Automated TrOOP Balance Transfer Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Backup User Access Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Best Available Evidence Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Bid Primary Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	CAP Report Contact for Public Website	CEO	Mr	Irwin	Mark		8145356000	22101				Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending	8145356000				PACE - Nat		C	Philadelphia
H5990	CEO - CMS Administrator Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	CEO - Senior Official for Contracting	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Chief Financial Officer	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Chief Operating Officer	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Chief Information Officer	IT Director	Mr	Keck	Cliff		4129630700					Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Chief Information Security Officer	IT Director	Mr	Keck	Cliff		4129630700					Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	CMS Casework Communication Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Complaints Tracking Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Contact for Fraud Investigations	Executive Director	Mr	Voeghtly	Robert		8145356000					Rvoeghtly@seniorlifejohnstown.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Coordination of Benefits Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Corporate Mailing						8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Customer Service Operations Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	DIR Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Discount Program Payment Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Emergency Part D Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Encounter Data & Risk Adjustment Operations Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Enrollment Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	EOB Transfer Contact	CFO	Mr	Dodson	David		8145356000				8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Financial Audit Contact	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Financial Reporting Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Formulary Contact		Mr	Rowland	Bob		7242751203					Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	General Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Government Relations Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	HIPAA Privacy Officer	IT Director	Mr	Keck	Cliff		4129630700					Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	HIPAA Security Officer	IT Director	Mr	Keck	Cliff		4129630700	144				Ckeck@pas-lp.com	209 Sigma Drive		Pittsburgh	PA	15238	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Interoperability Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	MA Appeals/Grievances Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	MA Claims Processing Contact for Public Website	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Marketing Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Medical Director	Medical Director	Mr	Ratchford	Donald		8145356000					DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Medicare Compliance Officer	Executive Director	Mr	Voeghtly	Robert		8145356000					Rvoeghtly@seniorlifejohnstown.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Medicare Coordinator	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Medicare Part D Opioid Overutilization Contact	Medical Director	Mr	Ratchford	Donald		8145356000					DRatchford@physiciansolutionsgrp.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Medication Therapy Management Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Boulevard, Suite 140		Columbia	SC	29209	02/14/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part D Appeals	CFO	Mr	Dodson	David							ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending	8145356000				PACE - Nat		C	Philadelphia
H5990	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Boulevard, Suite 140		Columbia	SC	29209	02/14/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part D Benefits Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part D Claims Submission Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part D Exceptions Contact	CFO	Mr	Dodson	David							ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending	8145356000				PACE - Nat		C	Philadelphia
H5990	Part D Price File Contact (Back-up)	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part D Price File Contact (Primary)	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part D Quality Assurance Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Part D Reporting Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Patient Safety Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Payment Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Pharmacy Director		Mr	Rowland	Bob		7242751203					Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Pharmacy Network Management Contact		Mr	Rowland	Bob		7242751203					Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Pharmacy Technical Help Desk Contact		Mr	Rowland	Bob							Browland@granerx.com	464 Nixon Road		Cheswick	PA	15024	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending	7242751203				PACE - Nat		C	Philadelphia
H5990	Plan Directory Contact for Public Website	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Plan to Plan Reconciliation Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Processor Contact	Claims Manager	Mrs	Best	Karen		8145356000					KBest@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Quality Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Reconciliation Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Recovery Audit Contact	CFO	Mr	Dodson	David		8145356000					ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Surveillance Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	System Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Third Party Administrator (TPA) Liaison	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	User Access Contact	CFO	Mr	Dodson	David		8145356000	22102			8142487902	ddodson@PACE-CS.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Utilization Management Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5990	Utilization Review Contact	CEO	Mr	Irwin	Mark		8145356000					Mirwin@pace-cs.com	401 Broad Street		Johnstown	PA	15906	03/25/2024	2026	SENIOR LIFE SOMERSET, INC.	National PACE	Senior LIFE Somerset, Inc.	National PACE		Senior Life Somerset, Inc.	842	Yes	Pending					PACE - Nat		C	Philadelphia
H5991	Agent/Broker Compensation Data Contact	Dir. Medicare Sales		Pappalardo	Kimberly		6464477024					kpappalardo@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Backup User Access Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Best Available Evidence Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Bid Audit Contact	Medicare Compliance Leader		Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Bid Audit Site Contact	Sr. Medicare Audit Spec.		Chan	Tat		6464470218					tchan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Bid Primary Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	CAP Report Contact for Public Website	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	CEO - CMS Administrator Contact	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	CEO - Senior Official for Contracting	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Chief Financial Officer	Chief Financial Officer	Ms.	Tamborino	Heather		6464476174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Chief Operating Officer	Chief Operating Officer	Mr.	MacMillan	Thomas		6464474401					tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Chief Information Officer	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Chief Information Security Officer	VP, Technology and CISO	Mr.	McDermott	Thomas	M	6464474110					tmcdermott@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	CMMI Model Point of Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	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	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Complaints Tracking Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Contact for Fraud Investigations	Director, Special Investigations		Lupo	Chris		6318442453					Clupo@EmblemHealth.com	395 North Service Road		Melville	NY	11747	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Coordination of Benefits Contact	AVP, Provider Claim Resolution		Maxwell	Christine		8606745751					cmaxwell@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Corporate Mailing						6464475000					Cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Customer Service Operations Contact	VP Customer Service		Tirado	Nicole		5184466981					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	DIR Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	DIR Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Discount Program Payment Contact	Financial Operations and Treasury		Czerczak	Ewelina		8606745716					egradka@emblemhealth.com	175 Scott Swamp Rd		New York	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Emergency Part D Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Emergency Part D Contact (Secondary)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Employer Waiver Contact	AVP, Product Dev., Admin., & Perf. Analysis		Averyanova	Nataliya		6464475044					naveryanova@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Encounter Data & Risk Adjustment Operations Contact	Dir., Enterprise Gov't Submissions		Guenther	Anne Marie		8606745847					aconnors@connecticare.com	175 Scott Swamp Rd		Farmington	CT	06034	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Enrollment Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	EOB Transfer Contact	Dir., Claims Operations		Salcedo	Clifford		2126150511				2125105319	csalcedo@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Financial Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Financial Reporting Contact	Dir., Financial Reporting		Nogajewski	Scott		7086461563					snogajewski@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Formulary Contact	Sr. Formulary Specialist		Sitilides Cimino	Irene		6864477926					isitilidescimino@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Formulary Contact (Secondary)	Director, Formulary Development & UM		Sandoval	Natalie		3479132921					nasandoval@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	General Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Government Relations Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	HIPAA Privacy Officer	VP, Corporate Compliance		Lurin	Joseph		6464475203					jlurin@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	HIPAA Security Officer	AVP, IT Governance		McDermott	Thomas		6464474110					TMcDermott@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Hospice Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Interoperability Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	MA Appeals/Grievances Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	MA Claims Processing Contact for Public Website	VP, Claims Operations		Henderson	Linda		6464476795					lhenderson@emblemhealth.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Marketing Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Medical Director	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Medicare Compliance Officer	Dir., Govt. Program Regulatory/MCO	Mr.	Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Medicare Coordinator	VP, Medicare	Mr.	Walsh	Eric		6464477893					ericwalsh@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Medicare Part D Opioid Overutilization Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Medication Therapy Management Contact	Clinical Pharmacy Program Leader		Mhajan	Ruby		6464477632					rumhajan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	OffShore Subcontractor Contact	Lead Admin., Regulatory Pgm.		Kelly	Veronica		6464477494					vkelly@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Online Enrollment Center Contact (Back-up)	Knowledge Manager, Enroll. & Bill.		Gonzalez	Gabriel		6464477722					gabriel.gonzalez@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Online Enrollment Center Contact (Optional)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com.com	55 water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Online Enrollment Center Contact (Primary)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part C Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part C Reporting Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Appeals	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A					2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	6464477215				HMO - Health Maintenance Organization		C	New York
H5991	Part D Appeals Contact (Secondary)	Mgr., G & A, Expedited Claims		Montana	Kim						2125108130	kgrace@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	6464470523				HMO - Health Maintenance Organization		C	New York
H5991	Part D Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Benefits Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Claims Submission Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Exceptions Contact	Pharmacy Client Ops Director		Der Weer	J'Nisha							jderweer@emblemhealth.com	55 Water street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	6464477198				HMO - Health Maintenance Organization		C	New York
H5991	Part D Exceptions Contact (Secondary)	Pharmacy Perf. Mgmt. Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	4015251683				HMO - Health Maintenance Organization		C	New York
H5991	Part D Price File Contact (Back-up)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Price File Contact (Optional)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Price File Contact (Primary)	Sr. Manager Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Quality Assurance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Part D Reporting Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Patient Safety Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Payment Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Personal Health Record Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Pharmacy Director	VP, Chief Pharmacy Officer		Smith	Jonalan		7858407007					jsmith@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Pharmacy Network Management Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Pharmacy Network Management Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	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	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	8009221557	2			HMO - Health Maintenance Organization		C	New York
H5991	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active	4015251683				HMO - Health Maintenance Organization		C	New York
H5991	PHR Beneficiary Contact																	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS	EmblemHealth	EmblemHealth, Inc.	361	Yes	Active	8773447364				HMO - Health Maintenance Organization		C	New York
H5991	Plan Directory Contact for Public Website	VP Customer Service		Tirado	Nicole		8773447364					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		6464473017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Processor Contact	AVP, Claims Operations		Gauthier	Kathleen	H	8604096435					kgauthier@connecticare.com	175 Scott Swamp Road	PO BOX 4050	Farmington	CT	06034	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Quality Contact	Data Analytics & Reporting Leader		Goldfarb	Julie		6315775110	65110				jgoldfarb@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Reconciliation Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Reconciliation Contact (Secondary)	Mgr., Enrollment & Billing		Roman	Erica		6464477125					eroman@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Recovery Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	SNP Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	SNP State Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Surveillance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	System Contact	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Third Party Administrator (TPA) Liaison	Dir., Treasury		Pastorello	Thomas		9172248582					tpastorello@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	User Access Contact	Lead Medicare Regulatory Spec.		Handy	Michelle		5184466949					mhandy@EmblemHealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Utilization Management Contact	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5991	Utilization Review Contact	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	HEALTH INSURANCE PLAN OF GREATER NEW YORK	Local CCP	EmblemHealth	HMO/HMOPOS		EmblemHealth, Inc.	361	Yes	Active					HMO - Health Maintenance Organization		C	New York
H5992	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H5992	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H5992	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5992	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H5992	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H5992	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	SENIOR WHOLE HEALTH OF NEW YORK, INC.	Local CCP	Senior Whole Health of New York	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H5992	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Backup User Access Contact	Development Director	Mr.	Koetz	Andrew		8725883183					development@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Best Available Evidence Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Bid Primary Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	CAP Report Contact for Public Website			Wildt	Jonathan		8725883000					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active	8725883000				PACE - Nat		C	New York
H5993	CEO - CMS Administrator Contact	CEO	Mr.	Brooks	James		8725883009					jamesbrooks@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	CEO - Senior Official for Contracting	CEO	Mr.	Brooks	James		8725883009					jamesbrooks@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Chief Financial Officer	PACE CFO	Mr.	Koetz	Andrew		8725883183					andrewkoetz@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	06/11/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Chief Operating Officer	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Chief Information Officer	CIO	Ms.	Herter	Rachel		8725883105					RachelHerter@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Chief Information Security Officer	CDO	Mr.	Cortez	Roger		8725883162					RogerCortez@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	CMS Casework Communication Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Complaints Tracking Contact			Martens	Erin		8725883132					development@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Contact for Fraud Investigations			Martens	Erin		8725883132					development@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Coordination of Benefits Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Corporate Mailing						8725883000					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Customer Service Operations Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	DIR Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Discount Program Payment Contact	External Relations Director	Mr.	Koetz	Andrew		8725883183					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/16/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Emergency Part D Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Encounter Data & Risk Adjustment Operations Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Enrollment Contact			Sible	Kelsey		8725883187					development@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	EOB Transfer Contact			Wildt	Jonathan		8725883000				8725883001	PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Financial Audit Contact	CFO	Mr.	Dons	Chris		8725883032					christopherdons@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Financial Reporting Contact			Dons	Chris		8725883032					christopherdons@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Formulary Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	General Contact			Wildt	Jonathan		8725883014					pace@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Government Relations Contact			Koetz	Andrew		8725883183					development@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	HIPAA Privacy Officer			Martens	Erin		8725883132					ErinMartens@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	HIPAA Security Officer			Cortez	Roger		8725883162					RogerCortez@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Interoperability Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	MA Appeals/Grievances Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	MA Claims Processing Contact for Public Website			Wildt	Jonathan		8725883000					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Marketing Contact			Sible	Kelsey		8725883187					communications@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Medical Director	CCO - Operations	Dr.	Detmer	Wayne		8725883102					WayneDetmer@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Medicare Compliance Officer	COO	Mr.	Koetz	Andrew		8725883183					AndrewKoetz@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	07/19/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Medicare Coordinator	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Medicare Part D Opioid Overutilization Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Medication Therapy Management Contact	Pharmacy Director	Dr.	Shah	Chris		8725883252					Christophershah@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part C Application Contact			Koetz	Andrew		8725883183					development@lawndale.org	3860 W. Ogden Avenue		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part D Appeals			Wildt	Jonathan							PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active	8725883000				PACE - Nat		C	New York
H5993	Part D Application Contact			Koetz	Andrew		8725883183					development@lawndale.org	3860 W. Ogden Avenue		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part D Benefits Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part D Claims Submission Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part D Exceptions Contact			Wildt	Jonathan							PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active	8725883000				PACE - Nat		C	New York
H5993	Part D Price File Contact (Back-up)			Dons	Chris		8725883032					christopherdons@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part D Price File Contact (Primary)	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part D Quality Assurance Contact		Dr.	Rowell	Bruce		8725883103					brucerowell@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Part D Reporting Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Patient Safety Contact			Martens	Erin		8725883132					erinmartens@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	04/29/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Payment Contact			Dons	Chris		8725883032					christopherdons@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Pharmacy Director	Pharmacy Director	Dr.	Greenhalgh	Mike		8889742763	4867				mgreenhalgh@trhc.com	228 Strawbridge Dr		Moorestown	NJ	08057	07/30/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Pharmacy Network Management Contact	Pharmacy Network Manager	Ms.	Matthys	Laurie		2196709133					lmatthys@carekinesis.com	228 Strawbridge Dr		Moorestown	NJ	08057	07/30/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Pharmacy Technical Help Desk Contact			TRHC	Support							info@trhc.com	228 Strawbridge Dr		Moorestown	NJ	08057	07/30/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active	8889742763	4			PACE - Nat		C	New York
H5993	Plan Directory Contact for Public Website			Wildt	Jonathan		8725883000					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/20/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Plan to Plan Reconciliation Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Processor Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Quality Contact			Rowell	Bruce		8725883107					BruceRowell@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Reconciliation Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Recovery Audit Contact	CFO	Mr.	Dons	Chris		8725883032					christopherdons@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Surveillance Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	System Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Third Party Administrator (TPA) Liaison	External Relations Director	Mr.	Koetz	Andrew		8725883183					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/16/2024	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	User Access Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Utilization Management Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5993	Utilization Review Contact	COO	Mr.	Wildt	Jonathan		8725883014					PACE@lawndale.org	3860 W Ogden Ave		Chicago	IL	60623	12/21/2022	2026	LAWNDALE CHRISTIAN HEALTH CENTER	National PACE	Lawndale Christian Health Center	National PACE		Lawndale Christian Health Center	822	Yes	Active					PACE - Nat		C	New York
H5995	Agent/Broker Compensation Data Contact	VP Sales Operations		Hohenberg	Brandon		5058600441					brandon.hohenberg@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		8587906445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Backup User Access Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Bid Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Bid Audit Site Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Bid Primary Contact	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	CAP Report Contact for Public Website	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	6026924381				HMO - Health Maintenance Organization		C	Dallas
H5995	CEO - CMS Administrator Contact	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	CEO - Senior Official for Contracting	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Chief Financial Officer	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Chief Operating Officer	Chief Operations Officer	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Chief Information Officer	Chief Information Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Chief Information Security Officer	Information Security Officer	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Complaints Tracking Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Contact for Fraud Investigations	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Coordination of Benefits Contact	President & CEO	Mrs.	Callhan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Corporate Mailing						8776728620				5035841772	compliance@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Customer Service Operations Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	DIR Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Discount Program Payment Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Emergency Part D Contact	Chief Medical Officer	Dr.	Work	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Enrollment Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	EOB Transfer Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441				9512067316	jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Financial Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Financial Reporting Contact	CFO	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Formulary Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Formulary Contact (Secondary)	Supervisor, Formulary Services		Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	General Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Government Relations Contact	VP of Compliance		Allotta	Tony		8303090299					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	HIPAA Privacy Officer	VP of Audits, Communications and Privacy		Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	HIPAA Security Officer	ISO	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Hospice Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Interoperability Contact	Chief Technology Officer		Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	MA Appeals/Grievances Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	MA Claims Processing Contact for Public Website	customer service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Marketing Contact	Compliance Manager	Mr.	Allotta	Tony		8303090299					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Medical Director	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Medicare Compliance Officer	Vice President of Compliance	Mr.	Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Medicare Coordinator	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	OffShore Subcontractor Contact	Chief Legal Officer, General Counsel		Wilson	Charles		5039677387				5035841772	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Online Enrollment Center Contact (Optional)	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Online Enrollment Center Contact (Primary)	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part C Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part C Reporting Contact	VP of Audits, Communications and Privacy	Mrs.	Luma	Yoleine		9172080084					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Appeals	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	8776728620	3			HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Appeals Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	9179920101				HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Benefits Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101				5035841772	aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Claims Submission Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	8776728620	3			HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Exceptions Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	9179920101				HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Price File Contact (Back-up)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Price File Contact (Optional)	Medicare Part D Project Manager		Maldonado	Cheryl		8587906397					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct,		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Price File Contact (Primary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101				5035841772	aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Part D Reporting Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Patient Safety Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Payment Contact	Chief Financial Officer	Mr.	Kirkpatrick	james		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Personal Health Record Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Pharmacy Director	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Pharmacy Network Management Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	8006819571				HMO - Health Maintenance Organization		C	Dallas
H5995	Pharmacy Technical Help Desk Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active	9179920101				HMO - Health Maintenance Organization		C	Dallas
H5995	PHR Beneficiary Contact																	05/09/2018	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS	ATRIO Health Plans	ATRIO Health Plans	5	Yes	Active	8776728620				HMO - Health Maintenance Organization		C	Dallas
H5995	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Processor Contact	Director, Medicare Programs		Scherlippens	Carine		8587907415					Carine.Scherlippens@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Quality Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Reconciliation Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Recovery Audit Contact	Chief Medical Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	SNP Application Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	SNP State Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Surveillance Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	System Contact	Chief Technology Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	User Access Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Utilization Management Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H5995	Utilization Review Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	HMO/HMOPOS		ATRIO Health Plans	5	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6018	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6018	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H6018	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6018	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6018	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H6018	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6018	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H6018	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Automated TrOOP Balance Transfer Contact	Medicare Front End Process Manager		Platts	Karen		8168435486					585HPSM@argushealth.com	423 W. 8th Street		Kansas City	MO	64105	02/02/2022	2026	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	New York
H6019	Backup User Access Contact	Chief Information Officer		Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Best Available Evidence Contact	CareAdvantage Manager		Barairo	Charlene		6506162183					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Bid Audit Contact	Chief Financial Officer		Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Bid Audit Site Contact	Chief Financial Officer		Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Bid Primary Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	CAP Report Contact for Public Website	Director of Compliance	Mrs.	Armenta	Brandy		6506161505					brandy.armenta@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	08/25/2022	2026	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	New York
H6019	CEO - CMS Administrator Contact	CEO	Mr.	Curran	Patrick		6506165104					pat.curran@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	08/25/2022	2026	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	New York
H6019	CEO - Senior Official for Contracting	CEO	Mr.	Curran	Patrick		6506165104					pat.curran@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	08/25/2022	2026	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	New York
H6019	Chief Financial Officer	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Chief Operating Officer	COO	Mrs.	Murphey	Colleen		6506162547					colleen.murphey@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	08/25/2022	2026	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	New York
H6019	Chief Information Officer	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Chief Information Security Officer	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	CMMI Model Point of Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	CMS Casework Communication Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Complaints Tracking Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Contact for Fraud Investigations	Director of Compliance	Mrs	Armenta	Brandy		6506161505					brandy.armenta@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Coordination of Benefits Contact	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Corporate Mailing						6506160050					info@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/15/2022	2026	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	New York
H6019	Customer Service Operations Contact	CareAdvantage Manager		Barairo	Charlene		6506162183					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	03/06/2023	2026	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	New York
H6019	DIR Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	DIR Contact (Secondary)	Director of Pharmacy		Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Discount Program Payment Contact	CFO		Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	10/07/2025	2026	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	New York
H6019	Emergency Part D Contact	Director of Pharmacy	Mr.	Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Emergency Part D Contact (Secondary)	Pharmacy Operations Supervisor		Cruz-McKernan	Karla		6506162075					karla.cruz-mckernan@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Encounter Data & Risk Adjustment Operations Contact	Medicare Risk Adjustment Director		Turner	KatieElyse		6506162565					katie-elyse.turner@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	Enrollment Contact	CareAdvantage Manager		Barairo	Charlene		6506162183					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/02/2022	2026	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	New York
H6019	EOB Transfer Contact	Configuration Specialist		Gonzalez	Jesse		6506162023				6506160060	CMS.EOB@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Financial Audit Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Financial Reporting Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Formulary Contact	Director of Pharmacy	Mr.	Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Formulary Contact (Secondary)	Senior Formulary Strategy Specialist		Howerton	Vance		8163090542					SS&C_Formulary_Team@dsthealth.com	SS&C Health	210 W. 10th Street	Kansas City	MO	64105	07/24/2024	2026	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	New York
H6019	General Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Government Relations Contact	Director of Compliance		Armenta	Brandy		6506161505					brandy.armenta@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	11/21/2022	2026	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	New York
H6019	HIPAA Privacy Officer	Chief Government Affairs and Compliance Officer	Mr	Johansson	Ian	K	6506162151					ian.johansson@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	HIPAA Security Officer	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Hospice Contact	CareAdvantage Manager		Barairo	Charlene		6506162183					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Interoperability Contact	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	MA Appeals/Grievances Contact	Chief Health Officer		Scribner	Amy		6506162151					CMSAppealsGrievances@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Marketing Contact	Manager of Marketing and Communications		Deinla	Joy		6506165036					Joy.Deinla@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	03/06/2023	2026	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	New York
H6019	Medical Director	Chief Medical Officer	Dr.	Esguerra	Chris		6506162540					chris.esguerra@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Medicare Compliance Officer	Chief Government Affairs and Compliance Officer	Mr	Johansson	Ian	K	6506162151					ian.johansson@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Medicare Coordinator	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/15/2022	2026	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	New York
H6019	Medication Therapy Management Contact	Director of Pharmacy		Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	OffShore Subcontractor Contact	Director of Compliance		Armenta	Brandy		6506161505					brandy.armenta@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	11/21/2022	2026	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	New York
H6019	Online Enrollment Center Contact (Back-up)	Enrollment/Disenrollment Supervisor		Bongolan	Sharon		6506162806					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	01/25/2023	2026	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	New York
H6019	Online Enrollment Center Contact (Optional)	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Online Enrollment Center Contact (Primary)	CareAdvantage Manager		Barairo	Charlene		6506162183					CMSEnrollmentCenter@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Part C Application Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Part C Reporting Contact	Director of Compliance		Armenta	Brandy		6506161505					brandy.armenta@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	11/21/2022	2026	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	New York
H6019	Part D Appeals	Director of Pharmacy		Shen	Ming							CMSAppealsGrievances@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active	6508292045				HMO - Health Maintenance Organization		C	New York
H6019	Part D Appeals Contact (Secondary)	Pharmacy Operations Manager		Cruz-McKernan	Karla							CMSAppealsGrievances@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	03/06/2023	2026	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active	8885767227				HMO - Health Maintenance Organization		C	New York
H6019	Part D Application Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Part D Benefits Contact	Director of Pharmacy	Mr.	Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Part D Claims Submission Contact	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Part D Exceptions Contact			Services	Pharmacy							PharmPA@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active	6506162088				HMO - Health Maintenance Organization		C	New York
H6019	Part D Price File Contact (Back-up)	Director of Pharmacy		Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Part D Price File Contact (Optional)	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Part D Price File Contact (Primary)			Joslin	Karen		8164352473					kjoslin@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	02/03/2022	2026	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	New York
H6019	Part D Quality Assurance Contact	Director of Pharmacy	Mr.	Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Part D Reporting Contact	Director of Compliance		Armenta	Brandy		6506161505					brandy.armenta@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	11/21/2022	2026	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	New York
H6019	Patient Safety Contact	Director of Pharmacy	Mr.	Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Payment Contact	Director of Medicare	Mr.	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	03/04/2024	2026	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	New York
H6019	Pharmacy Director	Director of Pharmacy	Mr.	Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Pharmacy Network Management Contact	Credentialing Specialist		Dela Cruz	Paul		6506162107					CMSPharmacyNetwork@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy						8162839785		1300 Washington Street		Kansas City	MO	64105	12/18/2023	2026	SAN MATEO HEALTH COMMISSION	Local CCP	HEALTH PLAN OF SAN MATEO	HMO/HMOPOS		Health Plan of San Mateo	115	Yes	Active	8886358362				HMO - Health Maintenance Organization		C	New York
H6019	Physician Incentive Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Plan Directory Contact for Public Website			Unit	Compliance		6506160050				6506160060	compliance@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Processor Contact	Sr. Client Relations Specialist		Evson	Freddie		8168451735					fdevson@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	02/10/2022	2026	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	New York
H6019	Quality Contact	Director, Quality		Ford	Nicole		6506162169					nicole.ford@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Reconciliation Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Reconciliation Contact (Secondary)	Controller		Lester	Francine		6506162111					FrancineL@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Recovery Audit Contact	Chief Financial Officer	Mr.	Ehrgood	Trent		6506162171					trent.ehrgood@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	SNP Application Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	SNP State Contact	Director of Medicare	Mr	Okonne	John		6506161521					john.okonne@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Surveillance Contact	Director of Compliance		Armenta	Brandy		6506161505					brandy.armenta@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	System Contact	Chief Information Officer	Mr.	Yong	Eben		6506162010					eben.yong@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Third Party Administrator (TPA) Liaison	Director of Pharmacy	Mr.	Shen	Ming		6506162073					ming.shen@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	10/07/2025	2026	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	New York
H6019	User Access Contact	Chief Government Affairs and Compliance Officer	Mr	Johansson	Ian	K	6506162151					ian.johansson@hpsm.org	801 Gateway Blvd,	Suite 100	South San Francisco	CA	94080	09/05/2023	2026	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	New York
H6019	Utilization Management Contact	Chief Medical Officer	Dr.	Esguerra	Chris		6506162540					chris.esguerra@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6019	Utilization Review Contact	Chief Medical Officer	Dr.	Esguerra	Chris		6506162540					chris.esguerra@hpsm.org	801 Gateway Blvd	Suite 100	South San Francisco	CA	94080	02/03/2022	2026	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	New York
H6059	Automated TrOOP Balance Transfer Contact	Health Plan Specialist		Powell	Greg		3365504040					Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Backup User Access Contact	President/CEO		Robinson	Ursula		3365504040					Ursula.Robinson@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Bid Primary Contact	Health Plan Specialist		Powell	Greg		3365504040					Greg.Powell@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	CAP Report Contact for Public Website	CEO	Mrs	Robinson	Ursula		3365504040				3364585550	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	04/04/2025	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	CEO - CMS Administrator Contact	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	CEO - Senior Official for Contracting	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	CFO	Mr	Nickerson	Kirby		7047548228				7049000766	Knickerson@LSCarolinas.net	1416 S. Martin Luther King Jr. Ave		Salisbury	NC	28145	02/24/2023	2026	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 Operating Officer	Site Director	Mrs	Marrow	Lucillia		3365504040				3364642190	Lucillia.Marrow@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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 Information Officer	Director of Quality & Compliance	Ms	Holyfield	Tracy		3365504040				3364585550	Tracy.Holyfield@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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 Information Security Officer	Health Informaton Technology Specialist	Mr.	Hiatt	Chris		3365504040				3364585550	Chris.Hiatt@pacetriad.org	1471 E. Cone Blvd		Greensboro	NC	27405	02/21/2024	2026	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	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Complaints Tracking Contact	Director of Quality & Compliance	Ms.	Holyfield	Tracy		3365504040				3364585550	Tracy.Holyfield@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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	Contact for Fraud Investigations	Director of Quality & Compliance		Holyfield	Tracy		3365504051				3364585550	Tracy.Holyfield@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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	Director of Intake and Outreach		Baldwin	Nedra		3365504040					Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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	Corporate Mailing						3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	Director of Outreach and Marketing	Mrs.	Baldwin	Nedra		3365504040				3365504044	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	DIR Contact	President/CEO		Robinson	Ursula		3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	DIR Contact (Secondary)	Health Plan Specialist	Mr	Powell	Greg		3365504040				3364642212	Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	Discount Program Payment Contact	Health Plan Specialist		Powell	Greg		3365504040					Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/04/2021	2026	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	Emergency Part D Contact	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Emergency Part D Contact (Secondary)	Health Plan Specialist		Powell	Greg		3365504040				3364642212	Greg.Powell@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact	President/CEO		Powell	Greg		3365504040				3364642212	Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/21/2024	2026	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	Enrollment Contact	Director of Intake and Marketing	Mrs	Baldwin	Nedra		3365504040				3365504044	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	EOB Transfer Contact	Director of Intake and Outreach	Mrs	Baldwin	Nedra		3365504040				3364642212	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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	Financial Audit Contact	CFO	Mr	Nickerson	Kirby		7047548228				7049000766	Knickerson@LSCarolinas.net	1416 S. Martin Luther King Jr. Ave		Salisbury	NC	28145	02/24/2023	2026	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	Financial Reporting Contact	CFO	Mr	Nickerson	Kirby		7047548228				7049000766	Knickerson@LSCarolinas.net	1416 S. Martin Luther King Jr. Ave		Salisbury	NC	28145	02/24/2023	2026	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	Formulary Contact	Medical Director	Dr	Reed	Tiffany		3365504040					Tiffany.Reed@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	01/24/2024	2026	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	Formulary Contact (Secondary)	Health Plan Specialist		Powell	Greg		3365504040				3364642212	Greg.Powell@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	General Contact	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Director of Quality & Compliance	Ms	Holyfield	Tracy		3365504040				3365504044	Tracy.Holyfield@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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	HIPAA Privacy Officer	Director of Quality & Compliance	Ms.	Holyfield	Tracy		3365504040				3364585550	Tracy.Holyfield@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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	HIPAA Security Officer	Health Informaton Technology Specialist	Mr	Hiatt	Chris		3365504040				3364585550	Chris.Hiatt@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/21/2024	2026	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	Interoperability Contact	Information Technology Specialist	Mr	Hiatt	Chris		3365504040				3364585550	Chris.Hiatt@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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	MA Appeals/Grievances Contact	Director of Quality & Compliance	Ms	Holyfield	Tracy		3365504040				3364585550	Tracy.Holyfield@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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	MA Claims Processing Contact for Public Website	Third Party Operations		Oakes	Jill	M	8562422110					Joakes@careventionhc.com	345 Marshal Ave Suite 101		St. Louis	MO	63119	03/02/2022	2026	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	Marketing Contact	Director of Outreach and Marketing	Mrs	Baldwin	Nedra		3365504040				3365504044	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Medical Director	Medical Director	Dr	Reed	Tiffany		3365504040					Tiffany.Reed@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	01/24/2024	2026	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 & Compliance	Ms.	Holyfield	Tracy		3365504040				3364585550	Tracy.Holyfield@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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 Coordinator	Director of Intake and Outreach	Mrs	Baldwin	Nedra		3365504040				3364642212	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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 Part D Opioid Overutilization Contact	Health Plan Specialist		Powell	Greg		3365504040				3365504045	Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	08/10/2022	2026	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	Medication Therapy Management Contact	Medical Director	Dr	Reed	Tiffany		3365504040					Tiffany.Reed@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	01/24/2024	2026	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	Online Enrollment Center Contact (Back-up)	Director of Intake and Marketing	Mrs	Baldwin	Nedra		3365504040				3364642212	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Online Enrollment Center Contact (Primary)	Marketing Coordinator	Mrs	Baldwin	Nedra		3365504040				3365504044	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	05/12/2014	2026	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 C Application Contact	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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 Appeals	CEO	Mrs	Robinson	Ursula	B					3364585550	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	04/04/2025	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	Part D Appeals Contact (Secondary)	Director of Quality & Compliance	Ms.	Holyfield	Tracy						3364642212	Tracy.Holyfield@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	Part D Application Contact	President/CEO	Mrs	Robinson	Ursula		3365504040				3364642212	Ursula.Robinson@PaceTriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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 Benefits Contact	CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/21/2024	2026	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 Claims Submission Contact	Health Plan Specialist	Mr	Powell	Greg		3365504040				3364642212	Greg.Powell@pacetriad.org	1471 E. Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	Health Plan Specialist	Mr	Powell	Greg						3365504044	Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	Part D Exceptions Contact (Secondary)	Director of Quality & Compliance		Holyfield	Tracy						3365504045	Tracy.Holyfield@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	Part D Price File Contact (Back-up)	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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 Price File Contact (Optional)	Health Plan Specialist		Powell	Greg		3365504070					Greg.Powell@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	06/17/2019	2026	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 Price File Contact (Primary)	Medical Director	Dr	Reed	Tiffany		3365504040					Tiffany.Reed@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	01/24/2024	2026	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 Quality Assurance Contact	Director of Quality & Compliance	Ms.	Holyfield	Tracy		3365504040				3364585550	Tracy.Holyfield@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	08/27/2025	2026	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 Reporting Contact	Health Plan Specialist		Powell	Greg		3365504040					Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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	Patient Safety Contact	Dir. Operations	Mrs	Marrow	Lucillia		3365504040				3365504045	Lucillia.Marrow@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	04/04/2025	2026	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	Payment Contact	President/CEO		Robinson	Ursula		3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 E. Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Personal Health Record Contact	CEO	Ms.	Robinson	Ursula		3365504040				3364585550	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	04/04/2025	2026	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 Director	Medical Director	Dr	Reed	Tiffany		3365504056				3365504045	Tiffany.Reed@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	01/24/2024	2026	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 Network Management Contact	Health Plan Specialistical Director	Mr	Powell	Greg		3365504040				3365504045	Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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 Network Management Contact (Secondary)	Medical Director	Dr.	Reed	Tiffany		3365504040				3364642212	Tiffany.Reed@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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	Dir of Clinical Services	Mrs	Rumble	Rhonda						3365504045	Rhonda.Rumple@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	Pharmacy Technical Help Desk Contact (Secondary)	Clinic Supervisor	Ms	Johnson	Latoya							Latoya.Johnson@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	02/21/2024	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE		Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	PHR Beneficiary Contact																	06/06/2013	2026	PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC.	National PACE	PACE OF THE TRIAD	National PACE	PACE of the Triad	Well-Spring Services, Inc.	641	Yes	Active	3365504040				PACE - Nat		C	Atlanta
H6059	Plan Directory Contact for Public Website	Director of Outreach and Marketing	Mrs	Baldwin	Nedra		3365504040				3365504044	Nedra.Baldwin@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Plan to Plan Reconciliation Contact	Health Plan Specialist		Powell	Greg		3365504040					Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	12/27/2020	2026	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	Processor Contact	Program Director	Mrs	Robinson	Ursula	B	3365504056				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	Quality Contact	Director of Quality & Compliance	Mrs	Rogers	Kelly		3365504040				3364585550	Kelly.Rogers@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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	Reconciliation Contact	President/CEO	Mrs	Robinson	Ursula		3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 E. Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Reconciliation Contact (Secondary)	Health Plan Specialist	Mr	Powell	Greg		3365504040				3364642212	Greg.Powell@pacetriad.org	1471 E Cone Blvd		Greensboro	NC	27405	03/02/2022	2026	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	Recovery Audit Contact	President/CEO	Mrs	Robinson	Ursula		3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd.		Greensboro	NC	27405	02/24/2023	2026	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	Surveillance Contact	President/CEO	Mrs.	Robinson	Ursula		3365504040	4056			3364642212	Ursula.Robinson@pacetriad.org	1471 E. Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	System Contact	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Third Party Administrator (TPA) Liaison	Health Plan Specialist	Mr	Powell	Greg	B	3365504040					Greg.Powell@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	06/02/2025	2026	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	User Access Contact	President/CEO	Mrs	Robinson	Ursula	B	3365504040				3364642212	Ursula.Robinson@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/24/2023	2026	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	Utilization Management Contact	Site Director	Mrs	Marrow	Lucillia		3365504040				3364585550	Lucillia.Marrow@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/21/2024	2026	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	Utilization Review Contact	Site Director	Ms	Marrow	Lucillia		3365504040				3364585550	Lucillia.Marrow@pacetriad.org	1471 East Cone Blvd		Greensboro	NC	27405	02/21/2024	2026	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
H6078	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Bid Primary Contact	Director II Product Development		Kerin	Michele		5186050449					michele.kerin@anthem.com	46 Berkshire Drive		Colonie	NY	12205	10/27/2020	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/10/2020	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H6078	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H6078	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H6078	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H6078	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H6078	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H6078	PHR Beneficiary Contact																	02/10/2020	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H6078	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6078	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	Group Retiree Health Solutions, Inc.	Local CCP	Blue Medicare Advantage	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H6079	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739					cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie	A	7206829848				3039961600	Lteter@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	9096779517				PACE - Nat		C	Dallas
H6079	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Chief Operating Officer	Market President	Ms.	Hopkins	Laura		7208127180				9094249948	lhopkins@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Chief Information Security Officer	Chief Information Security Officer	Mr.	Naus	Cole		7204564635				3039961600	mnaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	12/08/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	CMS Casework Communication Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Complaints Tracking Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Coordination of Benefits Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Corporate Mailing						7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Customer Service Operations Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	DIR Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	General Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Government Relations Contact	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Interoperability Contact	SVP, Application Systems		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	MA Appeals/Grievances Contact	Director of Compliance		Martin	Jeremy		7207896016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Appeals	Director of Compliance		Martin	Jeremy						3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Dallas
H6079	Part D Appeals Contact (Secondary)	Director of Compliance		Martin	Jeremy						3039961600	jmartin@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Dallas
H6079	Part D Application Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Dallas
H6079	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Dallas
H6079	Part D Price File Contact (Back-up)	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Quality Assurance Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/27/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Part D Reporting Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Dallas
H6079	PHR Beneficiary Contact																	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Dallas
H6079	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	AKizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/28/2023	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Reconciliation Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	System Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Third Party Administrator (TPA) Liaison	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	User Access Contact	Director of Compliance		Martin	Jeremy		7207896016					jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6079	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	TOTAL LONGTERM CARE, INC.	National PACE	InnovAge California PACE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Dallas
H6081	Automated TrOOP Balance Transfer Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Backup User Access Contact			Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Best Available Evidence Contact			Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Bid Primary Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	CAP Report Contact for Public Website			Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	CEO - CMS Administrator Contact	Vice President/Executive Director	Mrs.	Melancon	Sharon		5598926640					smelancon@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/10/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	CEO - Senior Official for Contracting	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Chief Financial Officer	Vice President/Executive Director	Mrs.	Melancon	Sharon		7609320920					smelancon@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/10/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Chief Operating Officer		MD	Milani	Arash		8056982795					sharon.melancon@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Chief Information Officer		MD	Ashtiani	Ramin		9173598164					sharon.melancon@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Chief Information Security Officer		MD	Ashtiani	Ramin		9173598164					sharon.melancon@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	CMS Casework Communication Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Complaints Tracking Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Contact for Fraud Investigations		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Coordination of Benefits Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Corporate Mailing						5598926640					sharon.melancon@highdesertpace.org	11833 Amethyst Rd		Victorville	CA	92392	05/27/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Customer Service Operations Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	DIR Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Discount Program Payment Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Emergency Part D Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Encounter Data & Risk Adjustment Operations Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Enrollment Contact	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	EOB Transfer Contact			Garza	Nicole		5599307722				7602459448	nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Financial Audit Contact	Director of Compiance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Financial Reporting Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Formulary Contact	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	General Contact	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Government Relations Contact	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	HIPAA Privacy Officer	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	HIPAA Security Officer	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Interoperability Contact	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	MA Appeals/Grievances Contact	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	MA Claims Processing Contact for Public Website	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Marketing Contact	Director of Marketing, Network and Business Dev.		Madrigal	Brandy		4428550565					bmadrigal@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	02/20/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Medical Director	Chief Clinical Officer/Medical Director	MD	Golden	Otashe		5598926640					sharon.melancon@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/10/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Medicare Compliance Officer	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Medicare Coordinator	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Medication Therapy Management Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part C Application Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Appeals	Director of Compliance	Mrs	Garza	Nicole							ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active	5599307722				PACE - Nat		C	San Francisco
H6081	Part D Application Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Benefits Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Claims Submission Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Exceptions Contact	Director of Compliance	Mrs	Garza	Nicole							ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active	5599307722				PACE - Nat		C	San Francisco
H6081	Part D Price File Contact (Back-up)	VIce President/Executive Director	Mrs.	Melancon	Sharon		5598926640					sharon.melancon@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Price File Contact (Optional)	Director of Compliance	Mrs.	Garza	Nicole	R	5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Price File Contact (Primary)	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Quality Assurance Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Part D Reporting Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Patient Safety Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Payment Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Pharmacy Director	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Pharmacy Network Management Contact	Director of Compiance		Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Pharmacy Technical Help Desk Contact	Director of Compliance		Garza	Nicole							ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active	5599307722				PACE - Nat		C	San Francisco
H6081	Plan Directory Contact for Public Website	Director of Marketing, Network and Business Dev.	Mrs.	Madrigal	Brandy		4428550565					bmadrigal@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	02/20/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Plan to Plan Reconciliation Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Processor Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Quality Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Reconciliation Contact	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Recovery Audit Contact	Director of Quality & Compliance	Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Surveillance Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	System Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Third Party Administrator (TPA) Liaison	Director of Compliance	Mrs.	Garza	Nicole		5599307722					ngarza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	09/22/2025	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	User Access Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Utilization Management Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6081	Utilization Review Contact		Mrs.	Garza	Nicole		5599307722					nicole.garza@highdesertpace.org	11833 Amethyst Road		Victorville	CA	92392	04/04/2024	2026	HIGH DESERT PACE, INC,	National PACE	High Desert PACE	National PACE		High Desert PACE, Inc.	848	Yes	Active					PACE - Nat		C	San Francisco
H6130	Agent/Broker Compensation Data Contact		Mr.	Handlan	James		8003506626					agents@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Backup User Access Contact		Mr.	Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Bid Audit Contact		Mr.	Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Bid Primary Contact		Mr.	Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	CAP Report Contact for Public Website		Ms.	Handlan	Jen		5597775728					hello@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	CEO - CMS Administrator Contact		Mr.	Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	CEO - Senior Official for Contracting		Mr.	Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Chief Financial Officer		Mr.	Broderick	Donald	J	8003506626					finance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/28/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Chief Operating Officer		Ms.	Yohey	Kristy		8003506626				5593963582	kristy@fenyxhealth.com	PO Box 135		Winfield	PA	17889	03/31/2025	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Chief Information Officer		Ms.	Darwicki	Lyndy		8003506626					tech@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Chief Information Security Officer		Ms.	Darwicki	Lyndy		8003506626					tech@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	CMS Casework Communication Contact			Handlan	James	B	8003506626				5593963582	clinical@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/28/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Complaints Tracking Contact		Ms.	Handlan	Jen		5597775728					compliance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Contact for Fraud Investigations		Ms.	Handlan	Jen		8003506626					compliance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Corporate Mailing						8003506626					hello@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Customer Service Operations Contact	Chief Operating Officer	Ms.	Yohey	Kristy		8003506626				5593963582	operations@fenyxhealth.com	PO Box 135		Winfield	PA	17889	03/31/2025	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Employer Waiver Contact		Mr.	Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Encounter Data & Risk Adjustment Operations Contact			Handlan	James	B	8003506626				5593963582	operations@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/29/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Enrollment Contact			Handlan	James	B	8003506626				5593963582	operations@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/29/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Financial Audit Contact	President & CEO	Mr.	Handlan	James		8003506626					finance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Financial Reporting Contact	President & CEO	Mr.	Handlan	James		8003506626					finance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	General Contact		Ms.	Handlan	Jen		5597775728					jen@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Government Relations Contact		Ms.	Handlan	Jen		5597775728					jen@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Interoperability Contact			Handlan	James	B	8003506626				5593963582	operations@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/29/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	MA Appeals/Grievances Contact		Ms.	Handlan	Jen		5597775728					compliance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	MA Claims Processing Contact for Public Website	Chief Operating Officer	Ms.	Yohey	Kristy		8003506626				5593963582	clinical@fenyxhealth.com	PO Box 135		Winfield	PA	17889	03/31/2025	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Marketing Contact		Ms.	Handlan	Jen		5597775728					marketing@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Medical Director		Dr.	Fine	Michael		8003506626				5593963582	clinical@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/28/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Medicare Compliance Officer		Ms.	Handlan	Jen		5597775728					jen@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Medicare Coordinator		Ms.	Handlan	Jen		5597775728					compliance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Part C Application Contact			Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Part C Reporting Contact			Handlan	James	B	8003506626				5593963582	operations@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/29/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Payment Contact		Mr.	Handlan	James		8003506626					finance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Plan Directory Contact for Public Website			Handlan	James		8003506626					hello@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Quality Contact		Dr.	Fine	Michael		8003506626				5593963582	clinical@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/28/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Recovery Audit Contact	President & CEO	Mr.	Handlan	James		8003506626					jim@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Surveillance Contact		Ms.	Handlan	Jen		5597775728					compliance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	System Contact		Ms.	Darwicki	Lyndy		8003506626					tech@fenyxhealth.com	PO Box 135		Winfield	PA	17889	06/14/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	User Access Contact		Ms.	Handlan	Jen		5597775728					compliance@fenyxhealth.com	PO Box 135		Winfield	PA	17889	01/27/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Utilization Management Contact		Dr.	Fine	Michael		8003506626				5593963582	clinical@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/28/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6130	Utilization Review Contact		Dr.	Fine	Michael		8003506626				5593963582	clinical@fenyxhealth.com	PO Box 135		Winfield	PA	17889	02/28/2024	2026	FENYX HEALTH INSURANCE COMPANY	MSA	Fenyx Health	MSA		Fenyx Health Holdings, Inc.	808	No	Active					MSA		C	Denver
H6142	CEO - CMS Administrator Contact	EXECUTIVE DIRECTOR	Ms.	Liu	Marsha		3124234200					mliu@unionhealth.org	1634 W POLK ST		CHICAGO	IL	60612	10/06/2022	2026	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	CEO - Senior Official for Contracting	EXECUTIVE DIRECTOR	Ms.	Liu	Marsha		3124234200					mliu@unionhealth.org	1634 W POLK ST		CHICAGO	IL	60612	10/06/2022	2026	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	Chief Financial Officer	CHIEF FINANCIAL OFFICER	Ms.	Vullmahn	Caroline		3124234200					cvullmahn@unionhealth.org	1634 W POLK ST		CHICAGO	IL	60612	10/06/2022	2026	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	Chief Operating Officer	DIRECTOR OF OPERATIONS	MS.	Vullmahn	Caroline		3124234200					cvullmahn@unionhealth.org	1634 W POLK ST		CHICAGO	IL	60612	10/06/2022	2026	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	Corporate Mailing						3124234200					MLIU@UNIONHEALTH.ORG	1634  W. POLK STREET		CHICAGO	IL	60612	02/06/2019	2026	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	Cost Report Contact	Accounting Supervisor	Ms.	Childs	Sujuana		3124234200	3358				schilds@unionhealth.org	1634 W. POLK STREET		CHICAGO	IL	60612	10/06/2022	2026	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	Enrollment Contact	SUPERVISOR, MEMBER SERVICE	MS.	CACCAVALE	DEANA		3124234200					DCACCAVALE@UNIONHEALTH.ORG	1634 W POLK ST		CHICAGO	IL	60612	06/28/2007	2026	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	General Contact	Accounting Supervisor	Ms.	Childs	Sujuana		3124234200	3358				schilds@unionhealth.org	1634 W. POLK STREET		CHICAGO	IL	60612	10/06/2022	2026	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		3124234200	3222				JROCK@UNIONHEALTH.ORG	1634  W POLK STREET		CHICAGO	IL	60612	04/28/2021	2026	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	System Contact	DIRECTOR OF OPERATIONS	MS.	LIU	MARSHA		3124234200					MLIU@UNIONHEALTH.ORG	1634 W POLK ST		CHICAGO	IL	60612	02/06/2019	2026	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	Business Services Manager		Valdivia	Nadina	M	9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Backup User Access Contact	Director, LLUH-PACE		von Esch	Leslie		9095587223				9092196691	lvonesch@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Best Available Evidence Contact	VP, Financial Services		Mowery	Lew		9095584000					lmowery@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Bid Primary Contact	Chief Financial Officer and SVP Finance	Ms.	Lalas	Angela		9095584000					ALalas@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	CAP Report Contact for Public Website	AVP, Quality & Patient Safety		Bruneau	Brenda		9095584000					BBruneau@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	CEO - CMS Administrator Contact	Program Director	Ms.	Von Esch	Leslie		9095587223				9092196691	LVonEsch@llu.edu	1790 West Park Ave	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	CEO - Senior Official for Contracting	Program Director	Ms.	Von Esch	Leslie		9095587223				9092196691	LVonEsch@llu.edu	1790 West Park Ave	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Chief Financial Officer	Chief Financial Officer and SVP Finance	Ms.	Lalas	Angela		9095584000					ALalas@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Chief Operating Officer	COO	Mr.	edwards	Lyndon		9095584000					lcedwards@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Chief Information Officer	CIO	Mr.	Zirkelbach	Mark		9095584000					MZirkelbach@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Chief Information Security Officer	Exec Director, IS Security	Mr.	Voon	Patrick		9095584000					PVoon@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	CMS Casework Communication Contact	AVP, Care Coordination		Glaspell	Pamela		9095584000	88682				pglaspell@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	11/07/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Complaints Tracking Contact	Executive Director, Patient Experience		McDonald	Jennifer		9095584000					JMcdonald@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Contact for Fraud Investigations	AVP, Quality & Patient Safety		Bruneau	Brenda		9095584000					BBruneau@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Coordination of Benefits Contact	Director, LLUH-PACE		von Esch	Leslie		9095587223				9092196691	lvonesch@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Corporate Mailing						9095587223					LVonEsch@llu.edu	1790 West Park Avenue		Redlands	CA	92373	09/11/2023	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Customer Service Operations Contact	Director-Patient Relations		Mikhail	Wagih		9095584000					WMikhail@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	DIR Contact	AVP, Pharmacy		Gobin	Antony		9095584000					AGobin@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/22/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	DIR Contact (Secondary)	Director-Home Delivery Pharmacy		Gunther	Larisa		9096514705					Lagunther@llu.edu	125 E. Club Center Drive, Suite 1500		San Bernardino	CA	92408	11/08/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Discount Program Payment Contact	Business Services Manager		Valdivia	Nadina	M	9095587223	49157				nmvaldiv@llu.edu	1790 Est Park Ave.	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Emergency Part D Contact	Business Services Manager		Valdivia	Nadina		9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Encounter Data & Risk Adjustment Operations Contact	Business Services Manager		Valdivia	Nadina		9095587223				9092196691	nmvaldiv@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	12/05/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Enrollment Contact	PACE Comm Outreach Manager		Manchan	Alicxa		9095587223	49158			9092196691	amanchan@llu.edu	1790 West Park Avenue	Suite 100	Loma Linda	CA	92354	08/01/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	EOB Transfer Contact	Operations Support Supervisor-Pharmastar		Biren	Alicia		8882987770				7158367683	jvang@pharmastarpbm.com	P.O. Box 3217		Eau Claire	WI	54702	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Financial Audit Contact	Chief Financial Officer and SVP Finance	Ms.	Lalas	Angela		9095584000					ALalas@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Financial Reporting Contact	Chief Financial Officer and SVP Finance	Ms.	Lalas	Angela		9095584000					ALalas@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Formulary Contact	AVP, Pharmacy		Gobin	Antony		9095584000					AGobin@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Formulary Contact (Secondary)	Director-Home Delivery Pharmacy		Gunther	Larisa		9096514705					Lagunther@llu.edu	125 E. Club Center Drive, Suite 1500		San Bernardino	CA	92408	11/08/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	General Contact	Program Director	Ms.	Von Esch	Leslie		9095587223					LVonEsch@llu.edu	1790 West Park Ave		Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Government Relations Contact	Program Director	Ms.	Von Esch	Leslie		9095587223					LVonEsch@llu.edu	1790 West Park Ave		Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	HIPAA Privacy Officer	AVP, Quality & Patient Safety		Bruneau	Brenda		9095584000					BBruneau@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	HIPAA Security Officer	Exec Director, IS Security	Mr.	Voon	Patrick		9095584000					PVoon@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Interoperability Contact	AVP, Quality & Patient Safety		Bruneau	Brenda		9095584000					BBruneau@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/11/2023	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	MA Appeals/Grievances Contact	Director, LLUH-PACE		von Esch	Leslie		9095587223				9092196691	lvonesch@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	MA Claims Processing Contact for Public Website	Manager, LLUH-PACE Business Office		Valdivia	Nadina		9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Marketing Contact	PACE Comm Outreach Manager		Manchan	Alicxa		9095587223	49158			9092196691	amanchan@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	08/01/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Medical Director	Geriatrics	Dr.	Labib	Wessam		9095584000					WLabib@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Medicare Compliance Officer	Program Director	Ms.	von Esch	Leslie		9095587223				9092196691	lvonesch@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Medicare Coordinator	Director, LLUH-PACE		von Esch	Leslie		9095587223				9092196691	lvonesch@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Medicare Part D Opioid Overutilization Contact	Business Services Manager		Valdivia	Nadina		9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Medication Therapy Management Contact	Business Services Manager		Valdivia	Nadina		9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part C Application Contact	Program Director	Ms.	Von Esch	Leslie		9095587223					LVonEsch@llu.edu	1790 West Park Avenue		Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Appeals	Director		Von Esch	Leslie						9092196691	LVonesch@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	07/11/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active	9095587223	49150			PACE - Nat		C	San Francisco
H6147	Part D Appeals Contact (Secondary)	Business Services Manager		Valdivia	Nadina	M						nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active	9095587223	49157			PACE - Nat		C	San Francisco
H6147	Part D Application Contact	Manager, Business Office LLUH-PACE	Ms.	Valdivia	Nadina		9095587223				9092196691	nmvaldiv@llu.edu	1790 West Park Ave	Suite 100	Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Benefits Contact	Business Services Manager		Valdivia	Nadina		9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Claims Submission Contact	Client Support Supervisor-Pharmastar		Vang	Jane		8882987770					jvang@pharmastaronline.com	2503 N. Hillcrest Parkway		Altoona	WI	54720	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Exceptions Contact	Business Services Manager		Valdivia	Nadina							nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active	9095587223	49157			PACE - Nat		C	San Francisco
H6147	Part D Exceptions Contact (Secondary)	AVP, Pharmacy		Gobin	Antony							AGobin@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active	9095584000				PACE - Nat		C	San Francisco
H6147	Part D Price File Contact (Back-up)	Client Support Manager-Pharmastar		Slowiak	Andre		7158522983					asloiak@pharmastarpbm.com	P.O. Box 3217		Eau Claire	WI	54702	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Price File Contact (Optional)	Business Services Manager		Valdivia	Nadina		9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Price File Contact (Primary)	AVP, Pharmacy		Gobin	Antony		9095584000					AGobin@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Quality Assurance Contact	Program Director	Ms.	Von Esch	Leslie		9095587223					LVonEsch@llu.edu	1790 West Park Ave		Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Part D Reporting Contact	Business Services Manager		Valdivia	Nadina	M	9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Patient Safety Contact	AVP, Quality & Patient Safety		Bruneau	Brenda		9095584000					BBruneau@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Payment Contact	Business Services Manager		Valdivia	Nadina	M	9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Pharmacy Director	AVP, Pharmacy		Gobin	Antony		9095584000					AGobin@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Pharmacy Network Management Contact	Director-Home Delivery Pharmacy		Gunther	Larisa		9096514705					Lagunther@llu.edu	125 E. Club Center Drive, Suite 1500		San Bernardino	CA	92408	11/08/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Pharmacy Network Management Contact (Secondary)	AVP, Pharmacy		Gobin	Antony		9095584000					AGobin@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					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	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active	8882987770				PACE - Nat		C	San Francisco
H6147	Plan Directory Contact for Public Website	Program Director	Ms.	Von Esch	Leslie		9095587223					LVonEsch@llu.edu	1790 West Park Ave		Redlands	CA	92373	03/06/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Plan to Plan Reconciliation Contact	Business Services Manager		Valdivia	Nadina	M	9095587223				9092196691	nmvaldiv@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	12/05/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Processor Contact	Client Support Supervisor-Pharmastar		Vang	Jane		8882987770					jvang@pharmastaronline.com	2503 N. Hillcrest Parkway		Altoona,	WI	54720	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Quality Contact	AVP, Quality & Patient Safety		Bruneau	Brenda		9095584000					BBruneau@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Reconciliation Contact	Business Services Manager		Valdivia	Nadina	M	9095587223				9092196691	nmvaldiv@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	12/05/2024	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Recovery Audit Contact	Business Services Manager	Mrs.	Valdivia	Nadina	M	9095587223	49157			9092196691	nmvaldiv@llu.edu	1790 West Park Avenue	Suite 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Surveillance Contact	AVP, Quality & Patient Safety		Bruneau	Brenda		9095584000					BBruneau@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	System Contact	CIO	Mr.	Zirkelbach	Mark		9095584000					MZirkelbach@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Third Party Administrator (TPA) Liaison	Business Services Manager		Valdivia	Nadina	M	9095587223	49157				nmvaldiv@llu.edu	1790 West Park Avenue	Ste. 100	Redlands	CA	92373	03/27/2025	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	User Access Contact	CIO	Mr.	Zirkelbach	Mark		9095584000					MZirkelbach@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Utilization Management Contact	Geriatrics	Dr.	Labib	Wessam		9095584000					WLabib@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6147	Utilization Review Contact	Geriatrics	Dr.	Labib	Wessam		9095584000					WLabib@llu.edu	11234 Anderson Street		Loma Linda	CA	92354	09/23/2021	2026	LOMA LINDA UNIVERSITY MEDICAL CENTER	National PACE	Loma Linda University Health PACE	National PACE		Loma Linda University Medical Center	819	Yes	Active					PACE - Nat		C	San Francisco
H6154	Agent/Broker Compensation Data Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Automated TrOOP Balance Transfer Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Backup User Access Contact			Berg	Lynnsey		6126326655					lynnsey.berg@optum.com	P.O. Box 9472		Minneapolis	MN	554409472	11/30/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Best Available Evidence Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Bid Audit Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Bid Audit Site Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Bid Primary Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	CAP Report Contact for Public Website	Manager - Compliance		Herbst	Travis		6088272856					Travis Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	09/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	CEO - CMS Administrator Contact	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Chief Financial Officer	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Chief Operating Officer	Chief Operations Officer	Mr	Hjerpe	Adam		6123861065					COO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/11/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Chief Information Officer	VP, Chief Technology Officer	Mr	Peterson	Scott		9529922625					Scott.Peterson@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	09/05/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Chief Information Security Officer		Mr	Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/12/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	CMMI Model Point of Contact			Schaefer	Jennifer		9529912803					jennifer.schaefer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/15/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	CMS Casework Communication Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Complaints Tracking Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Contact for Fraud Investigations	Director, Special Investigations Unit		Kalin	Dan		9529922587					Daniel.Kalin@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/05/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Coordination of Benefits Contact			Vilendrer	Krista		9529923252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Corporate Mailing						9529922900					Nichole.MeltonMitchell@medica.com	401 Carlson Parkway	P.O. Box 9310 CP320	Minnetonka	MN	55305	04/09/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Customer Service Operations Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	DIR Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	DIR Contact (Secondary)	VP & Chief Pharmacy Officer		Rogers	Nick		9529923611					Nicholas.Rogers@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Discount Program Payment Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Emergency Part D Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/06/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Emergency Part D Contact (Secondary)			Day	Colton		9529928537					Colton.Day@deancare.com	1277 Deming Way		Madison	WI	53717	01/06/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Employer Waiver Contact			Alness	Stacy		9529923825					stacy.alness@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/19/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Encounter Data & Risk Adjustment Operations Contact	Director- Risk Adjustment Operations		Werwinski	Michelle		6088305958					Michelle.Werwinski@deancare.com	1277 Deming Way		Madison	WI	53717	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Enrollment Contact			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	EOB Transfer Contact			Bourdages	Kathy		9529923653				9529923636	kathy.bourdages@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/13/2017	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Financial Audit Contact	Sr. Director of Finance, Medicaid & Medicare	Ms	Faig	Sara		9529928358					sara.faig@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Financial Reporting Contact			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Formulary Contact			Parr	Ross		9529921767					ross.parr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Formulary Contact (Secondary)			Seabright	Diane		9529922474					diane.valeo-seabright@deancare.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	General Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Government Relations Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	HIPAA Privacy Officer			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/20/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	HIPAA Security Officer		Mr	Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/12/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Hospice Contact			Bourdages	Kathy		9529923653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Interoperability Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/14/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	MA Appeals/Grievances Contact			Blum	Adam		6088305954					adam.blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	MA Claims Processing Contact for Public Website			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Marketing Contact			Teff	Melissa		9529923972					melissa.teff@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Medical Director	Chief Clinical & Provider Strategy Officer		Webster	David		9529922801					david.webster@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Medicare Compliance Officer	VP Compliance	Mrs	Koranteng	Milly		9529922090					complianceofficer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Medicare Coordinator	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Medication Therapy Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	OffShore Subcontractor Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Online Enrollment Center Contact (Primary)			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/13/2017	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part C Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part C Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Appeals			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/13/2017	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	9529922353				HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Appeals Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	6088277576				HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Benefits Contact			Rodine	Bridget		9529922353					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/09/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Claims Submission Contact			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/02/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/13/2017	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	9529922353				HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Exceptions Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	6088277576				HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Price File Contact (Back-up)			Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Farifield	OH	45014	11/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Price File Contact (Optional)			Bourdages	Kathy		9529923653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Price File Contact (Primary)			Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Quality Assurance Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Part D Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Patient Safety Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Payment Contact			Faig	Sara		9529928358					sara.faig@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Pharmacy Director	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Pharmacy Network Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Pharmacy Network Management Contact (Secondary)			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/13/2017	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H6154	Pharmacy Technical Help Desk Contact (Secondary)			Bourdages	Kathy							PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/09/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H6154	Plan Directory Contact for Public Website			Service	Customer		8002348755					AskGovtPrograms@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Plan to Plan Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Processor Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Quality Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Reconciliation Contact (Secondary)			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	06/27/2017	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Recovery Audit Contact	Manager Claims Operations	Mr	Foley	Steve		9529924160					steven.foley@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	SNP Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	SNP State Contact			Zillhardt	John		9529922290					John.Zillhardt@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/15/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Surveillance Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	System Contact			Schwartz	Pamela		9529922584					pamela.schwartz@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Third Party Administrator (TPA) Liaison			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	User Access Contact			Harrington	Dana		6122129075					dana.harrington@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Utilization Management Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6154	Utilization Review Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6158	Agent/Broker Compensation Data Contact	Manager, Individual Sales Agent		Creasman	Matthew		5013993923					mdcreasman@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Automated TrOOP Balance Transfer Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Backup User Access Contact	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Best Available Evidence Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Bid Audit Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Bid Audit Site Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Bid Primary Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	CAP Report Contact for Public Website	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	CEO - CMS Administrator Contact	VP Government Programs & Enterprise Analytics	Mr.	Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	CEO - Senior Official for Contracting	Executive VP	Mr.	Dillard	Gray		5013782436					gddillard@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/13/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Chief Financial Officer	Treasurer	Mr.	Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/13/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Chief Operating Officer	Chief Operating Officer	Mr.	Dillard	Gray		5013782436					gddillard@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/13/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Chief Information Officer	VP Infrastructure & Operations	Mr.	Martin	David		5012940910					dbmartin@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/16/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Chief Information Security Officer	Chief Security Officer	Mr.	Shirley	Devin		5016880747					dmshirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	CMS Casework Communication Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Complaints Tracking Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Contact for Fraud Investigations	Director, Performance Mgt. & Investigations		Gunter	Debbie		5013786610					dsgunter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/05/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Coordination of Benefits Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Corporate Mailing						5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Customer Service Operations Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	DIR Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570	25635				MDVANNATTA@arkbluecross.com	601 Gaines St		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	DIR Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/05/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Discount Program Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Emergency Part D Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Emergency Part D Contact (Secondary)	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Encounter Data & Risk Adjustment Operations Contact	Director Risk Adjustment		Dotson	Adonica		5012941964					andotson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Enrollment Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	EOB Transfer Contact	Account Manager		Ellinger	David		4802408415				4803146066	David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Financial Audit Contact	Medicare Compliance Manager	Mr.	Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Financial Reporting Contact	Director, Financial Reporting & Payroll		Russell	Holly		5013993954					hkrussell@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Formulary Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Formulary Contact (Secondary)	Clinical Advisor		Seto	Kim		6193460146					Kim.Seto@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	General Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872	25635				cnvermeulen@arkbluecross.com	601 Gaines St.		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		5013782103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/05/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	HIPAA Privacy Officer	Chief Privacy Officer		Gardner	Anne		5013932994					aegardner@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	HIPAA Security Officer	Physical Security/Chief Security Officer		Shirley	Devin		5016880747					DMShirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/11/2023	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		5013783743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Interoperability Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	MA Appeals/Grievances Contact	Supervisor, Medicare Member Services		Taylor	Alicia		5013783743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	MA Claims Processing Contact for Public Website	Manager, Medicare Claims Operations		Pilkington Ross	Amanda		5013013452					ampilkington@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Marketing Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872	25635				cnvermeulen@arkbluecross.com	601 Gaines St.		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Medical Director	Associate Medical Director	Dr.	Becker	Thomas		5013964196					tebecker@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/10/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Medicare Compliance Officer	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/05/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Medicare Coordinator	Lead Executive Medicare Products		Vermeulen	Chris		5012945872	25635				cnvermeulen@arkbluecross.com	601 Gaines St.		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Medicare Part D Opioid Overutilization Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Medication Therapy Management Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	OffShore Subcontractor Contact	Director, Medicare Operations		Bradford	Wanda		5013782387					wlbradford@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/20/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Online Enrollment Center Contact (Back-up)	Supervisor, Medicare Operations		Kaiser	Ashley		5012941625					aekaiser@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part C Application Contact	Manager Medicare Advantage Product Development		Pepper	Chad		5012941697					wcpepper@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part C Reporting Contact	Director, Medicare Operations		Bradford	Wanda		5013782387					wlbradford@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/20/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part D Appeals	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				HMO - Health Maintenance Organization		C	New York
H6158	Part D Appeals Contact (Secondary)	Senior Counsel, Appeals		Phillips	Ashleigh						5013783366	adphillips@arkbluecross.com	PO Box 2181	Attn: Legal Appeals	Little Rock	AR	72203	01/11/2021	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	5013782025				HMO - Health Maintenance Organization		C	New York
H6158	Part D Application Contact	Manager Medicare Advantage Product Development		Pepper	Chad		5012941697					wcpepper@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/17/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part D Benefits Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part D Claims Submission Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part D Exceptions Contact	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				HMO - Health Maintenance Organization		C	New York
H6158	Part D Exceptions Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza							mbegovic@arkbluecross.com	601 S Gaines St.		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	5013932813				HMO - Health Maintenance Organization		C	New York
H6158	Part D Price File Contact (Back-up)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part D Price File Contact (Primary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part D Quality Assurance Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Part D Reporting Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Patient Safety Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Pharmacy Director	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Pharmacy Network Management Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Pharmacy Network Management Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Pharmacy Technical Help Desk Contact			Customer Service	CVS								9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/10/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	8442805833				HMO - Health Maintenance Organization		C	New York
H6158	Pharmacy Technical Help Desk Contact (Secondary)	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				HMO - Health Maintenance Organization		C	New York
H6158	Plan Directory Contact for Public Website			Service	Customer		8442014934					MediPakAdvRx@arkbluecross.com	P O Box 3648		Little Rock	AR	72203	11/10/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		5012942491				5013783258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Processor Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Quality Contact	Director, Clinical Quality & HEDIS		Mattson	Sarah		5012943643					spmattson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Reconciliation Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570	25635				MDVANNATTA@arkbluecross.com	601 Gaines St		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Reconciliation Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/05/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Recovery Audit Contact	Financial Analyst	Ms.	Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	SNP Application Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570	25635				MDVANNATTA@arkbluecross.com	601 Gaines St		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	SNP State Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570	25635				MDVANNATTA@arkbluecross.com	601 Gaines St		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Surveillance Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	System Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Third Party Administrator (TPA) Liaison	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	User Access Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Utilization Management Contact	Director, Health Management		Seleski-Lopez	Verna		5013409235					vlseleskilopez@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6158	Utilization Review Contact	Associate Medical Director	Dr.	Becker	Thomas		5013964196					tebecker@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/10/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6170	Agent/Broker Compensation Data Contact	COO & Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	07/24/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Automated TrOOP Balance Transfer Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Backup User Access Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9498502552	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Best Available Evidence Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Bid Audit Contact	Actuary	Mr.	Feng	Yucheng		3146806102				9499989856	yucheng.feng@wakely.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Bid Audit Site Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Bid Primary Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395					CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	CAP Report Contact for Public Website	Chief Compliance Officer	Ms	Snyder	Constance		5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8008858000				HMO - Health Maintenance Organization		C	Dallas
H6170	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Davis	Jeff		8008858000				9499989856	Jeff.Davis@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	CEO - Senior Official for Contracting	COO / Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Chief Financial Officer	Chief Financial Officer	Mr	Kori	Vijay		8008858000				9499989856	vkori@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Chief Operating Officer	COO / Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Chief Information Officer	CIO	Mr	Vacant	Vacant	J	8008858000				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Chief Information Security Officer	TBD	Mr	TBD	TBD	J	8008858000				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	CMMI Model Point of Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach,	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Complaints Tracking Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Contact for Fraud Investigations	Compliance SIU Lead	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Coordination of Benefits Contact	VP Quality	Ms	Reed	Mechelle		8008858000				9499989856	Claims@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Corporate Mailing						5626829395				9499989856	CSnyder@ChampionPayer.com	5000 Airport Plazae	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Customer Service Operations Contact	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	DIR Contact	Part D Consultant	Dr.	Tso	Yvonne		3108973889				9499989856	Ytso@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	06/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	DIR Contact (Secondary)	CIO	Mr	Wyhinny	Andrew		8008858000				9499989856	AWyhinny@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Discount Program Payment Contact	CFO	Mr	Kori	Vijay		8008858000				9499989856	VKori@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Electronic Health Record Contact	VP Health Informatics	Mr.	Wyhinny	Andrew		8474713955				9499989856	AWyhinny@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8008858000				HMO - Health Maintenance Organization		C	Dallas
H6170	Emergency Part D Contact	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Emergency Part D Contact (Secondary)	Part D Consultant	Dr.	Tso	Yvonne		3108973889					YTso@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Encounter Data & Risk Adjustment Operations Contact	VP Quality	Ms	Reed	Mechelle		8008858000				9499989856	Claims@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Enrollment Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9498502552	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	EOB Transfer Contact	CIO	Mr	Wyhinny	Andrew		8008858000				9499989856	AWyhinny@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Financial Audit Contact	Chief Finance Officer	Mr	Kori	Vijay		8008858000				9499989856	VKori@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Financial Reporting Contact	Chief Financial Officer	Mr	Kori	Vijay		8008858000				9499989856	VKori@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Formulary Contact	Government Programs Specialist II	Ms.	Nyawablia	Christina		8587906297					Christina.Nyawablia@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Formulary Contact (Secondary)	Mgr Formulary Admin	Mr	Wong	Tim		8582915420					FAS@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	General Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Government Relations Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	HIPAA Security Officer	CIO	Mr	Wyhinny	Andrew		8008858000				9499989856	AWyhinny@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Hospice Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Interoperability Contact	Sr. VP Administration	Ms	Taylor	Sandie		9095733553				9492273741	STaylor@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	MA Appeals/Grievances Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	Grievance.Appeals@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	MA Claims Processing Contact for Public Website	Claims  Projects	Ms	Nguyen	Adriana		8008858000				9492273740	Claims@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Marketing Contact	EVP Sales & Marketing	Mr.	Davis	Jay	B	8008858000				9499989856	jay.davis@championpayer.com	5000 Airport Plaza Drive	Suite 100	Irvine	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Medical Director	Chief Medical Officer	Dr	Cross	Brian		8008858000				9498502542	BCross@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Medicare Compliance Officer	Compliance Officer / COO	Ms	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Medicare Coordinator	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Medicare Part D Opioid Overutilization Contact	Mgr Pharmacy Services	Ms.	Valdez	Sandra		8008858000				9499989856	SValdez@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/25/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Medication Therapy Management Contact	Mgr Pharmacy Services	Ms.	Valdez	Sandra		8008858000				9499989856	SValdez@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	OffShore Subcontractor Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Online Enrollment Center Contact (Back-up)	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Online Enrollment Center Contact (Optional)	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Online Enrollment Center Contact (Primary)	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part C Application Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395					CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part C Reporting Contact	VP Health Informatics	Mr	Wyhinny	Andrew		8008858000				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Appeals	Mgr Appeals & Gr	Ms	Martin	Dawn							Dawn.Martin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8442825341				HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Appeals Contact (Secondary)	EVP / Compliance Officer	Ms	Snyder	Constance	J					9499989856	hotline@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8008858000				HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Application Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaxa Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Benefits Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395					csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Claims Submission Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395					csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Exceptions Contact	Sup PA & UM Programs	Mr	deGuzman	Edwin							Edwin.deGuzman@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8442825341				HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Price File Contact (Back-up)	Compliance Director	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Price File Contact (Primary)	Part D Price File	Ms.	Keller	Shanon		8587907104					Shanon.Keller@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Quality Assurance Contact		Mr.	Hunt	Brian		8587907092					Brian.Hunt@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Part D Reporting Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airrport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Patient Safety Contact	Chief Medical Officer	Dr	Cross	Brian		8008858000				9499989856	BCross@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Payment Contact	VP	Ms.	Reed	Mechelle		8008858000				9499989856	Claims@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Pharmacy Director	Pharmacy Manager	Dr	Tso	Yvonne		3108973889					YTso@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Pharmacy Network Management Contact	Dir Pharm Net Admin	Mr.	Hunt	Brian		8587907092					Brian.Hunt@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Pharmacy Network Management Contact (Secondary)	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395					CSnyder@championpayer.com	19700 Fairchild Road	Suite 230	Irvine	CA	92612	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							CustomerService@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8442825341				HMO - Health Maintenance Organization		C	Dallas
H6170	Plan Directory Contact for Public Website	VP	Ms.	Reed	Mechelle		8008858000				9499989856	claims@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Plan to Plan Reconciliation Contact	CFO	Mr	Kori	Vijay		8008858000				9499989856	vkori@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Processor Contact		Mr.	Helmus	Scott		8584373471					Scott.Helmus@MedImpact.co	10181 Scripps Gateway Ct		San Diego	CA	92131	12/01/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Quality Contact	Chief Medical Officer	Dr.	Cross	Brian		8008858000				9499989856	BCross@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Reconciliation Contact	CFO	Mr	Kori	Vijay		8008858000				9499989856	accounting@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Reconciliation Contact (Secondary)	CFO	Mr.	Kori	Vijay		8008858000				9499989856	vkori@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Recovery Audit Contact	Chief Compliance Officer	Ms	Snyder	Constance		5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	SNP Application Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Surveillance Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	System Contact	VP Health Informatics	Mr	Wyhinny	Andrew		8008858000					Awyhinny@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Third Party Administrator (TPA) Liaison	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	User Access Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Utilization Management Contact	VP Utilization Mgt	Ms.	Mayo	Marcie		5623101247				4245324196	MMayo@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6170	Utilization Review Contact	VP Utilization Mgt	Ms.	Mayo	Marcie		5623101247				4245324196	MMayo@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	04/16/2025	2026	CHAMPION HEALTH PLAN OF CALIFORNIA INC	Local CCP	Champion Heath Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6188	Automated TrOOP Balance Transfer Contact	Director Financial Management	Mr.	Hamm	David	A	7247761100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/14/2024	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Backup User Access Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	03/10/2020	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Bid Primary Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	CAP Report Contact for Public Website	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	CEO - CMS Administrator Contact	CEO	Mr	Hamm	David	A	7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/19/2023	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	CEO - Senior Official for Contracting	CEO	Mr	Hamm	David	A	7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/19/2023	2026	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		7247761100					jeffrey.carraway@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	02/02/2018	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Chief Operating Officer	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	04/19/2023	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Chief Information Officer	VP Technology and Quality	Mr	Lamb	Charles		7247209202					charles.lamb@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	09/16/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Chief Information Security Officer	VP Technology and Quality	Mr	Lamb	Charles		7247209202					charles.lamb@lutheranseniorlife.org	191 Scharberry lane		Mars	PA	16046	08/15/2016	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Complaints Tracking Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Contact for Fraud Investigations	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Corporate Mailing						4123561688					leslie.kisow@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	06/07/2023	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	DIR Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Discount Program Payment Contact	Director Financial Management		Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/21/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Emergency Part D Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Emergency Part D Contact (Secondary)	Accounting Manager	Ms	Cionni	Jane		3042810400					maryjane.cionni@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	01/13/2025	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Encounter Data & Risk Adjustment Operations Contact	Director Financial Management		Hamm	David		7247422226					daave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Enrollment Contact	Accounting manager	Ms.	Cionni	Jane		7243022202				7247760811	maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	01/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	EOB Transfer Contact	Director Financial Management	Mr.	Hamm	David		7247422226				7247722960	dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Financial Audit Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Financial Reporting Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Formulary Contact	Medical Director	Dr.	Konitzky	Paul		7245458000				7245434370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	General Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	HIPAA Privacy Officer	Compliance Officer	Ms.	Kaminski	Leean		7247422295				7247722960	leean.kaminski@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/08/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	HIPAA Security Officer	Director MIS	Mr.	Gilson	Dennis		7246254841					dennis.gilson@lutheranseniorlife.org	500 Wittenberg Way	P. O. Box 928	Mars	PA	16046	08/09/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Interoperability Contact	Director Financial Management		Hamm	David		7247761100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	12/16/2024	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	MA Appeals/Grievances Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	MA Claims Processing Contact for Public Website	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Marketing Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Medical Director	Medical Director	Dr.	Konitzky	Paul		7245458000				7245434370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Medicare Coordinator	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Konitzky	Paul		7245458000				7245434370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Medication Therapy Management Contact	Medical Director	Dr.	Konitzky	Paul		7245458000				7245434370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part C Application Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part D Appeals	Director Financial Management	Mr.	Hamm	David							dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422226				PACE - Nat		C	Philadelphia
H6188	Part D Appeals Contact (Secondary)	Accounting Manager	Ms.	Cionni	Jane							maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422202				PACE - Nat		C	Philadelphia
H6188	Part D Application Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part D Benefits Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part D Claims Submission Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	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	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422226				PACE - Nat		C	Philadelphia
H6188	Part D Exceptions Contact (Secondary)	Accounting Manager		Cionni	Jane							Maryjane.cionni@lutheranseniorlife.org	Lutheran SeniorLife	1323 Freedom Road	Cranberry Township	PA	16066	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422202				PACE - Nat		C	Philadelphia
H6188	Part D Price File Contact (Back-up)	Accounting Manager	Ms.	Cionni	Jane		7247422202					Maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part D Price File Contact (Primary)	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part D Quality Assurance Contact	Director, Quality Assurance & Education	Ms.	Hankey	Laura		7243022017				7242875430	laura.hankey@lutheranseniorlife.org	740 Balckburb Rd, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Part D Reporting Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Patient Safety Contact	Medical Director	Dr.	Konitzky	Paul		7245458000				7245434370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Payment Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Personal Health Record Contact	Director Financial Management	Mr	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	01/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Pharmacy Director	Medical Director	Dr.	Konitzky	Paul		7245458000				7245434370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Pharmacy Network Management Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	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						7245434370	paul.konitzky@lutheranseniorlife.org	115 Nolte Drive		Kittanning	PA	16201	03/10/2020	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	7245458000				PACE - Nat		C	Philadelphia
H6188	Pharmacy Technical Help Desk Contact (Secondary)	Dir Financial Management		Hamm	David							dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/08/2017	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active	7245458000				PACE - Nat		C	Philadelphia
H6188	PHR Beneficiary Contact																	01/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE	Lutheran SeniorLife	Lutheran SeniorLife	352	Yes	Active	7247421100				PACE - Nat		C	Philadelphia
H6188	Plan Directory Contact for Public Website	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Plan to Plan Reconciliation Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Processor Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Quality Contact	Director, Quality Assurance & Education	Ms.	Hankey	Laura		7243022017				7242875430	laura.hankey@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Reconciliation Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Recovery Audit Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Surveillance Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	System Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Third Party Administrator (TPA) Liaison	Director Financial Management	Mr	Hamm	David		7247761100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/29/2025	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	User Access Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Utilization Management Contact	Utilization Review Coordinator	Ms.	Nemec	Dawn		4123561653					dawn.nemec@lutheranseniorlife.org	740 Blackburn Rd, Suite 300	School of Nursing, Third Floor	Sewickley	PA	15143	04/08/2019	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6188	Utilization Review Contact	Utilization Review Coordinator	Ms.	Nemec	Dawn		4123561653					dawn.nemec@lutheranseniorlife.org	740 Blackburn Rd, Suite 300	School of Nursing, Third Floor	Sewickley	PA	15143	04/08/2019	2026	VIECARE ARMSTRONG, LLC	National PACE	LIFE Armstrong	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H6200	Agent/Broker Compensation Data Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/12/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Automated TrOOP Balance Transfer Contact	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/04/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Backup User Access Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Best Available Evidence Contact	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63131	08/04/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Bid Audit Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Bid Audit Site Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Bid Primary Contact	LEAD ACTUARY	Mr.	Wolfe	Brandon		8158215190					brwolfe@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/17/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	CAP Report Contact for Public Website	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	CEO - CMS Administrator Contact	COO	Ms.	Slattery	Lisa		3147705644					lslattery@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	01/08/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	CEO - Senior Official for Contracting	President Essence HealthCare	Mr.	Reigel	Jordan		7202528130					jreigel@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/30/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Chief Financial Officer	Chief Financial Officer	Ms.	Venable	Erin		3143243689					evenable@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	05/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Chief Operating Officer	Chief Operating Officer	Ms.	Slattery	Lisa		3147705644					lslattery@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Chief Information Officer	Chief Technology Officer	Mr.	Saghabini	JeanClaude		6173124659					jsaghbini@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/15/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Chief Information Security Officer	Chief Information Security Officer	Mr.	Vannatta	Aaron		3147703700					avannatta@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	CMMI Model Point of Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	CMS Casework Communication Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Complaints Tracking Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Contact for Fraud Investigations	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Coordination of Benefits Contact			Inquiries	COB		8665979560					COBInquiry@lumeris.com	P O BOX 5907		TROY	MI	48007	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Corporate Mailing						8665979560					customerservice@essencehealthcare.com	CUSTOMER SERIVCE	P O BOX 5907	TROY	MI	48007	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Customer Service Operations Contact	Vice President, Health Plan Operations	Ms.	Meyerhoffer	Linda		6366869682					rmeyerhoffer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	DIR Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	DIR Contact (Secondary)	Sr. Manager, Compliance Monitoring & Reporting	Ms.	Young	Polly		3142092795					pyoung@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Discount Program Payment Contact	Sr Manager, Accounting		Almond	Barry		3142093068					balmond@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Emergency Part D Contact	VP, Health Plan Pharmacy		Wirick	Jennifer		7038585477					jwirick@lumeris.com	13900 Riverport Dr		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment Services	Mr.	Eschbach	Jason		6144397608					jeschbach@lumeris.com	13900 Riverport Drive		St. Louis	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Enrollment Contact	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63131	08/04/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	EOB Transfer Contact	Sr. Director Payment Strategy & Operations		Price	Alex		3142092800				8884802577	alprice@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/22/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Financial Audit Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Financial Reporting Contact	VP, Health Plan Finance		McGinnis	Lisa		3142092780					lmcginnis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Formulary Contact	VP, Health Plan Phamacy	Ms.	Wirick	Jennifer		7028585477					jwirick@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Formulary Contact (Secondary)	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	General Contact	President Essence HealthCare	Mr.	Reigel	Jordan		7202528130					jreigel@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/30/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Government Relations Contact	Chief Legal Officer	Ms.	Halterman	Gail		3142092717					ghalterman@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Davis	Amy		3142093945					adavis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	HIPAA Security Officer	CISO	Mr.	Vannatta	Aaron		3147703700					avannatta@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Hospice Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Interoperability Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	MA Appeals/Grievances Contact	Sr. Director, Appeals & Grievances	Ms.	Darnell	Erika		3162145746					edarnell@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/18/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	MA Claims Processing Contact for Public Website			Service	Customer		8665979560				8884802577	customerservice@essencehealthcare.com	P O BOX 5907		TROY	MI	48007	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Marketing Contact	Director, Compliance Marketing	Mr.	Ruiz	Lee		6366869602					lruiz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/10/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Medical Director	Chief Medical Officer EHI		Saccocio	Saria		3142092800					ssaccocio@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/06/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Medicare Compliance Officer	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Medicare Coordinator	Chief Operating Officer	Ms.	Slattery	Lisa		3147705644					lslattery@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	12/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Medication Therapy Management Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	OffShore Subcontractor Contact	VP Compliance, Medicare CO		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Online Enrollment Center Contact (Back-up)	Director, Compliance	Mr.	Ruiz	Lee		6366869602					lruiz@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/10/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Online Enrollment Center Contact (Optional)	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Online Enrollment Center Contact (Primary)	Director, Fulfillment		Kunkel	Shawn		3147703519					enrollment@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63131	08/04/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part C Application Contact	Sr. Director CMS Applications & PBP submissions	Mr.	Moser	Phil		3142092725					pmoser@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part C Reporting Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Appeals	Sr. Director, Appeals & Grievances	Ms.	Darnell	Erika							edarnell@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/15/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	3162145746				PPO - BBA		C	Dallas
H6200	Part D Appeals Contact (Secondary)	Director, Compliance	Ms.	Burgess	Sandra							sburgess@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/10/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	3142092886				PPO - BBA		C	Dallas
H6200	Part D Application Contact	Sr. Director, CMS Applications & PBP Submissions	Mr.	Moser	Phil		3142092725					pmoser@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Benefits Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_Dovico@express-scripts.com	One Express Way,		St Louis	MO	63121	11/26/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Exceptions Contact	Sr. Manager Pharmacy Prior Authorization		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way,	Mail Stop S13NB	St Louis	MO	63121	01/02/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	9013817109				PPO - BBA		C	Dallas
H6200	Part D Price File Contact (Back-up)	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Price File Contact (Optional)	Director, Compliance		Burgess	Sandy		3142092886					sburgess@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolphi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way,	Building 1	St Louis	MO	63121	10/21/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Part D Reporting Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Patient Safety Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Payment Contact	Vice President, Health Plan Finance	Ms.	McGinnis	Lisa		3142092780					lmcginnis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Pharmacy Director	VP, Health Plan Pharmacy		Wirick	Jennifer		7038585477					jwirick@lumeris.com	13900 Riverport Dr		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Pharmacy Network Management Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Pharmacy Network Management Contact (Secondary)	Network Acct. Director, Retail Strategy & Contract		Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way,		St Louis	MO	63121	11/26/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	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	11/26/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	8009221557				PPO - BBA		C	Dallas
H6200	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Operations		Summerfield	Kelly							ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active	3147703788				PPO - BBA		C	Dallas
H6200	Physician Incentive Contact	Sr. Manager, Health Plan Finance	Mr.	Privott	David		3147703732					dprivott@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	09/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Plan Directory Contact for Public Website			Service	Customer		8665979560					customerservice@essencehealthcare.com	1P O BOX 5907		TROY	MI	48007	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Plan to Plan Reconciliation Contact	Director, Health Plan Finance		Meyer	Jenell		3147703733					jameyer@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/04/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Processor Contact	Director, Government Programs Medicare		Steffen	Jeffrey		6363351729					jhsteffen@express-scripts.com	One Express Way,		St Louis	MO	63121	11/26/2024	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Quality Contact	Snr. Director, Quality Improvement		Pattison	Lisa		5082728692					lpattison@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Reconciliation Contact	Vice President, Health Plan Finance	Ms.	McGinnis	Lisa		3142092780					lmcginnis@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	03/21/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Reconciliation Contact (Secondary)	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Recovery Audit Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Surveillance Contact	VP Compliance, Medicare Compliance Officer		Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	System Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Third Party Administrator (TPA) Liaison	Sr. Manager, Accounting		Almond	Barry		3142093086					balmond@lumeris.com	13900 Riverport Dr		Maryland Heights	MO	63043	08/12/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	User Access Contact	VP Compliance, Medicare Compliance Officer	Mr.	Whitbeck	Britton		3142093989					jwhitbeck@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	11/17/2023	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Utilization Management Contact	Director, Pharmacy Operations		Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6200	Utilization Review Contact	Director, Pharmacy Operations	Ms.	Summerfield	Kelly		3147703788					ksummerfield@lumeris.com	13900 Riverport Drive		Maryland Heights	MO	63043	08/14/2025	2026	ESSENCE HEALTHCARE PPO, INC.	Local CCP	Essence Healthcare	Local PPO		Lumeris Group Holdings Corporation	86	Yes	Active					PPO - BBA		C	Dallas
H6202	Agent/Broker Compensation Data Contact	Consumer Sales Manager		Nichol	James (JD)		7012772846					james.nichol@bcbsnd.com	4510 13th Ave S		Fargo	ND	58121	02/07/2020	2026	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	Automated TrOOP Balance Transfer Contact	Manager, Business Process		Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/14/2022	2026	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	Bid Primary Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director		Pickens	Veronica		2483955887					vpickens@bcsbm.com	600 East Lafayette	TC 1301	Detroit	MI	48826	03/05/2024	2026	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	CEO - CMS Administrator Contact	Plan President	Ms.	West	Beth		7012821593					BethAnn.West@NextBlueND.com	4510 13th Ave S		Fargo	ND	58121	01/06/2025	2026	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	CEO - Senior Official for Contracting	Plan President	Ms.	West	Beth		7012821593					BethAnn.West@NextBlueND.com	4510 13th Ave S		Fargo	ND	58121	04/27/2022	2026	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		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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 Operating Officer	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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 Information Officer	IT Director II	Mrs.	Krause	Amy		3132256638					akrause@bcbsm.com	600 East Lafayette Blvd. MC 0506		Detroit	MI	48826	06/17/2022	2026	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 Information Security Officer	VP Chief Information Security Officer	Mr.	Cieszynski	Brent		3132258766					bcieszynski@bcbsm.com	600 Lafayette East		Detroit	MI	48226	08/22/2022	2026	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	CMMI Model Point of Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Complaints Tracking Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Corporate Mailing						7012821593					BethAnn.West@NextBlueND.com	4510 13th Ave S		Fargo	ND	58121	04/27/2022	2026	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		3132250555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/11/2021	2026	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	DIR Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	DIR Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.Zylstra@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Discount Program Payment Contact	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	Electronic Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Emergency Part D Contact	Manager		Zylstra	Jennifer		9544985880					jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	01/04/2023	2026	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	Emergency Part D Contact (Secondary)	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Employer Waiver Contact	Director		Nelson	Jessica		2483209946					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		King	Aleesha		9194303434					aking12@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	04/10/2025	2026	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	Enrollment Contact	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	EOB Transfer Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880				9528375607	Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Formulary Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Formulary Contact (Secondary)	Manager		Jones	Marini		3135706777					Marini.Jones@emergient.com	1000 Town Center		Southfeld	MI	48075	03/05/2024	2026	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	General Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	HIPAA Privacy Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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	HIPAA Security Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	Interoperability Contact	Manager, Functional Operations		Kingsley	Chris		2484444160					Christopher.kingsley@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	MA Appeals/Grievances Contact	Chief Operating Officer		Hower	Johanna		8048594034					Johanna.Hower@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	MA Claims Processing Contact for Public Website	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Marketing Contact	Plan President		West	Beth		7012821593					BethAnn.West@NextBlueND.com	4510 13th Ave S		Fargo	ND	58121	04/27/2022	2026	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	Medical Director	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director, Medicare Advantage Compliance		Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette	TC 1301	Detroit	MI	48226	03/05/2024	2026	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 Part D Opioid Overutilization Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	Medication Therapy Management Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	04/27/2022	2026	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	Online Enrollment Center Contact (Back-up)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Online Enrollment Center Contact (Optional)	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	Online Enrollment Center Contact (Primary)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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 C Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 C Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Appeals	Manager, Pharmacy PA/Appeals		Bricker	Bryce							bryce.m.bricker@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	8558124306				PPO - BBA		C	Chicago
H6202	Part D Appeals Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	8003443405	733326			PPO - BBA		C	Chicago
H6202	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Senior		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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 Claims Submission Contact	Manager, Business Process		Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	Manager, Pharmacy PA/Appeals		Bricker	Bryce							bryce.m.bricker@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	8558124306				PPO - BBA		C	Chicago
H6202	Part D Exceptions Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	6143363326				PPO - BBA		C	Chicago
H6202	Part D Price File Contact (Back-up)	Vice President		Siuta	Lori		2242312298					lori.siuta@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Price File Contact (Optional)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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 Price File Contact (Primary)	Sr. Business Analyst, Medicare Operations		Vargas	Danielle		4437101262					danielle.wooten@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Quality Assurance Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Payment Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Personal Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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 Director	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Network Management Contact	Sr. Account Manager, Network Account Management		Brown	Casey		6126427367					casey.brown@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Network Management Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Manager		Villanueva	Juan							Juan.Villanueva@optum.com	Telecommute		Costa Mesa	CA	92626	12/17/2025	2026	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	8007887871				PPO - BBA		C	Chicago
H6202	Pharmacy Technical Help Desk Contact (Secondary)	Manager		Betten	Brad							bradley.betten@optum.com	Telecommute		Costa Mesa	CA	92626	12/17/2025	2026	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	8007887871				PPO - BBA		C	Chicago
H6202	Physician Incentive Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Plan Directory Contact for Public Website	Director		Nelson	Jessica		8447538039					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Processor Contact	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Quality Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Reconciliation Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.Zylstra@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Recovery Audit Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP State Contact	Medical Director	Dr.	Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Surveillance Contact	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	User Access Contact	Administrative Assistant		Eddy	Chris		3132683879					CEddy@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/03/2024	2026	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	Utilization Management Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Utilization Review Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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
H6224	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Automated TrOOP Balance Transfer Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Best Available Evidence Contact	Senior Director,Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	11/21/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	11/21/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	CMMI Model Point of Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					Aaron.Laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	CMS Casework Communication Contact	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Complaints Tracking Contact	Sr. Quality Analyst, A&G	Ms.	Barbagallo	Toni Marie		4122557287					tbarbagallo@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Contact for Fraud Investigations	Director, Fraud, Waste and Abuse	Dr.	Berdell	Melissa		4126907432					mberdell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Coordination of Benefits Contact	Sr. Director, Operations	Ms.	Magliocco	Michelle		4122554810					COB-TPLMedicare@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Corporate Mailing						4122554640					medicareassured@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Customer Service Operations Contact	Manager Business Operations	Mr.	Hartman	Josh		8006855209					jhartman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	DIR Contact	Vice President, Accounting & Reporting		Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	Fifth Avenue Place		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager	Ms.	Stetson	Kelsey		4125445816					Kelsey.Stetson@highmarkhealth.org	120 Fifth Avenue	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Emergency Part D Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4122558830				8889188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Emergency Part D Contact (Secondary)	Senior Compliance Analyst	Mr	Woods	Shane		4129188763					Shane.Woods@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	09/18/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Encounter Data & Risk Adjustment Operations Contact	Senior Encounters Analyst	Mr.	McKay	Douglas		4129188447					GHP_Medicare_Encounters@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Enrollment Contact	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	EOB Transfer Contact	SVP, Operations	Mr.	Burgess	James		4122551318				4122551318	jburgess@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Financial Audit Contact	VP, Controller	Mr.	Cogan	Chris		4122554693					CCogan@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Formulary Contact	Pharmacy Relations & Formulary Specialist	Ms.	Stein	Victoria		1412255725					vstein@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Formulary Contact (Secondary)			McDonnell	Kallyn		4129188692					KMcDonnell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					justine.patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Hospice Contact	Supervisor, Pharmacy Call Center	Mr.	Woods	Shane		4129188763					SWoods2@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Interoperability Contact	VP,  Data Analytics & Strategy	Mr.	Castle	Brian		4129188449					bcastle@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	MA Appeals/Grievances Contact	Senior Director, Operations		Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	MA Claims Processing Contact for Public Website	SVP, Operations	Mr.	Burgess	James		4122551318					jburgess@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Medical Director	Senior Medical Director	Dr.	Reddy	Lakshmi		4124206517					lakshmi.reddy@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Medicare Part D Opioid Overutilization Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Medication Therapy Management Contact	Senior Director,  Stars Quality	Dr.	Serrano	Daniel	N	4129188572					dserrano@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Online Enrollment Center Contact (Back-up)	Manager, Enrollment, Systems Admin/Enrollment	Ms.	Blumentritt	Kristen		4122554172					KBlumentritt@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Online Enrollment Center Contact (Primary)	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part C Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Appeals	Supervisor, Medicare Appeals		Earlewine	Melissa							mearlewine@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4122557203				HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Appeals Contact (Secondary)	Manager, Appeals		Wright	Kristie							kwright@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4124206431				HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/03/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Benefits Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				8882452049	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Claims Submission Contact	Dir Initiative Mgt	Mr.	Smith	Cory		4129188825					csmith@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Exceptions Contact	VP, Pharmacy	Mr.	Yarnell	Eric						8882452049	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4129188830				HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Exceptions Contact (Secondary)	Director, Pharmacy Clinical Operations	Ms.	Nogrady	Lisa							lnogrady@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4122554256				HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Price File Contact (Back-up)	Director,  Pharmacy Business Operations	Ms.	Funkhouser	Christina		4122157123					cfunkhouser@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Price File Contact (Optional)	Program Manager, Pharmacy Quality		Michael	Alisa		4126907028					Alisa.Michael@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Price File Contact (Primary)	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Quality Assurance Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsbugh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Patient Safety Contact	Vice President, Pharmacy Business Administration	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Payment Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Pharmacy Director	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Pharmacy Network Management Contact	Director,  Pharmacy Business Operations	Ms.	Funkhouser	Christina		4122157123					cfunkhouser@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Pharmacy Network Management Contact (Secondary)	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	CVS								Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Philadelphia
H6224	Pharmacy Technical Help Desk Contact (Secondary)	VP, Pharmacy		Yarnell	Eric						4129188830	eric.yarnell@highmark.com	Four Gateway Center	444 Liberty Ave, Ste 2100	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8006855209				HMO - Health Maintenance Organization		C	Philadelphia
H6224	Physician Incentive Contact	Senior Director, Stars Quality	Mr.	O'Donnell	William		4129188572					wodonnell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Plan Directory Contact for Public Website	Manager Business Operations	Mr.	Hartman	Josh		8006855209					jhartman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Plan to Plan Reconciliation Contact	Manager, Operational Accounting		Stehr	Brett		7173022748					P2PRecon@highmark.com	Attn: Cashier	PO Box 898820	Camp Hill	PA	17089	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Processor Contact	Director, Claims Processing	Ms.	Goheen	Theresa		4129188706					tgoheen@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Quality Contact	Interim Director, Quality Improvement	Ms.	Uncapher	Patricia		4129188790					puncapher@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Reconciliation Contact	VP, Controller		Cogan	Chris		4122554693					CCogan@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Recovery Audit Contact	Director, Fraud, Waste and Abuse	Dr.	Berdell	Melissa		4126907432					mberdell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	SNP Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	SNP State Contact	Senior Risk Partner	Ms.	Bach	Vicki		4125441549					Vicki.Bach@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Third Party Administrator (TPA) Liaison	Senior Financial Analyst		Trautvetter	Jill		4122557132					jtrautvetter@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Utilization Management Contact	Director, Clinical Operations	Ms.	Layman	Katrina		4122554173					klayman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6224	Utilization Review Contact	Director, Clinical Operations	Ms.	Layman	Katrina		4122554173					klayman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	02/11/2025	2026	HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Philadelphia
H6231	Automated TrOOP Balance Transfer Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Backup User Access Contact	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Best Available Evidence Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Bid Primary Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	CAP Report Contact for Public Website	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	CEO - CMS Administrator Contact	Chief Physician Executive	Mr.	Craven	James		2257657077					james.craven@fmolhs.org	4200 Essen Lane		Baton Rouge	LA	70809	05/28/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	CEO - Senior Official for Contracting	Chief Physician Executive	Mr.	Craven	James		2257657707					james.craven@fmolhs.org	4200 Essen Lane		Baton Rouge	LA	70809	05/28/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Chief Financial Officer	Chief Financial Officer - FMOLHS	Mr.	Gleason	Mike		2259232701				2259264846	michael.gleason@fmolhs.org	4200 Essen Lane		Baton Rouge	LA	70808	07/25/2024	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Chief Operating Officer	Chief Physician Executive	Mr.	Craven	James		2257657077					james.craven@fmolhs.org	4200 Essen Lane		Baton Rouge	LA	70808	05/28/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Chief Information Officer	Chief Information Officer	Mr	Landry	Will		4433408915					will.landry@fmolhs.org	5959 S Sherwood Forest Blvd		Baton Rouge	LA	70816	06/30/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Chief Information Security Officer	SVP Chief Information Officer	Mr.	Landry	Will		4433408915					will.landry@fmolhs.org	5959 S Sherwood Forest Blvd		Baton Rouge	LA	70816	06/30/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	CMS Casework Communication Contact	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Complaints Tracking Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Contact for Fraud Investigations	Senior Director	Mrs.	Baldwin	Diane		2254900322				2259264846	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive.	4200 Essen Lane	Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Coordination of Benefits Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Corporate Mailing						2254900604				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Customer Service Operations Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	DIR Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	DIR Contact (Secondary)	Senior Director	Mrs.	Baldwin	Diane		2254900604					diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Discount Program Payment Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Emergency Part D Contact	Director of Finance	Mr.	Blanchard	W. John		2254900604	324			2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Emergency Part D Contact (Secondary)	Interim Director	Mrs.	Baldwin	Diane		2254900604				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive	4200  Essen Lane	Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Encounter Data & Risk Adjustment Operations Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324					whitney.blanchard@fmolhs.org	7436 Bishop Ott Dr		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Enrollment Contact	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900355	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	EOB Transfer Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Financial Audit Contact	Director of Finance	Mr.	Blanchard	W. John		2254900604				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Financial Reporting Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Formulary Contact	Medical Director	Dr.	Green	Michael		2254900604	325			2254900354	michael.green@fmolhs.org	7436 Bishop Ott Drive	4200  Essen Lane	Baton Rouge	LA	70806	12/28/2018	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	General Contact	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Government Relations Contact	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	HIPAA Privacy Officer	Compliance Officer	Mr.	Leblanc	Philip		2257655216				2254900354	philip.leblanc@fmolhs.org	5000 Hennessy Blvd.		Baton Rouge	LA	70809	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	HIPAA Security Officer	Compliance Officer	Mr.	Leblanc	Philip		2257655216				2254900354	philip.leblanc@fmolhs.org	5000 Hennessy Blvd.		Baton Rouge	LA	70809	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Interoperability Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604					diane.baldwin@trinity-health.org	7436 Bishop Ott Dr		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	MA Appeals/Grievances Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	MA Claims Processing Contact for Public Website	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Marketing Contact	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900355	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Medical Director	Franciscan PACE Inc. Medical Director	Dr.	Green	Michael		2254900325				2254900354	michael.green@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	12/27/2018	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Medicare Compliance Officer	Compliance Officer	Mr.	Leblanc	Philip		2257655216				2254900354	philip.leblanc@fmolhs.org	5000 Hennessy Blvd.		Baton Rouge	LA	70809	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Medicare Coordinator	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Medicare Part D Opioid Overutilization Contact	PACE Baton Rouge Medical Director	Dr.	Green	Michael		2254900325				2254900354	michael.green@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Medication Therapy Management Contact	Medical Director	Mr.	Green	Michael		2254900324				2254900354	michael.green@fmolhs.org	7436 Bishop Ott Drive	4200  Essen Lane	Baton Rouge	LA	70806	12/27/2018	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Online Enrollment Center Contact (Back-up)	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Online Enrollment Center Contact (Primary)	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part C Application Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Appeals	Director of Finance	Mr.	Blanchard	W. John						2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active	8007892863				PACE - Nat		C	New York
H6231	Part D Appeals Contact (Secondary)	Interim Director	Mrs.	Baldwin	Diane						2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active	2254900604				PACE - Nat		C	New York
H6231	Part D Application Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Benefits Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Claims Submission Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Exceptions Contact	Franciscan PACE Inc. Medical Director	Dr.	Green	Michael						2254900354	michael.green@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	12/27/2018	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active	8007892863				PACE - Nat		C	New York
H6231	Part D Exceptions Contact (Secondary)	Director of Finance	Mr.	Blanchard	W. John						2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active	8007892863				PACE - Nat		C	New York
H6231	Part D Price File Contact (Back-up)	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Price File Contact (Optional)	Interim Director	Mrs.	Baldwin	Diane		2254900322				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Price File Contact (Primary)	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Quality Assurance Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Part D Reporting Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Patient Safety Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Payment Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Pharmacy Director	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Pharmacy Network Management Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Green	Michael						2254900354	michael.green@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	07/18/2024	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active	2254900604				PACE - Nat		C	New York
H6231	Plan Directory Contact for Public Website	Interim Director	Mrs.	Baldwin	Diane		2254900604				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Plan to Plan Reconciliation Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Processor Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Quality Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604				2254900355	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Reconciliation Contact	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Reconciliation Contact (Secondary)	Interim Director	Mrs.	Baldwin	Diane		2254900604					diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Recovery Audit Contact	Director of Finance	Mr.	Blanchard	W. John		2254900326					whitney.blanchard@fmolhs.org	7436 Bishop Ott		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Surveillance Contact	Compliance Officer	Mr.	Leblanc	Philip		2257655216				2254900354	Philip.leblanc@fmolhs.org	5000 Hennessy Blvd.		Baton Rouge	LA	70809	02/02/2015	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	System Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604				2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Third Party Administrator (TPA) Liaison	Director of Finance	Mr.	Blanchard	W. John		2254900324				2254900354	whitney.blanchard@fmolhs.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	04/18/2023	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	User Access Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	326			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Utilization Management Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6231	Utilization Review Contact	Interim Director	Mrs.	Baldwin	Diane		2254900604	322			2254900354	diane.baldwin@trinity-health.org	7436 Bishop Ott Drive		Baton Rouge	LA	70806	08/12/2025	2026	FRANCISCAN PACE, INC.	National PACE	PACE Baton Rouge	National PACE		Franciscan Missionaries of Our Lady Health System	366	Yes	Active					PACE - Nat		C	New York
H6237	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	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	Dallas
H6237	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
H6237	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	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	Dallas
H6237	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	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	Dallas
H6237	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	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	Dallas
H6237	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Encounter Data & Risk Adjustment Operations Contact	AD Risk Adjustment Analytics		Aryal	Binaya		5032255305					Binaya.Aryal@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/06/2025	2026	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	Dallas
H6237	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	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	Dallas
H6237	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
H6237	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	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	Dallas
H6237	MA Appeals/Grievances Contact	Healthcare Svcs Program Mgr Sr	Ms.	Huque	Nita		5035531462					Nita.Huque@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	MA Claims Processing Contact for Public Website	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	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	Dallas
H6237	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	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	Dallas
H6237	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Part C Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Part C Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H6237	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H6237	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	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	Dallas
H6237	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H6237	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				HMO - Health Maintenance Organization		C	Dallas
H6237	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
H6237	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
H6237	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	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	Dallas
H6237	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
H6237	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	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	Dallas
H6237	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				HMO - Health Maintenance Organization		C	Dallas
H6237	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	REGENCE BLUECROSS BLUESHIELD OF OREGON	Local CCP	Regence BlueCross BlueShield of Oregon	HMO/HMOPOS		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				HMO - Health Maintenance Organization		C	Dallas
H6237	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	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	Dallas
H6237	Quality Contact	Director, Quality Management	Mr.	Mcclure	Andy		5032206189					Andrew.Mcclure@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	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	Dallas
H6237	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
H6237	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
H6237	Utilization Management Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6237	Utilization Review Contact	Director, Clinical Service Operations	Ms.	Adams	Lauren		2063325538					Lauren.Adams@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
H6248	Agent/Broker Compensation Data Contact	Chief Operating Officer		Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Rivera-Aquino	Denisse		8587905873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/05/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Backup User Access Contact	Compliance Audit Manager		Guzman	Guillermo		6196781833					gguzman@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	06/10/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Best Available Evidence Contact	Enrollment Manager		Fernandez	Judith		6194986418				6194269437	jferna@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Bid Audit Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Bid Audit Site Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Bid Primary Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	CAP Report Contact for Public Website	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8882444430				HMO - Health Maintenance Organization		C	New York
H6248	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Diaz	Norma		6199472959				6194225930	ndiaz@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/26/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Diaz	Norma		6194986416				6194225930	ndiaz@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Chief Financial Officer	Chief Financial Officer	Mr.	Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Chief Operating Officer	Chief Operating Officer	Mr.	Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Chief Information Officer	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Chief Information Security Officer	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	CMMI Model Point of Contact	Compliance & Fraud Prevention Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	CMS Casework Communication Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Complaints Tracking Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Contact for Fraud Investigations	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/02/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Coordination of Benefits Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Corporate Mailing						6194220422				6194225930	info@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Customer Service Operations Contact	Director of Member Services		Duenas	Chris		6192408923					cduenas@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	DIR Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	DIR Contact (Secondary)	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Discount Program Payment Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Electronic Health Record Contact	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Emergency Part D Contact	Director of Corporate Quality		Koizumi	Noreen		6193008758					NKoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/27/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Emergency Part D Contact (Secondary)	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/12/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Encounter Data & Risk Adjustment Operations Contact	Director of Information Systems		Flora	Tatsani	I	6194986439					tinkha@chgsd.com	2420 Fenton Street	S-100	Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Enrollment Contact	Enrollment Manager		Fernandez	Judith		6194986418				6194269437	jferna@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	EOB Transfer Contact	Director of Claims Administration		Valdez	Elizabeth		6199842109				6194258726	evaldez@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Financial Audit Contact	Chief Financial Officer	Mr.	Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Financial Reporting Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Formulary Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Formulary Contact (Secondary)	Part D Manager, Formulary Administration & Strateg		Wong	Tim		8587906297					fas@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/20/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	General Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Government Relations Contact	Associate CEO		Warren	Ann		6194986516				6194225930	awarre@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	HIPAA Privacy Officer	Chief Information Officer	Mr.	Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	HIPAA Security Officer	Chief Information Officer		Sombillo	Allan		6194986413					asombi@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Hospice Contact	Senior Director of Healthcare Services		Farook	Yousaf		6194986540					yfaroo@chgsd.com	2420 Fenton Street		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Interoperability Contact	Director of Information Systems		Flora	Tatsani	I	6194986439					tinkha@chgsd.com	2420 Fenton Street		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	MA Appeals/Grievances Contact	Corporate Quality Director		Koizumi	Noreen		6194986470					nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	MA Claims Processing Contact for Public Website	Claims Administration Director		Valdez	Elizabeth		6199842109				6194258726	evaldez@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Marketing Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Medical Director	Chief Medical Officer		Conrad, MD	Alan		6192714769					aconrad@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	12/27/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Medicare Compliance Officer	Associate Chief Executive Officer	Ms.	Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Medicare Coordinator	Chief Operating Officer		Garcia	Joseph		6194986557				6194225930	jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Medicare Part D Opioid Overutilization Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Medication Therapy Management Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Online Enrollment Center Contact (Back-up)	Enrollment Specialist		Padilla	Paloma		6199842073					ppadilla@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Online Enrollment Center Contact (Primary)	Enrollment Manager		Fernandez	Judith		6194986418					jferna@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part C Application Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part C Reporting Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Appeals	Director of Corporate Quality		Koizumi	Noreen							nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8882444430				HMO - Health Maintenance Organization		C	New York
H6248	Part D Appeals Contact (Secondary)	Grievance and Appeals Supervisor		Herrera	Yessenia							yesseniaherrera@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8882444430				HMO - Health Maintenance Organization		C	New York
H6248	Part D Application Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Benefits Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Claims Submission Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Exceptions Contact	Pharmacy Manager		Nicks	Ronald							rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	6192408859				HMO - Health Maintenance Organization		C	New York
H6248	Part D Exceptions Contact (Secondary)	Director of Corporate Quality		Koizumi	Noreen						6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8882444430				HMO - Health Maintenance Organization		C	New York
H6248	Part D Price File Contact (Back-up)	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Price File Contact (Optional)	Medicare Part D Project Manager		Keller	Shanon		8587907104					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/05/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Price File Contact (Primary)	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Quality Assurance Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Part D Reporting Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Patient Safety Contact	Director of Corporate Quality		Koizumi	Noreen		6194986476				6194074652	nkoizu@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Payment Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Pharmacy Director	Pharmacy Manager		Nicks	Ronald		6194986516					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Pharmacy Network Management Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Administration		Hunt	Brian		8007882949				8587906011	pharmacynetworkadministrators@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/05/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Pharmacy Technical Help Desk Contact	VP, Customer Contact Services		Battle	Dorry						8587906075	Customerservice@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	8337260674				HMO - Health Maintenance Organization		C	New York
H6248	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Manager		Nicks	Ronald							rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active	6192408859				HMO - Health Maintenance Organization		C	New York
H6248	Physician Incentive Contact	Chief Operating Officer		Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	04/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Plan Directory Contact for Public Website	Director of Member Services		Duenas	Chris		6192408923					cduenas@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Plan to Plan Reconciliation Contact	Pharmacy Manager		Nicks	Ronald		6192408859					rnicks@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Processor Contact	Claims Administration Director		Valdez	Elizabeth		6199842109				6194258726	evaldez@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	11/14/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Quality Contact	Corporate Quality Director		Koizumi	Noreen		6194986476					nkoizu@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Reconciliation Contact	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Reconciliation Contact (Secondary)	Senior Financial Analyst		Nissan	Silver		6194986543					snissan@chgsd.com	2420 Fenton Street Suite 100		Chula Vista	CA	91914	01/03/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Recovery Audit Contact	Associate Chief Executive Officer	Ms.	Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	SNP Application Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	SNP State Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Surveillance Contact	Chief Operating Officer		Garcia	Joseph		6194986557					jgarcia@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	System Contact	Chief Information Officer		Sombillo	Allan		6194986413				6194763818	asombi@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Carroll	Scott		6194986591				6194257803	scarro@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	02/15/2023	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	User Access Contact	Associate Chief Executive Officer		Warren	Ann		6194986516					awarre@chgsd.com	2420 Fenton Street	Suite 100	Chula Vista	CA	91914	10/01/2025	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Utilization Management Contact	Director of Utilization Management		Vargas	Barbara		6195007516					bvargas@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	06/28/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6248	Utilization Review Contact	Director of Utilization Management		Vargas	Barbara		6195007516					bvargas@chgsd.com	2420 Fenton Street   Suite 100		Chula Vista	CA	91914	06/28/2024	2026	COMMUNITY HEALTH GROUP	Local CCP	Community Health Group	HMO/HMOPOS		Community Health Group	320	Yes	Active					HMO - Health Maintenance Organization		C	New York
H6251	Automated TrOOP Balance Transfer Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Backup User Access Contact	Executive Director		Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Best Available Evidence Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Bid Primary Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	CAP Report Contact for Public Website	Executive Director	Ms	William	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	CEO - Senior Official for Contracting	Executive Director	Ms	William	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Chief Financial Officer	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Chief Operating Officer	COO	Ms	Lewis	Anne		4066472980					Anne.Lewis@trinity-health.org	6113 Norma Jean Ln.		Billings	MT	59101	05/30/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Chief Information Officer	Director of IT Operations	Mr.	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	1201 Langhorne-Newton Rd		Langhorne	PA	19047	02/26/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Chief Information Security Officer	VP Information Security	Mr.	Jennings	Preston		6105503083					Preston.jennings@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	CMS Casework Communication Contact	Executive Director	Ms	Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Complaints Tracking Contact	Director, Quality and Compliance	Ms	Wood	Casey		3017548530					Casey.Wood001@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Contact for Fraud Investigations	Director, Quality and Compliance	Ms	Wood	Casey		3017548530					Casey.Wood001@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	09/15/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Coordination of Benefits Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburgh	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Corporate Mailing						2489245892					murphysa@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	05/30/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Customer Service Operations Contact	Executive Director	Ms	Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	DIR Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburgh	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Discount Program Payment Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburgh	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Emergency Part D Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburgh	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/03/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Enrollment Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburgh	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	EOB Transfer Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530				6102719529	DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/25/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Financial Audit Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Financial Reporting Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	08/03/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	General Contact	Executive Director	Ms	Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Government Relations Contact	Executive Director	Ms	Willaims	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Maryland	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Interoperability Contact	Director of IT Operations	Mr.	Gillespie	Jeff		6142348686					gillespj@trinity-health.org	1201 Langhorne-Newtown Rd		Langhorne	PA	19047	02/26/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	MA Appeals/Grievances Contact	Director, Quality and Compliance	Ms	Wood	Casey		3017548530					Casey.Wood001@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	09/15/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	MA Claims Processing Contact for Public Website	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Marketing Contact	Director Marketing and Communication	Ms.	Lark	Azia		9735182754					azia.lark@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	05/30/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Medical Director	Medical Director		Chilakamarri	Geetha		3017548530					Geetha.Chilakamarri@trinity-health.org	200 Perry Parkway		Gaithersburg	MD	20877	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Medicare Compliance Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Medicare Coordinator	Executive Director	Ms	Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.Garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					Joseph.Garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part C Application Contact	COO		Lewis	Anne		4066472980					anne.lewis@trinity-health.org	6113 Norma Jean Lane		Billings	MT	59101	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part D Appeals	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.Garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H6251	Part D Application Contact	COO		Lewis	Anne		4066472980					anne.lewis@trinity-health.org	6113 Norma Jean Lane		Billings	MT	59101	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part D Benefits Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part D Claims Submission Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part D Exceptions Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.Garbarino@trinity-health.org	1001 Baltimore Pike		Springfield	PA	19064	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H6251	Part D Price File Contact (Back-up)	Executive Director	Ms	Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part D Price File Contact (Primary)	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part D Quality Assurance Contact	Director, Quality and Compliance	Ms	Wood	Casey		3017548530					Casey.Wood001@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	09/15/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Part D Reporting Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Patient Safety Contact	Director, Quality and Compliance	Ms	Wood	Casey		3017548530					Casey.Wood001@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	09/15/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Payment Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Pharmacy Director	Manager Part D Compliance	Mr.	Garbarino	Joseph		2153394362					joseph.Garbarino@trinity-health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Pharmacy Network Management Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph		2153394362					joseph.Garbarino@trinity-health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Pharmacy Technical Help Desk Contact	Manager Part D Compliance	Mr.	Garbarino	Joseph							joseph.Garbarino@trinity-health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H6251	Plan Directory Contact for Public Website	Executive Director	Ms	Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Plan to Plan Reconciliation Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Processor Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Quality Contact	Director, Quality and Compliance	Ms	Wood	Casey		3017548530					Casey.Wood001@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	09/15/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Reconciliation Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Recovery Audit Contact	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburgh	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Surveillance Contact	Executive Director	Ms	Williams	Kathleen		3017548530					willkast@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	05/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Third Party Administrator (TPA) Liaison	Regional Director, Finance	Mr.	Schmotzer	David		3017548530					DAVID.SCHMOTZER@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	11/24/2025	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Utilization Management Contact	Chief Medical Officer	Ms.	Nichols, MD	Karen		2154079507					karen.nichols001@trinity-health.org	20255 Victor Parkway		Livonia	MI	48152	08/03/2023	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6251	Utilization Review Contact	Medical Director		Chilakamarri	Geetha		3017548530					Geetha.Chilakamarri@trinity-health.org	200 Perry Parkway	Suite 1	Gaithersburg	MD	20877	06/20/2024	2026	TRINITY HEALTH PACE OF MONTGOMERY COUNTY	National PACE	Trinity Health PACE of Montgomery County	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6309	Agent/Broker Compensation Data Contact	VP Government Programs		Clelland	Jennifer	J	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Automated TrOOP Balance Transfer Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Backup User Access Contact	Coordinator Government Programs		Yu	Chao		9528837240					Chao.X.Yu@HealthPartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Best Available Evidence Contact	Sr. Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Bid Audit Contact	Director, Integrity and Compliance	Ms.	Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Bid Audit Site Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS:  21103C	Minneapolis	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Bid Primary Contact	Vice President, Actuary		Stewart	Sara	M	9528835049					sara.m.stewart@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21105H	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	CAP Report Contact for Public Website	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	CEO - CMS Administrator Contact	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	CEO - Senior Official for Contracting	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Chief Financial Officer	SVP & Chief Financial Officer	Ms.	Johnson	Kathleen	A	9528836531					kathy.a.johnson1@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Chief Operating Officer	EVP, Health Engagement and Informatics Officer	Ms.	Knudson	Susan	M	9528836185					susan.m.knudson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110A	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Chief Information Officer	Senior Vice President and CTO	Mr.	Thull	Tim	D	9528837636					timothy.d.thull@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Chief Information Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	CMS Casework Communication Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Complaints Tracking Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Contact for Fraud Investigations	Senior Manager Claims		Dahlberg	Kara	A	9529675640					kara.a.dahlberg@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  25510F	Minneapolis	MN	55101	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Coordination of Benefits Contact	Manager, Claims Production		Prine	Chantelle	M	9529677335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Corporate Mailing						9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Customer Service Operations Contact	Director Member Services		Renneke	Alison		9529677668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	554409463	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	DIR Contact	Sr. Pharmacy Plan Contract Manager		Reinhardt	Sandra	L	9528836739					sandra.l.reinhardt@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	DIR Contact (Secondary)	Consultant, Data Analysis		Binsfeld	David	T	9529675950					david.t.binsfeld@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS 21108Q	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Discount Program Payment Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Emergency Part D Contact	Sr. Director Pharmacy Services		Strahl	Christine	L	9528835022				9529676667	christine.l.strahl@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Emergency Part D Contact (Secondary)	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Employer Waiver Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Encounter Data & Risk Adjustment Operations Contact	Senior Manager Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South	MS: 21103J	Minneapolis	MN	55425	02/19/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Enrollment Contact	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	EOB Transfer Contact	Sr. Manager Claims Production		Huseby	Pam	J	9529675530				9528837666	pam.j.huseby@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Financial Audit Contact	Director Monitoring and Compliance	Ms	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Financial Reporting Contact	Director Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Formulary Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Formulary Contact (Secondary)	Formulary Administration Pharmacist		Savage	Robert		8587906426					robert.savage@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Ct.	San Diego	CA	92131	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	General Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Government Relations Contact	VP Government Programs		Clelland	Jennifer	J	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	HIPAA Privacy Officer	Sr. Director Integrity Compliance Privacy Officer		Wells	Prasanta	K	9528837325					prasanta.k.wells@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103K	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	HIPAA Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Hospice Contact	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Interoperability Contact	Program Manager, IT		Geisler	Chris	J	6122479067					Chris.J.Geisler@HealthPartners.Com	8170 33rd Avenue South		Bloomington	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	MA Appeals/Grievances Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	MA Claims Processing Contact for Public Website	Sr. Manager Claims Production		Huseby	Pam	J	9529675530					RVSCProviderInquiry@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Marketing Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Medical Director	Health Plan Chief Medical Officer	Dr.	Kakacek	Virginia	L	9528837120					virginia.l.kakacek@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110Q	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Medicare Compliance Officer	Director, Integrity and Compliance	Ms.	Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Medicare Coordinator	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Medicare Part D Opioid Overutilization Contact	Pharmacy UM Systems and Data Analyst		Hamm	Sarah	K	9529677652					sarah.k.hamm@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	02/12/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Medication Therapy Management Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Online Enrollment Center Contact (Back-up)	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Online Enrollment Center Contact (Optional)	Admin Product Implementation Manager		Wessel	Sara	C	9529677623					sara.c.wessel@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Online Enrollment Center Contact (Primary)	Senior Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part C Application Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part C Reporting Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part D Appeals	Manager Member Rights and Benefits		Kruse	Morgan	L						Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS:  21103R	Minneapolis	MN	554409463	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8007963806				PPO - BBA		C	Chicago
H6309	Part D Appeals Contact (Secondary)	Supervisor, Member Rights and Benefits		Dress	Samantha							Samantha.L.Dress@HealthPartners.com	8170 33rd Avenue South	MS: 21103R	Bloomington	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8007963806				PPO - BBA		C	Chicago
H6309	Part D Application Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part D Benefits Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part D Claims Submission Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part D Exceptions Contact	Mgr Pharmacy Clinical Svcs & UM Pharm Clin Srv		Whelan	Hillary	A					8888835434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8004927259				PPO - BBA		C	Chicago
H6309	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part D Price File Contact (Primary)	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part D Quality Assurance Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21108T	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Part D Reporting Contact	Director of Medicare and Shared Services		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Patient Safety Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Payment Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Pharmacy Director	VP Pharmacy		Busch	David	L	9529675049					david.l.busch@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Pharmacy Network Management Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Pharmacy Network Management Contact (Secondary)	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Pharmacy Technical Help Desk Contact	Manager Health Plan Pharmacy Customer Service		Whelan	Hillary	A					8888835434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8004927259				PPO - BBA		C	Chicago
H6309	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Customer Service		Sahs	Dale							dale.sahs@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active	8009221557				PPO - BBA		C	Chicago
H6309	Plan Directory Contact for Public Website			Services	Provider		9528837699					RVSCProviderInquiry@HealthPartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Plan to Plan Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Processor Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina		9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Quality Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Recovery Audit Contact	Director Monitoring and Compliance	Ms.	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Surveillance Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	System Contact	Senior Manager Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21193J	Minneapolis	MN	554401309	02/19/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Third Party Administrator (TPA) Liaison	Senior Accountant		Knights	Michelle		9528836532					michelle.m.knights@healthpartners.com	8170 33rd Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	User Access Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Utilization Management Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6309	Utilization Review Contact	Sr. Director Utilization Management		Gunderson	Susan	C	9528835576					susan.c.gunderson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21108T	Minneapolis	MN	554401309	01/29/2025	2026	HEALTHPARTNERS INSURANCE COMPANY	Local CCP	HealthPartners	Local PPO		HealthPartners, Inc.	117	Yes	Active					PPO - BBA		C	Chicago
H6316	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	11/09/2020	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H6316	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H6316	PHR Beneficiary Contact																	11/09/2020	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H6316	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	MISSOURI CARE, INCORPORATED	Local CCP	Healthy Blue	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6316	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Backup User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/29/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	CAP Report Contact for Public Website		Ms.	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	CEO - CMS Administrator Contact		Ms.	Davis	Amanda		6698771288					amanda.davis@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	CEO - Senior Official for Contracting		Ms.	Davis	Amanda		6698771288					amanda.davis@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Chief Financial Officer		Ms.	Davis	Amanda		6698771288					amanda.davis@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Chief Operating Officer		Ms.	Davis	Amanda		6698771288					amanda.davis@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Contact for Fraud Investigations			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Customer Service Operations Contact		Ms.	Davis	Amanda		6698771288					amanda.davis@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	05/30/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	DIR Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	DIR Contact (Secondary)			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Emergency Part D Contact (Secondary)			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	General Contact		Ms.	Davis	Amanda		6698771288					amanda.davis@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	05/30/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Government Relations Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	HIPAA Privacy Officer			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	HIPAA Security Officer			Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Medical Director			Robinson	Colin		6266577704					colin.robinson@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Medicare Compliance Officer		Ms.	Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Medicare Coordinator		Ms.	Davis	Amanda		6698771288					amanda.davis@welbehealth.com	1799 Hamilton Ave		San Jose	CA	95125	05/30/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	2192106392				PACE - Nat		C	San Francisco
H6317	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H6317	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H6317	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part D Quality Assurance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Patient Safety Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H6317	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/23/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Surveillance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6317	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/23/2023	2026	WELBEHEALTH BAY AREA PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H6322	Agent/Broker Compensation Data Contact	Director, Finance		Crowley	Daniel		8107339602					daniel.crowley@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/02/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Automated TrOOP Balance Transfer Contact	MIG Vice President Pharmacy		Musial	Brian		3178227523					bmusial@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	03/02/2022	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Backup User Access Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	11/07/2023	2026	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	MIG Director of Operations		Cuccia	Tami		8107339669					tami.cuccia@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	09/15/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Bid Audit Contact	Vice President, Finance		Hairston	Rachel		8107339678					rachel.hairston@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Bid Audit Site Contact	Medicare Compliance Officer		Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	09/30/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Bid Primary Contact	Director, Medicare Programs		Van Dusen	Kristin		9896273897					kristin.vandusen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/31/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	CAP Report Contact for Public Website	Medicare Compliance Officer		Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	09/30/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	CEO - CMS Administrator Contact	Market President MI	Ms.	Devine	Danielle		8107339702					danielle.devine@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	05/07/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	CEO - Senior Official for Contracting	Market President MI	Ms.	Devine	Danielle		8107339702					danielle.devine@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	05/07/2025	2026	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		9899923272					cheryl.diehl@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2026	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 Operating Officer	VP of BI and Operations	Ms.	Mavredes	Sara		8107339725					sara.mavredes@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	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 Information Officer	VP of BI and Operations	Ms.	Mavredes	Sara		8107339725					sara.mavredes@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	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 Information Security Officer	VP of BI and Operations	Ms.	Mavredes	Sara		8107339725					sara.mavredes@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	CMMI Model Point of Contact	Director, Medicare Programs		Van Dusen	Kristin		9896273897					kristin.vandusen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/31/2025	2026	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	Medicare Program Specialist		Sweet	Melissa		8107339672				8106007984	melissa.sweet@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Complaints Tracking Contact	Medicare Program Specialist		Sweet	Melissa		8107339672				8106007984	melissa.sweet@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	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	MIG Director of Operations		Cuccia	Tami		8107339669					tami.cuccia@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	09/15/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Corporate Mailing						8107339729					diab.rizk@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/10/2021	2026	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	Director, Customer Service		Marks	Ryan		3178227206					rmarks@mdwise.org	G-3245 Beecher Rd	Ste 201	Flint	MI	48532	05/20/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	DIR Contact	Vice President, Finance		Hairston	Rachel		8107339678					rachel.hairston@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	DIR Contact (Secondary)	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Discount Program Payment Contact	Director, Finance		Crowley	Daniel		8107339602					daniel.crowley@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/02/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Electronic Health Record Contact	Dir, Business Information		Sergent	Maria		9894131753					maria.sergent@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Emergency Part D Contact	MIG Vice President Pharmacy		Musial	Brian		3178227523					bmusial@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	03/02/2022	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Emergency Part D Contact (Secondary)	Director of Pharmacy		Taylor	Randall		8102441658					randall.taylor@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Employer Waiver Contact	Director, Medicare Programs		Van Dusen	Kristin		9896273897					kristin.vandusen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/31/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Encounter Data & Risk Adjustment Operations Contact	Dir Business Information		Sergent	Maria		8107339526					maria.sergent@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	11/18/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Enrollment Contact	Director of Enrollment Operations		Garrison	Lori		3178227487					lgarrison@mdwise.org	2955 N Meridian St	Ste 201	Indianapolis	IN	46208	08/27/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	EOB Transfer Contact	Director, Customer Service		Marks	Ryan		3178227206				8554175617	rmarks@mdwise.org	G-3245 Beecher Rd		Flint	MI	48532	05/20/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Financial Audit Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	09/30/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Financial Reporting Contact	Vice President, Finance		Hairston	Rachel		8107339678					rachel.hairston@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Formulary Contact	Director of Pharmacy		Taylor	Randall		8102441658					randall.taylor@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Formulary Contact (Secondary)	MIG Vice President Pharmacy		Musial	Brian		3178227523					bmusial@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	03/02/2022	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	General Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	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		8107339681					matthew.ehrlich@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	HIPAA Privacy Officer	Compliance Officer		Rizk	Diab		8107339729					diab.rizk@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	01/25/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	HIPAA Security Officer	Compliance Officer		Rizk	Diab		8107339729					diab.rizk@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/15/2021	2026	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		8106441660					angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Interoperability Contact	Dir Business Information		Sergent	Maria		8107339526					maria.sergent@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	11/19/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	MA Appeals/Grievances Contact	Medicare Program Specialist		Sweet	Melissa		8107339672				8106007984	medicareappeals@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	MA Claims Processing Contact for Public Website	MIG Director of Operations		Cuccia	Tami		8107339669					tami.cuccia@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	09/15/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Marketing Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Medical Director	Medical Director	Dr.	Perry	Dennis		8107339642					dennis.perry@mclaren.org	G3245 Beecher Rd	Ste 201	Flint	MI	48532	10/27/2023	2026	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		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/25/2022	2026	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 Coordinator	Director, Medicare Programs		Van Dusen	Kristin		9896273897					kristin.vandusen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/31/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy Intake Specialist		Russell	Danielle		8107339783					danielle.russell@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Medication Therapy Management Contact	MIG Vice President Pharmacy		Musial	Brian		3178227523					bmusial@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	03/02/2022	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Online Enrollment Center Contact (Back-up)	Director, Medicare Programs		Van Dusen	Kristin		9896273897					kristin.vandusen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Online Enrollment Center Contact (Primary)	Director of Enrollment Operations		Garrison	Lori		3178227487					lgarrison@mdwise.org	2955 N Meridian St	Ste 201	Indianapolis	IN	46208	08/27/2025	2026	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 C Application Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	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 C Reporting Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	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 Appeals	Pharmacy Project Coordinator		Slater	Angela							angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	8883270671				HMO - Health Maintenance Organization		C	Chicago
H6322	Part D Appeals Contact (Secondary)	Pharmacy Intake Specialist		Jehnsen	Ashley							ashley.jehnsen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/10/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	8883270671				HMO - Health Maintenance Organization		C	Chicago
H6322	Part D Application Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	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 Benefits Contact	Director of Pharmacy		Taylor	Randall		8102441658					randall.taylor@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	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 Claims Submission Contact	Software Developer		Vohwinkle	Jacob		8107339739					jacob.vohwinkle@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	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	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	8883270671				HMO - Health Maintenance Organization		C	Chicago
H6322	Part D Exceptions Contact (Secondary)	Pharmacy Intake Specialist		Jehnsen	Ashley							ashley.jehnsen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/10/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	8883270671				HMO - Health Maintenance Organization		C	Chicago
H6322	Part D Price File Contact (Back-up)	MIG Vice President Pharmacy		Musial	Brian		3178227523					bmusial@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	03/02/2022	2026	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 Price File Contact (Optional)	Pharmacy EDI Specialist		Ivancic	Matt		3178227391					mivancic@mdwise.org	2955 N Meridian St		Indianapolis	IN	46208	06/15/2021	2026	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 Price File Contact (Primary)	Medicare Part D Project Manager		Keller	Shanon		8587907104					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/15/2021	2026	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 Quality Assurance Contact	Pharmacy Project Coordinator		Slater	Angela		8102441660					angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	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 Reporting Contact	Pharmacy Project Coordinator		Slater	Angela		8102441660					angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Patient Safety Contact	Director of Pharmacy		Taylor	Randall		8102441658					randall.taylor@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Payment Contact	Director, Finance		Crowley	Daniel		8107339602					daniel.crowley@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/02/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Personal Health Record Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	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 Director	Director of Pharmacy		Taylor	Randall		8102441658					randall.taylor@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	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 Network Management Contact	Pharmacy Project Coordinator		Slater	Angela		8102441660					angela.slater@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	08/27/2024	2026	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 Network Management Contact (Secondary)	Director of Pharmacy		Taylor	Randall		8102441658					randall.taylor@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	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	Director, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/17/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active	8443362678				HMO - Health Maintenance Organization		C	Chicago
H6322	PHR Beneficiary Contact																	03/26/2021	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS	McLaren Health Plan	McLaren Health Care Corporation	494	Yes	Active	8883270671				HMO - Health Maintenance Organization		C	Chicago
H6322	Plan Directory Contact for Public Website			Services	Member		8333582404					medicarememberservices@mclaren.org	PO Box 44092		Indianapolis	IN	46208	04/01/2022	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Plan to Plan Reconciliation Contact	Director, Finance		Crowley	Daniel		8107339602					daniel.crowley@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/02/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Processor Contact	MIG Director of Operations		Cuccia	Tami		8107339669					tami.cuccia@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	09/15/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Quality Contact	VP of Health Services and Quality		Tapp	Becky		3178227267					rtapp@mdwise.org	2955 N Meridian St	Ste 201	Indianapolis	IN	46208	07/01/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Reconciliation Contact	Director, Finance		Crowley	Daniel		8107339602					daniel.crowley@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/02/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Reconciliation Contact (Secondary)	Director of Pharmacy		Taylor	Randall		8102441658					randall.taylor@mclaren.org	G-3245 Beecher Rd.		Flint	MI	48532	08/27/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Recovery Audit Contact	Director, Finance	Mr.	Crowley	Daniel		8107339602					daniel.crowley@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/02/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	SNP Application Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	SNP State Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Surveillance Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	System Contact	Medicare Compliance Officer	Ms.	Anderson	Paula		7656313511					Paula.Anderson1@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	02/28/2023	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Third Party Administrator (TPA) Liaison	Director, Finance		Crowley	Daniel		8107339602					daniel.crowley@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	10/02/2024	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	User Access Contact	Director, Medicare Programs		Van Dusen	Kristin		9896273897					kristin.vandusen@mclaren.org	G-3245 Beecher Rd		Flint	MI	48532	07/31/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Utilization Management Contact	Dir, Medical Management		DeVellis	Andrea		8107339631					andrea.devellis@mclaren.org	G-3245 Beecher Rd	Ste 201	Flint	MI	48532	07/31/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6322	Utilization Review Contact	Dir, Medical Management		DeVellis	Andrea		8107339631					andrea.devellis@mclaren.org	G-3245 Beecher Rd	Ste 201	Flint	MI	48532	07/31/2025	2026	MCLAREN HEALTH PLAN, INC.	Local CCP	McLaren Medicare	HMO/HMOPOS		McLaren Health Care Corporation	494	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6334	CAP Report Contact for Public Website	Provider Relations Representative	Mr.	Enoe	Mark	S	2125866400	4288			2122373080	menoe@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	08/29/2019	2026	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	Boston
H6334	CEO - CMS Administrator Contact	Chief Executive Officer	Dr.	Jacobson	David		2125866400	3937			2122373063	djacobson@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	11/17/2020	2026	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	Boston
H6334	CEO - Senior Official for Contracting	Chief Executive Officer	Dr.	Jacobson	David		2125866400	3937			2122373063	djacobson@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Chief Financial Officer	Chief Financial Officer	Mr.	Heim	John		2125866400	4551			2125863596	jheim@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Complaints Tracking Contact	Provider Relations Representative	Mr.	Enoe	Mark	S	2125866400	4288				menoe@hotelfunds.org	305 West 44th Street		New York	NY	10036	08/29/2019	2026	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	Boston
H6334	Corporate Mailing						2125866400					djacobson@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Customer Service Operations Contact	Provider Relations Representative	Mr.	Enoe	Mark		2125866400	4288				menoe@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6334	General Contact	Provider Relations Representative	Mr.	Enoe	Mark		2125866400	4288				menoe@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Government Relations Contact	Provider Relations Representative	Mr.	Enoe	Mark		2125866400	4288			2122373080	menoe@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	08/29/2019	2026	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	Boston
H6334	MA Appeals/Grievances Contact	Provider Relations Representative		Enoe	Mark		2125866400	4288				menoe@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Medical Director	Chief Executive Officer	Dr.	Jacobson	David		2125866400	3937			2122373063	djacobson@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Medicare Compliance Officer	Chief External Affairs Officer	Mr.	Yang	Jordan	E	2125866400	4340			2122373080	jyang@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	08/30/2019	2026	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	Boston
H6334	Medicare Coordinator	Provider Relations Representative	Mr.	Enoe	Mark		2125866400	4288			2122373080	menoe@hotelfunds.org	NYHTC and HANYC, Inc. Employee Benefit Funds	305 West 44th Street	New York	NY	10036	08/29/2019	2026	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	Boston
H6334	Plan Directory Contact for Public Website	Provider Relations Representative	Mr.	Enoe	Mark		2125866400					menoe@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Quality Contact	Chief Executive Officer	Dr.	Jacobson	David		2125866400					djacobson@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6334	User Access Contact	Provider Relations Representative	Mr.	Enoe	Mark		2125866400					menoe@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Utilization Management Contact	Chief Executive Officer	Dr.	Jacobson	David		2125866400					djacobson@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6334	Utilization Review Contact	Chief Executive Officer	Dr.	Jacobson	David		2125866400					djacobson@hotelfunds.org	305 West 44th Street		New York	NY	10036	11/17/2020	2026	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	Boston
H6340	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Backup User Access Contact			Oomerjee	Feroze		5624129865					feroze.oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/20/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	CEO - CMS Administrator Contact		Ms.	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/20/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	CEO - Senior Official for Contracting		Ms.	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/20/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Chief Financial Officer		Ms.	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Chief Operating Officer		Ms.	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		Pasadena	CA	91105	09/17/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/24/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		2192106392					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Contact for Fraud Investigations			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Customer Service Operations Contact			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/20/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	DIR Contact			Lincoln-Giang	Pam		6502948027					Pam.Lincoln-Giang@WelbeHealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	DIR Contact (Secondary)			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Emergency Part D Contact (Secondary)			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	General Contact			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/20/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Government Relations Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	HIPAA Privacy Officer			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	HIPAA Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Medical Director			Chen	Andy		6264561746					andy.chen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Medicare Compliance Officer		Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Medicare Coordinator			Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/20/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/19/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending	2192106392				PACE - Nat		C	San Francisco
H6340	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending	6502948027				PACE - Nat		C	San Francisco
H6340	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part D Quality Assurance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Patient Safety Contact			Lincoln-Giang	Pam		7143925198					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending	6502948027				PACE - Nat		C	San Francisco
H6340	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/10/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Reconciliation Contact (Secondary)			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	03/05/2024	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Surveillance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	User Access Contact			Oomerjee	Feroze		5624129865					feroze.oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6340	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/18/2023	2026	WELBEHEALTH ATLANTIC PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H6341	Agent/Broker Compensation Data Contact	National Director Retail Sales	Mr.	Javor	Chris		2159378396					cjavor@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Automated TrOOP Balance Transfer Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Backup User Access Contact	Medicare Compliance Sr Operations Analyst	Ms	Morris	Gail		2158635141					gpmorris@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875  West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Bid Audit Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Bid Audit Site Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Bid Primary Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	05/07/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	CEO - CMS Administrator Contact	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	CEO - Senior Official for Contracting	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Chief Operating Officer	President, Medicare Markets	Mr.	McDade	Chris		5704179770					cmcdad@amerihealthcaritas.com	AmeriHealth Caritas Families of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Chief Information Officer	Exec. Vice President, Chief Information Officer	Mr.	Dickson	Fred		2158636570					fdickson@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	CMS Casework Communication Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Complaints Tracking Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Contact for Fraud Investigations	Director, SIU	Mr.	McCall	Trevor		4844971241					tmccall2@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Coordination of Benefits Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Corporate Mailing						2159378725					KGrimmett@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive, 1st Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		2672981794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	DIR Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/07/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	DIR Contact (Secondary)	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2824045991					AKindred@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Discount Program Payment Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Electronic Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Emergency Part D Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Emergency Part D Contact (Secondary)	VP, Corporate Pharmacy		Cherian	Sheena		2158635768					scherian@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare ACA and Risk Adjustment	Mr.	Greer	Kevin		2159378761					kgreer@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Enrollment Contact	Manager, Enrollment Operations	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	EOB Transfer Contact	VP, Medicare Claims	Mr.	Boyer	Joseph		2158636668				2159375321	jboyer@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Financial Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					ak16850@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Financial Reporting Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Formulary Contact	Director of Clinical Services, Formulary/DUR	Ms.	Megargell	Lauren		2159374135					Lauren.megargell@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	General Contact	VP, Medicare Strategy & Execution	Mr.	Sukhu	Chistopher		4844233175					csukhu@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	06/27/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Government Relations Contact	VP, Government Relations, External Affairs	Mr.	Cozzo	Steven		2159378236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	HIPAA Privacy Officer	Director, Privacy		Desipio	Nicole		4844971132					ndesipio@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Hospice Contact	Dir.  Medicare Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Interoperability Contact	Director, Medicare Performance Management		Kindred	Amanda		2484045991					akindred@amerihealthcaritas.com	4000 Town Center	Suite 1300	Southfield	MI	48075	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	MA Appeals/Grievances Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	MA Claims Processing Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Marketing Contact	Medicare Compliance Sr Operations Analyst	Ms.	Morris	Gail	P	2158635141					gpmorris@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Medical Director	Chief Medical Officer, Population Health	Dr.	Wright	Julia		2159378000					jwright6@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Medicare Coordinator	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Medication Therapy Management Contact	Director, Clinical Outcomes & Therapeutic Optimiz	Ms.	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	OffShore Subcontractor Contact	Esquire	Ms.	Sitner	Roni		8602149125					rsitner@ameriheathcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Online Enrollment Center Contact (Primary)	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part C Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part C Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Appeals	Director,  Medicare Appeals and Grievances	Ms.	Lopez	Yismell							yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158635677				HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Appeals Contact (Secondary)	Manager, Medicare Appeals & Grievance	Ms.	Smith-Cooks	Tiarra							tsmithcooks@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2151112917				HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Benefits Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Claims Submission Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Prior Authorization	Mr.	McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Price File Contact (Back-up)	Medicare Part D program Analyst	Ms.	Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Price File Contact (Optional)	Medicare Part D Program Analyst	Ms	Wiehe	Heather		4127156363					heather.weihe@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Price File Contact (Primary)	Medicare Part D Program Anaylst	Ms.	West	Ariel		3133781225					Ariel.West@abarcahealth.com	PerformRx	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Part D Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Patient Safety Contact	Director,Clinical Outcomes &Therap Optimization	Ms	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Payment Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Personal Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Pharmacy Director	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Pharmacy Network Management Contact	President, Network Strategy	Mr	Sullivan	Tim		6303303638					tssullivan@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Pharmacy Network Management Contact (Secondary)	Network Operations Analyst	Mr.	Kramerov	Allen		2159374120					akramerov@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Pharmacy Technical Help Desk Contact	Manager, Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H6341	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H6341	PHR Beneficiary Contact																	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS	AmeriHealth Caritas	Independence Health Group, Inc.	609	Yes	Active	2672985710				HMO - Health Maintenance Organization		C	Chicago
H6341	Physician Incentive Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Plan Directory Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Plan to Plan Reconciliation Contact	Director, Finance	Ms	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	P.O. 7137	London	KY	40742	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Processor Contact	Director of Clincal Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerFormrx	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Quality Contact	Director, Quality Management	Ms.	Popiolek	Rose		6107234450					rpopiolek@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Reconciliation Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Reconciliation Contact (Secondary)	Manager, Medicare Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Recovery Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	SNP Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	SNP State Contact	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Surveillance Contact	Director, Retail Sales Operations	Ms.	Bech	Mary		4146875533					mbech@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	System Contact	Manager, Medicare IS	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Third Party Administrator (TPA) Liaison	Manager, MCR Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/06/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	User Access Contact	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Utilization Management Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6341	Utilization Review Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH MICHIGAN, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6342	Automated TrOOP Balance Transfer Contact	VP		Williams	Sheila		5014418001					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Backup User Access Contact	QI Coordinator		Stoneman	Kimberly		5014418000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/09/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Best Available Evidence Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/09/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Bid Primary Contact	Director of Finance		Mhoon	Blake		5014418003					Blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	CAP Report Contact for Public Website		Mrs	Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	CEO - CMS Administrator Contact		Mrs	Willias	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	CEO - Senior Official for Contracting	VP	Mrs	Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Chief Financial Officer	Director of Finance	Mr	Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Chief Operating Officer	VP	Mrs	Williams	Sheila		5014418001					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Chief Information Officer	QI Coordinator	Mrs	Stoneman	Kimberly		5014418000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/09/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Chief Information Security Officer	VP	Mrs.	Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Dr	Suite 450	North Little Rock	AR	72117	02/23/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	CMS Casework Communication Contact	VP	Mrs	Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Complaints Tracking Contact	QI Coordinator		Stoneman	Kimberly		5014418000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Contact for Fraud Investigations		Mrs.	Williams	Dana		5012026776					dana.williams@baptist-health.org	9601 Baptist Health Drive		Little Rock	AR	72205	11/06/2015	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Coordination of Benefits Contact	Director of Finance		Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Corporate Mailing						5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Customer Service Operations Contact	QI Coordinator		Stoneman	Kimberly		5014418000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	DIR Contact	Director of Finance		Mhoon	Blake		5014418003					Blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	DIR Contact (Secondary)			Williams	Sheila		5014418001					sheila.williams@baptist-health.org	3500 Springhill Dr		North Little Rock	AR	72117	12/18/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Discount Program Payment Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Emergency Part D Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Emergency Part D Contact (Secondary)	Director of Finance		Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Dr		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Encounter Data & Risk Adjustment Operations Contact	Director of Finance		Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Dr		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Enrollment Contact			Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	EOB Transfer Contact	Director of Finance		Mhoon	Blake		5014418003				5014418050	blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Financial Audit Contact	Director of Finance	Mr.	Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Financial Reporting Contact			Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Formulary Contact	Director of Finance	Mrs	Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	General Contact	VP	Mrs	Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Government Relations Contact	VP		Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Dr	Suite 410	North Little Rock	AR	72117	02/23/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	HIPAA Privacy Officer		Mrs.	Williams	Sheila		5012026776					sheila.williams@baptist-health.org	9601 Baptist Health Drive		Little Rock	AR	72205	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	HIPAA Security Officer		Mrs.	Williams	Sheila		5012026776					sheila.williams@baptist-health.org	9601 Baptist Health Drive		Little Rock	AR	72205	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Interoperability Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	MA Appeals/Grievances Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	MA Claims Processing Contact for Public Website			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Marketing Contact	Director of Finance	Ms.	Williams	Sheila		5014418003					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Medical Director	Medical Director	Dr.	Prime	Jasmine		5014418000					jasmine.prime@practice-plus.com	3500 Springhill Drive		North Little Rock	AR	72117	06/28/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Medicare Compliance Officer	VP	Mrs	Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Medicare Coordinator			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Prime	Jasmine		5014418000					jasmine.prime@practice-plus.com	3500 Springhill Drive		North Little Rock	AR	72117	06/28/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Medication Therapy Management Contact	Medical Director	Dr.	Prime	Jasmine		5014418000					jasmine.prime@practice-plus.com	3500 Springhill Drive		North Little Rock	AR	72117	06/28/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part C Application Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part D Appeals	vp		Williams	Sheila							sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active	5014418000				PACE - Nat		C	New York
H6342	Part D Application Contact	VP	Mrs	Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part D Benefits Contact			Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part D Claims Submission Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part D Exceptions Contact	VP		Williams	Sheila							sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active	5014418000				PACE - Nat		C	New York
H6342	Part D Price File Contact (Back-up)	VP		Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part D Price File Contact (Primary)			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part D Quality Assurance Contact			Stoneman	Kimberly		5014418000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/09/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Part D Reporting Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Patient Safety Contact	QI Coordinator		Stoneman	Kimberly		5014418000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Payment Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Pharmacy Director	Medical Director	Dr.	Prime	Jasmine		5014418000					jasmine.prime@practice-plus.com	3500 Springhill Drive		North Little Rock	AR	72117	06/28/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Pharmacy Network Management Contact	Medical Director	Dr.	Prime	Jasmine		5014418000					jasmine.prime@practice-plus.com	3500 Springhill Drive		North Little Rock	AR	72117	06/28/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Pharmacy Technical Help Desk Contact	VP		Williams	Sheila							sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/04/2024	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active	5014418000				PACE - Nat		C	New York
H6342	Plan Directory Contact for Public Website			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Plan to Plan Reconciliation Contact			Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Processor Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Quality Contact	QI Coordinator		Stoneman	Kimberly		5014418000					kimberly.stoneman@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Reconciliation Contact			Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Recovery Audit Contact	Director of Finance	Mr.	Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Dr		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Surveillance Contact			Williams	Sheila		5014418001					sheila.williams@baptist-health.org	3500 Springhill Dr		North Little Rock	AR	72117	12/18/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	System Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	08/15/2022	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Third Party Administrator (TPA) Liaison	Director of Finance		Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Dr		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	User Access Contact	QI Coordinator	Mrs	Stoneman	Kimberly		5014418001					kimberly.stoneman@baptist-health.org	3500 Springhill Dr	Suite 410	North Little Rock	AR	72117	12/18/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Utilization Management Contact			Williams	Sheila		5014418000					sheila.williams@baptist-health.org	3500 Springhill Drive		North Little Rock	AR	72117	02/21/2023	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6342	Utilization Review Contact	Director of Finance		Mhoon	Blake		5014418003					blake.mhoon@baptist-health.org	3500 Springhill Dr		North Little Rock	AR	72117	11/17/2025	2026	COMPLETE HEALTH WITH PACE	National PACE	Baptist Health PACE	National PACE		Baptist Health (Arkansas)	629	Yes	Active					PACE - Nat		C	New York
H6345	Agent/Broker Compensation Data Contact	Chief Operating Officer	Mr.	Beddingfield	Ryan		6785336300					rbeddingfield@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Best Available Evidence Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	CEO - CMS Administrator Contact		Mr.	Pruitt	Neil		7708066893					npruitt@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	CEO - Senior Official for Contracting		Mr.	Pruitt	Neil		7708066893					npruitt@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Chief Financial Officer	CFO	Mr	Small	Phil		7702796200					PhSmall@pruitthealth.com	1626 Jeurgens Ct		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Chief Operating Officer	Chief Operating Officer	Mr.	Beddingfield	Ryan		6785336300					rbeddingfield@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Chief Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens C0urt		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Coordination of Benefits Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Corporate Mailing						8442243659					customerservice@pruitthealthpremier.com	P.O. Box 2190		Glen Allen	VA	230582190	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Discount Program Payment Contact	VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	EOB Transfer Contact			Lowry	Kristy		8448546883				8003756496	customerservice@pruitthealthpremier.com	P.O. Box 2190		Glen Allen	VA	230582190	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Financial Audit Contact	CFO	Mr.	Small	Phil		7702796200					phsmall@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Financial Reporting Contact	CFO	Mr.	Small	Phil		7702796200					phsmall@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	General Contact			Tolbert	Angie		7068367966					atolbert@pruitthealth.com	1626 jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	HIPAA Privacy Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens COurt		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	HIPAA Security Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Marketing Contact	Marketing Director		Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Medical Director		Dr.	Stallings	Ravelle		6785336300					rstallings@pruitthealth.com	PruittHealth Premier	1626 Jeurgens Court	Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					Kelly.Christopher@pruitthealth.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Medicare Coordinator	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	rachel.blair@navitus.com	Navitus Health Solutions,	1025 West Navitus Drive	Appleton	WI	54913	09/30/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Price File Contact (Back-up)			Plan Finder	Navitus		5122313140				6087292584	plan.finder@navitus.com	Navitus Health Solutions, LLC	361 Integrity Drive	Madison	WI	53717	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Pharmacy Network Management Contact	VP, Network Mgmt		Santos	Christina		6088204408					christina.santos@navitus.com	Navitus Health Solutions	361 Integrity Drive	Madison	WI	53717	09/30/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H6345	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6345	Physician Incentive Contact			Thompson	Monica		4789720407					monica.thompson@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Plan Directory Contact for Public Website			Sidlinger	Rocio		8558550489	1664				rocio.sidlinger@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Reconciliation Contact (Secondary)	VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Christopher	Laura	K	4046944897					compliance@pruitthealthpremier.com	1626 Jeurgens Court		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Surveillance Contact	Chief Operating Officer	Mr.	Beddingfield	Ryan		6785336300					rbeddingfield@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Third Party Administrator (TPA) Liaison	CFO	Mr	Small	Phil		7702796200					PhSmall@pruitthealth.com	1626 Jeurgens Ct		Norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	User Access Contact	Medicare Compliance Officer	Ms.	Christopher	kelly		4046944897					kelly.christopher@pruitthealth.com	1626 jeurgens ct		norcross	GA	30093	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6345	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	Local CCP	PruittHealth Premier	HMO/HMOPOS		UNICO Services, Inc.	622	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6348	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	03/30/2021	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H6348	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H6348	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H6348	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H6348	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H6348	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H6348	PHR Beneficiary Contact																	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8665498289				PPO - BBA		C	Denver
H6348	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6348	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	COORDINATED CARE CORPORATION	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H6351	Agent/Broker Compensation Data Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	12/31/2019	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Backup User Access Contact	Compliance Officer	Mr.	ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/12/2023	2026	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		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/05/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Bid Audit Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Bid Audit Site Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Bid Primary Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	CAP Report Contact for Public Website	Compliance Officer		ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/10/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	CEO - CMS Administrator Contact		Mr.	Oliver	David		9102632306					doliver@libertyhcare.com	2334 S. 41st Street		Wilmington	NC	28403	01/29/2017	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	CEO - Senior Official for Contracting		Mr.	Oliver	David		9102632306					doliver@libertyhcare.com	2334 S. 41st Street		Wilmington	NC	28403	01/29/2017	2026	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	9103321793					jcalcutt@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	03/08/2021	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Chief Operating Officer		Mr.	Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	08/17/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Chief Information Officer	Chief  Operating Officer	Mr.	Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/05/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Chief Information Security Officer	Chief Operating Officer	Mr.	Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/05/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	CMMI Model Point of Contact			Beittel	Timothy		9103252425					timothy.beittel@libertyadvantageplan.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	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		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Complaints Tracking Contact	Compliance Officer		ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/10/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Contact for Fraud Investigations	Compliance Officer		ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/10/2023	2026	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		9106604772					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/27/2022	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Corporate Mailing						9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	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		ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/05/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	DIR Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	DIR Contact (Secondary)			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Discount Program Payment Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Emergency Part D Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Emergency Part D Contact (Secondary)			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Encounter Data & Risk Adjustment Operations Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Enrollment Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	EOB Transfer Contact			Oliver	David		9102632306				9102632306	doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Financial Audit Contact	Financial Manager	Mrs.	Fawson	Leesa		7062809154					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	08/09/2022	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Financial Reporting Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Formulary Contact			Paddock	Deanna		6087291628					Deanna.Paddock@navitus.com	361 Integrity Drive		Madison	WI	53717	01/12/2021	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Formulary Contact (Secondary)			Dede	Ledja		6087291690					Laura.Crain@navitus.com	361 Integrity Drive		Madison	WI	53717	01/12/2021	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	General Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 S. 41st Street		Wilmington	NC	28403	01/29/2017	2026	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		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	HIPAA Privacy Officer	Compliance Officer		ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/10/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	HIPAA Security Officer	Compliance Officer		ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/10/2023	2026	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		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Interoperability Contact			Oliver	David		9102632306					DOLIVER@LIBERTYHCARE.COM	2334 S. 41st St.		Wilmington	NC	28403	02/11/2022	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	MA Appeals/Grievances Contact	Operations		Troxler	Cynthia		9102632306					CTroxler@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	07/26/2022	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	MA Claims Processing Contact for Public Website			Fawson	Leesa		8448546884					LibertyProviderIVR@mirrahealthcare.com	2334 South 41st Street		Wilmington	NC	28403	10/04/2022	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Marketing Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Medical Director			Beittel	Timothy		9103252425					timothy.beittel@libertyadvantageplan.com	Liberty Advantage Plan	2324 S. 41st Street	Wilmington	NC	28403	12/01/2017	2026	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	Mr.	ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/10/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Medicare Coordinator			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Medicare Part D Opioid Overutilization Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Medication Therapy Management Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Part C Application Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Part C Reporting Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	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 Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Justin.LaCrosse@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	10/07/2025	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Atlanta
H6351	Part D Appeals Contact (Secondary)			Oliver	David							doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/05/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	9102632306				HMO - Health Maintenance Organization		C	Atlanta
H6351	Part D Application Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	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 Benefits Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	08/17/2020	2026	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 Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	12/31/2019	2026	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	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	9106604772				HMO - Health Maintenance Organization		C	Atlanta
H6351	Part D Exceptions Contact (Secondary)			Oliver	David							doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/05/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	9102632306				HMO - Health Maintenance Organization		C	Atlanta
H6351	Part D Price File Contact (Back-up)			Rogeberg	Derek		6087291595				6087292584	Derek.Rogeberg@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	08/21/2019	2026	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 Price File Contact (Optional)			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/05/2020	2026	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 Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	12/31/2019	2026	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 Quality Assurance Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	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 Reporting Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Patient Safety Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Payment Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Pharmacy Director			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Pharmacy Network Management Contact	VP Network Management		Santos	Christina		6088204408					Christina.Santos@navitus.com	Navitus Health Solutions	361 Integrity Drive	Madison	WI	53717	10/07/2025	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Pharmacy Network Management Contact (Secondary)			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/05/2020	2026	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						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	11/20/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	8662703877				HMO - Health Maintenance Organization		C	Atlanta
H6351	Pharmacy Technical Help Desk Contact (Secondary)			Oliver	David							doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/05/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active	9102632306				HMO - Health Maintenance Organization		C	Atlanta
H6351	Physician Incentive Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Plan Directory Contact for Public Website	Compliance Officer		ORourke	David	A	8448546884					LibertyProviderIVR@mirrahealthcare.com	PO Box 3325		Spring Hill	FL	34611	04/10/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Plan to Plan Reconciliation Contact			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/29/2017	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Quality Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Reconciliation Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Reconciliation Contact (Secondary)			Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Recovery Audit Contact	Executive Director	Mr.	Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	SNP Application Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	SNP State Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Surveillance Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	System Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Third Party Administrator (TPA) Liaison	Financial Director		Fawson	Leesa		9106604772					lfawson@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	12/09/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	User Access Contact	Compliance Officer		ORourke	David	A	9106222570					dorourke@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	04/10/2023	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Utilization Management Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6351	Utilization Review Contact			Oliver	David		9102632306					doliver@libertyhcare.com	2334 South 41st Street		Wilmington	NC	28403	06/03/2020	2026	LIBERTY ADVANTAGE, LLC	Local CCP	Liberty Medicare Advantage	HMO/HMOPOS		Liberty Healthcare Insurance	668	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6353	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Best Available Evidence Contact	VPO	Ms	Runyon	Bobbi		8129905800					brunyon@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	CAP Report Contact for Public Website	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923501	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	2675751196				PACE - Nat		C	New York
H6353	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	CMS Casework Communication Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Customer Service Operations Contact	Compliance Director	Mr	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Formulary Contact	Finance Specialist	Mr	Partlow	Jennie		6406501565					jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	General Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation	Mr	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Medical Director	Chief Medical Officer	Dr.	TBD	TBD		7325923400					WCooper@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Medicare Coordinator	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Medicare Part D Opioid Overutilization Contact	Director of Compliance		Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Medication Therapy Management Contact	Chief Medical Officer	Mr	TBD	TBD		9548395000				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	OffShore Subcontractor Contact	CFO	Mrs	Prentis	Kristin		7328063224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Online Enrollment Center Contact (Back-up)	CEO	Mrs	Austin	Mary		2156098714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Online Enrollment Center Contact (Primary)	CEO	Mrs	Austin	Mary		2156098714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part D Appeals	Compliance & HIS Coordinator		Cooper	Wanda						8563710276	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	2675751196				PACE - Nat		C	New York
H6353	Part D Appeals Contact (Secondary)	Chief Health Plan Operations	Mr.	Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7328063224				PACE - Nat		C	New York
H6353	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part D Exceptions Contact	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	9548395000				PACE - Nat		C	New York
H6353	Part D Exceptions Contact (Secondary)	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	09/11/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	9548395000				PACE - Nat		C	New York
H6353	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part D Quality Assurance Contact	Director of Compliance	Ms	Santilli	Lisa		8563710276					Lisa.Santilli@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Patient Safety Contact	Finance Specialist		Partlow	Jennie		9548395000					jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Pharmacy Director	Chief Medical Officer		TBD	TBD		9548395000					WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	8558012653				PACE - Nat		C	New York
H6353	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	8558012653				PACE - Nat		C	New York
H6353	PHR Beneficiary Contact																	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE	Beacon of Life SC	Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7325923400				PACE - Nat		C	New York
H6353	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Plan to Plan Reconciliation Contact	Financial Specialist	Mr	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Quality Contact	Director of Compliance	Ms	Santilli	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Surveillance Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/03/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	User Access Contact	Business Administrator	Ms	Ray	Jennifer		7326643786					jray@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/18/2024	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6353	Utilization Review Contact	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/28/2025	2026	BEACON OF LIFE FLORIDA, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6368	Agent/Broker Compensation Data Contact	Chief Compliance Officer		Blacklock	Gail	M	9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Automated TrOOP Balance Transfer Contact	Medicare Part D		MedImpact	MedImpact		8587906250					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Backup User Access Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Best Available Evidence Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Bid Audit Contact	CFO		Minor	Kenneth		8009581129					kminor@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	11/24/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Bid Audit Site Contact	Chief Compliance Officer		Blacklock	Gail	M	9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Bid Primary Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	CAP Report Contact for Public Website	Chief Compliance Officer		Blacklock	Gail	M	9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	CEO - CMS Administrator Contact	CEO	Dr	Jeereddi	Prasad	A	9099080768					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	CEO - Senior Official for Contracting	CEO	Dr	Jeereddi	Prasad	A	9099080768					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Chief Financial Officer	CFO Interim	Mr.	Minor	Kenneth		8009581129					kminor@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	11/24/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Chief Operating Officer	Chief Operating Officer	Ms.	Reeher	BaoBao		9498870202					breeher@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Chief Information Officer	Chief Information Officer	Mr.	Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Chief Information Security Officer	Chief Information Officer	Mr.	Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	CMS Casework Communication Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Complaints Tracking Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Contact for Fraud Investigations	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Coordination of Benefits Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/27/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Corporate Mailing						9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street Suite 225	Ste. 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Customer Service Operations Contact	Chief Compliance Officer		Blackklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	DIR Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	DIR Contact (Secondary)	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Discount Program Payment Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Electronic Health Record Contact	Chief Compliance Officer		Blacklock	Gail	M	9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Emergency Part D Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	4026700682					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Emergency Part D Contact (Secondary)	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Encounter Data & Risk Adjustment Operations Contact	Chief Information Officer		Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Enrollment Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	EOB Transfer Contact	Medicare Part D		MedImpact	MedImpact		8587906250				8587906250	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Financial Audit Contact	CFO	Mr.	Werderman	Brian		9092401590					bwerderman@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/31/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Financial Reporting Contact	CFO		Werderman	Brian		9092401590					bwerderman@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/31/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Formulary Contact	Clinical Formulary PHarmacist		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Formulary Contact (Secondary)	Part D Pharmacy Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	General Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Government Relations Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	HIPAA Privacy Officer	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	HIPAA Security Officer	Chief Information Officer		Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Hospice Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/27/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Interoperability Contact	Chief Information Officer		Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	MA Appeals/Grievances Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	MA Claims Processing Contact for Public Website	Chief Information Officer		Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Marketing Contact	Chief Operating Officer		Reeher	BaoBao		9498870202					breeher@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Medical Director	Medical Director	MD	Gorty	Sri		9098659890					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/27/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	11/17/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Medicare Coordinator	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Medicare Part D Opioid Overutilization Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Medication Therapy Management Contact	Medicare Part D		Management	Medication		8888075705					MTMP@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	OffShore Subcontractor Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Online Enrollment Center Contact (Back-up)	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Online Enrollment Center Contact (Primary)	Chief Compliance Officer		Blacklock	Gail	M	9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part C Application Contact			Blacklock	Gail		1111111111					gblacklock@elitehealthplan.com	1131 West 6th St, Suite 225	Ste. 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part C Reporting Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/31/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Appeals	Part D Appeals Management		Management	Appeals						8587906060	appealgrievancesmanagement@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active	8888075705				HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Appeals Contact (Secondary)	Medicare Part D Consultant	Dr.	Schoening	Shellie	K						sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active	8009581129				HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Application Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Benefits Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Claims Submission Contact	Sup Medicare Operations		Distel	Chris		3302127994					PDE@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Exceptions Contact	Dir PA & UM Programs		Emoto	Julianne							Julianne.emoto@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Exceptions Contact (Secondary)	Medicare Part D Consultant	Dr.	Schoening	Shellie	K						sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active	8009581129				HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Price File Contact (Back-up)	Medicare Part D		MedImpact	MedImpact		8007882949					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	02/11/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Price File Contact (Optional)	Medicare Part D Program Manager		Keller	Shannon		8587907104					planfindercommunications@medipact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Price File Contact (Primary)	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Quality Assurance Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Part D Reporting Contact	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Patient Safety Contact	Chief Medical Officer		Shivaram	Sunil		9096248077					shivaram@claremonteye.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	01/19/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Payment Contact	CFO		Werderman	Brian		9092401590					bwerderman@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/31/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Pharmacy Director	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Pharmacy Network Management Contact	Pharmacy Network		Network	Pharmacy		8007882949					pharmacyoperationssups@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Pharmacy Network Management Contact (Secondary)	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/17/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active	8888075705				HMO - Health Maintenance Organization		C	Kansas City
H6368	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Part D Consultant	Dr.	Schoening	Shellie	K						sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active	8009581129				HMO - Health Maintenance Organization		C	Kansas City
H6368	Plan Directory Contact for Public Website	Medicare Part D Consultant	Dr.	Schoening	Shellie	K	8009581129					sschoening@apothemetrx.com	PO Box 1489		Orange	CA	92856	08/13/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Plan to Plan Reconciliation Contact	Chief Information Officer		Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Processor Contact	Senior Vice President,  Government Programs and Se		Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Quality Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/27/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Reconciliation Contact	CFO		Werderman	Brian		9092401590					bwerderman@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/31/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Recovery Audit Contact	Chief Compliance Officer	Ms	Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Surveillance Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	System Contact	Chief Information Officer		Chen	Bill		9092635191					bchen@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Third Party Administrator (TPA) Liaison	Chief Operating Officer		Reeher	BaoBao		9498870202					breeher@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	User Access Contact	Chief Compliance Officer		Blacklock	Gail		9096302031					gblacklock@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	06/06/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Utilization Management Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/27/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6368	Utilization Review Contact	VP Operations		Del Villar	Jennifer	E	9099050367					jdelvillar@elitehealthplan.com	1131 West 6th Street	Suite 225	Ontario	CA	91762	07/27/2025	2026	ELITE HEALTH PLAN, INC.	Local CCP	Elite Health Plan, Inc.	HMO/HMOPOS		Elite Health Systems, Inc.	871	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6371	Automated TrOOP Balance Transfer Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Backup User Access Contact	CFO	Ms.	Richman	Jeannine		6093867171				6097477171	Jrichman@LSMNJ.ORG	3 Manhattan Drive		Burlington	NJ	08016	03/12/2021	2026	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	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Bid Primary Contact	CFO	Ms.	Richman	Jeannine		6097811379				6097474131	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	02/19/2021	2026	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	CAP Report Contact for Public Website	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	CEO - CMS Administrator Contact	Regional Director of PACE	Mr	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	CEO - Senior Official for Contracting	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	6097811379				6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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 Operating Officer	Chief Operating Officer	Ms.	OUTTEN	SHERRY		6096941717				6097474101	SOUTTEN@LSMNJ.ORG	3 MANHATTAN DRIVE		BURLINGTON	NJ	08016	02/19/2021	2026	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 Information Officer	Senior Client Solutions Analyst	Mr.	Medlin	Dawsey		6096994150					dmedlin@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	06/22/2020	2026	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 Information Security Officer	Senior Client Solutions Analyst	Mr.	Medlin	Dawsey		6096994150					dmedlin@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	06/22/2020	2026	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	Regional Director of PACE	Mr.	Chau	David		2014993900	3879			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Complaints Tracking Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3879			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Contact for Fraud Investigations	Regional Director of PACE	Mr.	Chau	David		2016007644	3897			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Regional Director of PACE	Mr.	Chau	David		2014993900	3879			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Corporate Mailing						6097811379				6097474101	jrichman@lsmnj.org	3 MANHATTAN DRIVE		BURLINGTON	NJ	08016	02/19/2021	2026	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	Regional Director of PACE	Mr.	Chau	David		2014993900	3879			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	DIR Contact	CFO, FInance	Ms.	Richman	Jeannine		6096994131				6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	03/01/2021	2026	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	DIR Contact (Secondary)	Accounting Manager		Schultz	Steve		6096994128	4128			6097474128	sschultz@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	04/23/2022	2026	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	Discount Program Payment Contact	CFO	Ms.	Richman	Jeannine		6097811379					jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	02/27/2025	2026	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	Emergency Part D Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Emergency Part D Contact (Secondary)	CFO		Richman	Jeannine		6096994140				6097474140	Jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	03/12/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	CFO		Richman	Jeannine		6097811379				6097474131	jrichman@lsmnj.org	3 MANHATTAN DRIVE		BURLINGTON	NJ	08016	04/23/2022	2026	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	Enrollment Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	EOB Transfer Contact	CFO	Ms	Richman	Jeannine	M	6097811379				6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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	Financial Audit Contact	CFO	Ms	Richman	Jeannine	M	6097811379				6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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	Financial Reporting Contact	Chief Financial Officer	Ms	Richman	Jeannine		6093867171				6093862305	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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	Formulary Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Formulary Contact (Secondary)	CFO		RICHMAN	JEANNINE		6097811379					jrichman@lsmnj.org	3 MANHATTAN DRIVE		BURLINGTON	NJ	08016	02/19/2021	2026	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	General Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	HIPAA Privacy Officer	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	HIPAA Security Officer	cfo	Ms.	M Richman	Jeannine		6097811379				6097474131	jrichman@lsmnj.org	3 Manhattan Dr	Suite   310	Burlington	NJ	08016	07/29/2024	2026	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	Interoperability Contact	CFO		Richman	Jeannine		6097811379				6097474131	jrichman@lsmnj.org	ATTN JEANNINE RICHMAN	3 MANHATTAN DR	Burlington	NJ	08016	04/23/2022	2026	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	MA Appeals/Grievances Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	MA Claims Processing Contact for Public Website	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 JERSEY AVENUE	SUITE 310	JERSEY CITY	NJ	07302	12/17/2025	2026	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	Marketing Contact	Director of Marketing	Ms.	Diaz	Bianca		2014993900				2017062092	bdiaz@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	10/31/2025	2026	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	Medical Director	Medical Director	Dr	Patel	Jayeshkuma		2014993900				2017062092	dchau@lsmnj.org	377 JERSEY AVENUE	SUITE 310	JERSEY CITY	NJ	07302	12/17/2025	2026	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	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 Coordinator	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 Part D Opioid Overutilization Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Medication Therapy Management Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 C Application Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 Appeals	Regional Director of PACE	Mr.	Chau	David						2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active	2014993900	3872			PACE - Nat		C	New York
H6371	Part D Appeals Contact (Secondary)	Client Development Liaison		M Richman	Jeannine							jrichman@lsmnj.org	3 Manhattan Dr		Burlington	NJ	08016	07/29/2024	2026	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active	6097811379				PACE - Nat		C	New York
H6371	Part D Application Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 Benefits Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 Claims Submission Contact	Chief Financial Officer	Ms	Richman	Jeannine		6096994131				6097474131	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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	Regional Director of PACE	Mr.	Chau	David						2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active	2014993900	3872			PACE - Nat		C	New York
H6371	Part D Exceptions Contact (Secondary)	CFO	Mrs.	Richman	Jeannine						6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	03/12/2021	2026	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active	6093867171				PACE - Nat		C	New York
H6371	Part D Price File Contact (Back-up)	Chief Financial Officer	Ms	Richman	Jeannine		6096994131				6097474131	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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 Price File Contact (Primary)	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 Quality Assurance Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 JERSEY AVENUE	SUITE 310	JERSEY CITY	NJ	07302	12/17/2025	2026	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 Reporting Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Patient Safety Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Payment Contact	CFO	Ms	Richman	Jeannine	M	6097811379				6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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	Personal Health Record Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872				dchau@lsmnj.org	377 Jersey AVenue	Suite 310	Jersey CIty	NJ	07302	12/17/2025	2026	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 Director	Regional Director of PACE	Mr.	Chau	David		2014993900	3879			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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 Network Management Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Regional Director of PACE	Mr.	Chau	David						2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE		Lutheran Social Ministries of New Jersey	427	Yes	Active	2014993900	3872			PACE - Nat		C	New York
H6371	PHR Beneficiary Contact																	03/12/2021	2026	LUTHERAN SENIOR HEALTHCARE, INC.	National PACE	Lutheran Senior LIFE	National PACE	Lutheran Senior Life	Lutheran Social Ministries of New Jersey	427	Yes	Active	2014993900	3879			PACE - Nat		C	New York
H6371	Plan Directory Contact for Public Website	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Plan to Plan Reconciliation Contact	CFO	Ms	Richman	Jeannine	M	6097811379				6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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	Processor Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Quality Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 JERSEY AVENUE	SUITE 310	JERSEY CITY	NJ	07302	12/17/2025	2026	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	Reconciliation Contact	CFO	Ms.	Richman	Jeannine		6093867171					jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	03/12/2021	2026	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	Recovery Audit Contact	CFO	Ms	Richman	Jeannine	M	6097811379				6097474140	jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	09/02/2020	2026	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	Surveillance Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	System Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Third Party Administrator (TPA) Liaison	CFO	Ms.	Richman	Jeannine		6097811379					jrichman@lsmnj.org	3 Manhattan Drive		Burlington	NJ	08016	02/27/2025	2026	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	User Access Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Utilization Management Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Utilization Review Contact	Regional Director of PACE	Mr.	Chau	David		2014993900	3872			2017062092	dchau@lsmnj.org	377 Jersey Avenue	Suite   310	Jersey City	NJ	07302	12/17/2025	2026	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	Agent/Broker Compensation Data Contact	National Director Retail Sales	Mr.	Javor	Chris		2159378396					cjavor@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Automated TrOOP Balance Transfer Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Backup User Access Contact	Medicare Compliance Sr Operations Analyst	Ms	Morris	Gail		2158635141					gpmorris@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Bid Audit Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Bid Audit Site Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Bid Primary Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	05/07/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	CEO - CMS Administrator Contact	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	CEO - Senior Official for Contracting	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Chief Operating Officer	President, Medicare Markets	Mr.	McDade	Chris		5704179770					cmcdad@amerihealthcaritas.com	AmeriHealth Caritas Families of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Chief Information Officer	Exec. Vice President, Chief Information Officer	Mr.	Dickson	Fred		2158636570					fdickson@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	CMS Casework Communication Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Complaints Tracking Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Contact for Fraud Investigations	Director, SIU	Mr.	McCall	Trevor		4844971241					tmccall2@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Coordination of Benefits Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Corporate Mailing						2159378725					KGrimmett@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive, 1st Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		2672981794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	DIR Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/07/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	DIR Contact (Secondary)	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2824045991					AKindred@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Discount Program Payment Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Electronic Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Emergency Part D Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Emergency Part D Contact (Secondary)	VP, Corporate Pharmacy		Cherian	Sheena		2158635768					scherian@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	2002 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare ACA and Risk Adjustment	Mr.	Greer	Kevin		2159378761					kgreer@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Enrollment Contact	Manager, Enrollment Operations	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	EOB Transfer Contact	VP, Medicare Claims	Mr.	Boyer	Joseph		2158636668				2159375321	jboyer@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Financial Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					ak16850@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Financial Reporting Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Formulary Contact	Director of Clinical Services, Formulary/DUR	Ms.	Megargell	Lauren		2159374135					Lauren.megargell@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	General Contact	VP, Medicare Strategy & Execution	Mr.	Sukhu	Chistopher		4844233175					csukhu@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	06/27/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Government Relations Contact	VP, Government Relations, External Affairs	Mr.	Cozzo	Steven		2159378236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	HIPAA Privacy Officer	Director Privacy	Ms.	Desipio	Nicole		4844971132					ndesipio@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Hospice Contact	Dir.  Medicare Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Interoperability Contact	Director, Medicare Performance Management		Kindred	Amanda		2484045991					akindred@amerihealthcaritas.com	4000 Town Center	Suite 1300	Southfield	MI	48075	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	MA Appeals/Grievances Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	MA Claims Processing Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Marketing Contact	Medicare Compliance Sr Operations Analyst	Ms.	Morris	Gail	P	2158635141					gpmorris@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Medical Director	Chief Medical Officer, Population Health	Dr.	Wright	Julia		2159378000					jwright6@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Medicare Coordinator	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	03/24/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Medication Therapy Management Contact	Director, Clinical Outcomes & Therapeutic Optimiz	Ms.	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	OffShore Subcontractor Contact	Esquire	Ms.	Sitner	Roni		8602149125					rsitner@ameriheathcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Online Enrollment Center Contact (Primary)	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part C Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part C Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Appeals	Director,  Medicare Appeals and Grievances	Ms.	Lopez	Yismell							yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158635677				HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Appeals Contact (Secondary)	Manager, Medicare Appeals & Grievance	Ms.	Smith-Cooks	Tiarra							tsmithcooks@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2151112917				HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Benefits Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Claims Submission Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Exceptions Contact (Secondary)	Manager, Pharmacy Prior Auth	Mr.	McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636370				HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Price File Contact (Back-up)	Medicare Part D program Analyst	Ms.	Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Price File Contact (Optional)	Medicare Part D Program Analyst	Ms	Wiehe	Heather		4127156363					heather.weihe@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Price File Contact (Primary)	Medicare Part D Program Anaylst	Ms.	West	Ariel		3133781225					Ariel.West@abarcahealth.com	PerformRx	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Part D Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Patient Safety Contact	Director,Clinical Outcomes &Therap Optimization	Ms	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Payment Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Personal Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Pharmacy Director	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Pharmacy Network Management Contact	President, Network Strategy	Mr	Sullivan	Tim		6303303638					tssullivan@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Pharmacy Network Management Contact (Secondary)	Network Operations Analyst	Mr.	Kramerov	Allen		2159374120					akramerov@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Pharmacy Technical Help Desk Contact	Manager, Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H6378	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H6378	PHR Beneficiary Contact																	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS	AmeriHealth Caritas	Independence Health Group, Inc.	609	Yes	Active	2672985710				HMO - Health Maintenance Organization		C	Chicago
H6378	Physician Incentive Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Plan Directory Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Plan to Plan Reconciliation Contact	Director, Finance	Ms	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	P.O. 7137	London	KY	40742	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Processor Contact	Director of Clincal Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerFormrx	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Quality Contact	Director, Quality Management	Ms.	Popiolek	Rose		6107234450					rpopiolek@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Reconciliation Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Reconciliation Contact (Secondary)	Manager, Medicare Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Recovery Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	SNP Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	SNP State Contact	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Surveillance Contact	Director, Retail Sales Operations	Ms.	Bech	Mary		4146875533					mbech@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	System Contact	Manager, Medicare IS	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Third Party Administrator (TPA) Liaison	Manager, MCR Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/06/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	User Access Contact	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Utilization Management Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6378	Utilization Review Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS FLORIDA INC	Local CCP	AmeriHealth Caritas VIP Care (HMO-D-SNP)	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Agent/Broker Compensation Data Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Backup User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Bid Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Bid Audit Site Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Bid Primary Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	CAP Report Contact for Public Website	Compliance Director	Ms.	Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Operating Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Information Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Information Security Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	CMMI Model Point of Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Complaints Tracking Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Contact for Fraud Investigations	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Corporate Mailing						8476968500					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway		Park Ridge	IL	60068	10/02/2025	2026	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	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	DIR Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	DIR Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Discount Program Payment Contact	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	Thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Emergency Part D Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Emergency Part D Contact (Secondary)	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Encounter Data & Risk Adjustment Operations Contact		Ms	Teibowei	Gladys		2142872625					gladys.teibowei@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Enrollment Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	EOB Transfer Contact			Lange	Tracie		8476968503				8008861082	tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Financial Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Financial Reporting Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Formulary Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Formulary Contact (Secondary)	Pharmacy Director		Lopez	Eduardo		7542085867					elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	General Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	HIPAA Privacy Officer	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	HIPAA Security Officer	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539				8555158166	Eric.Annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Interoperability Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	MA Appeals/Grievances Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	MA Claims Processing Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Marketing Contact	VP of Marketing	Ms.	Branco	Margaret		7187957495					margaret.branco@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Medical Director	Medical Director	Dr.	Butt, MD	Tariq		3125458471					tariq.butt@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Coordinator	Compliance Specialist	Ms.	Wilcox	Hailey		8476968503					Hailey.wilcox@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Part D Opioid Overutilization Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Medication Therapy Management Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3304058084	Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	OffShore Subcontractor Contact		Mrs.	Lange	Tracie		8476968503				8476923225	Tracie.Lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 C Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 C Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Appeals			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H6379	Part D Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Benefits Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Claims Submission Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H6379	Part D Price File Contact (Back-up)			Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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 Price File Contact (Optional)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Price File Contact (Primary)			Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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 Quality Assurance Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Patient Safety Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Payment Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Director	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Network Management Contact			Perez	Felix		3053313044				3053313044	Felix.perez@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	10/02/2025	2026	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 Network Management Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H6379	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Bretten	Brad							bradley.betten@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H6379	Physician Incentive Contact		Ms.	Wilcox-Lange	Tracie		8476968503				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Plan Directory Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		2249855588				3124290194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Processor Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Quality Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Reconciliation Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Recovery Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	SNP Application Contact		Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	SNP State Contact		Ms.	Wilcox-Lange	Tracie		8476968502				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Surveillance Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	System Contact	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539					eric.annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Third Party Administrator (TPA) Liaison	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Utilization Management Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6379	Utilization Review Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (CO), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6396	Agent/Broker Compensation Data Contact	AVP, Sales Operations	Mr.	Handerhan	Bill		7328291160					bill.handerhan@caresource.com	230 N Main St		Dayton	OH	45402	07/15/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Backup User Access Contact	Compliance Analyst	Mr.	Merrick	Nick		3306910252					macompliance@CareSource.com	230 North Main St		Dayton	OH	45402	01/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Best Available Evidence Contact	Enrollment Team Lead	Mr.	Richardson	Kal		9372243300	3437			9374250909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	02/02/2016	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Bid Audit Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wes.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/02/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Bid Audit Site Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wes.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/02/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Bid Primary Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wes.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/02/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	CAP Report Contact for Public Website	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 N Main St		Dayton	OH	45402	07/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Preitauer	Erhardt		9375312455					Erhardt.Preitauer@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/03/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Preitauer	Erhardt		9375312455					Erhardt.Preitauer@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/03/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Chief Financial Officer	Chief Financial Officer	Mr.	Smart	Lawrence		9375313335					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/03/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Chief Operating Officer	Chief Operating Officer	Mr.	Schultz	Fred		9379016371					fred.schulz@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Chief Information Officer	Chief Information Officer	Ms.	Valencia	Devon		9375312552					devon.valencia@caresource.com	P.O. Box 8738		Dayton	OH	45401	07/11/2019	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Chief Information Security Officer	VP , Information Security and Privacy	Mrs.	Heckler	Lisa		9375313895					lisa.heckler@caresource.com	P.O. Box 8738		Dayton	OH	45401	01/03/2017	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	CMMI Model Point of Contact	Product Management Specialist		Blankenship	Aaron		9374876526					aaron.blankenship@caresource.com	230 N. Main Street		Dayton	OH	45402	01/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	CMS Casework Communication Contact	AVP, Grievance and Appeals	Mr.	Mayo	Faustino		9377013522					faustino.mayo@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Complaints Tracking Contact	AVP, Grievance and Appeals	Mr.	Mayo	Faustino		9377013522					faustino.mayo@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Contact for Fraud Investigations	Program Integrity Analyst	Ms.	Johnson	Alexis	N	9372243300	2870			9373963876	SIUprogramintegrity@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/02/2016	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Coordination of Benefits Contact	Manager, Enrollment Operations	Mr.	Spivey	Michael		9375313682				9374870643	COBInquiry@caresource.com	230 N. Main St.		Dayton	OH	45402	04/15/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Corporate Mailing						9372243300					macompliance@caresource.com	P. O. Box 8738		Dayton	OH	45401	08/31/2020	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Customer Service Operations Contact	Director, Customer Care		Cary	Lisa		9372326458					lisa.cary@caresource.com	40 W 2nd St		Dayton	OH	45402	10/04/2021	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	DIR Contact	AVP, Actuarial Science		Chen	Frank		5625532115					Frank.Chen@CareSource.com	230 N. Main Street		Dayton	OH	45402	01/27/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Discount Program Payment Contact	Senior Manager, Accounting		Schoen	Dawn		4845230738					dawn.schoen@caresource.com	230 N. Main Street		Dayton	OH	45402	08/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Emergency Part D Contact	AVP, Pharmacy	Ms.	Hatton	Jessica		9374874477					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	01/03/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Emergency Part D Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Encounter Data & Risk Adjustment Operations Contact	Director, Claims Encounter Data	Mr.	Shareef	Akbar		9374876640					MyCare-MA_EncounterRequests@caresource.com	220 E. Monument Ave.		Dayton	OH	45402	12/03/2019	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Enrollment Contact	Enrollment Team Lead	Mr.	Richardson	Kal		9372243300	3437			9374250909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	02/02/2016	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	EOB Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479				9374870359	rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Financial Audit Contact	Director Compliance (External Audit)	Ms.	Hoben	Erin		8315885093					erin.hoben@caresource.com	230 N. Main Street		Dayton	OH	45402	12/21/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Financial Reporting Contact	Chief Financial Officer	Mr.	Smart	Lawrence		9375313335					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/15/2021	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Formulary Contact	Director, Clinical Strategy	Ms.	Condon	Kelani		7373142944					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	09/26/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	General Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		6788493008					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/11/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Government Relations Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	HIPAA Privacy Officer	AVP, Privacy and Compliance	Ms.	Fogler	Anne		9378231436					anne.fogler@caresource.com	P.O. Box 8738		Dayton	OH	45401	02/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	HIPAA Security Officer	VP, Cybersecurity, Privacy and Technology Services	Ms.	Heckler	Lisa		9375460770					lisa.heckler@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Hospice Contact	Director, Enrollment	Mr.	Castro	Armando		9375312291					armando.castro@caresource.com	230 N Main St		Dayton	OH	45402	05/29/2020	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Interoperability Contact	AVP, Enterprise Architecture		Hanley	Michael		8033721957					michael.hanley@caresource.com	230 N Main St		Dayton	OH	45402	06/01/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	MA Appeals/Grievances Contact	AVP, Grievance and Appeals	Mr.	Mayo	Faustino		9377013522					faustino.mayo@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	MA Claims Processing Contact for Public Website	VP of Claims and Configuration	Ms.	Hans	Holly		9375312750					Holly.Hans@caresource.com	P. O. Box 8738		Dayton	OH	45401	08/30/2018	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Marketing Contact	Compliance Analyst	Mr.	Merrick	Nick		3306910252					macompliance@CARESOURCE.COM	230 N Main St		Dayton	OH	45402	01/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Medical Director	Medical Director	Dr.	Mukunda	Beejadi		2166459092					beejadi.mukunda@caresource.com	5900 Landerbrook Drive	Ste 300	Mayfield Heights	OH	44124	10/29/2018	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Medicare Compliance Officer	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 N. Main St.		Dayton	OH	45402	07/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Medicare Coordinator	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Clinical Strategy	Ms.	Condon	Kelani		7373142944					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Medication Therapy Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Online Enrollment Center Contact (Optional)	Director, Enrollment	Mr.	Castro	Armando		9375312291					armando.castro@caresource.com	230 N Main Street		Dayton	OH	45402	05/29/2020	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Online Enrollment Center Contact (Primary)	Enrollment Team Lead	Mr.	Richardson	Kal		9372243300	3437			9374250909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	02/02/2016	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part C Application Contact	Director, Medicare & Marketplace Filing		Gray	Melissa		9375312328					melissa.gray@caresource.com	230 N Main St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part C Reporting Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part D Appeals	Express Scripts, Sr. Pharmacy Manager		Schumm	Brian						8555858246	Brian_Schumm@express-scripts.com	5151 B		Dublin	OH	43017	06/08/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Boston
H6396	Part D Appeals Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active	9378187479				HMO - Health Maintenance Organization		C	Boston
H6396	Part D Application Contact	Director, Medicare & Marketplace Filing		Gray	Melissa		9375312328					melissa.gray@caresource.com	230 N Main St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part D Benefits Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part D Claims Submission Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Boston
H6396	Part D Exceptions Contact (Secondary)	Director. Pharmacy Operations	Ms.	Rattan	Sangeet							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active	9375911634				HMO - Health Maintenance Organization		C	Boston
H6396	Part D Price File Contact (Back-up)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part D Price File Contact (Optional)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	11/22/2021	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part D Price File Contact (Primary)	Sr Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/22/2021	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part D Quality Assurance Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Part D Reporting Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Patient Safety Contact	Pharmacist, Formulary Strategy & Management	Mr.	Bogner	Craig		9374874026					rxcompliancerequest@caresource.com	140 N Jefferson St.		Dayton	OH	45402	02/08/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Payment Contact	Senior Manager, Accounting		Schoen	Dawn		4845230738					dawn.schoen@caresource.com	P. O. Box 8738		Dayton	OH	45401	08/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Pharmacy Director	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Pharmacy Network Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H6396	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active	9378187479				HMO - Health Maintenance Organization		C	Boston
H6396	Plan Directory Contact for Public Website	VP Enterprise Operational Improvement	Mr.	Gengo	Chris		9376600192					chris.gengo@caresource.com	P. O. Box 8378		Dayton	OH	45401	07/11/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Plan to Plan Reconciliation Contact	Senior Manager, Accounting	Ms.	Schoen	Dawn		9374876597					CareSourceP2P@CareSource.com	CareSource Accounting	P.O. Box 2208	Dayton	OH	45401	08/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Processor Contact	VP Claims and Configuration		Hans	Holly		9372243300	12750				Holly.Hans@caresource.com	PO Box 8738		Dayton	OH	45401	09/28/2018	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Quality Contact	Director, Enterprise Quality Improvement Programs	Mr.	Fox	Logan		9379742145					logan.fox@caresource.com	230 N Main St.		Dayton	OH	45502	02/06/2025	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Reconciliation Contact	Senior Manager, Accounting	Ms.	Schoen	Dawn		4845230738					dawn.schoen@caresource.com	P. O. Box 8738		Dayton	OH	45401	08/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Recovery Audit Contact	VP, Claims	Ms.	Hans	Holly		9375312750					holly.hans@caresource.com	P. O. Box 8738		Dayton	OH	45401	04/02/2019	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	SNP Application Contact	Director, Medicare & Marketplace Filing		Gray	Melissa		9375312328					melissa.gray@caresource.com	230 N Main St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Surveillance Contact	Manager Program Integrity	Ms.	Johnson	Alexis		9375312870					Alexis.Johnson@CareSource.com	230 North Main Street		Dayton	OH	45402	06/14/2017	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	System Contact	Chief Information Officer	Ms.	Valencia	Devon		9375312552					devon.valencia@caresource.com	P. O. Box 8738		Dayton	OH	45401	07/11/2019	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Third Party Administrator (TPA) Liaison	Senior Manager, Accounting		Schoen	Dawn		4845230738					dawn.schoen@caresource.com	230 N. Main Street		Dayton	OH	45402	08/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	User Access Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Utilization Management Contact	Director, Clinical Operations		Honig	Deronda		2162180296					Deronda.Honig@CareSource.com	P. O. Box 8738		Dayton	OH	45401	03/01/2021	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6396	Utilization Review Contact	Director, Clinical Operations		Honig	Deronda		2162180296					Deronda.Honig@CareSource.com	P. O. Box 8738		Dayton	OH	45401	03/01/2021	2026	CARESOURCE OHIO, INC.	Local CCP	CareSource MyCare Ohio (HMO D-SNP)	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6399	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	01/02/2024	2026	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	Atlanta
H6399	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	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	Atlanta
H6399	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	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	Atlanta
H6399	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	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	Atlanta
H6399	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	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	Atlanta
H6399	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	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	Atlanta
H6399	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	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	Atlanta
H6399	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	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	Atlanta
H6399	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	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	Atlanta
H6399	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	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	Atlanta
H6399	CMS Casework Communication Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	04/14/2023	2026	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	Atlanta
H6399	Complaints Tracking Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	04/14/2023	2026	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	Atlanta
H6399	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	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	Atlanta
H6399	Coordination of Benefits Contact	Director of Pharmacy		Stekol	Ilona		3478806082					StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/29/2022	2026	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	Atlanta
H6399	Corporate Mailing						4107525721				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/01/2020	2026	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	Atlanta
H6399	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		6146537335					PhillipsL1@aetna.com	7400 Campus Road		New Albany	OH	43054	11/18/2025	2026	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	Atlanta
H6399	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H6399	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H6399	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	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	Atlanta
H6399	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	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	Atlanta
H6399	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	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	Atlanta
H6399	Encounter Data & Risk Adjustment Operations Contact	Director, Informatics		Sevchik	Melissa		6026591404					sevchikm@aetna.com	4750 S. 44th Place		Phoenix	AZ	85040	07/08/2024	2026	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	Atlanta
H6399	Enrollment Contact	Lead Director Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	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	Atlanta
H6399	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H6399	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	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	Atlanta
H6399	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	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	Atlanta
H6399	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	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	Atlanta
H6399	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/05/2022	2026	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	Atlanta
H6399	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4802360860				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	06/18/2025	2026	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	Atlanta
H6399	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	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	Atlanta
H6399	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H6399	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	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	Atlanta
H6399	Hospice Contact	Lead Director, Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	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	Atlanta
H6399	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	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	Atlanta
H6399	MA Appeals/Grievances Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	04/14/2023	2026	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	Atlanta
H6399	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	09/06/2023	2026	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	Atlanta
H6399	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	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	Atlanta
H6399	Medical Director	Sr. Clinical Solutions MD	Dr.	Husain	Sajidah		6092356269					Husains@aetna.com	3 Independence Way, Suite 400		Princeton	NJ	08540	12/10/2024	2026	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	Atlanta
H6399	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/24/2020	2026	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	Atlanta
H6399	Medicare Coordinator	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	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	Atlanta
H6399	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	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	Atlanta
H6399	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2021	2026	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	Atlanta
H6399	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	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	Atlanta
H6399	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	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	Atlanta
H6399	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	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	Atlanta
H6399	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Part D Appeals	Supervisor, Clinical Pharmacy	Ms.	Spencer	Tiffane						8448142260	MedicareCoverageDeterminationMMP-SNP@AETNA.com	4750 South 44th Place		Phoenix	AZ	85040	11/18/2025	2026	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	6025589172				HMO - Health Maintenance Organization		C	Atlanta
H6399	Part D Appeals Contact (Secondary)	Director, of Pharmacy	Ms.	Stekol	Ilona							StekolI@aetna.com	7400 West Campus Road	F829	New Albany	OH	43054	05/02/2022	2026	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	3478806082				HMO - Health Maintenance Organization		C	Atlanta
H6399	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	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	Atlanta
H6399	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H6399	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H6399	Part D Exceptions Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	12/05/2022	2026	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	3478806082				HMO - Health Maintenance Organization		C	Atlanta
H6399	Part D Exceptions Contact (Secondary)	Pharmacy Director		Vergil	Gina							Vergilg@aetna.com	7400 West Campus Road		New Albany	OH	43054	01/13/2022	2026	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4026997768				HMO - Health Maintenance Organization		C	Atlanta
H6399	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	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	Atlanta
H6399	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	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	Atlanta
H6399	Part D Quality Assurance Contact	Director, Pharmacy		Stekol	Ilona		3478806082					StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	05/02/2022	2026	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	Atlanta
H6399	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	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	Atlanta
H6399	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	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	Atlanta
H6399	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	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	Atlanta
H6399	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	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	Atlanta
H6399	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	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	Atlanta
H6399	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Stekol	Ilona							StekolI@aetna.com	7400 West Campus Road		New Albany	OH	43054	04/29/2022	2026	AETNA BETTER HEALTH INC. (NJ)	Local CCP	Aetna Better Health of New Jersey	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H6399	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	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	Atlanta
H6399	Plan Directory Contact for Public Website	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/08/2025	2026	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	Atlanta
H6399	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	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	Atlanta
H6399	Processor Contact	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	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	Atlanta
H6399	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	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	Atlanta
H6399	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H6399	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	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	Atlanta
H6399	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	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	Atlanta
H6399	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	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	Atlanta
H6399	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	System Contact	Executive Director, Duals Market Enablement	Ms.	Tanzillo	Hollie	M	7407398501					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	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	Atlanta
H6399	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	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	Atlanta
H6399	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	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	Atlanta
H6399	Utilization Management Contact	AVP, Clinical Health Services		McKenna	Judith		2157758411					mckennaja@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	06/27/2024	2026	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	Atlanta
H6399	Utilization Review Contact	Director Clinical Health Services		Patel	Parul	P	2243633232					patelp12@aetna.com	7400 W. Campus Road		New Albany	OH	43054	01/03/2024	2026	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	Atlanta
H6425	Automated TrOOP Balance Transfer Contact	Business Office Manager	Mr	Lever	Jake		4794636609				4794636601	jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	09/25/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Backup User Access Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Best Available Evidence Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Bid Primary Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	CAP Report Contact for Public Website	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	CEO - CMS Administrator Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	CEO - Senior Official for Contracting	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Chief Financial Officer	Controller	Mr	Burrows	DJ		4794631120					dburrows@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	01/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Chief Operating Officer	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	09/05/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Chief Information Officer	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Chief Information Security Officer	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	CMS Casework Communication Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Complaints Tracking Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	08/16/2023	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Contact for Fraud Investigations	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Coordination of Benefits Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Corporate Mailing						4794636600					paceoftheozarks@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	09/27/2018	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Customer Service Operations Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	DIR Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	DIR Contact (Secondary)	Business Office Manager	Mr	Lever	Jake		4794636609					jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Discount Program Payment Contact	Business Office Supervisor	Mr	Lever	Jake		4794636609				4794636601	Jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Emergency Part D Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Dr E		Springdale	AR	72761	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Enrollment Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	EOB Transfer Contact	Business Office Supervisor	Mr	Lever	Jake		4794636609				4794636601	Jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Financial Audit Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Financial Reporting Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Formulary Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	General Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Government Relations Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	HIPAA Privacy Officer	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636600				4794636601	mharmon@wregional.com	813 Founders Park Dr E	Suite 107	Springdale	AR	72762	12/04/2024	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	HIPAA Security Officer	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Interoperability Contact	Executive Director	Mr	Morris	Jack		4794636600					jmorris@wregional.com	813 Founders Park Dr E		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	MA Appeals/Grievances Contact	Executive Director	Mr	Morris	Jack		4794636611					jmorris@wregional.com	813 Founders Park Dr E	Suite 107	Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	MA Claims Processing Contact for Public Website	Executive Director	Mr	Morris	Jack		4794636609				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Marketing Contact	Marketing/Intake Coordinator	Mrs	Schafer	Kimberly		4794636618				4794636601	kschafer@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Medical Director	Medical Director	Dr	Thomas	Mark		4794636600				4794636601	mthomas@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Medicare Compliance Officer	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	01/30/2024	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Medicare Coordinator	Business Office Supervisor	Mr	Lever	Jake		4794636609				4794636601	Jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Medicare Part D Opioid Overutilization Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636600				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Medication Therapy Management Contact	Medical Director	Dr	Thomas	Mark		4794636600				4794636601	mthomas@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part C Application Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part D Appeals	Executive Director	Mr	Morris	Jack						4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active	4794636611				PACE - Nat		C	New York
H6425	Part D Application Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part D Benefits Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part D Claims Submission Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part D Exceptions Contact	Executive Director	Mr	Morris	Jack						4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active	4794636611				PACE - Nat		C	New York
H6425	Part D Price File Contact (Back-up)	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part D Price File Contact (Primary)	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part D Quality Assurance Contact	Quality Coordinator	Mr	Harmon	Martin		4794636600				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	08/01/2023	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Part D Reporting Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Patient Safety Contact	Quality Coordinator	Mr	Harmon	Martin		4794636600				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Payment Contact	Business Office Supervisor	Mr.	Lever	Jake		4794636609				4794636601	Jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	04/08/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Pharmacy Director	Medical Director	Dr	Thomas	Mark		4794636600				4794636601	mthomas@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Pharmacy Network Management Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636600				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/04/2024	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Pharmacy Technical Help Desk Contact	Quality Improvement Coordinator	Mr	Harmon	Martin						4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	04/08/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active	4794636610				PACE - Nat		C	New York
H6425	Plan Directory Contact for Public Website	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Plan to Plan Reconciliation Contact	Business Office Supervisor	Mr.	Lever	Jake		4794636609				4794636601	jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	04/08/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Processor Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Quality Contact	Quality Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Dr E	Suite 107	Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Reconciliation Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Reconciliation Contact (Secondary)	Controller	Mr	Burrows	DJ		4794631120				4794636601	dburrows@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	02/16/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Recovery Audit Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Surveillance Contact	Medical Director	Dr	Thomas	Mark		4794636600				4794636601	mthomas@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	System Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	05/06/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Third Party Administrator (TPA) Liaison	Business Office Manager	Mr	Lever	Jake		4794636609				4794636601	jlever@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/17/2025	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	User Access Contact	Executive Director	Mr	Morris	Jack		4794636611				4794636601	jmorris@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	12/07/2022	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Utilization Management Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	01/30/2024	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6425	Utilization Review Contact	Quality Improvement Coordinator	Mr	Harmon	Martin		4794636610				4794636601	mharmon@wregional.com	813 Founders Park Drive East, Suite 107		Springdale	AR	72762	01/30/2024	2026	WASHINGTON REGIONAL MEDICORP	National PACE	PACE of the Ozarks	National PACE		Washington Regional Medical System	686	Yes	Active					PACE - Nat		C	New York
H6453	Agent/Broker Compensation Data Contact	Chief Financial Officer	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	CFO, Monroe Operations	Ms.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Backup User Access Contact	Medicare Advantage Compliance Program Manager	Mrs.	Rainer	Sally		3183720214					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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	Bid Audit Contact	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Bid Audit Site Contact	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Bid Primary Contact	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	CAP Report Contact for Public Website	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	CEO - CMS Administrator Contact	EVP, Chief Growth Officer	Mr.	Keller	Brian		2252981582					brian.keller@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Camerlinck	Bryan		2252952537					bryan.camerlinck@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 Operating Officer	VP, Monroe Operations	Mrs.	Self	Jessica		3183982853					jessica.self@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 Information Officer	SVP and CIO	Mrs.	Bourgeois	Tina		2252952018					tina.bourgeois@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Sotnikov	Slava		2252987036					slava.sotnikov@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Complaints Tracking Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Contact for Fraud Investigations	Manager, Federal Investigations	Mrs.	Cowart	Kandyce		2252952073					kandyce.cowart@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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	Corporate Mailing						2252957965					wesley.miller@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Mrs.	Trichel Jones	Amy		3189982870					amy.trichel@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	DIR Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	DIR Contact (Secondary)	Director, Medicare Advantage Operations	Mr.	Gray	Paul		2252987015					paul.gray@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Discount Program Payment Contact	CFO, Monroe Operations	Ms.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Electronic Health Record Contact	SVP and CIO	Mrs.	Bourgeois	Tina		2252952018					tina.bourgeois@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Emergency Part D Contact	Clinical Pharmacist I		Pennington	Hannah		2252987485					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Employer Waiver Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of Quality Improvement	Mr.	Murphy	Paul		3189983098					paul.murphy@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Enrollment Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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	EOB Transfer Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076				3188129987	chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Financial Audit Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Financial Reporting Contact	Chief Financial Officer, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Formulary Contact	Clinical Pharmacist I	Mrs.	Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Formulary Contact (Secondary)	Clinical Pharmacist	Mrs.	Branch	Amy		3189982755					amy.branch@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	General Contact	VP, Monroe Operations	Mrs.	Self	Jessica		3189982853					jessica.self@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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.	Harvey	Korey		2252972762					korey.harvey@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	HIPAA Privacy Officer	VP, Internal Audit, Compliance & Privacy	Mrs.	Saporito	Mary		2252981742					mary.saporito@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	HIPAA Security Officer	Interim Head of Information Security	Mr.	Sotnikov	Slava		2252987036					slava.sotnikov@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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		4802818763					slmorgan@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	08/20/2025	2026	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	Interoperability Contact	VP, Digital Health	Mr.	Badinger	Brian		2252981591					brian.badinger@lablue.com	5525 Re1tz Ave		Baton Route	LA	70809	08/20/2025	2026	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	MA Appeals/Grievances Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	MA Claims Processing Contact for Public Website	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076				8665087145	chelle.cupit@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Marketing Contact	EVP, Chief Growth Officer	Mr.	Keller	Brian		2252981582					brian.keller@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Medical Director	Lead Medical Director	Dr.	Barfield	Deirdre	Y	2252981978					deirdre.barfield@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Coordinator	Medicare Advantage Compliance Program Manager	Mrs.	Rainer	Sally		3183720214					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Part D Opioid Overutilization Contact	Director, Clinical Programs		Hunziker	Simone		3143976681					SHunziker@express-scripts.com	One Express Way		St. Louis	MO	63121	08/20/2025	2026	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	Medication Therapy Management Contact	Clinical Pharmacist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	OffShore Subcontractor Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252957361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Medicare Advantage Compliance Program Manager	Mrs.	Rainer	Sally		3183720214					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	10/14/2025	2026	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 C Application Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 C Reporting Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Appeals	Sr Mgr Pharmacy PA		Herbert	Joshua							joshua.herbert@evernorth.com	One Espress Way Mail Stop S13NB		St. Louis	MO	63121	10/27/2025	2026	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Dallas
H6453	Part D Appeals Contact (Secondary)	Clinical Pharmacy Sr. Manager		Duffy	Vallery							Valerie.Duffy@evernorth.com	One Espress Way Mail Stop S13NB		St Louis	MO	63121	08/20/2025	2026	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	4437973575				HMO - Health Maintenance Organization		C	Dallas
H6453	Part D Application Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 Benefits Contact	Clinical Pharamcist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Claims Submission Contact	Director Product Management	Mr.	Etherton	Jim		5133163889					jbetherton@express-scripts.com	8990 Duke Drive		Mason	OH	45040	08/20/2025	2026	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		Herbert	Joshua							joshua.herbert@evernorth.com	One Espress Way Mail Stop S13NB		St. Louis	MO	63121	10/27/2025	2026	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Dallas
H6453	Part D Exceptions Contact (Secondary)	Clinical Pharamcist I		Pennington	Hannah							hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	2252001752				HMO - Health Maintenance Organization		C	Dallas
H6453	Part D Price File Contact (Back-up)	Sr. Manager - Government Relations	Mrs.	Dolfi	Amanda		6147613606					amanda_dolfi@express-scripts.com	One Express Way	Building 1	St. Louis	MO	63121	08/20/2025	2026	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 Price File Contact (Optional)	Clinical Pharamcist I		Pennington	Hannah		2252001752					Hannah.Pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Price File Contact (Primary)	Director-Government Programs	Mr.	Westrum	Josh		4807363132	433132				jwestrum@express-scripts.com	7909 S. Hardy Drive, Suite 106		Tempe	AZ	85284	08/20/2025	2026	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 Quality Assurance Contact	Clinical Pharmacist I	Ms.	Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Reporting Contact	Clinical Pharmacist I		Pennington	Hannah		2252987485					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Patient Safety Contact	Lead Medical Director	Dr.	Barfield	Deirdre	Y	2252981978					deirdre.barfield@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Payment Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Personal Health Record Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252957361					sally.rainer@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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 Director	Clinical Pharmacist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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 Network Management Contact	Network Account Dir, Retail Strategy & Contracting	Ms.	Kelly	Heather		3146921866					Hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	08/20/2025	2026	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 Network Management Contact (Secondary)	Clinical Pharmacist I		Pennington	Hannah		2252001752					hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Director, Customer Service		Monroe	LaTasha							latasha_monroe@express-scripts.com	13051 N Telecom Parkway	Suite 150	Temple Terrace	FL	33637	08/20/2025	2026	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H6453	Pharmacy Technical Help Desk Contact (Secondary)	Clinical Pharmacist I		Pennington	Hannah							hannah.pennington@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	HMO LOUISIANA, INC.	Local CCP	Blue Cross and Blue Shield of Louisiana	HMO/HMOPOS		Louisiana Health Service & Indemnity Company	617	Yes	Active	2252001752				HMO - Health Maintenance Organization		C	Dallas
H6453	Physician Incentive Contact	Controller	Ms.	Cupit	Chelle		8665087145					chelle.cupit@lablue.com	130 Desiard Street		Monroe	LA	71201	08/20/2025	2026	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	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8665087145					customerservice@blueadvantage.lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Plan to Plan Reconciliation Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Processor Contact	Director, Government Programs, Medicare		Steffen	Jeff		6363351729					jhsteffen@express-scripts.com	One Express Way		St. Louis	MO	63121	08/20/2025	2026	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	Quality Contact	Director of Quality Improvement	Mr.	Murphy	Paul		3189983098					paul.murphy@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Reconciliation Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Reconciliation Contact (Secondary)	Director, Financial Strategic Planning	Mr.	Prescott	Clinton		2252981931					Clinton.Prescott@bcbsla.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/07/2018	2026	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	Recovery Audit Contact	CFO, Monroe Operations	Mrs.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	SNP Application Contact	VP, Monroe Operations	Mrs.	Self	Jessica		3189982853					jessica.self@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	SNP State Contact	VP, Monroe Operations	Mrs.	Self	Jessica		3189982853					jessica.self@lablue.com	5525 Reitz Ave		Baton Rouge	LA	70809	08/20/2025	2026	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	Surveillance Contact	VP, Medicare Advantage Sales	Mr.	Wagner	Dan		5048325831					dan.wagner@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	System Contact	Chief IT Programs, Monroe Ops	Mr.	Wright	Landon		2252953307					landon.wright@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Third Party Administrator (TPA) Liaison	CFO, Monroe Operations	Ms.	Cupit	Chelle		3189983076					chelle.cupit@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	User Access Contact	Medicare Advantage Compliance Officer	Mrs.	Rainer	Sally		2252987361					sally.rainer@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	708093809	08/20/2025	2026	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	Utilization Management Contact	Senior Medical Director	Dr.	Trunk	Laura		2252953307					laura.trunk@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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	Utilization Review Contact	Senior Medical Director	Dr.	Trunk	Laura		2252953307					laura.trunk@lablue.com	5525 Reitz Avenue		Baton Rouge	LA	70809	08/20/2025	2026	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
H6474	Agent/Broker Compensation Data Contact	COO & Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Automated TrOOP Balance Transfer Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Backup User Access Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9498502552	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Best Available Evidence Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Bid Audit Contact	Actuary	Mr.	Feng	Yucheng		3146806102				9499989856	yucheng.feng@wakely.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Bid Audit Site Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Bid Primary Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395					CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	CAP Report Contact for Public Website	Chief Compliance Officer	Ms	Snyder	Constance		5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8008858000				HMO - Health Maintenance Organization		C	Dallas
H6474	CEO - CMS Administrator Contact	Chief Executive Officer	Mr	Davis	Jeff		8008858000				9499989856	Jeff.Davis@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	CEO - Senior Official for Contracting	COO / Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Chief Financial Officer	Chief Financial Officer	Mr	Kori	Vijay		8008858000				9499989856	vkori@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Chief Operating Officer	COO / Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Chief Information Officer	CIO	Mr	Vacant	Vacant	J	8008858000				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Chief Information Security Officer	TBD	Mr	TBD	TBD	J	8008858000				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	CMMI Model Point of Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	CMS Casework Communication Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach,	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Complaints Tracking Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Contact for Fraud Investigations	Compliance SIU Lead	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Coordination of Benefits Contact	VP Quality	Ms	Reed	Mechelle		8008858000				9499989856	Claims@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Corporate Mailing						5626829395				9499989856	CSnyder@ChampionPayer.com	5000 Airport Plazae	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Customer Service Operations Contact	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	DIR Contact	Part D Consultant	Dr.	Tso	Yvonne		3108973889				9499989856	Ytso@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	DIR Contact (Secondary)	CIO	Mr	Wyhinny	Andrew		8008858000				9499989856	AWyhinny@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Discount Program Payment Contact	CFO	Mr	Kori	Vijay		8008858000				9499989856	VKori@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Electronic Health Record Contact	VP Health Informatics	Mr.	Wyhinny	Andrew		8474713955				9499989856	AWyhinny@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8008858000				HMO - Health Maintenance Organization		C	Dallas
H6474	Emergency Part D Contact	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Emergency Part D Contact (Secondary)	Part D Consultant	Dr.	Tso	Yvonne		3108973889					YTso@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Encounter Data & Risk Adjustment Operations Contact	VP Quality	Ms	Reed	Mechelle		8008858000				9499989856	Claims@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Enrollment Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9498502552	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	EOB Transfer Contact	CIO	Mr	Wyhinny	Andrew		8008858000				9499989856	AWyhinny@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Financial Audit Contact	Chief Finance Officer	Mr	Kori	Vijay		8008858000				9499989856	VKori@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Financial Reporting Contact	Chief Financial Officer	Mr	Kori	Vijay		8008858000				9499989856	VKori@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Formulary Contact	Government Programs Specialist II	Ms.	Nyawablia	Christina		8587906297					Christina.Nyawablia@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Formulary Contact (Secondary)	Mgr Formulary Admin	Mr	Wong	Tim		8582915420					FAS@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	General Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Government Relations Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	HIPAA Security Officer	CIO	Mr	Wyhinny	Andrew		8008858000				9499989856	AWyhinny@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Hospice Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Interoperability Contact	Sr. VP Administration	Ms	Taylor	Sandie		9095733553				9492273741	STaylor@ChampionPayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	MA Appeals/Grievances Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	Grievance.Appeals@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	MA Claims Processing Contact for Public Website	Claims  Projects	Ms	Nguyen	Adriana		8008858000				9492273740	Claims@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Marketing Contact	EVP Sales & Marketing	Mr.	Davis	Jay	B	8008858000				9499989856	jay.davis@championpayer.com	5000 Airport Plaza Drive	Suite 100	Irvine	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Medical Director	Chief Medical Officer	Dr	Cross	Brian		8008858000				9498502542	BCross@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Medicare Compliance Officer	Compliance Officer / COO	Ms	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Medicare Coordinator	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Medicare Part D Opioid Overutilization Contact	Mgr Pharmacy Services	Ms.	Valdez	Sandra		8008858000				9499989856	SValdez@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Medication Therapy Management Contact	Mgr Pharmacy Services	Ms.	Valdez	Sandra		8008858000				9499989856	SValdez@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	OffShore Subcontractor Contact	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Online Enrollment Center Contact (Back-up)	Compliance Director	Ms.	Snyder	Rebekah	J	6575058203				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Online Enrollment Center Contact (Optional)	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Online Enrollment Center Contact (Primary)	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part C Application Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395					CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part C Reporting Contact	VP Health Informatics	Mr	Wyhinny	Andrew		8008858000				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Appeals	Mgr Appeals & Gr	Ms	Martin	Dawn							Dawn.Martin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8442825341				HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Appeals Contact (Secondary)	EVP / Compliance Officer	Ms	Snyder	Constance	J					9499989856	hotline@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8008858000				HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Application Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaxa Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Benefits Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395					csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Claims Submission Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395					csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Exceptions Contact	Sup PA & UM Programs	Mr	deGuzman	Edwin							Edwin.deGuzman@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8442825341				HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Price File Contact (Back-up)	Compliance Director	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Price File Contact (Primary)	Part D Price File	Ms.	Keller	Shanon		8587907104					Shanon.Keller@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Quality Assurance Contact		Mr.	Hunt	Brian		8587907092					Brian.Hunt@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Part D Reporting Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airrport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Patient Safety Contact	Chief Medical Officer	Dr	Cross	Brian		8008858000				9499989856	BCross@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Payment Contact	VP	Ms.	Reed	Mechelle		8008858000				9499989856	Claims@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Pharmacy Director	Pharmacy Manager	Dr	Tso	Yvonne		3108973889					YTso@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Pharmacy Network Management Contact	Dir Pharm Net Admin	Mr.	Hunt	Brian		8587907092					Brian.Hunt@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Pharmacy Network Management Contact (Secondary)	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395					CSnyder@championpayer.com	19700 Fairchild Road	Suite 230	Irvine	CA	92612	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							CustomerService@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active	8442825341				HMO - Health Maintenance Organization		C	Dallas
H6474	Plan Directory Contact for Public Website	VP	Ms.	Reed	Mechelle		8008858000				9499989856	claims@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Plan to Plan Reconciliation Contact	CFO	Mr	Kori	Vijay		8008858000				9499989856	vkori@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Processor Contact		Mr.	Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/01/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Quality Contact	Chief Medical Officer	Dr.	Cross	Brian		8008858000				9499989856	BCross@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Reconciliation Contact	CFO	Mr	Kori	Vijay		8008858000				9499989856	accounting@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Reconciliation Contact (Secondary)	CFO	Mr.	Kori	Vijay		8008858000				9499989856	vkori@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Recovery Audit Contact	Chief Compliance Officer	Ms	Snyder	Constance		5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	SNP Application Contact	Chief Compliance Officer	Ms	Snyder	Constance	J	5626829395				9499989856	csnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Surveillance Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	System Contact	VP Health Informatics	Mr	Wyhinny	Andrew		8008858000					Awyhinny@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Third Party Administrator (TPA) Liaison	Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	BSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	User Access Contact	Chief Compliance Officer	Ms.	Snyder	Constance	J	5626829395				9499989856	CSnyder@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Utilization Management Contact	VP Utilization Mgt	Ms.	Mayo	Marcie		5623101247				4245324196	MMayo@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6474	Utilization Review Contact	VP Utilization Mgt	Ms.	Mayo	Marcie		5623101247				4245324196	MMayo@championpayer.com	5000 Airport Plaza Drive	Suite 100	Long Beach	CA	90815	10/29/2025	2026	RENAL PAYER SOLUTIONS INC	Local CCP	Champion Health Plan	HMO/HMOPOS		Champion Health Plans-USA, LLC.	804	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6515	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Atlanta
H6515	Best Available Evidence Contact	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Chief Financial Officer	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Chief Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Chief Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Chief Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	CMS Casework Communication Contact	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Atlanta
H6515	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Atlanta
H6515	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Coordination of Benefits Contact	Director, Payment Integrity		Hartberger	Jake		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Customer Service Operations Contact	Vice President, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	Atlanta
H6515	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Government Relations Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Hospice Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	01/23/2025	2026	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	Atlanta
H6515	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Atlanta
H6515	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Medicare Compliance Officer	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Medicare Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Medicare Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Atlanta
H6515	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Part C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Part C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Part D Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	Atlanta
H6515	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	Atlanta
H6515	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Part D Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Part D Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Part D Exceptions Contact	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	Atlanta
H6515	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	Atlanta
H6515	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Part D Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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	Atlanta
H6515	Part D Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Part D Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Part D Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Pharmacy Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Pharmacy Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Pharmacy Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Atlanta
H6515	Pharmacy Technical Help Desk Contact	Director, Client Operations		Help Desk	Pharmacy						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H6515	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	Atlanta
H6515	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6515	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Atlanta
H6517	Automated TrOOP Balance Transfer Contact	VP of Finance and Managed Care	Mr	Li	Scott		5597374907					sxli@fhcn.org	305 E Center Ave		Visalia	CA	93291	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Backup User Access Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Best Available Evidence Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Bid Primary Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	CAP Report Contact for Public Website	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 E. School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	CEO - CMS Administrator Contact	Deputy CEO & Senior VP	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	CEO - Senior Official for Contracting	President and CEO	Mrs	Hydash	Kerry		5597374700					khydash@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Chief Financial Officer	VP of Finance and Managed Care	Mr	Li	Scott		5597374907					sxli@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/17/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Chief Operating Officer	Vice President of Operations	Mrs	Verduzco	Norma	D	5597374755					nverduzco@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/12/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Chief Information Officer	Vice President of Information Systems	Mr	Kelley	Jay		5597374700					jkelley@fhcn.org	305 E Center Ave		Visalia	CA	93291	07/25/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Chief Information Security Officer	Vice President of Information Systems	Mr	Kelley	Jay		5597374700					jkelley@fhcn.org	305 E Center Ave		Visalia	CA	93291	10/07/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	CMS Casework Communication Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Complaints Tracking Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Contact for Fraud Investigations	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Coordination of Benefits Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Corporate Mailing						5597374700					helpdesk@fhcn.org	305 E Center Ave		Visalia	CA	93291	04/02/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Customer Service Operations Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	DIR Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	DIR Contact (Secondary)	VP of Operations	Mrs.	Verduzco	Norma		5597374907					Nverduzco@fhcn.org	305 E Center Ave		Visalia	CA	93291	01/29/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Discount Program Payment Contact	VP of Finance and Managed Care	Mr	Li	Scott		5597374700					sxli@fhcn.org	305 E. Center Ave.		Visalia	CA	93292	09/17/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Emergency Part D Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Emergency Part D Contact (Secondary)	VP of Finance and Managed Care	Mr	Li	Scott		5597374700					sxli@fhcn.org	305 E. Center Ave		Visalia	CA	93291	10/07/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Encounter Data & Risk Adjustment Operations Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Enrollment Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	EOB Transfer Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842			5597412675	antgutierrez@fhcn.org	500 E. School Ave.		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Financial Audit Contact	Deputy CEO	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	07/25/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Financial Reporting Contact	Deputy CEO	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	07/25/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Formulary Contact	Medical Director	Mr.	Patel, MD	Niraj		5597374907					npatel@fhcn.org	305 E Center Ave		Visalia	CA	93291	12/09/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Formulary Contact (Secondary)	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	General Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Government Relations Contact	Deputy CEO	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	HIPAA Privacy Officer	Deputy CEO	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	HIPAA Security Officer	Deputy CEO	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Interoperability Contact	Vice President of Information Systems	Mr	Kelley	Jay		5597374700					jkelley@fhcn.org	305 E Center Ave		Visalia	CA	93291	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	MA Appeals/Grievances Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 E. School Ave		Visalia	CA	93291	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	MA Claims Processing Contact for Public Website	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Marketing Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Medical Director	Medical Director	Mr	Srivastava, MD	Anshuman		8773267223	4412				asrivastava@fhcn.org	500 E. School Ave		Visalia	CA	93292	07/22/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Medicare Compliance Officer	VP of Operations	Mrs.	Verduzco	Norma		5597374755				5597374907	NVerduzco@fhcn.org	305 E Center Ave		Visalia	CA	93291	11/25/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Medicare Coordinator	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Medicare Part D Opioid Overutilization Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Medication Therapy Management Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	OffShore Subcontractor Contact	Deputy CEO	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Online Enrollment Center Contact (Back-up)	PACE Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	16730				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Online Enrollment Center Contact (Optional)	VP of Operations	Mrs.	Verduzco	Norma		5597374907					Nverduzco@fhcn.org	500 E. Center Ave		Visalia	CA	93291	01/29/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Online Enrollment Center Contact (Primary)	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part C Application Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Appeals	Vice President of Operations	Mrs	Verduzco	Norma							nverduzco@fhcn.org	500 E. School Ave		Visalia	CA	93291	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active	5597374755				PACE - Nat		C	San Francisco
H6517	Part D Appeals Contact (Secondary)	Medical Director	Mr.	Srivastava, MD	Anshuman							asrivastava@fhcn.org	500 E. School Ave		Visalia	CA	93292	07/22/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active	8773267223	4412			PACE - Nat		C	San Francisco
H6517	Part D Application Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Benefits Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Claims Submission Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Exceptions Contact	Vice President of Operations	Mrs	Verduzco	Norma							nverduzco@fhcn.org	500 E. School Ave		Visalia	CA	93291	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active	5597374755				PACE - Nat		C	San Francisco
H6517	Part D Exceptions Contact (Secondary)	Medical Director	Mr	Srivastava, MD	Anshuman							asrivastava@fhcn.org	500 E. School Ave		Visalia	CA	93292	07/22/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active	8773267223	4412			PACE - Nat		C	San Francisco
H6517	Part D Price File Contact (Back-up)	Director of Pharamacy	Mr.	Mahal, PharmD	Pargat		5597374907					pmahal@fhcn.org	305 E Center Ave		Visalia	CA	93291	12/09/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Price File Contact (Optional)	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Price File Contact (Primary)	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Quality Assurance Contact	VP of QI and Risk Management	Mrs.	Neely	Whitney		5597374907					wneely@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/17/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Part D Reporting Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Patient Safety Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Payment Contact	VP of Finance and Managed Care	Mr.	Li	Scott		5597374907					sxli@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/17/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Personal Health Record Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Pharmacy Director	Director of Pharmacy	Dr.	Mahal	Pargat		5597374907					pmahal@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/17/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Pharmacy Network Management Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Pharmacy Network Management Contact (Secondary)	Director of Pharamacy	Mr	Mahal, PharmD	Pargat		5597374907					pmahal@fhcn.org	305 E Center Ave		Visalia	CA	93291	12/09/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mrs	Verduzco	Norma							nverduzco@fhcn.org	500 E. School Ave		Visalia	CA	93291	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active	5597374755				PACE - Nat		C	San Francisco
H6517	Pharmacy Technical Help Desk Contact (Secondary)	Director of Pharamacy	Mr	Mahal, PharmD	Pargat							pmahal@fhcn.org	305 E Center Ave		Visalia	CA	93291	12/09/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active	5597374907				PACE - Nat		C	San Francisco
H6517	PHR Beneficiary Contact																	10/07/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE	Pharmastar PBM	Family Healthcare Network	835	Yes	Active	8882987770				PACE - Nat		C	San Francisco
H6517	Plan Directory Contact for Public Website	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Plan to Plan Reconciliation Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Processor Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Quality Contact	VP of QI and Risk Management	Mrs.	Neely	Whitney		5597374907					wneely@fhcn.org	305 E Center Ave		Visalia	CA	93291	12/09/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Reconciliation Contact	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Reconciliation Contact (Secondary)	VP of Operations	Mrs.	Verduzco	Norma		5597374907					nverduzco@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/17/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Recovery Audit Contact	VP of QI and Risk Management	Mrs.	Neely	Whitney		5597374907					Wneely@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/17/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Surveillance Contact	VP of QI and Risk Management	Mrs.	Neely	Whitney		5597374907					wneely@fhcn.org	305 E Center Ave		Visalia	CA	93291	12/09/2024	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	System Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Third Party Administrator (TPA) Liaison	Business Office Analyst	Mr	Gutierrez	Antonio		8779603426	2842				antgutierrez@fhcn.org	500 E. School Ave		Visalia	CA	93292	09/11/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	User Access Contact	Deputy CEO	Mr	Vawter	Chad		5597374907					cvawter@fhcn.org	305 E Center Ave		Visalia	CA	93291	09/29/2022	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Utilization Management Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6517	Utilization Review Contact	Vice President of Operations	Mrs	Verduzco	Norma		5597374755					nverduzco@fhcn.org	500 East School Ave		Visalia	CA	93292	11/13/2025	2026	Family HealthCare Network (FHCN) PACE	National PACE	Family HealthCare Network PACE	National PACE		Family Healthcare Network	835	Yes	Active					PACE - Nat		C	San Francisco
H6529	Agent/Broker Compensation Data Contact	Vice President, MTA Sales		Ward	Lisa		8123748215					lisa.ward@mytruadvantage.com	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Automated TrOOP Balance Transfer Contact	Director of Medicare Advantage Technical Services	Mr.	Coleman	Jonathan		8123142500	1022				jonathan.coleman@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Backup User Access Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Best Available Evidence Contact	Manager of Eligibility		Ralston	Tonya		8123142500	1033				tonya.ralston@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Bid Audit Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47202	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Bid Audit Site Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Bid Primary Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	CAP Report Contact for Public Website	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	CEO - CMS Administrator Contact	President & CEO	Mr.	Sadtler	John		8123738714					john.sadtler@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	CEO - Senior Official for Contracting	President & CEO	Mr.	Sadtler	John		8123738714					john.sadtler@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Chief Financial Officer	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Chief Operating Officer	COO	Mr.	Brey	Austin		8123793514					Austin.Brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Chief Information Officer	Vice President, Information Technology	Mr.	Clancy	Mike		8123787052					Mike.Clancy@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Chief Information Security Officer	Director of Technology Services	Mr.	Taylor	Rob		8123787046					Rob.Taylor@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	CMS Casework Communication Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Complaints Tracking Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Contact for Fraud Investigations	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Coordination of Benefits Contact	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Corporate Mailing						8123787023					Hannah.Hauser@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Customer Service Operations Contact	Vice President, MTA Sales		Ward	Lisa		8123748215					lisa.ward@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	DIR Contact	Director, Part D Operations & Vendor Oversight	Ms.	Helsley	Kimberly		8123787028					Kim.helsley@SIHO.org	417 Washington Street		Columbus	IN	47201	08/13/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	DIR Contact (Secondary)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Discount Program Payment Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Electronic Health Record Contact	Director, Care Management & Quality Programs		Albright	Jennifer		3178165183					jennifer.albright@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Emergency Part D Contact	COO	Mr.	Brey	Austin		8123793514					Austin.Brey@siho.org	417 Washington St		Columbus	IN	47201	11/11/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Emergency Part D Contact (Secondary)	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Encounter Data & Risk Adjustment Operations Contact	VP Operations	Mr.	Massard	Gary		8123787083					Gary.Massard@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Enrollment Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	EOB Transfer Contact	Claims Director		Coomer	Dawn		8123142500	1106			3178603632	dawn.coomer@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Financial Audit Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Financial Reporting Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Formulary Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Formulary Contact (Secondary)	Part D Mgr, Formulary Administration & Strategy		Wong	Tim		8582915420					tim.wong@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	General Contact	COO	Mr.	Brey	Austin		8123793514					Austin.Brey@siho.org	417 Washington St		Columbus	IN	47201	11/11/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Government Relations Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	HIPAA Privacy Officer	Administration and PHO Lead		Prabhune	Sheetal		8123787097	3003				sprabhune@inspirehealthpartners.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	HIPAA Security Officer	Director Technology Services	Mr.	Taylor	Rob		8123787046					Rob.Taylor@siho.org	417 Washignton Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Hospice Contact	Medicare Advantage Utilization Management Nurse		Graham	Jessica		8123142500	1016				jessica.graham@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Interoperability Contact	Director of Provider Relations		Jones	Michelle		8123787107					Michelle.Jones@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	MA Appeals/Grievances Contact	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	MA Claims Processing Contact for Public Website	Claims Director		Coomer	Dawn		8123142500	1106				dawn.coomer@siho.org	417 Washingotn Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Marketing Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Medical Director	Medical Director	Dr.	Goode	Roy		8123430967					Roy.Goode@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Medicare Coordinator	Reports Specialist	Ms.	Gottman	Melissa		8123142500	1107				Melissa.Gottman@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Medicare Part D Opioid Overutilization Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Medication Therapy Management Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	OffShore Subcontractor Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Online Enrollment Center Contact (Back-up)	Manager of Quality Assurance, G&A, FWA & RA		Do	Nicole		8123142500	1102				Nicole.Do@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Online Enrollment Center Contact (Optional)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Online Enrollment Center Contact (Primary)	Director of Data Integration & Development	Mr.	Katheeder	Tim		8123787066					Tim.Katheeder@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part C Application Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part C Reporting Contact	Reports Specialist	Ms.	Gottman	Melissa		8123142500	1107				Melissa.Gottman@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Appeals	Manager of Quality Assurance		Do	Nicole							Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	8123142500	1102			HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Appeals Contact (Secondary)	Grievances & Appeals Coordinator		Hamilton-Brogdon	Gretchen							gretchen.hamilton@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	8123142500	1031			HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Application Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Benefits Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Claims Submission Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Exceptions Contact	Manager of Quality Assurance		Do	Nicole							Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	8123142500	1102			HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Exceptions Contact (Secondary)	Grievances & Appeals Coordinator		Hamilton-Brogdon	Gretchen							gretchen.hamilton@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	8123142500	1031			HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Price File Contact (Back-up)	General Consultant User		Keller	Sharon		8587907104					PlanFinderCommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Price File Contact (Optional)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Price File Contact (Primary)	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Quality Assurance Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Part D Reporting Contact	Reports Specialist	Ms.	Gottman	Melissa		8123142500	1107				Melissa.Gottman@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Patient Safety Contact	Director, Part D Operations & Vendor Oversigh	Ms.	Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Payment Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Personal Health Record Contact	Director, Care Management & Quality Programs		Albright	Jennifer		3178165183					jennifer.albright@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Pharmacy Director	Medical Director	Dr.	Goode	Roy		8123430967					Roy.Goode@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Pharmacy Network Management Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Pharmacy Network Management Contact (Secondary)	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	8774036035				HMO - Health Maintenance Organization		C	Dallas
H6529	Pharmacy Technical Help Desk Contact (Secondary)	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly							kim.helsley@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active	8774036035				HMO - Health Maintenance Organization		C	Dallas
H6529	PHR Beneficiary Contact																	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS	Southeastern Indiana Health Organization Inc	SIHO Holding, Inc.	761	Yes	Active	8444254280				HMO - Health Maintenance Organization		C	Dallas
H6529	Physician Incentive Contact	Director of Provider Relations		Jones	Michelle		8123787107					Michelle.Jones@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Plan Directory Contact for Public Website	Director of Provider Relations		Jones	Michelle		8123787107					Michelle.Jones@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Plan to Plan Reconciliation Contact	Staff Accountant I		Dobbs	Rachel		8123142500	1202				rachel.dobbs@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Processor Contact	Senior Executive	Mr.	Massard	Gary		8123787083					Gary.Massard@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Quality Contact	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.Do@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Reconciliation Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Reconciliation Contact (Secondary)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Recovery Audit Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Surveillance Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	System Contact	Vice President Information Technology	Mr.	Clancy	Mike		8123787052					Mike.Clancy@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Third Party Administrator (TPA) Liaison	Staff Accountant I		Dobbs	Rachel		8123142500	1202				rachel.dobbs@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	User Access Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Utilization Management Contact	Medicare Advantage Utilization Management Nurse		Graham	Jessica		8123142500	1016				jessica.graham@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6529	Utilization Review Contact	Medicare Advantage Utilization Management Nurse		Graham	Jessica		8123142500	1016				jessica.graham@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	HMO/HMOPOS		SIHO Holding, Inc.	761	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6537	Automated TrOOP Balance Transfer Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Backup User Access Contact			Durbin	Patrick		8446642248					pdurbin@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Best Available Evidence Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Bid Primary Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	CAP Report Contact for Public Website			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	CEO - CMS Administrator Contact		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	CEO - Senior Official for Contracting		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Chief Financial Officer		Mr.	Fuentes	Robert		8446642248					rfuentes@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Chief Operating Officer		Ms.	Funk	Jennie		8446642248					jfunk@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Chief Information Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Chief Information Security Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	CMS Casework Communication Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Complaints Tracking Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Contact for Fraud Investigations			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Coordination of Benefits Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Corporate Mailing						8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Customer Service Operations Contact			Oglevee	Brad		8446642248					boglevee@habitathealth.com	855 Howe Ave		Sacramento	CA	95825	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	DIR Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Discount Program Payment Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Emergency Part D Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Encounter Data & Risk Adjustment Operations Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Enrollment Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	EOB Transfer Contact			Siler	Sarah		8556592670				9165144953	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Financial Audit Contact	Sr. Dir, Health Plan	Mrs.	Siler	Sarah		8446642248				9167372990	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Financial Reporting Contact			Ryan	Chandler		8446642248					cryan@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Formulary Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	General Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Government Relations Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	HIPAA Privacy Officer			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	HIPAA Security Officer			Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	10/23/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Interoperability Contact			Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	MA Appeals/Grievances Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	MA Claims Processing Contact for Public Website			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Marketing Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Medical Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Medicare Compliance Officer		Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Medicare Coordinator	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Medicare Part D Opioid Overutilization Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Medication Therapy Management Contact	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part C Application Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part D Appeals		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active	8446642248				PACE - Nat		C	San Francisco
H6537	Part D Application Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part D Benefits Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part D Claims Submission Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part D Exceptions Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active	8556592670				PACE - Nat		C	San Francisco
H6537	Part D Price File Contact (Back-up)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part D Price File Contact (Primary)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part D Quality Assurance Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Part D Reporting Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Patient Safety Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Payment Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Pharmacy Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Pharmacy Network Management Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Pharmacy Technical Help Desk Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active	8556592670				PACE - Nat		C	San Francisco
H6537	Plan Directory Contact for Public Website			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Plan to Plan Reconciliation Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Processor Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Quality Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Reconciliation Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Recovery Audit Contact	VP, Compliance	Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Surveillance Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	System Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Third Party Administrator (TPA) Liaison			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	User Access Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Utilization Management Contact			Siler	Sarah		8556592670					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	09/08/2025	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6537	Utilization Review Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	12/17/2024	2026	TUNGSTEN HEALTH SACRAMENTO, LLC	National PACE	Habitat Health Sacramento	National PACE		Tungsten Health Holdings, LLC	826	Yes	Active					PACE - Nat		C	San Francisco
H6541	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Backup User Access Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	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		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Bid Primary Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	CAP Report Contact for Public Website			Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	CEO - CMS Administrator Contact	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	CEO - Senior Official for Contracting	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	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.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Chief Operating Officer	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Chief Information Officer	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Chief Information Security Officer	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	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		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Complaints Tracking Contact	Quality Director		Latham	Amber		6066882143					alatham@forhorizonpace.com	PO Box 135		Albany	KY	42602	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Contact for Fraud Investigations	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	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		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/07/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Corporate Mailing						8596234080					kellyupchurch@forhorizon.com	PO Box 572		Richmond	KY	40476	02/20/2023	2026	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		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	DIR Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	DIR Contact (Secondary)	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	01/10/2025	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Discount Program Payment Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Emergency Part D Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Emergency Part D Contact (Secondary)	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Ms.	Hickman	Stacey		6063099068					shickman@forhorizon.com	98 JIMMY DYER LN		ALBANY	KY	42602	09/25/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Enrollment Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	EOB Transfer Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Financial Audit Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Financial Reporting Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Formulary Contact	Ex Director	Ms	Hickman	Stacey		6066881549					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	02/20/2023	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Formulary Contact (Secondary)	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	General Contact	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	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		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	HIPAA Privacy Officer	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	HIPAA Security Officer	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Interoperability Contact	COO		Burchett	Melinda		6063873376					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	11/08/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	MA Appeals/Grievances Contact	Quality Director		Latham	Amber		6066882143					alatham@forhorizonpace.com	PO Box 135		Albany	KY	42602	09/25/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	MA Claims Processing Contact for Public Website	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Marketing Contact			Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Medical Director	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Medicare Compliance Officer	Quality Director	Mrs.	Latham	Amber	L	6066882143					alatham@forhorizonpace.com	PO Box 135		Albany	KY	42602	11/18/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Medicare Coordinator	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Medicare Part D Opioid Overutilization Contact	Quality Director		Latham	Amber		6066882143					alatham@forhorizonpace.com	PO Box 135		Albany	KY	42602	09/25/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Medication Therapy Management Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	OffShore Subcontractor Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Online Enrollment Center Contact (Back-up)	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/07/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Online Enrollment Center Contact (Optional)	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/07/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Online Enrollment Center Contact (Primary)	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/07/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part C Application Contact			Upchurch	Kelly		8596234080					kellyupchurch.com@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	01/25/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Appeals	CEO	Mr.	Upchurch	Kelly						8596245771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	8596234080				PACE - Nat		C	Atlanta
H6541	Part D Appeals Contact (Secondary)	CEO	Mr.	Upchurch	Kelly						8596245771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	8596234080				PACE - Nat		C	Atlanta
H6541	Part D Application Contact			Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Benefits Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Claims Submission Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	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						8596245771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	8596234080				PACE - Nat		C	Atlanta
H6541	Part D Exceptions Contact (Secondary)	CEO	Mr.	Upchurch	Kelly						8596245771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	8596234080				PACE - Nat		C	Atlanta
H6541	Part D Price File Contact (Back-up)	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Price File Contact (Optional)	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Price File Contact (Primary)	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Quality Assurance Contact	Quality Director		Latham	Amber		6066882143					alatham@forhorizonpace.com	PO Box 135		Albany	KY	42602	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Part D Reporting Contact	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Patient Safety Contact	Quality Director		Latham	Amber		6066882143					alatham@forhorizonpace.com	PO Box 135		Albany	KY	42602	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Payment Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Personal Health Record Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/07/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Pharmacy Director	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Pharmacy Network Management Contact	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Pharmacy Network Management Contact (Secondary)	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	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						8596245771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	8596234080				PACE - Nat		C	Atlanta
H6541	Pharmacy Technical Help Desk Contact (Secondary)	CEO	Mr.	Upchurch	Kelly						8596245771	kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active	8596234080				PACE - Nat		C	Atlanta
H6541	Plan Directory Contact for Public Website	CEO	Mr.	Upchurch	Kelly		8596234080					kellyupchurch@forhorizon.com	2028 Merrick Dr		Richmond	KY	40475	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Plan to Plan Reconciliation Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Processor Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Quality Contact	Quality Director		Latham	Amber		6066882143					alatham@forhorizonpace.com	PO Box 135		Albany	KY	42602	09/25/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Reconciliation Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Reconciliation Contact (Secondary)	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Recovery Audit Contact	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Surveillance Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	System Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Third Party Administrator (TPA) Liaison	CFO	Mr.	Dapkus	Cody		8596234080	1104			8596245771	cdapkus@forhorizon.com	2028 Merrick Drive		Richmond	KY	40475	12/10/2024	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	User Access Contact	Executive Director		Hickman	Stacey		6063099068					shickman@forhorizon.com	PO Box 135		Albany	KY	42602	06/08/2022	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Utilization Management Contact	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6541	Utilization Review Contact	COO	Ms.	Burchett	Melinda		6063053028					mburchett@forhorizon.com	PO Box 135		Albany	KY	42602	02/09/2021	2026	HORIZON-PACE, LLC	National PACE	Horizon - PACE	National PACE		American Health Management, Inc.	783	Yes	Active					PACE - Nat		C	Atlanta
H6545	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted Health Insurance Company of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6545	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted Health Insurance Company of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H6545	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted Health Insurance Company of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6545	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted Health Insurance Company of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6545	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted Health Insurance Company of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H6545	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted Health Insurance Company of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6545	PHR Beneficiary Contact																	11/20/2025	2026	Devoted Health Insurance Company of Illinois, Inc.	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H6545	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H6550	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H6550	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H6550	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H6550	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H6550	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H6550	PHR Beneficiary Contact																	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H6550	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6550	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6551	Automated TrOOP Balance Transfer Contact	Regional Finance Director		Schmotzer	David		2153394533				6102719530	David.Schmotzer@Trinity-Health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	08/02/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Backup User Access Contact	Executive Director	Mr.	Moore	Daniel		2679917620					Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	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	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Bid Primary Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	CAP Report Contact for Public Website	Executive Director	Mr	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	CEO - Senior Official for Contracting	Executive Director	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	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	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Chief Operating Officer	COO	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	04/28/2022	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Chief Information Officer	Director Enterprise IT Operations	Mr	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	1201 Langhorne-Newtown Road		Langhorne	PA	19047	09/15/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Chief Information Security Officer	VP Information Security	Ms.	Jennings	Preston		6105503183					Preston.Jennings@trinity-health.org	1201 Langhorne-Newtown Road		Langhorne	PA	19047	09/15/2023	2026	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	Executive Director	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Complaints Tracking Contact	Director, Quality and Compliance		Michel	Katie		2679917626					Katie.Michel@trinity-health.org	2500 Northgate Rd	Suite 1	Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Contact for Fraud Investigations	Director, Quality and Compliance	Ms	Michel	Katie		2679917626					Katie.Michel@trinity-health.org	2500 Northgate Rd		Trevose	PA	19053	09/30/2025	2026	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	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Corporate Mailing						2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	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	Executive Director	Mr	Moore	Daniel		2679917620					Dmoore2@trinity-health.org	2500 Northgate Rd		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	DIR Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Discount Program Payment Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Emergency Part D Contact	Regional Finance Director	Mr	Schmotzer	David		2153394533				6102719530	David.Schmotzer@Trinity-Health.org	1930 South Broad Street	Unit 3	Philadelphia	PA	19145	08/02/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	10/25/2019	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Enrollment Contact	Outreach/Enrollment Specialist/Community Liaison	Ms	Leib	Margaret		2679917622				2679917618	MLeib@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/09/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	EOB Transfer Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533				2679917618	David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Financial Audit Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Financial Reporting Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				2679917618	joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	General Contact	Executive Director	Mr	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	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	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Interoperability Contact	Director IT Operations		Gillespie	Jeff		6142348636					gillespj@trinity-health.org	1201 Langhorne-Newtown Road	TH PACE	Langhorne	PA	19047	02/26/2024	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	MA Appeals/Grievances Contact	Director, Quality and Compliance	Ms	Michel	Katie		2679917626					Katie.Michel@trinity-health.org	2500 Northgate		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	MA Claims Processing Contact for Public Website	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Marketing Contact	Director Marketing & Communications	Ms	Lark	Azia		9735182754					azia.lark@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	02/03/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Medical Director	Medical Director	Dr	Sojan	Antonia		2679917601				2679917618	antonia.sojan@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/03/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Medicare Compliance Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Medicare Coordinator	Executive Director	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				2679917618	joseph.Garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362				4134932024	joseph.garbarino@mercyhealth.org	200 Hillside Circle	Suite 1	West Springfield	MA	01089	07/27/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part C Application Contact	Executive Director	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part D Appeals	Manager Part D Compliance	Mr	Garbarino	Joseph							Joseph.Garbarino@trinity-health.org	1930 South Broad St	Unit 3	Philadelphia	PA	19145	09/09/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H6551	Part D Application Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part D Benefits Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part D Claims Submission Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	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	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H6551	Part D Price File Contact (Back-up)	Executive Director	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/13/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part D Price File Contact (Primary)	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part D Quality Assurance Contact	Director, Quality and Compliance	Ms	Michel	Katie		2679917626					Katie.Michel@trinity-health.org	2500 Northgate Rd		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Part D Reporting Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Patient Safety Contact	Director, Quality and Compliance	Ms	Michel	Katie		2679917626					Katie.Michel@trinity-health.org	2500 Northgate Rd		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Payment Contact	Regional Finance Director	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Pharmacy Director	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@mercyhealth.org	1930 South Broad Street		Philadelphia	PA	19145	08/02/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Pharmacy Network Management Contact	Manager Part D Compliance		Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/09/2021	2026	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	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Philadelphia
H6551	PHR Beneficiary Contact																	06/26/2015	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE	LIFE St.Mary	Trinity Health Corporation	234	Yes	Active	8009999999				PACE - Nat		C	Philadelphia
H6551	Plan Directory Contact for Public Website	Executive Director	Mr.	Moore	Daniel		2679917620				2679917618	Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Plan to Plan Reconciliation Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Processor Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Quality Contact	Director QI/Compliance	Ms	Michel	Katie		2679917626					katie.michel@trinity-health.org	2500 Northgate Rd		Trevose	PA	19053	09/13/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Reconciliation Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Recovery Audit Contact	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Surveillance Contact	Executive Director	Mr	Moore	Daniel		2679917620					Dmoore2@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/30/2025	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Third Party Administrator (TPA) Liaison	Director of Finance	Mr.	Schmotzer	David	P	2153394533					David.Schmotzer@Trinity-Health.org	1930 South Broad Street, Unit 3		Philadelphia	PA	19145	08/13/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Utilization Management Contact	Medical Director	Dr	Sojan	Antonia		2679917601				2679917618	antonia.sojan@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/03/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6551	Utilization Review Contact	Medical Director	Dr	Sojan	Antonia		2679917601				2679917618	antonia.sojan@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	09/03/2021	2026	LIFE ST. MARY	National PACE	LIFE St. Mary	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Philadelphia
H6566	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Backup User Access Contact	Medicare Compliance Officer, Plan Partner Support	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Best Available Evidence Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/06/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	CEO - CMS Administrator Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	CEO - Senior Official for Contracting	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Chief Financial Officer	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Chief Operating Officer	Chief Operating Officer/General Manager	Mr.	Emami	John		7038837508					john.emami@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Chief Information Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Coordination of Benefits Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/06/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Corporate Mailing						8448546883					customerservice@lifeworksadvantage.com	PO BOX 2190		Glen Allen	VA	23058	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Discount Program Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					Mark.Hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Enrollment Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/06/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	EOB Transfer Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797				8336102390	stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	06/06/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Financial Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Financial Reporting Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	General Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	HIPAA Privacy Officer	Chief Compliance Officer and HIPAA Privacy Officer	Ms.	Crowe	Melanie		4049330409					melanie.crowe@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Interoperability Contact	Director of Data Operations and Architecture	Mr.	Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Marketing Contact	Marketing Director	Mrs	Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Medical Director	VP Medical Affairs		Dahlgren	Andrew		8042968288					Andrew.Dahlgren@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Medicare Coordinator	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part C Reporting Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/09/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active	9202214372				PPO - BBA		C	Chicago
H6566	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active	3476835717				PPO - BBA		C	Chicago
H6566	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active	9202214176				PPO - BBA		C	Chicago
H6566	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active	3476835717				PPO - BBA		C	Chicago
H6566	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Pharmacy Network Management Contact	VP Network Management		Santos	Christina		6088204408					christina.santos@navitus.com	361 Integrity Drive		Madison	WI	53717	06/06/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active	8662703877	4224			PPO - BBA		C	Chicago
H6566	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active	3476835717				PPO - BBA		C	Chicago
H6566	Physician Incentive Contact	Executive Director	Mr.	Dunn	Jamie		8048140844					jamie.dunn@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Plan Directory Contact for Public Website			Sindlinger	Rocio		8558550489					rocio.sindlinger@curanahealth.com	PO BOX 4440		Glen Allen	VA	23058	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Plan to Plan Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Processor Contact	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/09/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Quality Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Reconciliation Contact (Secondary)	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Recovery Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Surveillance Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					Katie.Bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	User Access Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Utilization Management Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6566	Utilization Review Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	02/10/2025	2026	LAGNIAPPE ADVANTAGE INSURANCE COMPANY	Local CCP	Lagniappe Advantage	Local PPO		Curana Health Holdings, LLC	733	Yes	Active					PPO - BBA		C	Chicago
H6586	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6586	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H6586	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6586	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6586	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H6586	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6586	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H6586	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H6595	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H6595	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H6595	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H6595	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H6595	Plan Directory Contact for Public Website			Customer Service	UHC		8448559774					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6595	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF WISCONSIN, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6596	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Backup User Access Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689722					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Bid Primary Contact	Actuary	Mr.	Nganga	Francis		5087992100	79339				Francis.Nganga@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	CAP Report Contact for Public Website	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	CEO - CMS Administrator Contact	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	CEO - Senior Official for Contracting	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Interim Chief Financial Officer	Mr.	Consolmagno	Anthony		5083689473					Anthony.Consolmagno@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	07/15/2025	2026	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 Operating Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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 Information Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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 Information Security Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Complaints Tracking Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Contact for Fraud Investigations	Director Internal Audit	Ms.	Brown	Velinda		5083689016				5083689111	Velinda.Brown@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Corporate Mailing						7168101892					contactcustomerservice@fallonweinberg.org	461 John James Audubon Parkway		Amherst	NY	14228	09/30/2024	2026	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	Director, Customer Service	Mr.	Fregeau	Andrew		5083689958					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/10/2025	2026	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	DIR Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	DIR Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Discount Program Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Emergency Part D Contact	Manager, Customer Service	Mr.	Fregeau	Andrew		9784347996					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Emergency Part D Contact (Secondary)	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Manager, Business Service Delivery	Ms.	Ernst	Alicia		5083689369					Alicia.Ernst@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Enrollment Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	EOB Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089			5088311136	Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Financial Audit Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Financial Reporting Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Formulary Contact	Manager of Pharmacy Ops	Ms.	Doran	Kate		5087992100	79169				Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Formulary Contact (Secondary)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	General Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	HIPAA Privacy Officer	Privacy Officer	Ms.	Sanford	Katrin		5083689838					Katrin.Sanford@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	HIPAA Security Officer	VP IT Operations	Mr.	Petisce	Tony		5083689300					Tony.Petisce@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Interoperability Contact	VP, Enterprise Technology Officer	Mr.	Budaj	John		5083689362					john.budaj@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	MA Appeals/Grievances Contact	Director, Care Services Support	Ms.	Ryan	Patricia		5083689771					Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		7168101892					contactcustomerservice@fallonweinberg.org	461 John James Audubon Parkway		Amherst	NY	14228	11/07/2014	2026	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	Marketing Contact	Manager, Medicare Programs	Ms.	Kudron	Julie		5083689591					Julie.Kudron@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Medical Director	PACE Primary Care Physician Fallon Health Weinberg	Dr.	Thurairajah	Arunan		7162897815					Arunan.Thurairajah@fallonweinberg.org	461 John James Audubon Pkwy.		Amherst	NY	14228	01/06/2025	2026	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		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Coordinator	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Part D Opioid Overutilization Contact	Supervisor, Formulary Coordinators & Technicians	Ms.	Kendall	Kate		8003332535	79169				Kate.Kendall@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Medication Therapy Management Contact	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	OffShore Subcontractor Contact	Manager, Medicare Compliance & Regulatory Affairs	Ms.	DeForge	Dena		5083689294					dena.deforge@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 C Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Appeals	Director, Care Services Support	Ms.	Ryan	Patricia							Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689771				PACE - Nat		C	New York
H6596	Part D Appeals Contact (Secondary)	Manager, Member Appeals and Grievances	Ms.	Foulkes	Christina							Christina.Foulkes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689447				PACE - Nat		C	New York
H6596	Part D Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Benefits Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Claims Submission Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689790				PACE - Nat		C	New York
H6596	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Ops	Ms.	Doran	Kate							Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	5087992100	79169			PACE - Nat		C	New York
H6596	Part D Price File Contact (Back-up)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Price File Contact (Optional)	VP, Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Price File Contact (Primary)	Govt Programs and Quality Clinical Pharmacist	Mr.	Huynh	Jayce		5087992100	69212				Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Quality Assurance Contact	Sr. Director, Pharmacy Therapeutics	Mr.	Huynh	Jayce		5083689212					Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Reporting Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Patient Safety Contact	PACE Primary Care Physician Fallon Health Weinberg	Dr.	Thurairajah	Arunan		7162897815					Arunan.Thurairajah@fallonweinberg.org	461 John James Audubon Pkwy.		Amherst	NY	14228	01/06/2025	2026	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	Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Director	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Network Management Contact	VP, Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Network Management Contact (Secondary)	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	2026	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	8443688734				PACE - Nat		C	New York
H6596	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager (OptumRx)		Villanueva	Juan							Juan.Villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/13/2024	2026	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active	8007887871				PACE - Nat		C	New York
H6596	Plan Directory Contact for Public Website	Senior Vice President, PACE Programs	Ms.	Bostek	Kristine		5083689923					Kristine.Bostek@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Plan to Plan Reconciliation Contact	Director, Medical Accounting	Mr.	Beaulieu	Michael		5083689020					Michael.Beaulieu@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Processor Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Quality Contact	Senior Director, PACE Nursing and Quality	Ms.	Malkoski	Michelle		8003332535	49979				Michelle.Malkoski@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Reconciliation Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Reconciliation Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Recovery Audit Contact	Senior Director, Claims Administration	Ms.	Straitiff	Kirsten		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Surveillance Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	System Contact	Senior Vice President and Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Third Party Administrator (TPA) Liaison	Revenue Senior Accountant I	Ms.	Peloquin	Kristin		5083689297					Kristin.Peloquin@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	12/04/2024	2026	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	User Access Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Utilization Management Contact	PACE Primary Care Physician Fallon Health Weinberg	Dr.	Thurairajah	Arunan		7162897815					Arunan.Thurairajah@fallonweinberg.org	461 John James Audubon Pkwy.		Amherst	NY	14228	01/06/2025	2026	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	Utilization Review Contact	PACE Primary Care Physician Fallon Health Weinberg	Dr.	Thurairajah	Arunan		7162897815					Arunan.Thurairajah@fallonweinberg.org	461 John James Audubon Pkwy.		Amherst	NY	14228	01/06/2025	2026	FALLON HEALTH WEINBERG, INC.	National PACE	Fallon Health Weinberg	National PACE		Fallon Community Health Plan, Inc.	88	Yes	Active					PACE - Nat		C	New York
H6622	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/14/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H6622	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H6622	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H6622	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H6622	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H6622	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H6622	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6622	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H6652	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8555210626				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	01/18/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	05/16/2022	2026	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	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8555210626				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8555210626				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Marketing Contact	SVP, Operations	Mr	Haney	Jason		3149607231				8442805360	jhaney@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Coordinator	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	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	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8555210626				HMO - Health Maintenance Organization		C	Dallas
H6652	Part D Appeals Contact (Secondary)	Clinical Operations Supervisor	Ms	Dozier	Rhea						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	06/25/2021	2026	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8555210626				HMO - Health Maintenance Organization		C	Dallas
H6652	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H6652	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8555210626				HMO - Health Maintenance Organization		C	Dallas
H6652	Part D Price File Contact (Back-up)	Director, Reporting & Analytics		Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Network Management Contact	Director of Pharmacy Network Contracting		Dyer	Tim		3308884812				3304058094	tdyer@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	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 Network Management Contact (Secondary)	R.Ph, Pharmacy and Part D Director	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	01/18/2021	2026	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	2026	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8336746202				HMO - Health Maintenance Organization		C	Dallas
H6652	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn						4056015627	lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	02/10/2020	2026	AMERICAN HEALTH PLAN OF FL, INC.	Local CCP	American Health Advantage of Florida	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8334786370				HMO - Health Maintenance Organization		C	Dallas
H6652	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8555210626				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	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	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	SNP State Contact	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Review Contact	Director , Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Agent/Broker Compensation Data Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Backup User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Bid Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Bid Audit Site Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Bid Primary Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	CAP Report Contact for Public Website	Compliance Director	Ms.	Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Operating Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Information Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Information Security Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	CMMI Model Point of Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Complaints Tracking Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Contact for Fraud Investigations	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Corporate Mailing						8476968500					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway		Park Ridge	IL	60068	10/02/2025	2026	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	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	DIR Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	DIR Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Discount Program Payment Contact	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	Thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Emergency Part D Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Emergency Part D Contact (Secondary)	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Encounter Data & Risk Adjustment Operations Contact		Ms	Teibowei	Gladys		2142872625					gladys.teibowei@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Enrollment Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	EOB Transfer Contact			Lange	Tracie		8476968503				8008861082	tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Financial Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Financial Reporting Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Formulary Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Formulary Contact (Secondary)	Pharmacy Director		Lopez	Eduardo		7542085867					elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	General Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	HIPAA Privacy Officer	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	HIPAA Security Officer	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539				8555158166	Eric.Annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Interoperability Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	MA Appeals/Grievances Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	MA Claims Processing Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Marketing Contact	VP of Marketing	Ms.	Branco	Margaret		7187957495					margaret.branco@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Medical Director	Medical Director	Dr.	Butt, MD	Tariq		3125458471					tariq.butt@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Coordinator	Compliance Specialist	Ms.	Wilcox	Hailey		8476968503					Hailey.wilcox@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Part D Opioid Overutilization Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Medication Therapy Management Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3304058084	Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	OffShore Subcontractor Contact		Mrs.	Lange	Tracie		8476968503				8476923225	Tracie.Lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 C Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 C Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Appeals			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H6672	Part D Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Benefits Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Claims Submission Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	7148253783				HMO - Health Maintenance Organization		C	Chicago
H6672	Part D Price File Contact (Back-up)			Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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 Price File Contact (Optional)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Price File Contact (Primary)			Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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 Quality Assurance Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Patient Safety Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Payment Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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 Director	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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 Network Management Contact			Perez	Felix		3053313044				3053313044	Felix.perez@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	10/02/2025	2026	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 Network Management Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H6672	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Bretten	Brad							bradley.betten@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active	8004611308				HMO - Health Maintenance Organization		C	Chicago
H6672	Physician Incentive Contact		Ms.	Wilcox-Lange	Tracie		8476968503				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Plan Directory Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		2249855588				3124290194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Processor Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Quality Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Reconciliation Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Recovery Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	SNP Application Contact		Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	SNP State Contact		Ms.	Wilcox-Lange	Tracie		8476968502				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Surveillance Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	System Contact	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539					eric.annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Third Party Administrator (TPA) Liaison	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Utilization Management Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6672	Utilization Review Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	HMO/HMOPOS		Group 1001	689	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6700	Automated TrOOP Balance Transfer Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Backup User Access Contact	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Best Available Evidence Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Bid Primary Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	CAP Report Contact for Public Website	Quality and Compliance Manager		Shultz	Lisa		9892048213					shultzl@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	CEO - CMS Administrator Contact	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	CEO - Senior Official for Contracting	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Chief Financial Officer	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Chief Operating Officer	Center Manager	Mrs.	Dacey	Amy		9892048230					daceya@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Chief Information Officer	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Chief Information Security Officer	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	CMS Casework Communication Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Complaints Tracking Contact	Quality and Compliance Manager	Ms.	Shultz	Lisa		9892048213					shultzl@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Contact for Fraud Investigations	Quality and Compliance Manager	Ms.	Shultz	Lisa		9892048213					shultzl@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Coordination of Benefits Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Corporate Mailing						9893584833					medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Customer Service Operations Contact	Center Manager	Mrs.	Dacey	Amy		9892048230					daceya@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	DIR Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Discount Program Payment Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Emergency Part D Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Encounter Data & Risk Adjustment Operations Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Enrollment Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/17/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	EOB Transfer Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9893584968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Financial Audit Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Financial Reporting Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Formulary Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	General Contact	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Government Relations Contact	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	HIPAA Privacy Officer	Quality Coordinator	Ms.	Shultz	Lisa		9892048213				9899634968	shultzl@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	HIPAA Security Officer	Quality Coordinator	Ms.	Shultz	Lisa		9892048213				9899634968	shultzl@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Interoperability Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	MA Appeals/Grievances Contact	Quality and Compliance Manager	Ms.	Shultz	Lisa		9892048213					shultzl@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	MA Claims Processing Contact for Public Website	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Marketing Contact	Business Operations Manager		Jozwiak	Morgan		9892048229					jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Medical Director	Medical Director	Dr.	MacMaster	John		9893584833					macmasterj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	08/04/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Medicare Compliance Officer	Quality and Compliance Manager	Ms.	Shultz	Lisa		9892048213					shultzl@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Medicare Coordinator	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Medicare Part D Opioid Overutilization Contact	Clinical Manager	Mrs.	Leask	Kelli		9892048212				9899634968	leaskk@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Medication Therapy Management Contact	Clinical Manager	Mrs.	Leask	Kelli		9892048212				9899634968	leaskk@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Boulevard, Suite 140		Columbia	SC	29209	01/18/2024	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part D Appeals	Quality and Compliance Manager	Ms.	Shultz	Lisa							shultzl@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending	9892048213				PACE - Nat		C	Atlanta
H6700	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Boulevard, Suite 140		Columbia	SC	29209	01/18/2024	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part D Benefits Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part D Claims Submission Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part D Exceptions Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan							jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending	9892048229				PACE - Nat		C	Atlanta
H6700	Part D Price File Contact (Back-up)	Executive Director	Mr.	Meden	Jeff		9892048210				9899634968	medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part D Price File Contact (Primary)	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part D Quality Assurance Contact	Quality Coordinator	Mrs.	Shultz	Lisa		9892048213				9899634968	shultzl@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Part D Reporting Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Patient Safety Contact	Clinical Manager	Mrs.	Leask	Kelli		9892048212				9899634968	leaskk@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Payment Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Pharmacy Director	Clinical Manager	Mrs.	Leask	Kelli		9892048212				9899634968	leaskk@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Pharmacy Network Management Contact	Clinical Manager	Mrs.	Leask	Kelli		9892048212				9899634968	leaskk@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Pharmacy Technical Help Desk Contact	Clinical Manager	Mrs.	Leask	Kelli							leaskk@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending	9892048212				PACE - Nat		C	Atlanta
H6700	Plan Directory Contact for Public Website	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Plan to Plan Reconciliation Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Processor Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Quality Contact	Quality Coordinator	Ms.	Shultz	Lisa		9892048213				9899634968	shultzl@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Reconciliation Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Recovery Audit Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Surveillance Contact	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	System Contact	Executive Director	Mr.	Meden	Jeff		9892048210					medenj@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	10/10/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Third Party Administrator (TPA) Liaison	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	User Access Contact	Business Operations Manager	Mrs.	Jozwiak	Morgan		9892048229				9899634968	jozwiakm@pacenemi.org	2676 US Highway 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Utilization Management Contact	Center Manager	Mrs.	Dacey	Amy		9892048230					daceya@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6700	Utilization Review Contact	Center Manager	Mrs.	Dacey	Amy		9892048230					daceya@pacenemi.org	2676 US HWY 23 S		Alpena	MI	49707	09/18/2025	2026	PACE NORTHEAST MICHIGAN	National PACE	PACE Northeast Michigan	National PACE		PACE Northeast Michigan	843	Yes	Pending					PACE - Nat		C	Atlanta
H6706	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H6706	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H6706	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H6706	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H6706	Plan Directory Contact for Public Website			Customer Service	UHC		8665798774					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6706	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UnitedHealthcare Benefits of Texas, Inc.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6723	Agent/Broker Compensation Data Contact	Dir, Administrative Expense Management		Fiala	Ladimir		2166877820					ladimir.fiala@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Automated TrOOP Balance Transfer Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Backup User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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		2166876585					BAEdocs@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Bid Audit Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Bid Audit Site Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Bid Primary Contact	Lead Medicare Products Analyst		Kotecki	Bradley		2166872762					bradley.kotecki@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	CAP Report Contact for Public Website	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	CEO - CMS Administrator Contact	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	CEO - Senior Official for Contracting	President and CEO	Mr.	Helton	Anthony		2166877409					anthony.helton@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	VP, Chief Financial Officer	Mr.	McNutt	Jim		2166877006					james.mcnutt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Operating Officer	EVP, President of Paramount Health	Ms.	Johnston	Lori		2166877000					lori.johnston@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Information Security Officer	Chief Data & Information Officer	Mr.	Donovan	Chris		4408786450					chris.donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Complaints Tracking Contact	Director, Customer Care		Glaspie	Anissa		2166877059					anissa.glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Contact for Fraud Investigations	Manager, Financial Investigations		Jorz	Nicholas		2166877433					nicholas.jorz@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Manager, COB and Workers Comp		Njaim	Stephanie		4194737733					Stephanie.Njaim@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Corporate Mailing						2166877000					Victoria.Kressler@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	DIR Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	DIR Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Discount Program Payment Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					michelle.stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Electronic Health Record Contact	Manager, Compliance		Dean	Herbert		2166877000					herbert.dean@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Emergency Part D Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Emergency Part D Contact (Secondary)	Mgr, Medicare Pharmacy Operations		Lamento	Angela		2166877917					angela.lamento@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Employer Waiver Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment Information Services		Shaner	Donald		2166877159					Donald.Shaner@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Enrollment Contact	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	EOB Transfer Contact	Sr. Project Manager		Rush	Jamie		5132347613	617613			2166877675	ESITrOOPTransfer@express-scripts.com	8990 Duke Drive		Mason	OH	45040	06/30/2025	2026	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	Financial Audit Contact	Lead Financial Analyst	Ms.	Lohrke	Maureen		2162933190					maureen.lohrke@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Financial Reporting Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					cory.hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Formulary Contact	Clinical Pharmacist		Ivec	Carl		2166876017					Carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Formulary Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katherine		2166877344					Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	General Contact	Medicare Compliance Officer		Beadle	Nicole		3976812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	HIPAA Privacy Officer	Chief Compliance and Privacy Officer		Fichter	Lynn		2166872617					Lynn.Fichter@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	HIPAA Security Officer	EVP, Chief Data and Information Officer		Donovan	Chris		4408786450					Chris.Donovan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Interoperability Contact	Manager, EDI Compliance		Huebler	Kathleen		4408785420					kathleen.huebler@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	MA Appeals/Grievances Contact	Director, Customer Care		Glaspie	Anissa		2166877059					Anissa.Glaspie@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	MA Claims Processing Contact for Public Website	Director, Claims Operations		Rittner	Kim		2166874377					kim.rittner@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Marketing Contact	Director, Acquisition Marketing Govermnt Prgms		Schultz	Melissa		2166877000					Melissa.Schultz@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Medical Director	VP, Sr. Medical Officer	Dr.	Bialecki-Haase	Dee		2166877000					dee.bialeckihaase@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Medicare Compliance Officer	Ms.	Beadle	Nicole		2166877830					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Coordinator	Lead Compliance Analyst		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44115	06/30/2025	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist		Ivec	Carl		2166876017					carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Medication Therapy Management Contact	Clinical Pharmacist		Ivec	Carl		2166876017					carl.ivec@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	OffShore Subcontractor Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Manager, Member Services & System Administration		Bartholomai	Diane		2166877357					Diane.Bartholomai@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Online Enrollment Center Contact (Optional)	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Membership Services		Miller	Sue		2166877454					sue.miller@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 C Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 C Reporting Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Appeals	Sr. Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Chicago
H6723	Part D Appeals Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				HMO - Health Maintenance Organization		C	Chicago
H6723	Part D Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Benefits Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Claims Submission Contact	Director   Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive.		Franklin Lakes	NJ	07417	06/30/2025	2026	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	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	6143363326				HMO - Health Maintenance Organization		C	Chicago
H6723	Part D Exceptions Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katherine							Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				HMO - Health Maintenance Organization		C	Chicago
H6723	Part D Price File Contact (Back-up)	Director, Pharmacy - Medicare and Information		Goff	Katherine		2166877344					Katherine.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Price File Contact (Optional)	Sr. Manager Government Programs		Dolfi	Amanda		6147613606				2166872623	amanda_dolfi@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/30/2025	2026	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 Price File Contact (Primary)			Westrum	Joshua		4807363132	433132				Medicarewebsitefiles@express-scripts.com	7909 S. Hardy Dr.	#106	Tempe	AZ	85284	06/30/2025	2026	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 Quality Assurance Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Reporting Contact	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Patient Safety Contact	VP, Pharmacy		Blagojevic	Marko		2166876239					Marko.Blagojevic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Payment Contact	VP, Corporate Controller		Hanawalt	Cory		2166872790					Cory.Hanawalt@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Personal Health Record Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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 Director	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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 Network Management Contact			Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	06/30/2025	2026	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 Network Management Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katie		2166877344					Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H6723	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy - Medicare and Information		Goff	Katie							Katie.Goff@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	MEDICAL MUTUAL OF OHIO	Local CCP	Medical Mutual of Ohio	HMO/HMOPOS		MEDICAL MUTUAL OF OHIO	289	Yes	Active	2166877344				HMO - Health Maintenance Organization		C	Chicago
H6723	Physician Incentive Contact	Mgr, Clinical Quality Improvement		Brooks	Melissa		4408784163					melissa.brooks@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Plan Directory Contact for Public Website	Dir, Operations Technology Transformation		Palace	Ted		2166872807					ted.palace@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Plan to Plan Reconciliation Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road	MZ: 02-3B-5320	Cleveland	OH	44144	06/30/2025	2026	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	Processor Contact	Sr. Director, Government Programs Medicare		Gibson	Sharon		8057779130					SGGibson@express-scripts.com	One Express Way		St. Louis	MO	63121	06/30/2025	2026	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	Quality Contact	Director, Clinical Quality Improvement		Sullivan	Suzanne		4408786481					suzanne.sullivan@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Reconciliation Contact	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Reconciliation Contact (Secondary)	Director, Corporate Financial Reporting		Fallon	Pembroke		2166877181					pembroke.fallon@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Recovery Audit Contact	VP, Health Plan Payment Integrity	Mr.	Palace	Ted		2166872807					Ted.Palace@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	SNP Application Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	SNP State Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					MACompliance@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Surveillance Contact	Director, Individual Sales and Compliance		Coyne	Jaime		2166872676					MASalesCompliance@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	System Contact	VP, Chief Technology Officer		Stein	Matt		4408786460					matt.stein@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Third Party Administrator (TPA) Liaison	Manager, Financial Reporting and Data Analytics		Stepic	Michelle		2166877151					Michelle.Stepic@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	User Access Contact	Medicare Compliance Officer		Beadle	Nicole		9376812032					nicole.beadle@medmutual.com	100 American Road		Cleveland	OH	44144	08/20/2025	2026	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	Utilization Management Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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	Utilization Review Contact	VP, Clinical Population Health		Corzine	Christian		3147575792					christian.corzine@medmutual.com	100 American Road		Cleveland	OH	44144	06/30/2025	2026	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
H6724	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Backup User Access Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Best Available Evidence Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	CAP Report Contact for Public Website	Compliance Officer		Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	CEO - CMS Administrator Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Chief Operating Officer	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	07/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Complaints Tracking Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Contact for Fraud Investigations	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Coordination of Benefits Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Customer Service Operations Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	DIR Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Encounter Data & Risk Adjustment Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Enrollment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Financial Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	General Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Government Relations Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	HIPAA Privacy Officer	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	HIPAA Security Officer	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	MA Appeals/Grievances Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Marketing Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Medical Director	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	10/10/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Medicare Compliance Officer	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Medicare Coordinator	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Medicare Part D Opioid Overutilization Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part C Application Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part D Appeals	Compliance Officer	Mrs	Hulon	Amber							ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending	8662117082				PACE - Nat		C	Philadelphia
H6724	Part D Application Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part D Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part D Claims Submission Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending	5703717371				PACE - Nat		C	Philadelphia
H6724	Part D Price File Contact (Back-up)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part D Price File Contact (Primary)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part D Quality Assurance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Part D Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending	5703717371				PACE - Nat		C	Philadelphia
H6724	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Quality Contact	Compliance Officer	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	System Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	User Access Contact	VP of Business Development & Compliance	Ms	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/24/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6724	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	07/21/2025	2026	KH PA OPERATIONS HOLDINGS, LLC	National PACE	Albright LIFE	National PACE		CitiPACE Management Service Organization, LLC	888	Yes	Pending					PACE - Nat		C	Philadelphia
H6743	Agent/Broker Compensation Data Contact	VP Sales Operations		Hohenberg	Brandon		5058600441					brandon.hohenberg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		8587906445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Backup User Access Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Bid Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Bid Audit Site Contact	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Bid Primary Contact	Chief Operations Officer		Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	CAP Report Contact for Public Website	Vice President of Compliance		Allotta	Tony		5303967149					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	6026924381				PPO - BBA		C	Dallas
H6743	CEO - CMS Administrator Contact	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	CEO - Senior Official for Contracting	President & CEO	Mrs	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Chief Financial Officer	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Chief Operating Officer	Chief Operations Officer	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Chief Information Officer	Chief Information Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Chief Information Security Officer	Information Security Officer	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Complaints Tracking Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Contact for Fraud Investigations	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Coordination of Benefits Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Corporate Mailing						8776728620				5035841772	compliance@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Customer Service Operations Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	DIR Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Discount Program Payment Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Emergency Part D Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Enrollment Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	EOB Transfer Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441				9512067316	jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Financial Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Financial Reporting Contact	CFO	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Formulary Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Formulary Contact (Secondary)	Supervisor, Formulary Services		Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	General Contact	Compliance Audits & Communications Manager	Mrs	Luma	Yoleine		5414925104				5035841772	yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Government Relations Contact	Vice President of Compliance		Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	HIPAA Privacy Officer	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		9713040043					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	HIPAA Security Officer	ISO	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Hospice Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Interoperability Contact	Chief Technology Officer		Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	MA Appeals/Grievances Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	MA Claims Processing Contact for Public Website	customer service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Marketing Contact	Compliance Manager	Mr.	Allotta	Tony		8303090299					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Medical Director	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Medicare Compliance Officer	Chief Compliance Officer	Mr	Allotta	Tony		8303090299				5035841772	Tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Medicare Coordinator	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	OffShore Subcontractor Contact	Chief Legal Officer, General Counsel		Wilson	Charles		5039677387				5035841772	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Online Enrollment Center Contact (Optional)	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Online Enrollment Center Contact (Primary)	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part C Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part C Reporting Contact	Compliance Manager	Mrs.	Luma	Yoleine		9172080084					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Appeals	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140, Salem		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	8776728620	3			PPO - BBA		C	Dallas
H6743	Part D Appeals Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140, Salem		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	9179920101				PPO - BBA		C	Dallas
H6743	Part D Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Benefits Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Claims Submission Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	8776728620	3			PPO - BBA		C	Dallas
H6743	Part D Price File Contact (Back-up)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Price File Contact (Optional)	Medicare Part D Project Manager		Maldonado	Cheryl		8587906397					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct,		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Price File Contact (Primary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Part D Reporting Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Patient Safety Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Payment Contact	Chief Financial Officer		Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Personal Health Record Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Pharmacy Director	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Pharmacy Network Management Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
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	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	8006819571				PPO - BBA		C	Dallas
H6743	Pharmacy Technical Help Desk Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	9179920101				PPO - BBA		C	Dallas
H6743	PHR Beneficiary Contact																	05/09/2018	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO	ATRIO Health Plans	ATRIO Health Plans	5	Yes	Active	8776728620				PPO - BBA		C	Dallas
H6743	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Plan to Plan Reconciliation Contact	Chief Medical Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Processor Contact	Director, Medicare Programs		Scherlippens	Carine		8587907415					Carine.Scherlippens@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Quality Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Reconciliation Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Recovery Audit Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	SNP Application Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	SNP State Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Surveillance Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	System Contact	Chief Technology Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	User Access Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Utilization Management Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6743	Utilization Review Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H6752	Part C Application Contact			Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th  CT		Vancouver	WA	98682	11/30/2025	2026	KINSHIP PACE OF THE TRI-CITIES, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H6752	Part D Application Contact			Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th  CT		Vancouver	WA	98682	11/30/2025	2026	KINSHIP PACE OF THE TRI-CITIES, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H6757	Part C Application Contact			Avendano	Luzdarys		7038700264					compassionateheartva@gmail.com	1660 International Drive, Suite 600		Mclean	VA	22102	11/02/2025	2026	COMPASSIONATE HEART HOME CARE SERVICES LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H6757	Part D Application Contact			Avendano	Luzdarys		7038700264					compassionateheartva@gmail.com	1660 International Drive, Suite 600		Mclean	VA	22102	11/02/2025	2026	COMPASSIONATE HEART HOME CARE SERVICES LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H6759	Automated TrOOP Balance Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Backup User Access Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Best Available Evidence Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	CAP Report Contact for Public Website	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	CEO - CMS Administrator Contact	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	psoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	CEO - Senior Official for Contracting	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	psoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Chief Financial Officer	Regional Vice President, PACE Operations	Mr.	Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Chief Operating Officer	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Chief Information Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Chief Information Security Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	CMS Casework Communication Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Complaints Tracking Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Contact for Fraud Investigations	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Coordination of Benefits Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Customer Service Operations Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	DIR Contact (Secondary)	Director of Health Plan Operations		Gallagher	Tierney		9705950523				9708295842	tgallagher@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/09/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Discount Program Payment Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Emergency Part D Contact (Secondary)	Vice President of Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Enrollment Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	General Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Government Relations Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	HIPAA Privacy Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	02/20/2023	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	HIPAA Security Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	02/20/2023	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	MA Appeals/Grievances Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	MA Claims Processing Contact for Public Website	Claims Administrator		Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	09/21/2023	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Marketing Contact	Executive Director		Booker	Chiquita		5023142059				5026767517	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Medical Director	Medical Director		Brennan	Megan		5026767516				5026767517	mbrennan@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Medicare Compliance Officer	Director of Quality	Ms	Peterson	Nora		9709643500				9705250166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Medicare Coordinator	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Medicare Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Medication Therapy Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part C Application Contact	Executive Director		Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th Street		Louisville	KY	40203	03/08/2023	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part D Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H6759	Part D Application Contact	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part D Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part D Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part D Exceptions Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H6759	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9705087737				PACE - Nat		C	Atlanta
H6759	Part D Price File Contact (Back-up)	Vice President of Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part D Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part D Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Part D Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Patient Safety Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Payment Contact	Regional Vice President, PACE Operations	Mr.	Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Personal Health Record Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Pharmacy Director	Vice President of Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Pharmacy Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Pharmacy Technical Help Desk Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H6759	Plan Directory Contact for Public Website	Executive Director		Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th Street		Louisville	KY	40203	03/08/2023	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Processor Contact	Claims Administrator		Ford	Jill		9705087711				9529410428	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Quality Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	12/09/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Surveillance Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	System Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Third Party Administrator (TPA) Liaison	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	User Access Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Utilization Management Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6759	Utilization Review Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	06/15/2022	2026	Senior CommUnity Care Of Kentucky	National PACE	Senior CommUnity Care of Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H6765	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Chief Financial Officer	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Chief Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Chief Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Chief Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Customer Service Operations Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8663270523				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8663270523				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8663270523				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Medicare Coordinator	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Medicare Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Part D Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Pharmacy Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@ElixirSolutions.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/17/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Pharmacy Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8335026757				HMO - Health Maintenance Organization		C	Dallas
H6765	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn						4056015627	lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8555210627				HMO - Health Maintenance Organization		C	Dallas
H6765	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8663270523				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	SNP State Contact	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6765	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	AMERICAN HEALTH PLAN OF IOWA INC	Local CCP	Iowa Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6776	Agent/Broker Compensation Data Contact	SVP of Finance		Kehoe	John		3478423503					John.Kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Automated TrOOP Balance Transfer Contact	VP of ITS		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	04/25/2018	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Backup User Access Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Best Available Evidence Contact	VP of Operational Support		Rosen	Richard		3478423684					richard.rosen@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Bid Audit Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Bid Primary Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	CAP Report Contact for Public Website	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active	8009509000				HMO - Health Maintenance Organization		C	Boston
H6776	CEO - CMS Administrator Contact	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	CEO - Senior Official for Contracting	Executive Vice President	Ms.	Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Chief Financial Officer	SVP of Finance	Mr.	Kehoe	John		3478423503					john.kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Chief Operating Officer	SVP Clinical Operations	Ms.	Lau	Julieanne		3478423554					julieanne.lau@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Chief Information Officer	VP of IT	Mr.	Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Chief Information Security Officer	AVP of IT	Mr.	Balzano	Silvio		8007710088					silvio.balzano@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	CMS Casework Communication Contact	Executive Vice President		Aldrich	Susan	Y	9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Complaints Tracking Contact	AVP of Regulatory Affairs		Ducheine	Narda		9296871878					Narda.Ducheine@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	11/05/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Contact for Fraud Investigations	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Coordination of Benefits Contact	SVP of Finance		Kehoe	John		3478423503					John.Kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Corporate Mailing						8009509000					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	04/25/2018	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Customer Service Operations Contact	VP of Member Services		Hron	Patty		3478423541					patty.hron@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	DIR Contact	VP of Compliance		Khassanov	Yana		3478423509					yana.khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	10/15/2025	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	DIR Contact (Secondary)	Senior Director of Medicare		Williams	Sadirah		9292436197					Sadirah.Williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	10/15/2025	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Discount Program Payment Contact	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/19/2021	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Emergency Part D Contact	Sr. Account Manager		Latko	Jeff		6363352997					JLatko@express-scripts.com	Express Scripts	one Express Way	St. Louis	MO	63121	12/21/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Emergency Part D Contact (Secondary)	Senior Director of Medicare	Ms.	Williams	Sadirah		9292436197					Sadirah.williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	12/13/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Encounter Data & Risk Adjustment Operations Contact	VP of IT	Mr.	Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Enrollment Contact	Executive Vice President		Aldrich	Susan	Y	9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	EOB Transfer Contact	SVP of Finance		Kehoe	John		3478423503				8666907596	John.Kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Financial Audit Contact	SVP of Finance	Mr.	Kehoe	John		3478423503					john.kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Financial Reporting Contact	SVP of Finance		Kehoe	John		3478423503					John.Kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Formulary Contact	Director of Medicare		Williams	Sadirah		3477787881					sadirah.williams@elderservehealth.org	80 West 225th St.		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Formulary Contact (Secondary)	AVP of Compliance		Khassanov	Yana		3478423509				8887778279	yana.khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/19/2021	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	General Contact	Executive Vice President		Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Government Relations Contact	Executive Vice President		Aldrich	Susan	Y	9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	HIPAA Privacy Officer	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	HIPAA Security Officer	AVP of IT		Balzano	SIlvio		8007710088					silvio.balzano@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Hospice Contact	SVP Clinical Operations	Ms.	Lau	Julieanne		3478423554					julieanne.lau@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Interoperability Contact	VP of IT		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	MA Appeals/Grievances Contact	SVP of Quality		Konrad	Marcia		9142688418					marcia.konrad@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	MA Claims Processing Contact for Public Website	VP of Claims		Flanagan	Fiona		3478423526					fiona.flanagan@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Marketing Contact	Executive Vice President		Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Medical Director	Medical Director	Dr.	Davidson	Peter		3478423546					peter.davidson@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Medicare Compliance Officer	SVP of Regulatory Affairs	Esq.	Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Medicare Coordinator	VP of Compliance		Khassanov	Yana		3478423509					yana.khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	10/15/2025	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Medicare Part D Opioid Overutilization Contact	Director, Clinical & Trend Solutions		Muralidharan	Adrienne		3143131932					amuralidharan@express-scripts.com	ESI	One Express Way	St. Louis	MO	63121	10/28/2022	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Medication Therapy Management Contact	VP of Compliance		Khassanov	Yana		3478423509					Yana.Khassanov@elderservehealth.org	80 West 225th St.		Bronx	NY	10463	10/15/2025	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part C Application Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part C Reporting Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Appeals	Sr. Manager Pharmacy PA		Herbert	Joshua							joshua.herbert@evernorth.com	One Express Way Mail Stop S13 NB		Saint Louis	MO	63121	10/15/2025	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Boston
H6776	Part D Appeals Contact (Secondary)	Director of Medicare		Williams	Sadirah							sadirah.williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	03/15/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active	8007710088				HMO - Health Maintenance Organization		C	Boston
H6776	Part D Application Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Benefits Contact	AVP of Compliance		Khassanov	Yana		3478423509					Yana.Khassanov@elderservehealth.org	80 West 225th St.		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	ESI	1 Express Way	St. Louis	MO	63121	10/28/2022	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Exceptions Contact	Sr. Pharmacy Manager		Herbert	Jo							joshua.herbert@evernorth.com	One Express Way Mail Stop S13 NB		Saint Louis	MO	63121	10/15/2025	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active	5132920563				HMO - Health Maintenance Organization		C	Boston
H6776	Part D Exceptions Contact (Secondary)	Director of Medicare		Williams	Sadirah							sadirah.williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	03/13/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active	9292436197				HMO - Health Maintenance Organization		C	Boston
H6776	Part D Price File Contact (Back-up)	Manager Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	ESI	4865 Dixie Hway	Fairfield	OH	45014	04/12/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Price File Contact (Optional)	Director of Medicare		Williams	Sadirah		9292436197					sadirah.williams@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	03/15/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	ESI	5151 Blazer Pkwy	Dublin	OH	43017	04/12/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Quality Assurance Contact	Director of Medicare		Williams	Sadirah		9292436197					Sadirah.Williams@elderservehealth.org	80 West 225th St.		Bronx	NY	10463	03/02/2021	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Part D Reporting Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528					jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Patient Safety Contact	SVP Clinical Operations		Lau	Julieanne		3478423554					julieanne.lau@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Payment Contact	SVP of Finance		Kehoe	John		3478423503					John.Kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Pharmacy Director	AVP of Compliance		Khassanov	Yana		3478423509					Yana.Khassanov@elderservehealth.org	80 West 225th St.		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Pharmacy Network Management Contact	Network Account, Director, Retail Strategy Network		Kelly	Heather		3146921866					hakelly@express-scripts.com	ESI	1 Express Way	St. Louis	MO	63121	10/28/2022	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Pharmacy Network Management Contact (Secondary)	AVP of Network Development		Altamirano	Bolivar		3478423527					bolivar.altamirano@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/16/2022	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Pharmacy Technical Help Desk Contact	Sr. Director, Customer Service		Sahs	Dale							dale.sahs@expressscripts.com	one		Saint Louis	MO	63121	10/15/2025	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H6776	Plan Directory Contact for Public Website	AVP of Network Development		Altamirano	Bolivar		3478423527					bolivar.altamirano@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/16/2022	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Plan to Plan Reconciliation Contact	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/19/2021	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Processor Contact	VP of Claims		Flanagan	Fiona		3478423526					fiona.flanagan@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/16/2022	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Quality Contact	VP of Quality		Konrad	Marcia		9142688418					marcia.konrad@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Reconciliation Contact	SVP of Finance		Kehoe	John		3478423503					John.Kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Reconciliation Contact (Secondary)	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/19/2021	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Recovery Audit Contact	SVP of Finance	Mr.	Kehoe	John		3478423503					john.kehoe@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	SNP Application Contact	SVP of Regulatory Affairs		Ling	Jenny		3478423528				8887778279	jenny.ling@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Surveillance Contact	Executive Vice President		Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	System Contact	VP of IT		Ramaglia	Damon		3478423584					damon.ramaglia@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/23/2024	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Third Party Administrator (TPA) Liaison	AVP of Finance		Lugo	Michelle		3478423557					michelle.lugo@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/19/2021	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	User Access Contact	AVP of Compliance		Khassanov	Yana		3478423509				8887778279	Yana.Khassanov@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/19/2021	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Utilization Management Contact	Executive Vice President		Aldrich	Susan		9149604407					susan.aldrich@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	07/17/2019	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6776	Utilization Review Contact	Medical Director	Dr.	Davidson	Peter		3478423546					peter.davidson@elderservehealth.org	80 West 225th Street		Bronx	NY	10463	02/22/2023	2026	ELDERSERVE HEALTH, INC.	Local CCP	RiverSpring Health Plans	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H6787	Automated TrOOP Balance Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Backup User Access Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Best Available Evidence Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	CAP Report Contact for Public Website	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	CEO - CMS Administrator Contact	Senior Vice President, Healthcare	Mr.	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	CEO - Senior Official for Contracting	Senior Vice President, Healthcare	Mr.	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Chief Financial Officer	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Chief Operating Officer	Executive Director	Ms.	McKenna	Rebecca		5173190690					rmckenna@voa.org	1921 E. Miller Road		Lansing	MI	48911	04/28/2025	2026	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	Atlanta
H6787	Chief Information Officer	Chief Information & Technology Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Chief Information Security Officer	Chief Information & Technology Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	CMS Casework Communication Contact	Quality and Compliance Manager		Hardin	Jessica		5173190700				5179135991	jhardin@voa.org	1921 East Miller Road		Lansing	MI	48911	04/16/2024	2026	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	Atlanta
H6787	Complaints Tracking Contact	Quality and Compliance Manager		Hardin	Jessica		5173190700				5179135991	jhardin@voa.org	1921 East Miller Road		Lansing	MI	48911	04/16/2024	2026	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	Atlanta
H6787	Contact for Fraud Investigations	Quality and Compliance Manager		Hardin	Jessica		5173190700				5179135991	jhardin@voa.org	1921 East Miller Road		Lansing	MI	48911	04/16/2024	2026	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	Atlanta
H6787	Coordination of Benefits Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	Atlanta
H6787	Customer Service Operations Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	DIR Contact (Secondary)	Director of Health Plan Operations		Gallagher	Tierney		9705950523				9708295842	tgallagher@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	10/23/2024	2026	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	Atlanta
H6787	Discount Program Payment Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	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	Atlanta
H6787	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Emergency Part D Contact (Secondary)	Vice President of Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Enrollment Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	Atlanta
H6787	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	Atlanta
H6787	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	General Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Government Relations Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	HIPAA Privacy Officer	Chief Information & Technology Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	HIPAA Security Officer	Chief Information & Technology Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	MA Appeals/Grievances Contact	Quality and Compliance Manager		Hardin	Jessica		5173190700				5179135991	jhardin@voa.org	1921 East Miller Road		Lansing	MI	48911	04/16/2024	2026	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	Atlanta
H6787	MA Claims Processing Contact for Public Website	Claims Administrator	Ms	Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	09/21/2023	2026	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	Atlanta
H6787	Marketing Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Medical Director	Quality and Compliance Manager		Hardin	Jessica		5173190700				5179135991	jhardin@voa.org	1921 East Miller Road		Lansing	MI	48911	04/16/2024	2026	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	Atlanta
H6787	Medicare Compliance Officer	Director of Quality	Ms	Peterson	Nora		9709643500				9702520166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Medicare Coordinator	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Medicare Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Medication Therapy Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Part C Application Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Part D Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H6787	Part D Application Contact	Regional Vice President, PACE Operations	Mr.	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Part D Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Part D Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Part D Exceptions Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H6787	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H6787	Part D Price File Contact (Back-up)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Part D Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Part D Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Part D Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Patient Safety Contact	Quality and Compliance Manager		Hardin	Jessica		5173190700				5179135991	jhardin@voa.org	1921 East Miller Road		Lansing	MI	48911	04/16/2024	2026	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	Atlanta
H6787	Payment Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Personal Health Record Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Pharmacy Director	Vice President of Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Pharmacy Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Pharmacy Technical Help Desk Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC.	National PACE	Senior Community Care of Michigan	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H6787	Plan Directory Contact for Public Website	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Processor Contact	Claims Administrator	Ms	Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Quality Contact	Quality and Compliance Manager		Hardin	Jessica		5173190700				5179135991	jhardin@voa.org	1921 East Miller Road		Lansing	MI	48911	04/16/2024	2026	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	Atlanta
H6787	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/16/2024	2026	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	Atlanta
H6787	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Praire	MN	55344	04/16/2024	2026	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	Atlanta
H6787	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	06/15/2022	2026	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	Atlanta
H6787	Surveillance Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	System Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Third Party Administrator (TPA) Liaison	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	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	Atlanta
H6787	User Access Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Utilization Management Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6787	Utilization Review Contact	Executive Director		McKenna	Rebecca		5173190690				5173190650	rmckenna@voa.org	1921 East Miller Road		Lansing	MI	48911	10/23/2024	2026	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	Atlanta
H6796	Automated TrOOP Balance Transfer Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Backup User Access Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Best Available Evidence Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Bid Primary Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	CAP Report Contact for Public Website	Executive Director		Felix	Carole		7607907706					carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	CEO - CMS Administrator Contact		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	CEO - Senior Official for Contracting		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Chief Financial Officer		Ms.	Rizzo	Marlene		7603449951					marlener@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Chief Operating Officer		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Chief Information Officer		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Chief Information Security Officer		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	CMS Casework Communication Contact		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Complaints Tracking Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Contact for Fraud Investigations	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Coordination of Benefits Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Corporate Mailing						7603449951					carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Customer Service Operations Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	DIR Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Discount Program Payment Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Emergency Part D Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Encounter Data & Risk Adjustment Operations Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Enrollment Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	EOB Transfer Contact			Felix	Carole		7607907706				7603449951	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Financial Audit Contact	CFO	Ms.	Rizzo	Marlene		7603449951					marlener@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Financial Reporting Contact		Ms.	Rizzo	Marlene		7603449951					marlener@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Formulary Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	General Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Government Relations Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	HIPAA Privacy Officer	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	HIPAA Security Officer	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Interoperability Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	MA Appeals/Grievances Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	MA Claims Processing Contact for Public Website	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Marketing Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Medical Director			Slone	Jonathan		7603449951					jonathans@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Medicare Compliance Officer		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Medicare Coordinator		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Medicare Part D Opioid Overutilization Contact			Slone	Jonathan		7603449951					jonathans@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Medication Therapy Management Contact			Slone	Jonathan		7603449951					jonathans@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part C Application Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Appeals			Felix	Carole							carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending	8004653203				PACE - Nat		C	San Francisco
H6796	Part D Application Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Benefits Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Claims Submission Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Exceptions Contact			Felix	Carole							carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending	8004653203				PACE - Nat		C	San Francisco
H6796	Part D Price File Contact (Back-up)			Slone	Jonathan		7603449951					jonathans@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Price File Contact (Primary)	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Quality Assurance Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Part D Reporting Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Patient Safety Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Payment Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Pharmacy Director			Slone	Jonathan		7603449951					jonathans@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Pharmacy Network Management Contact			Slone	Jonathan		7603449951					jonathans@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Pharmacy Technical Help Desk Contact			Felix	Carole							carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending	8004653203				PACE - Nat		C	San Francisco
H6796	Plan Directory Contact for Public Website	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Plan to Plan Reconciliation Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Processor Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Quality Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Reconciliation Contact	CFO	Ms.	Rizzo	Marlene		7603449951					marlener@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Recovery Audit Contact	CFO	Ms.	Rizzo	Marlene		7603449951					marlener@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Surveillance Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	System Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Third Party Administrator (TPA) Liaison	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	User Access Contact		Ms.	Bell	Yvonne		7603449951					yvonneb@innercare.org	852 East Danenberg Drive		El Centro	CA	92243	12/28/2022	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Utilization Management Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6796	Utilization Review Contact	Executive Director		Felix	Carole		7607907706				7603524579	carolef@innercare.org	1600 N. Imperial Avenue		Imperial	CA	92251	11/12/2025	2026	CLINICAS DE SALUD DEL PUEBLO, INC.	National PACE	Innercare PACE	National PACE		Clinicas de Salud del Pueblo, Inc.	890	Yes	Pending					PACE - Nat		C	San Francisco
H6813	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6813	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H6813	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H6813	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6813	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H6813	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H6813	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TEXAS INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H6813	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Medical Director	Chief Medical Officer	Dr.	Chen	Alex		8186766564					alex.y.chen@healthnet.com	21281 Burbank Blvd		Woodland Hills	CA	91367	03/30/2021	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/13/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H6815	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H6815	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H6815	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H6815	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/10/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H6815	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H6815	PHR Beneficiary Contact																	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H6815	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/24/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6815	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	HEALTH NET HEALTH PLAN OF OREGON, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H6824	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H6824	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H6824	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H6824	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H6824	Plan Directory Contact for Public Website			Customer Service	UHC		8889501169					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6824	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H6832	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Backup User Access Contact	Medicare Compliance Officer, Plan Partner Support	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Best Available Evidence Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	CEO - CMS Administrator Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	CEO - Senior Official for Contracting	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Chief Financial Officer	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Chief Operating Officer	Chief Operating Officer/General Manager	Mr.	Emami	John		7038837508					john.emami@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Chief Information Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Coordination of Benefits Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Corporate Mailing						8558550489					customerservice@alignseniorcare.com	PO BOX 4440		Glen Allen	VA	23058	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Discount Program Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					Mark.Hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Enrollment Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	EOB Transfer Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797				8336102390	stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Financial Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Financial Reporting Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	General Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	HIPAA Privacy Officer	Chief Compliance Officer and HIPAA Privacy Officer	Ms.	Crowe	Melanie		4049330409					melanie.crowe@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Interoperability Contact	Director of Data Operations and Architecture	Mr.	Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Marketing Contact	Marketing Director	Mrs	Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Medical Director	VP Medical Affairs		Dahlgren	Andrew		8042968288					Andrew.Dahlgren@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Medicare Coordinator	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part C Reporting Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/09/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Pharmacy Network Management Contact	VP Network Management		Santos	Christina		6088204408					christina.santos@navitus.com	361 Integrity Drive		Madison	WI	53717	06/06/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H6832	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6832	Physician Incentive Contact	Executive Director	Ms	Kemp	Sherian		3135104648					Sherian.Kemp@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Plan Directory Contact for Public Website			Sindlinger	Rocio		8558550489					rocio.sindlinger@curanahealth.com	PO BOX 4440		Glen Allen	VA	23058	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Plan to Plan Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Processor Contact	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/09/2025	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Quality Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Reconciliation Contact (Secondary)	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Recovery Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Surveillance Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					Katie.Bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	User Access Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Utilization Management Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6832	Utilization Review Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE MI, LLC	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6846	Automated TrOOP Balance Transfer Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Backup User Access Contact	Finance Manager	Mr.	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	02/22/2024	2026	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.	Capps	Lisa		8282138440					lisa.capps@hcahealthcare.com	286 Overlook Rd		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Bid Primary Contact	Finance Manager	Mr.	Earley	Trey		8282138440					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	02/22/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	CAP Report Contact for Public Website	Program Director	Ms.	Capps	Lisa		8282138442				8286818913	Lisa.Capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	CEO - CMS Administrator Contact	CEO	Mr	Brown	Jeffrey		8282746185					jeffrey.brown5@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	08/05/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	CEO - Senior Official for Contracting	CEO	Mr.	Brown	Jeffrey		8282138440					jeffrey.brown5@hcahealthcare.com	286 Overlook Rd		Asheville	NC	28803	11/07/2024	2026	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		8282774818					tyler.groesser@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	08/13/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Chief Operating Officer	Program Director	Ms.	Capps	Lisa		8282138440				8286818913	Lisa.Capps@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Chief Information Officer	Chief Information Officer	Mr.	Brown	Jon		8282130422					jon.brown3@hcahealthcare.com	980 Hendersonville Road		Asheville	NC	28803	02/18/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Chief Information Security Officer	Information Security Officer	Mr.	Kelly	Jim		8282130330					Jim.Kelly@hcahealthcare.com	980 Hendersonville Road		Asheville	NC	28803	02/18/2021	2026	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	Quality and Compliance Manager	Ms.	Capps	Lisa		8282138442					lisa.capps@hcahealthcare.com	286 Overlook Rd		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Complaints Tracking Contact	Program Director	Ms.	Capps	Lisa		8282138440	1021047				Lisa.Capps@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Contact for Fraud Investigations	Ethics and Compliance Officer & Privacy	Mr.	Burnette	Bryan		8282774800					Bryan.Burnette@HCAHealthcare.com	68 Sweeten Creek Road		Asheville	NC	28803	04/17/2025	2026	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		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Corporate Mailing						8282138442				8286818913	lisa.capps@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	08/23/2024	2026	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.	Capps	Lisa		8282138442				8286818913	Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	DIR Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	DIR Contact (Secondary)	CFO	Mr	Groesser	Tyler		9415397329					tyler.groesser@hcahealthcare.com	68 Sweeten Creek		Asheville	NC	28803	09/09/2022	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Discount Program Payment Contact	Asst CFO		Silver-Barnwell	Anita	M	8282774800					Anita.SilverBarnwell@HCAHealthcare.com	68 Sweeten Creek Rd		Asheville	NC	28803	03/21/2025	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Emergency Part D Contact	Finance Manager	Mr.	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	02/22/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Emergency Part D Contact (Secondary)	Program Director	Ms	Capps	Lisa		8282138442				8286818913	lisa.capps@hcahealthcare.com	286 Overlook Rd		Asheville	NC	28803	01/13/2025	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Encounter Data & Risk Adjustment Operations Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	10/31/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Enrollment Contact	Finance Manager	Mr.	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	02/22/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	EOB Transfer Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Financial Audit Contact	Finance Manager	Mr.	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/20/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Financial Reporting Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Formulary Contact	Pharmacist	Ms.	Cronquist	Jamie		8282138442					Jamie.Cronquist@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	12/04/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Formulary Contact (Secondary)	Finance Manager	Mr	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/29/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	General Contact	Program Director	Ms.	Capps	Lisa		8282138442					lisa.capps@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/12/2024	2026	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.	Capps	Lisa		8282138440					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	HIPAA Privacy Officer	Ethics and Compliance Officer & Privacy	Mr.	Burnette	Bryann		8282774800					bryan.burnette@HCAHealthcare.com	68 Sweeten Creek Road		Asheville	NC	28803	04/17/2025	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	HIPAA Security Officer	Ethics and Compliance Officer & Privacy	Mr.	Burnette	Bryan		8282774800					Bryan.Burnette@HCAHealthcare.com	68 Sweeten Creek Road		Asheville	NC	28803	04/17/2025	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Interoperability Contact	Program Director	Ms.	Capps	Lisa		8282138440					Lisa.capps@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	MA Appeals/Grievances Contact	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.Capps@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	MA Claims Processing Contact for Public Website	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Marketing Contact	Finance Manager	Ms.	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	12/04/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Medical Director	Medical Director	Dr.	LArson	Jennifer		8282138441				8286818913	Jennifer.Larson@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	04/10/2025	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Medicare Compliance Officer	Ethics and Compliance Officer & Privacy	Mr.	Burnette	Bryan		8282774800				8286818913	bryan.burnette@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	04/17/2025	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Medicare Coordinator	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/29/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Medicare Part D Opioid Overutilization Contact	Pharmacist	Ms.	Cronquist	Jamie		8282138442				8286818913	Jamie.Cronquist@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	02/22/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Medication Therapy Management Contact	Clinical Nurse Coordinator	Ms.	Tolley	Stephanie		8282138442				8286818913	Stephanie.tolley1@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/20/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Online Enrollment Center Contact (Primary)	Finance Manager	Mr	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/29/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part C Application Contact	Program Director	Ms.	Capps	Lisa		8282138442				8286818913	Lisa.capps@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part D Appeals	Finance Manager	Mr	Earley	Trey							trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	01/08/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active	8282138442				PACE - Nat		C	Atlanta
H6846	Part D Application Contact	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part D Benefits Contact	Finance Manager	Mr	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	01/08/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part D Claims Submission Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	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						8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	03/18/2020	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active	8282138442				PACE - Nat		C	Atlanta
H6846	Part D Price File Contact (Back-up)	Finance Manager	Mr	Earley	Trey		8282138442					Trey.Earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	02/18/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part D Price File Contact (Primary)	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part D Quality Assurance Contact	Ethics and Compliance Officer	Ms.	Davis	Bailey		8287778191				8286818913	Bailey.Davis3@HCAHealthcare.com	68 Sweeten Creek		Asheville	NC	28803	09/20/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Part D Reporting Contact	Finance Manager	Mr	Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	01/08/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Patient Safety Contact	Quality and Compliance Manager	Ms.	Hickman	Candice		8282138442					candice.hickman@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Payment Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Personal Health Record Contact	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.capps@hcahealthcare.com	286 Overlook Rd		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Pharmacy Director	Pharmacist	Ms.	Cronquist	Jamie		8282138442					Jamie.Cronquist@HCAHealthcare.com	2 Medical Park Drive		Asheville	NC	28803	12/04/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Pharmacy Network Management Contact	Clinical RN Coord	Ms.	Tolley	Stephanie		8282138442				8286818913	Stephanie.tolley1@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/20/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Pharmacy Network Management Contact (Secondary)	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	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 Nurse Coordinator	Ms.	Tolley	Stephanie						8286818913	Stephanie.tolley1@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/20/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active	8001112222				PACE - Nat		C	Atlanta
H6846	Pharmacy Technical Help Desk Contact (Secondary)	Program Director	Ms.	Capps	Lisa							Lisa.capps@HCAHealthcare.com	286 Overlook Rd.		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active	8282138442				PACE - Nat		C	Atlanta
H6846	Plan Directory Contact for Public Website	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Plan to Plan Reconciliation Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Processor Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Quality Contact	Quality and Compliance Manager	Ms.	Hickman	Candice		8282138442					candice.hickman@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Reconciliation Contact	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	02/18/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Reconciliation Contact (Secondary)	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Recovery Audit Contact	Quality and Compliance Manager	Ms.	Hickman	Candice		8282138442				8286818913	candice.hickman@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	09/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Surveillance Contact	Ethics and Compliance Officer & Privacy	Ms.	Davis	Bailey		8287778191					bailey.davis3@HCAHealthcare.com	68 Sweeten Creek Road		Asheville	NC	28803	02/22/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	System Contact	Program Director	Ms.	Capps	Lisa		8282138442					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Third Party Administrator (TPA) Liaison	Finance Manager	Mr.	Earley	Trey		8282138442				8286818913	Trey.Earley@HCAHealthcare.com	286 Overlook Rd		Asheville	NC	28803	08/07/2019	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	User Access Contact	Finance Manager		Earley	Trey		8282138442					trey.earley@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	12/04/2023	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Utilization Management Contact	Program Director	Ms.	Capps	Lisa		8282138440					Lisa.capps@HCAHealthcare.com	286 Overlook Road		Asheville	NC	28803	06/12/2024	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6846	Utilization Review Contact	Medical Director	Dr.	Patterson	Christophe		8282138440				8286818913	Christopher.Patterson@hcahealthcare.com	286 Overlook Road		Asheville	NC	28803	02/18/2021	2026	CAREPARTNERS REHABILITATION HOSPITAL, LLLP	National PACE	CarePartners PACE	National PACE		HCA Healthcare, Inc.	606	Yes	Active					PACE - Nat		C	Atlanta
H6847	Agent/Broker Compensation Data Contact	VP, Sales		Gabryjelski	Andre		9783608216					agabryjelski@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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	Automated TrOOP Balance Transfer Contact	Vice President, Business Operations		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Backup User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Bid Audit Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Bid Primary Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	01701	01/09/2024	2026	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	CAP Report Contact for Public Website	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	CEO - CMS Administrator Contact	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	CEO - Senior Official for Contracting	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Chief Financial Officer	Ms	Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Operating Officer	Chief Operations Officer	Mr	Mcormick	Mark		8572823180					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Information Officer	Chief Information Officer	Mr	Bundela	Yogi		8572822863					ybundela@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Information Security Officer	Chief Information Security and Privacy Officer	Mr	Tsuchida	Toby		8572823518					ttsuchida@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Complaints Tracking Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Contact for Fraud Investigations	Director, Special Investigation Unit		Roy	Jessica		6179594150					jroy22@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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		8572829131					cryan17@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Corporate Mailing						8572823348					bbowen1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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		Armstrong	Carolyn		4134270087					carmstrong6@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	DIR Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	06/03/2024	2026	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	Discount Program Payment Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	06/03/2024	2026	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	Emergency Part D Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Vice President, Risk Adjustment		Keefe	Kevin		8572826420					kkeefe6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Enrollment Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	EOB Transfer Contact	Vice President, Business Operations		Malvo	Donovan		8572823015				1111111111	dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Financial Audit Contact	Finance Director	Ms.	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	06/03/2024	2026	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	Financial Reporting Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	06/03/2024	2026	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	Formulary Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Formulary Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	General Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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		8572823376					jsullivan77@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	HIPAA Privacy Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	HIPAA Security Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Interoperability Contact	Vice President, Legal and Regulatory Affairs		Richardson	Stephanie		5087760489					srichardson1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	MA Appeals/Grievances Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Marketing Contact	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Medical Director	Chief Medical Director	Dr	Yoon	Ed		2074581035					ebyoon@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/03/2025	2026	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		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Coordinator	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Drive		Somerville	MA	02145	01/09/2024	2026	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 Part D Opioid Overutilization Contact	Director, Pharmacy		Gallagher	Angela		8572823348					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Medication Therapy Management Contact	Director, Pharmacy		Gallagher	Angela		8572822645					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 C Application Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 C Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Appeals	Director, Appeals and Grievances		Swasey	Andrea							aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8004335556	105			HMO - Health Maintenance Organization		C	Boston
H6847	Part D Application Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Benefits Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Claims Submission Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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							agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8572822493				HMO - Health Maintenance Organization		C	Boston
H6847	Part D Price File Contact (Back-up)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Price File Contact (Primary)	Director, Pharmacy		Gallagher	Angela		8572822438					agallagher1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Quality Assurance Contact	Director, Pharmacy		Gallagher	Angela		8572822438					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Patient Safety Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Payment Contact	Chief Financial Officer		Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Director	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Network Management Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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							agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8443688732				HMO - Health Maintenance Organization		C	Boston
H6847	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen							mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	HMO/HMOPOS		Mass General Brigham Incorporated	784	Yes	Active	8572825333				HMO - Health Maintenance Organization		C	Boston
H6847	Plan Directory Contact for Public Website	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Plan to Plan Reconciliation Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	06/03/2024	2026	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	Processor Contact	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Quality Contact	Sr. Director, Clinical Operations		Gargasz	Reagan		2079394468					rgargasz@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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	Reconciliation Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Recovery Audit Contact	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Surveillance Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	System Contact	Director, Business Systems Configuration		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Third Party Administrator (TPA) Liaison	Lead Financial Analyst		Boyadjian	James		2018323300					jboyadjian@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/28/2024	2026	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	User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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	Utilization Management Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	11/26/2024	2026	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	Utilization Review Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	11/26/2024	2026	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	Agent/Broker Compensation Data Contact	Director, Sales Operations and Oversight		Hunt	Bae		2163751430					Bae.Hunt@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Automated TrOOP Balance Transfer Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					ashley.smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Backup User Access Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/31/2025	2026	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	Sr Enrollment & Reconciliation Analyst		Cason	Joseph		6177486356					joseph.cason@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Bid Audit Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	Bid Audit Site Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	Bid Primary Contact	Director, Medicare Advantage Products		Gabrieli	Michael		3305186111					Michael.Gabrieli@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	CAP Report Contact for Public Website	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	CEO - CMS Administrator Contact	Interim President	Ms.	Cruz	Diana		4235030063					Diana.Cruz@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	08/27/2025	2026	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	CEO - Senior Official for Contracting	Interim President	Ms.	Cruz	Diana		4235030063					Diana.Cruz@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	08/27/2025	2026	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.	Bennett	Darren		6177486160					Darren.Bennett@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	09/26/2024	2026	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 Operating Officer	Interim COO / SVP, Service & Ops	Ms.	Carbone	Jennifer		8578100850					Jennifer.Carbone@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	08/27/2025	2026	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 Information Officer	Chief Information Officer	Mr	Nair	Rajesh		6177486295					rajesh.nair@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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 Information Security Officer	Sr. Director - Chief Information Security Officer	Mr	Cullivan	Lee		6179010454					lee.cullivan@bmc.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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		7746446922					jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Complaints Tracking Contact	Director, Appeals & Grievances		Bigbee	Jacqueline		7746446922					jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Contact for Fraud Investigations	Supervisor, Special Investigations Unit		Maurer	Randy		6174783977					Randy.Maurer@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	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, Coordination of Benefits		Castillo	Yvonne		6177486133					yvonne.castillo@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/23/2024	2026	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	Corporate Mailing						6174783654					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Sr. Mgr, Regulatory Operations		Day	Jennifer		7815769126					jennifer.day@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	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	DIR Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	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	Discount Program Payment Contact	Vice President of Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Emergency Part D Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Emergency Part D Contact (Secondary)	Sr. Director of Pharmacy Services		Pham	Phuong		6174783707					phuong.pham@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	SVP & Chief Actuary		Li	Bo		6177486313					Bo.Li@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	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	Enrollment Contact	Sr Enrollment & Reconciliation Analyst		Cason	Joseph		6177486356					joseph.cason@wellsense.org	100 City Square, Suite 20		Charlestown	MA	02129	06/04/2024	2026	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	EOB Transfer Contact	Director, Claims, Enrollment & Provider Appeals		Hinderman	Emily		6174783614				6178970884	emily.hinderman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Financial Audit Contact	Medicare Compliance Officer	Mr.	Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	Financial Reporting Contact	Vice President of Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Formulary Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Formulary Contact (Secondary)	Manager Medicare Pharmacy Services		Dean	Wendy		4137304835					wendy.dean@wellsense.org	100 City Sq	Suite 200	Charlestown	MA	02129	09/17/2025	2026	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	General Contact	Medicare Compliance Officer		Comerford	Michael	J	7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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		6177486490					Josh.Krintzman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	HIPAA Privacy Officer	Chief Privacy Officer		Wholley	Joseph		6177486226					Joseph.Wholley@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	HIPAA Security Officer	Information Security Officer		Tavares	Heather		6177486221					Heather.Tavares@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Interoperability Contact	VP, IT Enterprise Architecture		Ellis	Ezren		6177486381					ezren.ellis@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Bigbee	Jacqueline		7746446922					jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Claims, Enrollment & Provider Appeals		Hinderman	Emily		6174783614					emily.hinderman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Marketing Contact	Director of Medicare Marketing		Chrzanowski	Kelly		2166950332					Kelly.Chrzanowski@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Medical Director	Senior Medical Director	Dr.	Rubinstein	Jessica		8573010164					Jessica.Rubinstein@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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 Coordinator	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/31/2025	2026	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 Part D Opioid Overutilization Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					ashley.smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	OffShore Subcontractor Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	Online Enrollment Center Contact (Back-up)	Programmer Analyst II		Lapaix	Anord		7865415843					anord.lapaix@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Online Enrollment Center Contact (Primary)	EDI Analyst II		MacMillan	Sheba		6174783538					Sheba.MacMillan@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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 C Application Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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 C Reporting Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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 Appeals	Director, Appeals & Grievances		Bigbee	Jacqueline							jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	8558338125				HMO - Health Maintenance Organization		C	Boston
H6851	Part D Appeals Contact (Secondary)	Manager, Appeals & Grievances		DiSciscio	Felicia							Felicia.DiSciscio@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	6174783556				HMO - Health Maintenance Organization		C	Boston
H6851	Part D Application Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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 Benefits Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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 Claims Submission Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	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@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	8558338125				HMO - Health Maintenance Organization		C	Boston
H6851	Part D Exceptions Contact (Secondary)	Senior Director of Pharmacy Services		Pham	Phuong							Phuong.Pham@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	8558338125				HMO - Health Maintenance Organization		C	Boston
H6851	Part D Price File Contact (Back-up)	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	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 Price File Contact (Optional)	Manager Medicare Pharmacy Services		Dean	Wendy		4137304835					wendy.dean@wellsense.org	100 City Sq	Suite 200	Charlestown	MA	02129	09/17/2025	2026	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 Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/23/2021	2026	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 Quality Assurance Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	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 Reporting Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@bmchp-wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	Patient Safety Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Payment Contact	VP, Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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 Director	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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 Network Management Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	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	Director of Clinical Pharmacy		Smith	Ashley							Ashely.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	HMO/HMOPOS		BMC Health System, Inc.	493	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H6851	Plan Directory Contact for Public Website	Director Provider Data Integrity		de Medeiros	Sherri-Ann		8885660008					providerinfo@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Plan to Plan Reconciliation Contact	Staff Accountant		Fraser	Amanda		8572215098					Amanda.Fraser@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	09/03/2025	2026	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	Processor Contact	Director, Claims, Enrollment & Provider Appeals		Hinderman	Emily		6174783614					emily.hinderman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Quality Contact	SVP, Chief Behavioral Health and Quality Officer		Borrelli	Jill		6177482457					jill.borrelli@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/21/2024	2026	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	Reconciliation Contact	SVP & Chief Actuary		Li	Bo		6177486313					Bo.Li@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	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	Reconciliation Contact (Secondary)	Senior Actuarial Analyst		Wagner	Rachel		7037407564					Rachel.Wagner@Wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/23/2024	2026	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	Recovery Audit Contact	Medicare Compliance Officer	Mr.	Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	SNP Application Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	Surveillance Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	System Contact	VP, IT Enterprise Architecture		Ellis	Ezren		6177486381					ezren.ellis@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Third Party Administrator (TPA) Liaison	Vice President of Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/06/2025	2026	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	User Access Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	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	Utilization Management Contact	Director of Utilization Management		Costello	Barbara		6174783648					Barbara.Costello@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Utilization Review Contact	Director of Utilization Management		Costello	Barbara		6174783648					Barbara.Costello@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	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	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H6852	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H6852	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H6852	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H6852	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H6852	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H6852	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H6852	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Best Available Evidence Contact	Compliance Director	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	700 E Walnut	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	CAP Report Contact for Public Website	Director of Compliance		Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	CMS Casework Communication Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcoooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Customer Service Operations Contact	Compliance Director	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	700 E Walnut St	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Discount Program Payment Contact	Chief of Health Plan Operations	Ms.	Ternay	Jennifer	M	4437610607				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/01/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Formulary Contact	Medical Director	Dr	Everette	Kenya		6406501565					Keverette@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	General Contact	Compliance Director	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	700 E Walnut St	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	HIPAA Privacy Officer	Director of Compliance		Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	11/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation		Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Medical Director	Chief Medical Officer	Dr.	everette	Kenya		2196142067					keverette@boldagepace.com	700 East walnut Street		Evansville	IN	47713	08/29/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Medicare Coordinator	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Medication Therapy Management Contact	Medical Direcor	Dr	Everette	Kenya		9548395000				7325923500	Keverette@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		8558012653					maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part D Appeals	Director of Compliance	Ms	Cooper	Wanda							wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	2675751196				PACE - Nat		C	New York
H6868	Part D Appeals Contact (Secondary)	Chief Health Plan Operations		Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7328063224				PACE - Nat		C	New York
H6868	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part D Exceptions Contact	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H6868	Part D Exceptions Contact (Secondary)	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	11/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H6868	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part D Quality Assurance Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Patient Safety Contact	Finance Specialist		Partlow	Jennie		9548395000					jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Pharmacy Director	Medical Director	Dr	Everette	Kenya		9548395000					Keverette@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H6868	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H6868	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Plan to Plan Reconciliation Contact	Financial Specialist	Mr	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Surveillance Contact	Compliance Director	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	700 E Walnut St	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Third Party Administrator (TPA) Liaison	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/01/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	User Access Contact	Business Administrator	Ms	Gaffney	Karen		9804201351					Kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6868	Utilization Review Contact	Compliance Director	Ms	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	700 E Walnut St	Suite B	Evansville	IN	47713	11/05/2025	2026	BOLDAGE PACE KENTUCKY, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H6874	Agent/Broker Compensation Data Contact	Vice President Strategy & Product Management		Hounchell	Dan		6126763530					dhounchell@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/09/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Automated TrOOP Balance Transfer Contact	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					FIR_Transactions@ucare.org	500 Stinson Boulevard NE		Minnneapolis	MN	55413	04/30/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Backup User Access Contact	Medicare Policy Specialist		Paciorek	Joshua		6122945225					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	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	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					ldolan@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/30/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Bid Audit Contact	Corporate Actuary		Uding	Chris		6126763372					cuding@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/23/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Bid Audit Site Contact	Corporate Actuary		Uding	Chris		6126763372					cuding@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/23/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Bid Primary Contact	Corporate Actuary		Uding	Chris		6126763372					bids@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/23/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	CAP Report Contact for Public Website	Regulatory Audit Manager		Bons	Nicole		6122945889					nbons@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/05/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	CEO - CMS Administrator Contact	President	Mr.	Cindrich	Stephen		7158450947					Stephen.Cindrich@Aspirus.org	3000 Westhill Drive, Suite 303		Wausau	WI	54401	06/03/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	CEO - Senior Official for Contracting	President	Mr.	Cindrich	Stephen		7158450947					Stephen.Cindrich@Aspirus.org	3000 Westhill Drive, Suite 303		Wausau	WI	54401	06/03/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Chief Financial Officer	CFO	Mr.	Yang	Jerry		7158472526					jerry.yang@aspirus.org	P.O. Box 395		Wausau	WI	54402	06/07/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Chief Operating Officer	Health Plan Compliance Specialist	Mrs.	Nadolski	Elizabeth		7155712198					elizabeth.nadolski@aspirushealthplan.com	3000 Westhill Drive, Suite 303		Wausau	WI	54401	03/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Chief Information Officer	SVP and Chief Information Officer	Mr	Weider	Will		7158472887					will.weider@aspirus.org	2200 Westwood Drive, 3rd Floor		Wausau	WI	54401	02/19/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Chief Information Security Officer	VP Information Technology	Mr	Larson	Kirk		8153706669					kirk.larson@aspirus.org	3200 Westhill Drive		Wausau	WI	54401	02/20/2024	2026	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 Senior Manager		Randolph	Takeisha		6122945906					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Complaints Tracking Contact	A&G Senior Manager		Randolph	Takeisha		6122945906					trandolph@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Contact for Fraud Investigations	SIU Senior Manager		Monson	Peter		6126763373					pmonson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/25/2025	2026	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	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Corporate Mailing						6126766500				6126766501	sschwartz@ucare.org	UCare	500 Stinson Boulevard NE	Minneapolis	MN	55413	01/15/2020	2026	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	Business Analyst		Pena	Jennifer		6122945251					jstromquist@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/03/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	DIR Contact	Actuarial Services Manager		Ordansky	Nathan		6122945999					nordansky@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	03/04/2022	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	DIR Contact (Secondary)	Principal Analyst		Litzow	Jina		6122943344					jlitzow@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	10/06/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Discount Program Payment Contact	Accountant Senior		Ly	Tong		6126277157					tly@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2021	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Emergency Part D Contact	Business Analyst		Pena	Jennifer		6122945251					jstromquist@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/03/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Emergency Part D Contact (Secondary)	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030					anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment & Revenue Associate Director		Olberding	Milissia		6126763205					molberding@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Enrollment Contact	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					ldolan@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/30/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	EOB Transfer Contact	Business Analyst		Pena	Jennifer		6122945251				6128842145	jstromquist@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/29/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Financial Audit Contact	Controller	Mr.	Marshall	Greg		6126763213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Financial Reporting Contact	Controller		Marshall	Greg		6126763213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Formulary Contact	Pharmacy Formulary Manager		Merk	Zachariah		6126763483					zmerk@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Formulary Contact (Secondary)	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	General Contact	Medicare Policy Specialist		Wood	Nakia		6122945668					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Government Relations Contact	Medicare Policy Specialist Senior		Vang	Julie		6122945654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/06/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	HIPAA Privacy Officer	Health Plan Compliance Specialist		Nadolski	Elizabeth		7155712198					elizabeth.nadolski@aspirushealthplan.com	3000 Westhill Drive, Suite 303		Wausau	WI	54401	03/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	HIPAA Security Officer	Health Plan Compliance Specialist		Nadolski	Elizabeth		7155712198					elizabeth.nadolski@aspirushealthplan.com	3000 Westhill Drive, Suite 303		Wausau	WI	54401	03/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Hospice Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030					anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Interoperability Contact	Associate General Counsel		Roller	Melissa		6126763616					mroller@ucare.org	500 Stinson Blvd NE		Minneapolis	MN	55413	04/03/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	MA Appeals/Grievances Contact	A&G Senior Manager		Randolph	Takeisha		6122945906					cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	MA Claims Processing Contact for Public Website	CCO Audit & Compliance Manager		Tenhoff	Reed		6126763664					rtenhoff@ucare.og	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/11/2022	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Marketing Contact	Government Relations Materials Coordinator Senior		Morales	Ana Sophia		6122945641					amorales@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Medical Director	Senior VP Chief Medical Officer		Emiru	Tenbit		6122945865					temiru@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Medicare Compliance Officer	Healthplan Compliance Specalist	Mrs.	Nadolski	Elizabeth		7155712198					elizabeth.nadolski@aspirushealthplan.com	3000 Westhill Drive, Suite 303	P.O. Box 395	Wausau	WI	54401	03/07/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Medicare Coordinator	Medicare Team Manager		Berglund	Marie		6126763598					mberglund@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacy Manager		Nelson	Adam		6122945030					anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Medication Therapy Management Contact	Pharmacy Quality Manager		Bower	Erika		6122945800				6128842321	ebower@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/10/2021	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	OffShore Subcontractor Contact	Medicare Policy Specialist		Paciorek	Joshua		6122945225					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Online Enrollment Center Contact (Back-up)	MBE Operations Director		Rooney	Courtney		6126763468					crooney@ucare.org	500 Stinson Blvd NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Online Enrollment Center Contact (Primary)	MBE Operations Senior Manager		Dolan	Lindsey		6126765130					ldolan@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/30/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part C Application Contact	Health Plan Compliance Specialist	Mrs.	Nadolski	Elizabeth	M	7155712198					elizabeth.nadolski@aspirushealthplan.com	3000 Westhill Drive	suite 303	Wausau	WI	54401	03/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part C Reporting Contact	Regulatory Audit Manager		Bons	Nicole		6122945889					nbons@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/05/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Appeals	A&G Senior Manager		Randolph	Takeisha							cag@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	6122945906				PPO - BBA		C	Chicago
H6874	Part D Appeals Contact (Secondary)	Supervisor Appeals & Grievances		Johnsen	Sarah							sjohnsen@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/30/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	6122945292				PPO - BBA		C	Chicago
H6874	Part D Application Contact	Health Plan Compliance Specialist	Mrs.	Nadolski	Elizabeth	M	7155712198					elizabeth.nadolski@aspirushealthplan.com	3000 Westhill Drive	suite 303	Wausau	WI	54401	03/10/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Benefits Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Claims Submission Contact	Financial Analyst		Jackson	Lyndsey		6126073663					ljackson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/28/2023	2026	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	Clinical Pharmacy Associate Director		Nelson	Adam						6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	6122945030				PPO - BBA		C	Chicago
H6874	Part D Exceptions Contact (Secondary)	Clinical Pharmacy Manager		Nelson	Adam						6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	6122945030				PPO - BBA		C	Chicago
H6874	Part D Price File Contact (Back-up)	Pharmacy Operations Manager Sr.		Lex	Brian		6122945907				6128842263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Price File Contact (Optional)	Medicare Policy Specialist Senior		Vang	Julie		6122945654					jvang@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	09/06/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Price File Contact (Primary)	Government Programs		Noel	Bailee		5122313140					plan.finder@navitus.com	361 Integrity Drive		Madison	WI	53717	12/28/2023	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Quality Assurance Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Part D Reporting Contact	Regulatory Audit Manager		Bons	Nicole		6122945889					nbons@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	06/05/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Patient Safety Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Payment Contact	Chief Financial Officer		Monsrud	Beth		6126763217				6126766501	bmonsrud@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Pharmacy Director	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Pharmacy Network Management Contact	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842263	anelson@ucare.org	500 Stinson		Minneapolis	MN	55413	12/17/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacy Associate Director		Nelson	Adam		6122945030				6128842013	anelson@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	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	Sr Manager Customer Care Accounts		Nett	Danielle							Danielle.Nett@Navitus.com	1025 West Navitus Dr		Appleton	WI	54913	12/14/2023	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	8338374300				PPO - BBA		C	Chicago
H6874	Pharmacy Technical Help Desk Contact (Secondary)	Sr Director Customer Care		Visco	Victoria							victoria.visco@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active	8338374300				PPO - BBA		C	Chicago
H6874	PHR Beneficiary Contact																	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO	UCare	Aspirus, Inc.	747	Yes	Active	8775231515				PPO - BBA		C	Chicago
H6874	Physician Incentive Contact	Senior VP Chief Medical Officer		Emiru	Tenbit		6122945865					temiru@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/06/2023	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Plan Directory Contact for Public Website	Business Analyst		Pena	Jennifer		8559314851					providerassistancecenterMA@aspirushealthplan.com	500 Stinson Boulevard NE		Minneapolis	MN	55413	11/18/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Plan to Plan Reconciliation Contact	Controller		Marshall	Greg		6126763213					gmarshall@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Processor Contact	Pharmacy Operations Manager Sr		Lex	Brian		6122945907				6128842263	pharmacyintake@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Quality Contact	Vice President Quality Management		Hanley	Greg		6122945296					ghanley@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	01/15/2020	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Reconciliation Contact	Actuarial Services Manager		Ordansky	Nathan		6122945999					nordansky@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	03/04/2022	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Reconciliation Contact (Secondary)	Principal Analyst		Litzow	Jina		6122943344					jlitzow@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	10/06/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Recovery Audit Contact	Chief Reg Internal Audit Off & Comp Director	Mr.	Schach	Steve		6126763562					sschach@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	554132615	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	SNP State Contact	Medicare Team Manager		Berglund	Marie		6126763598					MedicareGRLeadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Surveillance Contact	Medicare Policy Specialist Senior		Vang	Julie		6122945654					MedicareGRLeadershipteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	System Contact	Chief Information Security Officer, Director		Wiech	Justin		6122945218					jwiech@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	08/01/2022	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Third Party Administrator (TPA) Liaison	Accountant Senior		Ly	Tong		6126277157					tly@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/18/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	User Access Contact	Medicare Policy Specialist		Wood	Nakia		6122945668					MedicareGRteam@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	02/14/2025	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Utilization Management Contact	Director, Utilization Management		Williams	Amanda		6122945527					awilliams4@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/03/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6874	Utilization Review Contact	Clinical Regulatory Lead		Brown	Julie	B	6126763433					jbbrown@ucare.org	500 Stinson Boulevard NE		Minneapolis	MN	55413	04/03/2024	2026	ASPIRUS HEALTH PLAN, INC.	Local CCP	Aspirus Health Plan	Local PPO		Aspirus, Inc.	747	Yes	Active					PPO - BBA		C	Chicago
H6876	Agent/Broker Compensation Data Contact	Chief Revenue Officer	Mr.	Van Der Bosch	Matthew		3123818453					matthew.vanderbosch@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	07/09/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Automated TrOOP Balance Transfer Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Backup User Access Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Best Available Evidence Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Bid Audit Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Bid Primary Contact	V.P.  Product Development		Pamanian	Lily		3127763356	325				lily.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	CAP Report Contact for Public Website	Chief Information Officer	Mr.	Shah	Vrajesh		3122057948	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	CEO - CMS Administrator Contact	CEO	Mr.	Clifton	Andrew		3128588400					andrew.clifton@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	CEO - Senior Official for Contracting	CEO	Mr.	Clifton	Andrew		3128588400					andrew.clifton@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Chief Financial Officer	Interim CFO	Ms.	Hoenstine	Jennifer		3127249092	157				jennifer.hoenstine@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	10/30/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Chief Operating Officer	COO	Mr.	Collins	GARFIELD		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Chief Information Officer	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Chief Information Security Officer	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	CMS Casework Communication Contact	Director, Compliance Audit and Monitoring		Gordon	Reneatha		3128097947					reneatha.gordon@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Complaints Tracking Contact	Director, Compliance Audit and Monitoring	Ms.	Gordon	Reneatha		3128097947					compliance@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Contact for Fraud Investigations	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Coordination of Benefits Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Corporate Mailing						6126077433					reneatha.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Customer Service Operations Contact	COO	Mr.	Collins	Garfield		3123195468	101				garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	DIR Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	DIR Contact (Secondary)	Director, Pharmacy Services		Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 West Washington Street, Suite 450	Suite 450	Chicago	IL	60606	01/23/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Discount Program Payment Contact	Controller	Ms.	Jackson	Amy		3128833465					amy.jackson@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Emergency Part D Contact	Chief Medical Officer	Dr.	Fessenden	Michael		8472170105					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Emergency Part D Contact (Secondary)	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Employer Waiver Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Encounter Data & Risk Adjustment Operations Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Enrollment Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	EOB Transfer Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Financial Audit Contact	Interim CFO	Ms.	Hoenstine	Jennifer		3127249092	157				jennifer.hoenstine@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	10/30/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Financial Reporting Contact	Controller	Ms.	Jackson	Amy		3128833465					amy.jackson@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Formulary Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Formulary Contact (Secondary)	Director, Pharmacy Services		Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	General Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Government Relations Contact	General Counsel and Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676					russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	HIPAA Privacy Officer	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	HIPAA Security Officer	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Hospice Contact	V.P. Clinical Operations		Wohkittel	Karen		3128585770					karen.wohkittel@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Interoperability Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	MA Appeals/Grievances Contact	Director, Grievance & Appeals		Simpson	Reugenia		3126904781					reugenia.simpson@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	07/09/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	MA Claims Processing Contact for Public Website	COO	Mr.	Collins	Garfield		3122057948					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Marketing Contact	Chief Growth Officer		Van Der Bosch	Matthew		3123818453					matthew.vanderbosch@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Medical Director	Chief Medical Officer	Dr	Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	07/09/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Medicare Coordinator	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	03/03/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Medication Therapy Management Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street, Suite 450		Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	OffShore Subcontractor Contact	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part C Application Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part C Reporting Contact	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Appeals	Chief Medical Officer		Fessenden	Michael							michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active	3123003495				PPO - BBA		C	Chicago
H6876	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Santaya	Carlos							carlos.santaya@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active	3122057948	247			PPO - BBA		C	Chicago
H6876	Part D Application Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Benefits Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Claims Submission Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Exceptions Contact	Chief Medical Officer		Fessenden	Michael							michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active	3123003495				PPO - BBA		C	Chicago
H6876	Part D Exceptions Contact (Secondary)	Director, Pharmacy Services		Santaya	Carlos							carlos.santaya@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active	3122057948	247			PPO - BBA		C	Chicago
H6876	Part D Price File Contact (Back-up)	Director, Pharmacy Services		Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Price File Contact (Optional)	Director, Pharmacy Services		Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 West Washington Street, Suite 450	Suite 450	Chicago	IL	60606	01/23/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Price File Contact (Primary)	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Quality Assurance Contact	CMO	Dr.	Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Part D Reporting Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Patient Safety Contact	CMO	Dr.	Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 W. Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Payment Contact	Controller	Ms.	Jackson	Amy		3128833465					accountspayable@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Pharmacy Director	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Pharmacy Network Management Contact	Chief Medical Officer		Fessenden	Michael		3123003495					michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Services	Mr.	Santaya	Carlos		3124770778					carlos.santaya@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Pharmacy Technical Help Desk Contact	Chief Medical Officer		Fessenden	Michael							michael.fessenden@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60624	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active	8666934620				PPO - BBA		C	Chicago
H6876	Pharmacy Technical Help Desk Contact (Secondary)	CMO	Dr.	Fessenden	Michael							michael.fessenden@myzinghealth.com	225 West Washington Street, Suite 450		Chicago	IL	60606	09/25/2023	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active	3123003495				PPO - BBA		C	Chicago
H6876	Plan Directory Contact for Public Website	COO	Mr.	Collins	Garfield		8669464458					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Plan to Plan Reconciliation Contact	Controller	Ms.	Jackson	Amy		3128833465					amy.jackson@myzinghealth.com	225 W. Washington Street, Suite 450	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Processor Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Quality Contact	Sr. V.P.  Stars & Quality	Mr.	Weaver	Daniel		3126615667					daniel.weaver@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Reconciliation Contact	COO	Mr.	Collins	Garfield		3123195468					garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Recovery Audit Contact	Director, Compliance Audit and Monitoring	Ms.	Gordon	Reneatha		3128097947					reneatha.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	SNP Application Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	SNP State Contact	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Surveillance Contact	Chief Compliance Officer	Mr.	Matuszak	Russell		3128326676	292				russell.matuszak@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	System Contact	Chief Information Officer	Mr.	Shah	Vrajesh		3127763435	140				vrajesh.shah@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Third Party Administrator (TPA) Liaison	COO	Mr.	Collins	Garfield		3123195468				3122398304	garfield.collins@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	User Access Contact	Director of Compliance Audit and Monitoring	Ms.	Gordon	Reneatha		3122057948	121				reneatha.gordon@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Utilization Management Contact	V.P. Clinical Operations		Wohkittel	Karen		3128585770					karen.wohkittel@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6876	Utilization Review Contact	V.P. Clinical Operations		Wohkittel	Karen		3128585770					karen.wohkittel@myzinghealth.com	225 West Washington Street	Suite 450	Chicago	IL	60606	02/20/2025	2026	ZING HEALTH OF MICHIGAN, INC.	Local CCP	Zing Health	Local PPO		Zing Health Consolidator, Inc	730	Yes	Active					PPO - BBA		C	Chicago
H6887	Automated TrOOP Balance Transfer Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Backup User Access Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	Patel	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	Bid Primary Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	CAP Report Contact for Public Website	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	CEO - CMS Administrator Contact	CEO	Mrs.	Mansue	Amy		8566416610					mansuea@ihn.org	165 Bridgeton Pike		Mullica Hill	NJ	08062	05/04/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mrs.	Mansue	Amy		8566416610					mansuea@ihn.org	165 Bridgeton Pike		Mullica Hill	NJ	08062	04/14/2025	2026	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	Senior VP of Finance and CFO	Mr.	Pelino	William	D	8566416605					pelinow@ihn.org	165 Bridgeton Pike		Mullica Hill	NJ	08062	03/09/2023	2026	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 Operating Officer	Chief Operating Officer	Mr.	Moore	Warren	E	8566416602					mooreew@ihn.org	165 Bridgeton Pike		Mullica Hill	NJ	08062	06/01/2022	2026	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 Information Officer	Information Systems Analyst	Mr.	Coyle	David		8565078551				8565754929	CoyleD@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/23/2019	2026	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 Information Security Officer	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	06/18/2025	2026	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	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	06/18/2025	2026	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	Complaints Tracking Contact	Quality Director		Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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	Contact for Fraud Investigations	Quality Director		Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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 and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Corporate Mailing						8563624515					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	DIR Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Discount Program Payment Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Emergency Part D Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	Emergency Part D Contact (Secondary)	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542				8564975250	maddens@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Enrollment Contact	Center Director	Ms.	Rossi	Alicia		8563624510					RossiA@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/23/2019	2026	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	EOB Transfer Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542				8564975250	maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Financial Audit Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Financial Reporting Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Formulary Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	General Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	HIPAA Privacy Officer	Quality Director	Mrs.	Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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	HIPAA Security Officer	Quality Director	Mrs.	Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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	Interoperability Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	MA Appeals/Grievances Contact	Quality Director		Wallace	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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	MA Claims Processing Contact for Public Website	Liason		Collabrios	Health TPA		7015669255					tpasupport@collabrios.com	511 South Church Streeet	Suite 106	Mooresville	NC	28115	06/25/2025	2026	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	Marketing Contact	Enrollment Manager	Mr.	Hymer	Anna		8564185433	67118				hymera@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	02/23/2024	2026	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	Medical Director	Medical Director	Dr	Stefanacci	Richard		2152667509					stefanaccir@ihn.org	2445 S. Delsea Dr.		Vineland	NJ	08360	02/12/2025	2026	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		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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 Coordinator	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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 Part D Opioid Overutilization Contact	Quality Director	Ms.	Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	11/29/2022	2026	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	Medication Therapy Management Contact	Medical Director	Dr	Stefanacci	Richard		2152667509					stefanaccir@ihn.org	2445 S. Delsea Dr.		Vineland	NJ	08360	02/12/2025	2026	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	Online Enrollment Center Contact (Primary)	Manager of Intake & Enrollment	Mrs.	Hymer	Anna		8564185433					hymera@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	11/29/2022	2026	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 C Application Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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 Appeals	Quality Director	Mrs.	Powell	Al'Asia							powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active	8563624517				PACE - Nat		C	New York
H6887	Part D Appeals Contact (Secondary)	President	Dr.	Patel	Ankur							patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active	9084053779				PACE - Nat		C	New York
H6887	Part D Application Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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 Benefits Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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 Claims Submission Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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 and Health Plan Manager	Mr.	Madden	Sean							maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active	8565078542				PACE - Nat		C	New York
H6887	Part D Price File Contact (Back-up)	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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 Price File Contact (Primary)	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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 Quality Assurance Contact	Quality Director		Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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 Reporting Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Patient Safety Contact	Quality Director		Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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	Payment Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Personal Health Record Contact	Health Information Management Specialist	Ms.	LaBoy	Susan		8564185433	67115			8565755045	laboys@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	05/17/2021	2026	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 Director	Medical Director	Dr	Stefanacci	Richard		2152667509					stefanaccir@ihn.org	2445 S. Delsea Dr.		Vineland	NJ	08360	02/12/2025	2026	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 Network Management Contact	Medical Director	Dr	Stefanacci	Richard		2152667509					stefanaccir@ihn.org	2445 S. Delsea Dr.		Vineland	NJ	08360	02/12/2025	2026	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	President	Dr.	Patel	Ankur							patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active	9084053779				PACE - Nat		C	New York
H6887	Pharmacy Technical Help Desk Contact (Secondary)	Client Support Specialist	Ms.	Krall	Megan							mkrall@pharmastar.com	2445 S. Delsea Drive		Vineland	NJ	08360	06/18/2025	2026	INSPIRA HEALTH NETWORK LIFE, INC.	National PACE	Inspira Health Network LIFE	National PACE		Inspira Health Network, Inc.	454	Yes	Active	8882987770				PACE - Nat		C	New York
H6887	Plan Directory Contact for Public Website	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	Plan to Plan Reconciliation Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Processor Contact	Liasion	Ms.	Robinson	Laura		7042309406					tpasupport@collabrios.com	511 South Church Streeet	Suite 106	Mooresville	NC	28115	06/18/2025	2026	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	Quality Contact	Quality Director		Powell	Al'Asia		8563624517					powella@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	01/10/2021	2026	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	Reconciliation Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Recovery Audit Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Surveillance Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	System Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	Third Party Administrator (TPA) Liaison	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S. Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	User Access Contact	President	Dr.	Patel	Ankur		9084053779					patela16@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	05/19/2025	2026	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	Utilization Management Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Utilization Review Contact	Finance and Health Plan Manager	Mr.	Madden	Sean		8565078542					maddens@ihn.org	2445 S Delsea Drive		Vineland	NJ	08360	08/06/2025	2026	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	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8555210628				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	01/18/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Ms	Brimm	Angie		8555210628				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8555210628				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Coordinator	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	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	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	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	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H6891	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H6891	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H6891	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H6891	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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 Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	2026	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8336746201				HMO - Health Maintenance Organization		C	Dallas
H6891	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn						4056015627	lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF TX, INC.	Local CCP	American Health Advantage of Texas	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8555210627				HMO - Health Maintenance Organization		C	Dallas
H6891	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8555210628				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	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	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	SNP State Contact	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Agent/Broker Compensation Data Contact	Product Coordinator		Armstrong	Chris		8023713250					carmstrong@bcbsvt.com	P.O. Box 186		Montpelier	VT	05601	02/07/2020	2026	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	Automated TrOOP Balance Transfer Contact	Manager, Business Process		Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/14/2022	2026	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	Bid Primary Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director		Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette	TC 1301	Detroit	MI	48226	03/05/2024	2026	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	CEO - CMS Administrator Contact	Plan President	Ms.	Getsie	Pamela		8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	01/06/2025	2026	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	CEO - Senior Official for Contracting	Plan President	Ms.	Getsie	Pamela		8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	04/27/2022	2026	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		2486654348					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	VT	05601	02/07/2020	2026	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 Operating Officer	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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 Information Officer	IT Director II	Mrs.	Krause	Amy		3132256638					akrause@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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 Information Security Officer	VP Chief Information Security Officer	Mr.	Cieszynski	Brent		3132258766					bcieszynski@bcbsm.com	600 Lafayette East		Detroit	MI	48226	08/22/2022	2026	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	CMMI Model Point of Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Complaints Tracking Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/28/2022	2026	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		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Corporate Mailing						8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	04/27/2022	2026	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		3132250555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/11/2021	2026	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	DIR Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	DIR Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.Zylstra@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Discount Program Payment Contact	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	Electronic Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Emergency Part D Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	01/04/2023	2026	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	Emergency Part D Contact (Secondary)	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Employer Waiver Contact	Director		Nelson	Jessica		2483209946					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		King	Aleesha		9194303434					aking12@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	04/10/2025	2026	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	Enrollment Contact	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	EOB Transfer Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880				9528375607	Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Formulary Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/27/2022	2026	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	Formulary Contact (Secondary)	Manager		Jones	Marini		3135706777					Marini.Jones@emergient.com	1000 Town Center		Southfield	MI	48075	03/05/2024	2026	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	General Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	HIPAA Privacy Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	HIPAA Security Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	Interoperability Contact	Manager, Functional Operations		Kingsley	Chris		2484444160					Christopher.kingsley@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	MA Appeals/Grievances Contact	Chief Operating Officer		Hower	Johanna		8048594034					Johanna.Hower@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	MA Claims Processing Contact for Public Website	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Marketing Contact	Plan President	Ms.	Getsie	Pamela		8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	04/27/2022	2026	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	Medical Director	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director, Medicare Advantage Compliance		Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette	TC 1301	Detroit	MI	48226	03/05/2024	2026	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 Part D Opioid Overutilization Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/02/2022	2026	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	Medication Therapy Management Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/02/2022	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	05/27/2022	2026	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	Online Enrollment Center Contact (Back-up)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Online Enrollment Center Contact (Optional)	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	Online Enrollment Center Contact (Primary)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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 C Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 C Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Appeals	Manager, Pharmacy PA/Appeals		Bricker	Bryce							bryce.m.bricker@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8554890646				PPO - BBA		C	Chicago
H6898	Part D Appeals Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/27/2022	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8003443405	733326			PPO - BBA		C	Chicago
H6898	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/27/2022	2026	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 Claims Submission Contact	Manager, Business Process		Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	Manager, Pharmacy PA/Appeals		Bricker	Bryce							bryce.m.bricker@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8554890646				PPO - BBA		C	Chicago
H6898	Part D Exceptions Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/27/2022	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	9544985880				PPO - BBA		C	Chicago
H6898	Part D Price File Contact (Back-up)	Vice President		Siuta	Lori		2242312298					lori.siuta@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Price File Contact (Optional)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/27/2022	2026	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 Price File Contact (Primary)	Sr. Business Analyst, Medicare Operations		Vargas	Danielle		4437101262	433132				danielle.wooten@optum.com	11000 Optum Circle	Suite 106	Eden Prairie	MN	55344	01/11/2023	2026	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 Quality Assurance Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/05/2024	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	12/05/2024	2026	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	Payment Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Personal Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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 Director	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/05/2024	2026	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 Network Management Contact	Sr. Account Manager, Network Account Management		Brown	Casey		6126427367					casey.brown@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Network Management Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/27/2022	2026	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	Senior Manager		Villanueva	Juan							Juan.Villanueva@optum.com	11000 Optum Cir		Eden	MN	55344	01/03/2024	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8009038346				PPO - BBA		C	Chicago
H6898	Pharmacy Technical Help Desk Contact (Secondary)	Senior Manager		Villanueva	Juan							claimsmanager-client-support@optum.com	11000 Optum Cir		Eden	MN	55344	01/03/2024	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8007887871				PPO - BBA		C	Chicago
H6898	Physician Incentive Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Plan Directory Contact for Public Website	Director		Nelson	Jessica		8448395122					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Processor Contact	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Quality Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Reconciliation Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.Zylstra@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Recovery Audit Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Surveillance Contact	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	User Access Contact	Administrative Assistant		Eddy	Chris		3132683879					CEddy@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/03/2024	2026	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	Utilization Management Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Utilization Review Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Agent/Broker Compensation Data Contact	Director of Sales		Dues	Travis		6145463157				6145463131	Travis.Dues@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		6145463183				6145463131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Backup User Access Contact	Sr. Application Specialist		Crawford	Carl		6145463215				6145463144	ccrawford@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Bid Audit Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463211	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Bid Audit Site Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Bid Primary Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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	CAP Report Contact for Public Website	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	Jack.Randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/06/2025	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463211				6145463131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Operating Officer	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Information Officer	VP Service Optimization	Mr.	Trimmer	Matt		3017547190					matt.trimmer@trinity-health.org	3100 Easton Square Place		Columbus	OH	43219	07/17/2023	2026	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 Information Security Officer	Sr Security Manager, Enterprise Information Securi	Mr.	Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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	6147068474				6142348372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Complaints Tracking Contact	Compliance Specialist	Mr	Jordan	David	A	6147068474					djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Corporate Mailing						4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	DIR Contact	CEO		Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square  Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	DIR Contact (Secondary)	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Discount Program Payment Contact	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Electronic Health Record Contact	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Emergency Part D Contact	Chief Compliance Officer		Suffern	Patricia		4124780244				6145463132	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/23/2022	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Director	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/17/2024	2026	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	Employer Waiver Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Reconciliation Analyst		Sloan	Mike		6145463134					mike.sloan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Enrollment Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	EOB Transfer Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Financial Audit Contact	Chief Compliance Officer	Ms.	Suffern	Patricia	A	4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/24/2025	2026	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	Financial Reporting Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Formulary Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	General Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	HIPAA Privacy Officer	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	HIPAA Security Officer	Sr Security Manager, Enterprise Information Securi		Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	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		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Interoperability Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	MA Appeals/Grievances Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	MA Claims Processing Contact for Public Website	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	Marketing Contact	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Medical Director	MD	Dr.	Wise	Greg		6145463151				6145463131	gwise@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Coordinator	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Part D Opioid Overutilization Contact	Pharmacy Data Analyst	Ms.	Houk	Kimberly		6145463183					kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	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	Medication Therapy Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	OffShore Subcontractor Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment	Ms	Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Online Enrollment Center Contact (Optional)	Director, Enrollment and Premium Billing		Caudle	Jeff		6145463224				6145463148	jcaudle@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 C Application Contact	Director, Product Management and Business Devlpt		Mauck	Brandon		6145955681					brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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 C Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Appeals	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H6910	Part D Appeals Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H6910	Part D Application Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	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 Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Claims Submission Contact	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H6910	Part D Exceptions Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H6910	Part D Price File Contact (Back-up)	Formulary Consultant		Scott	Sarah		4803109219					sarah.scott@CVSHealth.com	9501 E. Shea		Scottsdale	AZ	85260	05/02/2025	2026	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 Price File Contact (Primary)	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Quality Assurance Contact	Director of Pharmacy, Health Plans	Ms.	McGhee	Anna		2165345375				6142346481	anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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 Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Patient Safety Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Payment Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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 Director	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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 Network Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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 Network Management Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H6910	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Data Analyst	Mrs	Miller	Kim							kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H6910	PHR Beneficiary Contact																	01/16/2019	2026	MOUNT CARMEL HEALTH PLAN OF IDAHO, INC.	Local CCP	Saint Alphonsus Health Plan	HMO/HMOPOS	MediGold	Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H6910	Physician Incentive Contact	Interim VP, Health Services	Ms	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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	Plan Directory Contact for Public Website	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Processor Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	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	Quality Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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	Reconciliation Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Reconciliation Contact (Secondary)	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Recovery Audit Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Surveillance Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	System Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	Third Party Administrator (TPA) Liaison	Sr Finance Analyst		Fountain	Lisa		6145463220					lfountain@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	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	User Access Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	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	Utilization Management Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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	Utilization Review Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	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
H6941	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Backup User Access Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	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		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Bid Primary Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	CAP Report Contact for Public Website	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Bradshaw	Eileen		9186649000				9186649922	eileen.bradshaw@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	09/28/2021	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	CEO - Senior Official for Contracting	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	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		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Chief Operating Officer	Chief Executive Officer	Mrs.	Bradshaw	Eileen		9186649000					eileen.bradshaw@lifeseniorservices.org	5330 E. 31st Street, Suite 800		Tulsa	OK	74135	12/09/2022	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Chief Information Officer	Senior Director	Mrs	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Chief Information Security Officer	Compliance Officer	Mrs.	Crow	Mary		9186649000					mcrow@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	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	Senior Director	Mrs	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Complaints Tracking Contact	SeniorDirector	Mrs	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Contact for Fraud Investigations	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	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		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Corporate Mailing						9186649000	1224				sblue@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	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	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	DIR Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	DIR Contact (Secondary)	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Discount Program Payment Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Emergency Part D Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Emergency Part D Contact (Secondary)	Chief Financial Officer	Mr.	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 E. 31st Street, Suite 800		Tulsa	OK	74135	01/06/2021	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Encounter Data & Risk Adjustment Operations Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Enrollment Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	EOB Transfer Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Financial Audit Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Financial Reporting Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Formulary Contact	COO		Greenhalgh	Michael		8889742763				8562730135	mgreenhalgh@trhc.com	CareKinesis, Inc.	228 Strawbridge Drive	Moorestown	NJ	08057	12/09/2022	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	General Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	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		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	HIPAA Privacy Officer	Compliance Officer	Mrs.	Crow	Mary		9186649000					mcrow@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	HIPAA Security Officer	Compliance Officer	Mrs.	Crow	Mary		9186649000					mcrow@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Interoperability Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	MA Appeals/Grievances Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Marketing Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Medical Director	Medical Director	Dr.	Reeves	Renetta		9189499969				9186649922	RReeves@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	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		9186649000					mcrow@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Medicare Coordinator	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Reeves	Renetta		9189499969					RReeves@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Medication Therapy Management Contact	Medical Director	Dr.	Reeves	Renetta		9189499969				9186649922	RReeves@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part C Application Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part D Appeals	Senior Director	Mrs.	Blue	Samantha						9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active	8446644440				PACE - Nat		C	Dallas
H6941	Part D Appeals Contact (Secondary)	Chief Financial Officer	Mr.	Copeland	Bill						9186649922	bcopeland@lifeseniorservices.org	5330 E. 31st Street, Suite 800		Tulsa	OK	74135	08/12/2024	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active	9189499969				PACE - Nat		C	Dallas
H6941	Part D Application Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part D Benefits Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part D Claims Submission Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	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						9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	08/12/2024	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active	9186649000				PACE - Nat		C	Dallas
H6941	Part D Exceptions Contact (Secondary)	Senior Director	Mrs.	Blue	Samantha						9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active	9186644440				PACE - Nat		C	Dallas
H6941	Part D Price File Contact (Back-up)	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part D Price File Contact (Primary)	COO		Greenhalgh	Michael		8889742763				8562730135	mgreenhalgh@trhc.com	CareKinesis, Inc.	228 Strawbridge Drive	Moorestown	NJ	08057	12/09/2022	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part D Quality Assurance Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Part D Reporting Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Patient Safety Contact	Medical Director	Dr.	Reeves	Renetta		9189499969					Rreeves@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Payment Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000	1211			9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Pharmacy Director	COO		Greenhalgh	Michael		8889742763				8562730135	mgreenhalgh@trhc.com	CareKinesis, Inc.	228 Strawbridge Drive	Moorestown	NJ	08057	12/09/2022	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Pharmacy Network Management Contact	COO		Greenhalgh	Michael		8889742763				8562730135	mgreenhalgh@trhc.com	CareKinesis, Inc.	228 Strawbridge Drive	Moorestown	NJ	08057	12/09/2022	2026	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						8562730135	mgreenhalgh@trhc.com	CareKinesis, Inc.	228 Strawbridge Drive	Moorestown	NJ	08057	12/09/2022	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active	8889742763				PACE - Nat		C	Dallas
H6941	Plan Directory Contact for Public Website	PACE Program Director	Ms	Blue	Samatha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Processor Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Quality Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Reconciliation Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Reconciliation Contact (Secondary)	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Recovery Audit Contact	Chief Financial Officer	Mr	Copeland	Bill		9186649000				9186649922	bcopeland@lifeseniorservices.org	5330 East 31st Street, Suite 800		Tulsa	OK	74135	02/27/2019	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Surveillance Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	System Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr.	Copeland	Bill		9186649000					bcopeland@lifeseniorservices.org	5330 E 31st Street, Suite 800		Tulsa	OK	74135	02/17/2022	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	User Access Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Utilization Management Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6941	Utilization Review Contact	Senior Director	Mrs.	Blue	Samantha		9189387648				9187011795	sblue@lifeseniorservices.org	4821 S. 72nd East Ave.		Tulsa	OK	74145	10/03/2025	2026	LIFE PACE	National PACE	LIFE PACE, INC.	National PACE		LIFE Senior Services, Inc.	601	Yes	Active					PACE - Nat		C	Dallas
H6958	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Best Available Evidence Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	CAP Report Contact for Public Website	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooperi@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	CMS Casework Communication Contact	Director of Compliance	Mr.	Cooper	Wanda		2675751196				7325923500	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Customer Service Operations Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Formulary Contact	Finance Specialist		Partlow	Jennie		6406501565					jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923500	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	General Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation		Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Medical Director	Medical Director	Dr.	Fornadel	Brian		7325923400					bfornadol@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Medicare Coordinator	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Medicare Part D Opioid Overutilization Contact	Director of Compliance		Cooper	Wanda		2675751196					Wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Medication Therapy Management Contact	Medical Director	Dr	Fornadel	Brian		9548395000				7325923500	bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part D Appeals	Director of Compliance		Cooper	Wanda						2675751196	wcoooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7325923407				PACE - Nat		C	New York
H6958	Part D Appeals Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7328063224				PACE - Nat		C	New York
H6958	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part D Exceptions Contact	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	9548395000				PACE - Nat		C	New York
H6958	Part D Exceptions Contact (Secondary)	Health Plan Dir		Ternay	Jennifer							Jternay@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	09/11/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	9548395000				PACE - Nat		C	New York
H6958	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part D Quality Assurance Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Patient Safety Contact	Finance Specialist		Partlow	Jennie		9548395000					jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Pharmacy Director	Medical Director	Mr	Fornadel	Brian		9548395000					bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	8558012653				PACE - Nat		C	New York
H6958	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	8558012653				PACE - Nat		C	New York
H6958	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Plan to Plan Reconciliation Contact	Financial Specialist		Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Surveillance Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	User Access Contact	Business Administrator		Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6958	Utilization Review Contact	Executive Director	Ms	Runyon	Bobbi		5082502267					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/22/2025	2026	ACUTECARE PACE MONTGOMERY, LLC	National PACE	Acutecare PACE Montgomery, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H6959	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Best Available Evidence Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	CAP Report Contact for Public Website	Chief Compliance Officer, ISNP Ventures, LLC		O'Shea	Holly		4107661995					compliance@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	02/02/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	CEO - CMS Administrator Contact	President, ISNP Ventures, LLC	Mr.	Attman	Gary		4108028073	114				gattman@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	12/31/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	CEO - Senior Official for Contracting	President, ISNP Ventures, LLC	Mr.	Attman	Gary		4107661995	114				gattman@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	03/25/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Chief Financial Officer	CFO, ISNP Ventures, LLC	Mr.	Finglass	Brian		4107661995	114			4105051525	finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	03/26/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Chief Operating Officer	COO	Mr	Attman	Gary	L	4107661995	99510				gattman@futurecare.com	8028 Ritchie Hwy	Suite 210	Pasadena	MD	21122	02/10/2020	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Chief Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Contact for Fraud Investigations	Chief Compliance Officer, ISNP Ventures, LLC		O'Shea	Holly		4107661995	114				compliance@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	02/02/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Coordination of Benefits Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Corporate Mailing						8442061205					keycarecustomerservice@allyalign.com	P.O. Box 6510		Glen Allen	VA	230586510	02/16/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Discount Program Payment Contact	VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/19/2024	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	EOB Transfer Contact			Lowry	Kristy		8448546886				8336102390	kristy.lowry@curanahealth.com	P.O. Box 5849		Glen Allen	VA	23058	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Financial Audit Contact	CFO, ISNP Ventures LLC	Mr.	Finglass	Brian		4107661995	114				finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	09/28/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Financial Reporting Contact	CFO, ISNP Ventures, LLC	Mr.	Finglass	Brian		4107661995	114			4105051525	finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	09/28/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	General Contact	Chief Compliance Officer, ISNP Ventures, LLC		O'Shea	Holly		4107661995	114				compliance@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	02/02/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	09/28/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	HIPAA Privacy Officer		Ms.	O'Shea	Holly		4107661995	114				osheah@futurecarehealth.com	8028 Ritchie Highway		Pasadena	MD	21122	03/22/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	HIPAA Security Officer		Ms.	O'Shea	Holly		4107661995	114				osheah@futurecarehealth.com	8028 Ritchie Highway		Pasadena	MD	21122	03/22/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Marketing Contact	Marketing Director		Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Medical Director	Chief Medical Officer, ISNP Ventures, LLC	Dr.	Sheikh	Fatima		4107661995					sheikhf@futurecare.com	8028 Ritchie Highway		Pasadena	MD	21122	04/02/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Medicare Compliance Officer	Chief Compliance Officer, ISNP Ventures, LLC	Ms.	O'Shea	Holly		4107661995	114				compliance@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	10/08/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Medicare Coordinator			O'Shea	Holly		4107661995	114				osheah@futurecarehealth.com	8028 Ritchie Highway		Pasadena	MD	21122	10/07/2019	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part C Application Contact	Chief Financial Officer, ISNP Ventures, LLC	Mr.	Finglass	Brian		4107661995	114			4105051525	finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	02/02/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	Navitus Health Solutions,	1025 West Navitus Drive	Appleton	WI	54913	12/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Application Contact	Chief Financial Officer, ISNP Ventures, LLC	Mr.	Finglass	Brian		4107661995	114			4105051525	finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	02/02/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Payment Contact	CFO, ISNP Ventures, LLC	Mr.	Finglass	Brian		4107661995	114			4105051525	finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	09/28/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Pharmacy Network Management Contact	VP, Network Management		Santos	Christina		6088204408					christina.santos@navitus.com	Navitus Health Solutions	361 Integrity Drive	Madison	WI	53717	12/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H6959	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H6959	Physician Incentive Contact			Howells	Heather		8049215196					heather.howells@allyalign.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/13/2021	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Plan Directory Contact for Public Website			Sidlinger	Rocio		8558550489	1664				rocio.sidlinger@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Reconciliation Contact (Secondary)	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Recovery Audit Contact	Chief Compliance Officer, ISNP Ventures, LLC	Ms.	O'Shea	Holly		4107661995					compliance@keycareadvantage.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/02/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Surveillance Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Third Party Administrator (TPA) Liaison	CFO, ISNP Ventures, LLC	Mr.	Finglass	Brian		4107661995	114			4105051525	finglassb@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	09/28/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	User Access Contact	Chief Compliance Officer, ISNP Ventures, LLC	Ms.	O'Shea	Holly		4107661995	114				compliance@keycareadvantage.com	8028 Ritchie Highway		Pasadena	MD	21122	02/24/2022	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6959	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	ISNP VENTURES, LLC	Local CCP	KeyCare Advantage	HMO/HMOPOS		ISNP Holdings, LLC	732	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6971	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504200				HMO - Health Maintenance Organization		C	Dallas
H6971	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337504200				HMO - Health Maintenance Organization		C	Dallas
H6971	PHR Beneficiary Contact																	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Dallas
H6971	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6971	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H6988	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Cuevas	Lauren		8587905849				8587906052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/04/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Backup User Access Contact	Director II Compliance		Fernandes	Natalie		9179936586	3142				compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/26/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Best Available Evidence Contact	Medicare Enrollment Manager		Thompkins	Alicia		9176365717	3750			7185815552	AThompkins@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/26/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Bid Audit Site Contact	Chief Compliance Officer		Faust	Lois		7182157000	3104				compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	New York	NY	10304	03/11/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	03/11/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	03/11/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	03/11/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Complaints Tracking Contact	Compliance Director	Ms.	Ng	Wendy		9179936647					compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/26/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Contact for Fraud Investigations	Investigator II		Chernyakhovsky	Yevgeny		6467669533					ychernyakhovsky@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/26/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Coordination of Benefits Contact	Manager II Claims		Montalvo	Crystal		6468594039					claims@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/26/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Customer Service Operations Contact	Director Network Support		Castillo	Yaritza		9179937892					ycastillo@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/26/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	DIR Contact	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/26/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	DIR Contact (Secondary)	Director II Compliance		Fernandes	Natalie		9179936586					compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Discount Program Payment Contact	Financial Accounting Database Analyst Sr		Racine	Max		8058163930					max.racine@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	07/10/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Electronic Health Record Contact	Chief Compliance Officer		Faust	Lois		7182157000	3104				compliance@centersplan.com	75 Vanderbilt Ave.	7th Floor	Staten Island	NY	10304	07/07/2021	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Emergency Part D Contact	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Emergency Part D Contact (Secondary)	Medical Director		Graf	Alisa		9179936886					agraf@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Encounter Data & Risk Adjustment Operations Contact	Director II Claims		Koegel	Adam		9177895320					adam.koegel@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	04/28/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	10/15/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Formulary Contact	Manager, Formulary Administration and Maintenance		Wong	Tim		8085519931					FAS@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/04/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Hospice Contact	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	Ste. 700	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	MA Appeals/Grievances Contact	Manager II Grievance/Appeals		Rolffot	Julia		9179936661					jrolffot@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	MA Claims Processing Contact for Public Website	Manager II Claims		Montalvo	Crystal		6468594039					cmontalvo@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	08/20/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Medical Director	Medical Director		Graf	Alisa		9179936886					agraf@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	05/29/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Online Enrollment Center Contact (Back-up)	Manager II GBD Special Programs		Sharma	Manu		6469333371					msharma@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Online Enrollment Center Contact (Optional)	Director GBD Special Programs	Ms.	Mejia	Serena		9179936665					smejia@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	10/15/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part C Reporting Contact	Compliance Director		Combs	Yvonne		6468494441					compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Appeals	Manager Pharmacy Clinical Operations		Segal	Penina							Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	9179936829				HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Appeals Contact (Secondary)	Manager II Grievance/Appeals		Rolffot	Julia							jrolffot@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	9179936661				HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Benefits Contact	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Claims Submission Contact	Manager II Claims		Montalvo	Crystal		6468594039					cmontalvo@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Exceptions Contact	Manager Pharmacy Clinical Operations		Segal	Penina							Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	9179936829				HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Exceptions Contact (Secondary)	Pharmacist Clinical Sr.		Vysotski	Sora							svysotski@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	9179936667				HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Price File Contact (Back-up)	Medicare Part D Project Manager I		Keller	Shanon		8582139401					shanon.keller@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/04/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Price File Contact (Optional)	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Quality Assurance Contact	Director Clinical Quality Management		Seifert	Julie		9177895495					jseifert@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Part D Reporting Contact	Manager, Medicare Programs and Services		Scott	Susan		8587906565					MedicarePartDProjectManagers@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	03/11/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	07/11/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Pharmacy Director	Manager Pharmacy Clinical Operations		Segal	Penina		9179936829					Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Straten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Pharmacy Network Management Contact	Director of Configuration Services		Cornwall	Allen		8586633317					allen.cornwall@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/24/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Pharmacy Network Management Contact (Secondary)	Pharmacist Clinical Sr.		Vysotski	Sora		9179936667					svysotski@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Pharmacy Technical Help Desk Contact	VP, Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/04/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8888075717				HMO - Health Maintenance Organization		C	Chicago
H6988	Pharmacy Technical Help Desk Contact (Secondary)	Manager Pharmacy Clinical Operations		Segal	Penina							Penina.segal@anthem.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	9179936829				HMO - Health Maintenance Organization		C	Chicago
H6988	PHR Beneficiary Contact																	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H6988	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Plan Directory Contact for Public Website			Castillo	Yaritza		8442745227					memberservices@centersplan.com	75 Vanderbilt Avenue		Straten Island	NY	10304	09/10/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/13/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Processor Contact	Manager, Medicare Programs and Services		MacLochlainn	Tine		8588293907					christine.maclochlainn@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	04/04/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Quality Contact	Director of Clinical Quality Management		Seifert	Julie		9177895495					jseifert@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Reconciliation Contact (Secondary)	Chief Compliance Officer		Faust	Lois		7182157000	3104				compliance@centersplan.com	75 Vanderbilt Ave	7th Floor	Staten Island	NY	10304	07/07/2021	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Recovery Audit Contact	Compliance Director	Ms.	Walfish	Yvonne		6468494441					compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/14/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Surveillance Contact	Chief Compliance Officer		Faust	Lois		7182157000	3104				compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	03/11/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	System Contact	Director I Technology		Shonk	Brian		9177895360					bshonk@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr		Racine	Max		8058163930					max.racine@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	07/10/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	User Access Contact	Director II Compliance		Fernandes	Natalie		9179936586					compliance@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Utilization Management Contact	Director I Medical Management		Mavrinac	Peggy		9179937938					PMavrinac@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6988	Utilization Review Contact	Director I Medical Management		Mavrinac	Peggy		9179937938					PMavrinac@centersplan.com	75 Vanderbilt Avenue	7th Floor	Staten Island	NY	10304	08/27/2025	2026	Anthem HP, LLC	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H6994	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H6994	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Atlanta
H6994	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	Atlanta
H6994	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H6994	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF VIRGINIA INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7003	Automated TrOOP Balance Transfer Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Backup User Access Contact	DIR Health Plan Management	Mrs.	Boyle	Amanda		4028292993				4028292998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Best Available Evidence Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Bid Primary Contact	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	CAP Report Contact for Public Website	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	CEO - CMS Administrator Contact	CEO	Mr	Gurley	Eric		4028292950				4028292939	egurley@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	CEO - Senior Official for Contracting	CEO	Mr	Gurley	Eric		4028292950				4028292939	egurley@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Chief Financial Officer	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Chief Operating Officer	Senior VP & COO	Mrs	Kaminski	Julie		4028292954				4028292939	Jkaminski@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Chief Information Officer	CFO	Mr	Bear	Scott		4028292922					sbear@immanuel.com	1044 North 115th Street Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Chief Information Security Officer	CFO	Mr.	Bear	Scott		4028292922					sbear@immanuel.com	1044 North 115th Street Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	CMS Casework Communication Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Complaints Tracking Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Contact for Fraud Investigations	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	TDurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Coordination of Benefits Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Corporate Mailing						4028292999				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Customer Service Operations Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	DIR Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	DIR Contact (Secondary)	Dir. Health Plan Management	Mrs.	Boyle	Amanda		4028292993				4028292998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Discount Program Payment Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Emergency Part D Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Emergency Part D Contact (Secondary)	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951					tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Encounter Data & Risk Adjustment Operations Contact	Dir. Health Plan Management	Mrs.	Boyle	Amanda		4028292993				4028292998	aboyle@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Enrollment Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	EOB Transfer Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Financial Audit Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951					tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Financial Reporting Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951					tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Formulary Contact	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	General Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Government Relations Contact	Corporate Compliance Officer	Mr	Sigmond	John		4028292910					jsigmond@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	HIPAA Privacy Officer	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	Tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	HIPAA Security Officer	CFO	Mr	Bear	Scott		4028292922					sbear@immanuel.com	1044 North 115th Street Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Interoperability Contact	CFO	Mr	Bear	Scott		4028292922					sbear@immanuel.com	1044 N 115th Street		Omaha	NE	68135	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	MA Appeals/Grievances Contact	Director of PACE Clinical Operations	Mrs	Grasz	Liza		4028292967					LGrasz@immanuel.com	1044 N 115th Street	Suite 500	Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	MA Claims Processing Contact for Public Website	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Marketing Contact	VP of PACE Operations	Mrs.	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Medical Director	VP of Clinical Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Medicare Compliance Officer	Corp Compliance Officer	Ms	Durbin	Tracy		4028292968					tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Medicare Coordinator	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Medicare Part D Opioid Overutilization Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 N 115th Street		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Medication Therapy Management Contact	Vice President of Clinic Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part C Application Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part D Appeals	Corporate Compliance Officer	Mrs	Durbin	Tracy						4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active	4028292968				PACE - Nat		C	San Francisco
H7003	Part D Appeals Contact (Secondary)	Dir. Health Plan Management	Mrs.	Boyle	Amanda						4028292939	aboyle@immanuel.com	1044 N 115th Street		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active	4028292993				PACE - Nat		C	San Francisco
H7003	Part D Application Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part D Benefits Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part D Claims Submission Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part D Exceptions Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha						4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active	4028296951				PACE - Nat		C	San Francisco
H7003	Part D Exceptions Contact (Secondary)	DIR Health Plan Management	Mrs	Boyle	Amanda						4028292939	aboyle@immanuel.com	1044 N Street		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active	4028292993				PACE - Nat		C	San Francisco
H7003	Part D Price File Contact (Back-up)	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part D Price File Contact (Primary)	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part D Quality Assurance Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 N 115th Street		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Part D Reporting Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Patient Safety Contact	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Payment Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Personal Health Record Contact	VP of PACE Operations	Mrs	Butterfield	April		4028292900				4028292998	abutterfield@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Pharmacy Director	VP of Clinical Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Pharmacy Network Management Contact	VP of Clincial Operations	Mr	Fox	Devin		4028293278					DFox@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Pharmacy Technical Help Desk Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha						4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active	4028296951				PACE - Nat		C	San Francisco
H7003	Plan Directory Contact for Public Website	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Plan to Plan Reconciliation Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Processor Contact	Health Plan Analyst	Mrs	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Quality Contact	Director of Clincial Operations	Mrs	Grasz	Liza		5155182403					LGrasz@immanuel.com	1044 N 115th Street		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Reconciliation Contact	CFO	Mr	Bear	Scott		4028292922				4028292939	sbear@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Recovery Audit Contact	Corporate Compliance Officer	Mrs	Durbin	Tracy		4028292968				4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Surveillance Contact	Corporate Compliance Officer	Ms	Durbin	Tracy		4028292968				4028292939	tdurbin@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	System Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Third Party Administrator (TPA) Liaison	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	User Access Contact	Health Plan Analyst	Mrs.	Battaglia	Trisha		4028296951				4028292998	tbattaglia@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Utilization Management Contact	Director of Clinical Operations	Mrs	Grasz	Liza		4028292967					LGrasz@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7003	Utilization Review Contact	Director of Clinical Operations	Mrs	Grasz	Liza		4028292697					LGrasz@immanuel.com	1044 North 115th Street, Suite 500		Omaha	NE	68154	06/17/2024	2026	PACE NEBRASKA	National PACE	Immanuel Pathways Omaha	National PACE		Immanuel	460	Yes	Active					PACE - Nat		C	San Francisco
H7006	Agent/Broker Compensation Data Contact	VP Sales Operations		Hohenberg	Brandon		5058600441					brandon.hohenberg@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Esp	Bryan		8587906445					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Backup User Access Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Best Available Evidence Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Bid Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Bid Audit Site Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140, Salem, OR 97301		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Bid Primary Contact	President & CEO		Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE	Suite #140	Salem	OR	97301	02/21/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	CAP Report Contact for Public Website	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	6026924381				PPO - BBA		C	Dallas
H7006	CEO - CMS Administrator Contact	President & CEO	Ms.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE	Suite #140	Salem	OR	97301	02/21/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	CEO - Senior Official for Contracting	President & CEO	Ms.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE	Suite #140	Salem	OR	97301	02/21/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Chief Financial Officer	CFO	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Chief Operating Officer	Chief Operations Officer	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE	Suite #140	Salem	OR	97301	02/21/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Chief Information Officer	Chief Information Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Chief Information Security Officer	Information Security Officer	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	CMS Casework Communication Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Complaints Tracking Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Contact for Fraud Investigations	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Coordination of Benefits Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE	Suite #140	Salem	OR	97301	02/21/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Corporate Mailing						8776728620				5035841772	compliance@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Customer Service Operations Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE	Suite #140	Salem	OR	97301	02/21/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	DIR Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Discount Program Payment Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Emergency Part D Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Enrollment Contact	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	EOB Transfer Contact	President & CEO	Mrs.	Callahan	Jennifer		9715992441				9512067316	jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Financial Audit Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Financial Reporting Contact	Chief Financial Officer		Kirkpatrick	James		5034285602				5416728670	james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Formulary Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Formulary Contact (Secondary)	Supervisor, Formulary Services		Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	11/04/2015	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	General Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104				5035841772	yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Government Relations Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	HIPAA Privacy Officer	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		5414925104					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	HIPAA Security Officer	ISO	Mr.	Rohver	Eric		5414922164					eric.rohveri@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Hospice Contact	Chief Medical Officer	Mr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Interoperability Contact	Chief Technology Officer		Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	MA Appeals/Grievances Contact	Director of Appeals and Grievances		Vaughn	Sara		9712094307				5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	MA Claims Processing Contact for Public Website	customer service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Marketing Contact	Vice President of Compliance	Mr.	Allotta	Tony		8303090299					tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Medical Director	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Medicare Compliance Officer	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Medicare Coordinator	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	OffShore Subcontractor Contact	Chief Legal Officer, General Counsel		Wilson	Charles		5039677387				5035841772	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Online Enrollment Center Contact (Optional)	President & CEO	Mrs.	Callahan	Jennifer		9715992441					jennifer.callahan@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Online Enrollment Center Contact (Primary)	Enrollment Manager		Vredenburg	Cristi		5414925119					Cristi.vredenburg@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part C Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part C Reporting Contact	VP of Audits, Communications and Privacy	Mrs	Luma	Yoleine		9172080084					yoleine.luma@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Appeals	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	8776728620	3			PPO - BBA		C	Dallas
H7006	Part D Appeals Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	9179920101				PPO - BBA		C	Dallas
H7006	Part D Application Contact	Chief Legal Officer		Wilson	Charles		5039677387				8662569002	charles.wilson@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Benefits Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Claims Submission Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Exceptions Contact	Director of Appeals and Grievances		Vaughn	Sara						5416728670	sara.vaughn@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	8776728620	3			PPO - BBA		C	Dallas
H7006	Part D Exceptions Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	9179920101				PPO - BBA		C	Dallas
H7006	Part D Price File Contact (Back-up)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Price File Contact (Optional)	Medicare Part D Project Manager		Maldonado	Cheryl		8587906397					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct,		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Price File Contact (Primary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Part D Reporting Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Patient Safety Contact	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Payment Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Pharmacy Director	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Pharmacy Network Management Contact	Supervisor, Pharmacy Network Support		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	03/13/2019	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Pharmacy Network Management Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
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	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	8006819571				PPO - BBA		C	Dallas
H7006	Pharmacy Technical Help Desk Contact (Secondary)	Chief Medical Officer	Dr.	Worku	Aelaf							aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active	9179920101				PPO - BBA		C	Dallas
H7006	PHR Beneficiary Contact																	05/09/2018	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO	ATRIO Health Plans	ATRIO Health Plans	5	Yes	Active	8776728620				PPO - BBA		C	Dallas
H7006	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8776728620				5416728670	customerservice@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Plan to Plan Reconciliation Contact	Chief Financial Officer		Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Processor Contact	Director, Medicare Programs		Scherlippens	Carine		8587907415					Carine.Scherlippens@Medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/09/2014	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Quality Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Reconciliation Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Recovery Audit Contact	Chief Financial Officer	Mr.	Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	SNP Application Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	SNP State Contact	Director of SNP Programs		Klunk	Amanda		9712395038					Amanda.klunk@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Surveillance Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	System Contact	Chief Technology Officer	Mr.	Snyder	Dan		9712089848					dan.snyder@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Kirkpatrick	James		5034285602					james.kirkpatrick@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	User Access Contact	Vice President of Compliance	Mr.	Allotta	Tony		5303967149				5035841772	tony.allotta@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Utilization Management Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7006	Utilization Review Contact	Chief Medical Officer		Worku	Aelaf		9179920101					aelaf.worku@atriohp.com	550 Hawthorne Ave SE #140		Salem	OR	97301	10/29/2025	2026	ATRIO HEALTH PLANS	Local CCP	ATRIO Health Plans	Local PPO		ATRIO Health Plans	5	Yes	Active					PPO - BBA		C	Dallas
H7020	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H7020	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H7020	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H7020	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H7020	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H7020	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H7020	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7020	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7027	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Backup User Access Contact	Director of Foundation and Government Relations		Hayford	Justin		7738288270					jhayford@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Best Available Evidence Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Bid Primary Contact	CFO		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	CAP Report Contact for Public Website	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	CEO - CMS Administrator Contact	Vice President of PACE	Ms	Weiss	Jennifer		7732204350					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	07/29/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	CEO - Senior Official for Contracting	Interim CEO and Chief Financial Officer	Mr.	Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	05/23/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Chief Financial Officer	Chief Financial Officer	Mr.	Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Chief Operating Officer	VP of PACE	Ms.	Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/31/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Chief Information Officer	VP of Information Technology	Mr.	Shivnani	Nish		7734821969					nshivnani@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/29/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Chief Information Security Officer	VP of Information Technology	Mr.	Shivnani	Nish		7734821969					nshivnani@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/29/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	CMS Casework Communication Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Complaints Tracking Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Contact for Fraud Investigations	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Coordination of Benefits Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Corporate Mailing						7735846200					PACE@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	10/23/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Customer Service Operations Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	DIR Contact	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	DIR Contact (Secondary)	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Discount Program Payment Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	10/23/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Emergency Part D Contact	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Emergency Part D Contact (Secondary)	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Enrollment Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	EOB Transfer Contact	CFO		Gadia	Ryan		7736405792				7738234224	rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Financial Audit Contact	Chief Financial Officer	Mr.	Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Financial Reporting Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Formulary Contact	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	General Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Government Relations Contact	Director of Foundation and Government Relations		Hayford	Justin		7738288270					jhayford@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	HIPAA Privacy Officer	VP of PACE	Ms.	Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/31/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	HIPAA Security Officer	VP of Information Technology		Shivnani	Nish		7734821969					nshivnani@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Interoperability Contact	VP of Information Technology		Shivnani	Nish		7734821969					nshivnani@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	MA Appeals/Grievances Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	MA Claims Processing Contact for Public Website	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Marketing Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	05/13/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Medical Director	Chief Medical Officer		Kim	Thomas		7735846200					tkim@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Medicare Compliance Officer	Vice President of PACE	Ms	Weiss	Jennifer		7732204350					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	07/29/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Medicare Coordinator	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Medicare Part D Opioid Overutilization Contact	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Medication Therapy Management Contact	Chief Medical Officer		Kim	Thomas		7735846200					tkim@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part C Application Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part D Appeals	Chief Financial Officer		Gadia	Ryan							rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active	7735846200				PACE - Nat		C	New York
H7027	Part D Application Contact	CFO		Gadia	Ryan		7746405792					rgadia@esperanzachicago.org	1940 S. Western Avenue, Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part D Benefits Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part D Claims Submission Contact	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part D Exceptions Contact	Vice President of PACE		Weiss	Jennifer							jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active	7744821989				PACE - Nat		C	New York
H7027	Part D Price File Contact (Back-up)	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part D Price File Contact (Primary)	Chief Financial Officer	Mr.	Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part D Quality Assurance Contact	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Part D Reporting Contact	Controller		Cardenas	Juan		7739164428					jcardenas@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	08/14/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Patient Safety Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	05/13/2025	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Payment Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Pharmacy Director	Chief Medical Officer		Kim	Thomas		7735846200					tkim@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Pharmacy Network Management Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Pharmacy Technical Help Desk Contact	Vice President of PACE		Weiss	Jennifer							jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active	7744821989				PACE - Nat		C	New York
H7027	Plan Directory Contact for Public Website	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Plan to Plan Reconciliation Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Processor Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Quality Contact	Director of Quality		Ross	Samuel		7735846206					sross@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Reconciliation Contact	Chief Financial Officer		Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Recovery Audit Contact	Chief Financial Officer	Mr.	Gadia	Ryan		7736405792					rgadia@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/23/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Surveillance Contact	VP of External Affairs		Cifuentes	Ricardo		7739321015					rcifuentes@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	System Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Third Party Administrator (TPA) Liaison	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	User Access Contact	Vice President of PACE		Weiss	Jennifer		7734821989					jweiss@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	01/12/2024	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Utilization Management Contact	Chief Medical Officer		Kim	Thomas		7735846200					tkim@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7027	Utilization Review Contact	Chief Medical Officer		Kim	Thomas		7735846200					tkim@esperanzachicago.org	1940 S Western Ave. Suite 205		Chicago	IL	60608	12/28/2022	2026	ESPERANZA HEALTH CENTERS	National PACE	Panorama PACE	National PACE		Esperanza Health Centers	814	Yes	Active					PACE - Nat		C	New York
H7028	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H7028	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H7028	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H7028	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H7028	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H7028	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H7028	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H7028	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Backup User Access Contact	VP of IT		Clark	Arthur		7275234050				7275234006	ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Best Available Evidence Contact	Interim Program Director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Bid Primary Contact	Interim Program Director	Ms.	Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	CAP Report Contact for Public Website	Interim Program Director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	CEO - CMS Administrator Contact	CEO	Mr.	Fleece	Jonathan		9415527525					JFleece@stratumhealthsystem.org	5955 Rand Blvd.		Sarasota	FL	34238	03/22/2021	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	CEO - Senior Official for Contracting	CEO	Mr.	Fleece	Jonathan		9415527525					JFleece@stratumhealthsystem.org	5955 Rand Blvd.		Sarasota	FL	34238	03/22/2021	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Chief Financial Officer	CFO	Ms.	Bouhamid	Saida		9415527599					SaidaBouhamid@EmpathHealth.org	5955 Rand Blvd.		Sarasota	FL	34238	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Chief Operating Officer	COO	Ms	Lowry	Tarrah		5612275277					tlowry@trustbridge.com	5771 Roosevelt Blvd		Clearwater	FL	33760	04/14/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Chief Information Officer	VP of IT	Mr.	Clark	Arthur		7275234050				7275234006	ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Chief Information Security Officer	VP of IT	Mr.	Clark	Arthur		7275234050				7275234006	ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	CMS Casework Communication Contact	Interim Program Director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Complaints Tracking Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Contact for Fraud Investigations	Interim Program Director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Coordination of Benefits Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave North		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Corporate Mailing						9412481550					michaelmason@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Customer Service Operations Contact	Interim Program Director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	DIR Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	DIR Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Discount Program Payment Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Emergency Part D Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Emergency Part D Contact (Secondary)	Health Plan Medicare Specialist		Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Encounter Data & Risk Adjustment Operations Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Enrollment Contact	Interim program director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	EOB Transfer Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716				7272458892	jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Financial Audit Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Financial Reporting Contact	CFO/COO	Ms.	Bouhamid	Saida		9415527599					SaidaBouhamid@EmpathHealth.org	5955 Rand Blvd.		Sarasota	FL	34238	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Formulary Contact	Interim Program Director	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Formulary Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	General Contact	Interim program director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Government Relations Contact	Interim program director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	HIPAA Privacy Officer	CEO/President		Fleece	Jonathan		9415527525				9415565800	jonathanfleece@empathhealth.org	5955 Rand Blvd		Sarasota	FL	34238	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	HIPAA Security Officer	VP of Compliance		Mosby	Laura		7275232106					LauraMosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Interoperability Contact	Interim program director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	MA Appeals/Grievances Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	MA Claims Processing Contact for Public Website	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Marketing Contact	Interim program director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Medical Director	Medical Director	Dr.	Alokeh	Wael		7272890062				9417615536	waelalokeh@empathhealth.org	5414 Beaumont Center Blvd Ste 210		Tampa	FL	33634	09/11/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Medicare Compliance Officer	VP of Compliance	Ms.	Mosby	Laura		7275232106				7275232122	LauraMosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Medicare Coordinator	Interim Program Director		Schulte	Komal		8136512851				8134418467	komalschulte@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Medicare Part D Opioid Overutilization Contact	Director of Health Plan Operations		Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Medication Therapy Management Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Online Enrollment Center Contact (Back-up)	Interim Program Director	Ms.	Schulte	Komal		7272890062					komalschulte@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Online Enrollment Center Contact (Primary)	Director of Health Plan Operatons	Ms.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part C Application Contact	Director of Health Plan Operations	Mr//	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part D Appeals	Director of Health Plan Operations	Mr.	Pettry	Jason							jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7277355716				PACE - Nat		C	Atlanta
H7059	Part D Appeals Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H7059	Part D Application Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part D Benefits Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part D Claims Submission Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part D Exceptions Contact	Director of Health Plan Operations	Mr.	Pettry	Jason							jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7277355716				PACE - Nat		C	Atlanta
H7059	Part D Exceptions Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H7059	Part D Price File Contact (Back-up)	Director of Health Plan Operations		Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part D Price File Contact (Primary)	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part D Quality Assurance Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Part D Reporting Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Patient Safety Contact	Director of Heath Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Payment Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Personal Health Record Contact	Interim program director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Pharmacy Director	Pharmacy Director		Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	04/14/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Pharmacy Network Management Contact	Pharmacy Director		Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33765	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Pharmacy Network Management Contact (Secondary)	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Pharmacy Technical Help Desk Contact	Pharmacy Director		Harvey	Tracey							tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33765	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7275232530				PACE - Nat		C	Atlanta
H7059	Pharmacy Technical Help Desk Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra							sandrawoodstuff@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active	7272890062				PACE - Nat		C	Atlanta
H7059	PHR Beneficiary Contact																	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE	Empath Health	Empath Health, Inc.	635	Yes	Active	9412481550				PACE - Nat		C	Atlanta
H7059	Plan Directory Contact for Public Website	Interim program director	Mr.	Mason	Michael		9412481550					michaelmason@empathhealth.org	303 13th Ave E		Bradenton	FL	34208	04/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Plan to Plan Reconciliation Contact	Director of Health Plan Operations	Ms.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Processor Contact	Pharmacy Director		Harvey	Tracey		7275232530					tracyharvey@empathhealth.org	5771 Roosevelt Blvd		Clearwater	FL	33760	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Quality Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Reconciliation Contact	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave. No.		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Reconciliation Contact (Secondary)	Health Plan Medicare Specialist	Ms.	Woodstuff	Sandra		7272890062					sandrawoodstuff@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Recovery Audit Contact	VP of Compliance	Mr.	Mosby	Laura		7275232106					LauraMosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Surveillance Contact	VP of Compliance		Mosby	Laura		7275232106					LauraMosby@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	System Contact	VP of IT		Clark	Arthur		7275234050				7275234006	ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Third Party Administrator (TPA) Liaison	Director of Health Plan Operations	Mr.	Pettry	Jason		7277355716					jpettry@empathhealth.org	6774 102nd Ave N		Pinellas Park	FL	33782	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	User Access Contact	VP of IT		Clark	Arthur		7275234050				7275234006	ArthurClark@empathhealth.org	5771 Roosevelt Blvd.		Clearwater	FL	33760	09/06/2023	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Utilization Management Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7059	Utilization Review Contact	Director of Regulatory Compliance and Best Practic	Ms.	Seis	Jeanne		7275232123				7275232122	jeanneseis@empathhealth.org	2675 Tampa Rd.		Palm Harbor	FL	34684	09/29/2025	2026	STRATUM LIFE, LLC	National PACE	Stratum LIFE	National PACE		Empath Health, Inc.	635	Yes	Active					PACE - Nat		C	Atlanta
H7063	Agent/Broker Compensation Data Contact	Director Medicare Advantage		Nolte	Erin		7852916589				7852900783	erin.nolte@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	01/28/2019	2026	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	Chicago
H7063	Automated TrOOP Balance Transfer Contact	Director PBM Operations	Ms.	Cain	Christina		6127771330				6127771330	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/27/2023	2026	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	Chicago
H7063	Backup User Access Contact	Compliance Officer		Reeves	Johnathan		7852917855					Compliance@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	12/17/2025	2026	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	Chicago
H7063	Best Available Evidence Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	02/03/2020	2026	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	Chicago
H7063	Bid Audit Contact	Compliance Officer		Reeves	Johnathan		7852916811					compliance@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/23/2025	2026	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	Chicago
H7063	Bid Audit Site Contact	Compliance Officer		Reeves	Johnathan		7852916811					compliance@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/23/2025	2026	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	Chicago
H7063	Bid Primary Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	CAP Report Contact for Public Website	Manager Government Programs Operations		Gilmer-Gentry	Janice		8002400577					janice-gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	02/03/2020	2026	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	Chicago
H7063	CEO - CMS Administrator Contact	President and CEO	Mr.	All	Matt		7852917631					matt.all@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	01/04/2021	2026	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	Chicago
H7063	CEO - Senior Official for Contracting	President and CEO	Mr.	All	Matt		7852917631					matt.all@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	01/04/2021	2026	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	Chicago
H7063	Chief Financial Officer	Chief Financial Officer	Mr	Bergman	Jeff		7852917263				7852918465	jeff.bergman@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/01/2022	2026	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	Chicago
H7063	Chief Operating Officer	Chief Operating Officer	Mrs.	Graves	Holly		7852917953					holly.graves@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	09/26/2023	2026	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	Chicago
H7063	Chief Information Officer	VP Information Technology/CIO	Mr	Langdon	Matt		7852918426					matt.langdon@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	02/28/2020	2026	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	Chicago
H7063	Chief Information Security Officer	Chief Information Security Officer	Mr.	Pourmirza	Payam		7852918198					Payam.Pourmirza@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	03/26/2024	2026	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	Chicago
H7063	CMS Casework Communication Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer.gentry@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	01/27/2025	2026	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	Chicago
H7063	Complaints Tracking Contact	Compliance Officer		Reeves	Johnathan		7852916811				7852900783	medicareadvantage.ctm@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	06/23/2025	2026	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	Chicago
H7063	Contact for Fraud Investigations	Manager SIU		Zimmerman	Tina		7852917693					tina.zimmerman@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	01/12/2021	2026	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	Chicago
H7063	Coordination of Benefits Contact	Director PBM Operations	Ms.	Cain	Christina		6127771330				6127771330	COBmedd@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/27/2023	2026	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	Chicago
H7063	Corporate Mailing						7852916589				7852900783	erin.nolte@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	01/28/2019	2026	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	Chicago
H7063	Customer Service Operations Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	DIR Contact			Smith	Jennifer		7852917991				7852900805	Jennifer.Smith@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	06/02/2025	2026	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	Chicago
H7063	DIR Contact (Secondary)	Manager Financial Accounting		Wright	Stephanie		7852917404				7852900728	stephanie.wright@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	04/28/2025	2026	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	Chicago
H7063	Discount Program Payment Contact	Supervisor Cost Accounting		Smith	Jennifer		7852917991				7852900783	jennifer.smith@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	06/05/2025	2026	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	Chicago
H7063	Electronic Health Record Contact	STARS Program Manager		Koops	Samantha		7852916703					samantha.koops@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	03/27/2024	2026	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	Chicago
H7063	Emergency Part D Contact	Manager of Enrollment		Ware	Anita		5083309500					anita.ware@advantasure.com	4121 Cox Rd	Suite 200	Glen Allen	VA	23060	12/09/2019	2026	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	Chicago
H7063	Emergency Part D Contact (Secondary)	Operations Enrollment Supervisor		LaMontagne	Amanda		2489436684					amanda.lamontagne@advantasure.com	4121 Cox Rd	Suite 200	Glen Allen	VA	23060	12/05/2019	2026	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	Chicago
H7063	Employer Waiver Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Encounter Data & Risk Adjustment Operations Contact	Manager, Revenue Management		Herber	Matthew		7852918095					matthew.herber@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	03/31/2022	2026	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	Chicago
H7063	Enrollment Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	EOB Transfer Contact	Director PBM Operations	Ms	Cain	Christina		6127771330				6127771330	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/27/2023	2026	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	Chicago
H7063	Financial Audit Contact	AVP Finance Strategy and Operations	Ms.	Okunoren	Margaret		7852917792					margaret.okunoren@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/07/2025	2026	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	Chicago
H7063	Financial Reporting Contact	Chief Financial Officer		Bergman	Jeff		7852917263				7852918465	jeff.bergman@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/01/2022	2026	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	Chicago
H7063	Formulary Contact	Corporate Pharmacist		Trinh	Chau		7852918569				7852900734	Chau.Trinh@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	03/26/2024	2026	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	Chicago
H7063	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	06/08/2025	2026	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	Chicago
H7063	General Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Government Relations Contact	VP Government & Community Relations		Mickle	Sunee		7852917194					sunee.mickle@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	04/17/2019	2026	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	Chicago
H7063	HIPAA Privacy Officer	Privacy Officer		Hoopes	Lisa		7852916940					lisa.hoopes@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	12/31/2024	2026	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	Chicago
H7063	HIPAA Security Officer	Chief Information Security Officer		Pourmirza	Payam		7852918198					Payam.Pourmirza@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	03/26/2024	2026	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	Chicago
H7063	Hospice Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Interoperability Contact	Manager IS Services		Carver	Brian		7852918148					brian.carver@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	03/31/2022	2026	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	Chicago
H7063	MA Appeals/Grievances Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	MA Claims Processing Contact for Public Website	Manager Government Programs Operations		Gilmer-Gentry	Janice		8002400577					janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	02/03/2020	2026	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	Chicago
H7063	Marketing Contact	Manager Strategic Marketing		Thimmesch	Madi		7852917119					madi.thimmesch@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	05/23/2025	2026	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	Chicago
H7063	Medical Director	Medical Director	Dr.	Broomes	Stephen		7852917947				7852900809	stephen.broomes@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	11/07/2025	2026	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	Chicago
H7063	Medicare Compliance Officer	Compliance Officer	Mr.	Reeves	Johnathan		7852916811					johnathan.reeves@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/23/2025	2026	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	Chicago
H7063	Medicare Coordinator	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms	Anderson	Ally		8554570763				8557297271	partdoverutil@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	04/04/2022	2026	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	Chicago
H7063	Medication Therapy Management Contact	Manager MTM Care Management		Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	12/23/2021	2026	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	Chicago
H7063	Online Enrollment Center Contact (Back-up)	Director of Medicare Advantage		Nolte	Erin		7852916589					erin.nolte@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	02/03/2020	2026	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	Chicago
H7063	Online Enrollment Center Contact (Primary)	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Part C Application Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Part C Reporting Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Part D Appeals	Director Regulatory and Audit Response	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/15/2020	2026	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	8772775449	3			PPO - BBA		C	Chicago
H7063	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing		Eagan	MN	55121	04/04/2022	2026	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	8006936651	3			PPO - BBA		C	Chicago
H7063	Part D Application Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Part D Benefits Contact	Manager, PBM Operations	Ms.`	McCambridge	Danielle		6127772978					Danielle.McCambridge@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/02/2021	2026	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	Chicago
H7063	Part D Claims Submission Contact	Consultant Government Programs	Mr.	Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/15/2020	2026	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	Chicago
H7063	Part D Exceptions Contact	Director Regulatory and Audit Response	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/15/2020	2026	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	8772775449	3			PPO - BBA		C	Chicago
H7063	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	04/04/2022	2026	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	8006936651	3			PPO - BBA		C	Chicago
H7063	Part D Price File Contact (Back-up)	File Price Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/14/2023	2026	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	Chicago
H7063	Part D Price File Contact (Optional)	QA Analyst		Ly	Martin		6127776931					martin.ly@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/23/2021	2026	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	Chicago
H7063	Part D Price File Contact (Primary)	Pharmacist		Trinh	Chau		7852918569				7852900774	Chau.Trinh@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	03/26/2024	2026	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	Chicago
H7063	Part D Quality Assurance Contact	Corporate Pharmacist		Trinh	Chau		7852918569				7852900734	Chau.Trinh@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	03/26/2024	2026	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	Chicago
H7063	Part D Reporting Contact	Corporate Pharmacist		Trinh	Chau		7852918569				7852900734	Chau.Trinh@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	03/26/2024	2026	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	Chicago
H7063	Patient Safety Contact	Senior Director		Puckett	Reese		6127775037					rpuckett@primetherapeutics.com	8400 Normandale Lake Blvd	Suite 700	Bloomington	MN	55437	12/16/2019	2026	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	Chicago
H7063	Payment Contact	Manager Financial Accounting		Wright	Stephanie		7852917404				7852900728	stephanie.wright@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	04/28/2025	2026	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	Chicago
H7063	Pharmacy Director	Corporate Pharmacist		Liesmann	Tiffany		7852918296					tiffany.liesmann@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/28/2023	2026	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	Chicago
H7063	Pharmacy Network Management Contact	AVP Network Management	Ms.	Conlin	Marci		6127772837				8778236373	MConlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/14/2023	2026	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	Chicago
H7063	Pharmacy Network Management Contact (Secondary)	Sr. Director Network Management	Ms	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/04/2021	2026	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	Chicago
H7063	Pharmacy Technical Help Desk Contact	Director Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	12/14/2023	2026	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	8663255231				PPO - BBA		C	Chicago
H7063	Pharmacy Technical Help Desk Contact (Secondary)	Director Member Services Gov Programs, Prime		Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	01/22/2020	2026	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	8663255231				PPO - BBA		C	Chicago
H7063	Plan Directory Contact for Public Website	Manager Government Programs Operations		Gilmer-Gentry	Janice		8002400577					janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	02/03/2020	2026	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	Chicago
H7063	Plan to Plan Reconciliation Contact			Smith	Jennifer		7852917991				7852900733	jennifer.smith@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/02/2025	2026	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	Chicago
H7063	Processor Contact	Director Government Programs & Ops	Ms.	Allie	Cindy		6127776722					medicareclaimresearch@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/10/2022	2026	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	Chicago
H7063	Quality Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Reconciliation Contact			Smith	Jennifer		7852917991				7852900733	jennifer.smith@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/02/2025	2026	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	Chicago
H7063	Reconciliation Contact (Secondary)	Manager Financial Accounting		Wright	Stephanie		7852917404				7852900733	stephanie.wright@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	04/28/2025	2026	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	Chicago
H7063	Recovery Audit Contact	Compliance Officer	Mr	Reeves	Johnathan		7852916811					johnathan.reeves@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/23/2025	2026	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	Chicago
H7063	Surveillance Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900783	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	02/03/2020	2026	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	Chicago
H7063	System Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900783	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	02/03/2020	2026	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	Chicago
H7063	Third Party Administrator (TPA) Liaison	Manager Financial Accounting		Wright	Stephanie		7852917404				7852900783	stephanie.wright@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	04/28/2025	2026	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	Chicago
H7063	User Access Contact	Compliance Officer		Reeves	Johnathan		7852916811					johnathan.reeves@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/23/2025	2026	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	Chicago
H7063	Utilization Management Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7063	Utilization Review Contact	Manager Government Programs Operations		Gilmer-Gentry	Janice		7852918592				7852900733	janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	10/25/2019	2026	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	Chicago
H7074	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				PPO - BBA		C	Chicago
H7074	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			PPO - BBA		C	Chicago
H7074	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				PPO - BBA		C	Chicago
H7074	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				PPO - BBA		C	Chicago
H7074	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				PPO - BBA		C	Chicago
H7074	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				PPO - BBA		C	Chicago
H7074	PHR Beneficiary Contact																	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				PPO - BBA		C	Chicago
H7074	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7074	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H7093	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/07/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	02/15/2022	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	01/21/2021	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/21/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/11/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/21/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H7093	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H7093	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H7093	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H7093	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	05/07/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H7093	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H7093	PHR Beneficiary Contact																	01/21/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H7093	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/07/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	COMMUNITY INSURANCE COMPANY	Local CCP	Anthem Blue Cross and Blue Shield	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7093	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Backup User Access Contact	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Best Available Evidence Contact	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Bid Primary Contact	CEO		Kurtzig	Joshua		4056093688					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	CAP Report Contact for Public Website	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	CEO - CMS Administrator Contact	CEO	Mr.	Kurtzig	Joshua		4056093688					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	CEO - Senior Official for Contracting	CEO	Mr.	Kurtzig	Joshua		4056093688					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Chief Financial Officer	CEO	Mr	Kurtzig	Joshua		4056093668					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Chief Operating Officer	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Chief Information Officer	IT Project Manager	Mrs	Ford	Katie		4056093688					kford@valir.com	721 NW 6th St		Oklahoma City	OK	73102	04/18/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Chief Information Security Officer	IT Project Manager	Mrs	Ford	Katie		4056093688					kford@valir.com	721 NW 6th St		Oklahoma City	OK	73102	04/18/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	CMS Casework Communication Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Complaints Tracking Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Contact for Fraud Investigations	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Coordination of Benefits Contact	Director of Business Operations		Bridges	Vincent		4057244325					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Corporate Mailing						4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	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 Business Operations		Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	DIR Contact	CEO	Mr.	Kurtzig	Joshua		4056093688					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	DIR Contact (Secondary)	Director of Business Operations	Mr.	Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	04/18/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Discount Program Payment Contact	CEO	Mr.	Kurtzig	Joshua		4056093688					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Emergency Part D Contact	CEO	Mr.	Kurtzig	Joshua		4056093688					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Encounter Data & Risk Adjustment Operations Contact	Director of Business Operations	Mr.	Bridges	Vincent		4056093688				8778875107	vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Enrollment Contact	Director of Business Operations	Mr.	Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 N.W. 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	EOB Transfer Contact	Director of Business Operations		Bridges	Vincent		4056093688				4055531188	vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	04/19/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Financial Audit Contact	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Financial Reporting Contact	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Formulary Contact	Medical Director	Dr	Raju	Senthil		4056093688					senthil.raju@valir.com	721 NW 6th		Oklahoma City	OK	73102	07/30/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	General Contact	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Government Relations Contact	Director of Quality	Mrs	Dan	Jennifer		4056093688					jennifer.dan@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	HIPAA Privacy Officer	Director of Compliance		Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	HIPAA Security Officer	IT Project Manager		Ford	Katie		4056093688					kford@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Interoperability Contact	Medical Director		Raju	Senthil		4056093668					senthil.raju@valir.com	721 nw 6th street		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	MA Appeals/Grievances Contact	Quality Director		Dan	Jennifer		4056093688					jennifer.dan@valir.com	721 NW 6th St		Oklahoma City	OK	73102	11/18/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	MA Claims Processing Contact for Public Website	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Marketing Contact	Director of Business Development		Collins	Darcy		4056093688					darcy.collins@valir.com	721 NW 6th St		Oklahoma City	OK	73102	04/19/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Medical Director	Medical Director	Dr	Raju	Senthil		4056093688					senthil.raju@valir.com	721 NW 6th		Oklahoma City	OK	73102	07/30/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Medicare Compliance Officer	Director of Compliance	Mrs	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnoia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Medicare Coordinator	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Medication Therapy Management Contact	Medical Director	Dr	Raju	Senthil		4056093688					Senthil.raju@valir.com	721 NW 6th		Oklahoma City	OK	73102	07/30/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part C Application Contact	VP PACE	Mrs.	Williams	Dawna		4056093688				8778875107	dawna.williams@valir.com	721 NW 6th Street		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Appeals	VP PACE	Mrs.	Williams	Dawna							dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active	4056093688				PACE - Nat		C	Dallas
H7114	Part D Application Contact	VP PACE	Mrs.	Williams	Dawna		4056093688				8778875107	dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Benefits Contact	VP PACE	Mrs.	Williams	Dawna		4056093688				8778875107	dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Claims Submission Contact	VP PACE	Mrs.	Williams	Dawna		4056093688				8778875107	dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Exceptions Contact	Medical Director	Dr	Raju	Senthil							Senthil.raju@valir.com	721 NW 6th St		Oklahoma City	OK	73102	07/30/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active	4056093688				PACE - Nat		C	Dallas
H7114	Part D Price File Contact (Back-up)	Director of Business Operations		Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	04/19/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Price File Contact (Primary)	VP PACE	Mrs.	Williams	Dawna		4056093688				8778875107	dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Quality Assurance Contact	Director of Compliance	Mrs	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Part D Reporting Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Patient Safety Contact	Medical Director	Dr	Raju	Senthil		4056093688					Senthil.raju@valir.com	721 NW 6th ST		Oklahoma City	OK	73102	07/30/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Payment Contact	Director of Business Operations		Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Pharmacy Director	Medical Director	Dr	Raju	Senthil		4056093688					Senthil.raju@valir.com	721 NW 6th		Oklahoma City	OK	73102	07/30/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Pharmacy Network Management Contact	Director of Business Operations	Mr	Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th		Oklahoma City	OK	73102	04/19/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Raju	Senthil							senthil.raju@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active	4056093688				PACE - Nat		C	Dallas
H7114	Plan Directory Contact for Public Website	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Plan to Plan Reconciliation Contact	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Processor Contact	Director of Business Operations		Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	04/19/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Quality Contact	Quality Director	Mrs	Dan	Jennifer		4056093688					jennifer.dan@valir.com	721 NW 6th ST		Oklahoma City	OK	73102	11/18/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Reconciliation Contact	CEO	Mr.	Kurtzig	Joshua		4056093688					jkurtzig@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Recovery Audit Contact	Director of Compliance	Mrs.	Santilli	Lisa		8563710276					lisa.santilli@valir.com	610 Otter Branch Dr		Magnolia	NJ	08049	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Surveillance Contact	Director of Business Development		Collins	Darcy		4056093688					darcy.collins@valir.com	721 NW 6th ST		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	System Contact	Director of Business Operations		Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Third Party Administrator (TPA) Liaison	Director of Business Operations	Mr	Bridges	Vincent		4056093688					vincent.bridges@valir.com	721 NW 6th St		Oklahoma City	OK	73102	04/19/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	User Access Contact	IT Project Manager		Ford	Katie		4056093688					kford@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Utilization Management Contact	VP PACE	Mrs.	Williams	Dawna		4056093688					dawna.williams@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7114	Utilization Review Contact	Medical Director	Dr.	Raju	Senthil		4056093688					senthil.raju@valir.com	721 NW 6th St		Oklahoma City	OK	73102	12/09/2025	2026	VALIR PACE	National PACE	Valir PACE	National PACE		Valir PACE, LLC.	716	Yes	Active					PACE - Nat		C	Dallas
H7115	Agent/Broker Compensation Data Contact	VP, Marketing & Brand		Dutka	Pete		6152182867					pete.dutka@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Automated TrOOP Balance Transfer Contact	Director, Government Programs Operations		Cano	Diego		6467917201					governmentprograms@cap-rx.com	Capital Rx	228 Park Avenue South Suite 87234	New York	NY	10003	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Backup User Access Contact	Compliance Officer		Clark	Robert		7133386429					Robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77079	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Best Available Evidence Contact	VP, Marketing & Brand		Dutka	Pete		6152182867					pete.dutka@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Bid Audit Contact	CFO	Mr.	Lenhart	Kurt		9374780674					kurt.lenhart@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	03/05/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Bid Audit Site Contact	CFO	Mr.	Lenhart	Kurt		9374780674					kurt.lehhart@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	03/05/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Bid Primary Contact	CFO	Mr.	Lenhart	Kurt		9374780674					kurt.lenhart@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	03/05/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	CAP Report Contact for Public Website	VP, Marketing & Brand		Dutka	Pete		6152182867					pete.dutka@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	CEO - CMS Administrator Contact	CEO	Mr.	Hurt	Jay		2814150510					Jay.Hurt@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	12/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	CEO - Senior Official for Contracting	CEO	Mr	Hurt	Jay		2814150510					Jay.Hurt@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	12/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Chief Financial Officer	Chief Financial Officer	Mr.	Lenhart	Kurt		9374780674					kurt.lenhart@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/27/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Chief Operating Officer	COO	Mr.	Hurt	Jay		7135972523	1107				jay.hurt@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	12/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Chief Information Officer		Ms.	Hammel	Amanda		7133385755					amanda.hammel@memorialhermann.org	920 Frostwood		Houston	TX	77024	06/12/2018	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Chief Information Security Officer		Mr.	Yates	Randy		7133386050					Randy.yates@memorialhermann.org	920 Frostwood, Suite 2.500.16		Houston	TX	77024	03/11/2016	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	CMMI Model Point of Contact	VP Health Services		Surber	Melanie		4028700920					melanie.surber@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	CMS Casework Communication Contact	VP, Marketing & Brand		Dutka	Pete		6152182867					pete.dutka@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Complaints Tracking Contact	A&G Manager		Reuter	Megan		6605371821					megan.reuter@apex4health.com	929 Gessner, Suite 1500		Houston	TX	77024	08/18/2022	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Contact for Fraud Investigations	Compliance Officer		Clark	Robert		7133386429					robert.clark@memorialherman.org	929 Gessner, Suite 2500		Houston	TX	77079	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Coordination of Benefits Contact	Manager, Eligibility & Enrollment		Smith	Noel		7135972523					noel.smith@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	10/01/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Corporate Mailing						8556458448					MHHPFulfillment@apex4health.com	Memorial Hermann Health Plan	929 Gessner Suite 1500	Houston	TX	77024	12/19/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Customer Service Operations Contact	VP, Health Plan Operations		Ward	Lindsay		7249723130					lindsay.ward@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	DIR Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	DIR Contact (Secondary)	Director, Government Programs Operations		Cano	Diego		6467917201					governmentprograms@cap-rx.com	Capital Rx	228 Park Avenue South Suite 87234	New York	NY	10003	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Discount Program Payment Contact	Director of Finance		Powell	John		7139060870					john.powell@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/25/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Emergency Part D Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	3463724106					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Emergency Part D Contact (Secondary)	Director Pharmacy Operations		Soman, PharmD	Steve		5164743409					steve.soman@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Employer Waiver Contact	Vice President, Finance	Ms.	De Moya	Cindy		7133384314					Cindy.DeMoya@memorialhermann.org	929 Gessner, Suite 1900		Houston	TX	77024	07/05/2019	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Encounter Data & Risk Adjustment Operations Contact	VP ,  Value Base Care Operations		Columbus	Jessica		2816179929					jessica.columbus@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/29/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Enrollment Contact	Manager, Eligibility & Enrollment		Smith	Noel		7135972523					noel.smith@apex4health.com	24 Greenwood Plaza	Suite 1150	Houston	TX	77046	10/01/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	EOB Transfer Contact	V.P. of Health Plan Operations		Ward	Lindsay		7249723130				7133386487	lindsay.ward@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Financial Audit Contact	Director of Finance	Mr.	Powell	John		7139060870					john.powell@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/25/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Financial Reporting Contact	Director of Finance		Powell	John		7139060870					john.powell@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/25/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Formulary Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/24/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	General Contact	Chief Executive Officer		Hurt	Jay		7135972523	1107				Jay.Hurt2@memorialhermann.org	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Government Relations Contact	Chief Executive Officer		Hurt	Jay		7135972523	1107				Jay.Hurt2@memorialhermann.org	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	HIPAA Privacy Officer	Chief Privacy Officer & Associate General Counsel		Allen	Monique		7133385983					monique.allen@memorialhermann.org	929 Gessner		Houston	TX	77024	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	HIPAA Security Officer	Chief Privacy Officer & Associate General Counsel		Allen	Monique		7133385983					monique.allen@memorialhermann.org	929 Gessner		Houston	TX	77024	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Hospice Contact	VP of Health Services	Ms.	Surber	Melanie		4028700920					melanie.surber@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Interoperability Contact	Compliance Officer		Clark	Robert		7133386429					robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77079	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	MA Appeals/Grievances Contact	Manager of A&G		Reuter	Megan		7134243144	1026				megan.reuter@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	MA Claims Processing Contact for Public Website	V.P. of Health Plan Operations		Ward	Lindsay		7249723130					lindsay.ward@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Marketing Contact	VP, Marketing & Brand		Dutka	Pete		6152182867					pete.dutka@apex4health.com	24 Greenway Plaza	1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Medical Director	Chief Medical Officer		Bates, MD	Karmen		7135972523					karmen.bates@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Medicare Compliance Officer	Compliance Officer	Mr.	Clark	Robert		7133386429					robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77079	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Medicare Coordinator	CEO		Hurt	Jay		7135972523	1107				Jay.Hurt2@memorialhermann.org	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Medicare Part D Opioid Overutilization Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Medication Therapy Management Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	OffShore Subcontractor Contact	V.P. of Health Plan Operations		Ward	Lindsay		7249723130					Lindsay.ward@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Online Enrollment Center Contact (Back-up)	Manager, Eligibility & Enrollment		Smith	Noel		1713597252					noel.smith@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	10/01/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Online Enrollment Center Contact (Optional)	Compliance Officer		Clark	Robert		7133386429					Robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77079	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Online Enrollment Center Contact (Primary)	VP, Marketing & Brand		Dutka	Pete		6152182867					pete.dutka@apex4health.com	24 Greenway Plaza	1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part C Application Contact	Compliance Officer		Clark	Robert		7133386429					robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77024	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part C Reporting Contact	Compliance Officer		Clark	Robert		7133386429					Robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77024	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Appeals	Manager, Medicare Utilization Management		Popwell	Chris							pacc_support@cap-rx.com	Capital Rx, Attn: Appeals Department	9450 SW Gemini Dr., #87234	Beaverton	OR	97008	09/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	8888322779				HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Appeals Contact (Secondary)	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W						Hector.Ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	7134876952				HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Application Contact	CFO		Lenhart	Kurt		9374780674					kurt.lenhart@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Benefits Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876592					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Claims Submission Contact	Sr Product Manager		Brockner	Jeff		3015036508					governmentprograms@cap-rx.com	Capital Rx	228 Park Avenue South Suite 87234	New York	NY	10003	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Exceptions Contact	Manager, Medicare Utilization Management		Popwell	Chris							pacc_support@cap-rx.com	Capital Rx, Attn: Appeals Department	9450 SW Gemini Dr., #87234	Beaverton	OR	97008	09/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	8888322779				HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Exceptions Contact (Secondary)	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W						Hector.Ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	7134876952				HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Price File Contact (Back-up)	Manager, Government Programs Operations		Bogenrief	Amy		8019101994					governmentprograms@cap-rx.com	Capital Rx	228 Park Avenue South Suite 87234	New York	NY	10003	06/17/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Price File Contact (Optional)	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Price File Contact (Primary)	Sr Manager, Government Programs Operations		Todd	Beth		6154231269					governmentprograms@cap-rx.com	Capital Rx	228 Park Avenue South Suite 87234	New York	NY	10003	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Quality Assurance Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Part D Reporting Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Patient Safety Contact	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Payment Contact	Director of Finance		Powell	John		7139060870					John.Powell@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/25/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Pharmacy Director	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					hector.ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Pharmacy Network Management Contact	VP, Provider Relations		Ortiz	Kasi		8884342619					network@cap-rx.com	Capital Rx	228 Park Avenue South Suite 87234	New York	NY	10003	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Pharmacy Network Management Contact (Secondary)	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					Hector.Ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Pharmacy Technical Help Desk Contact	Sr Director, Customer Care Operations		Ellerhorst	Lisa							lellerhorst@cap-rx.com	Capital Rx	228 Park Avenue South Suite 87234	New York	NY	10003	05/29/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	8882277940				HMO - Health Maintenance Organization		C	Seattle
H7115	Pharmacy Technical Help Desk Contact (Secondary)	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W						Hector.Ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	05/29/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active	3463724106				HMO - Health Maintenance Organization		C	Seattle
H7115	Physician Incentive Contact	CEO		Hurt	Jay		7135972523	1107				Jay.Hurt2@memorialhermann.org	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Plan Directory Contact for Public Website	Chief Executive Officer		Hurt	Jay		7135972523	1107				Jay.Hurt2@memorialhermann.org	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Plan to Plan Reconciliation Contact	Director, Finance		Powell	John		7139060870					john.powell@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/25/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Processor Contact	V.P. of Health Plan Operations		Ward	Lindsay		7249723130					lindsay.ward@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/25/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Quality Contact	VP, Value Base Care Operations		Columbus	Jessica		2816179929					jessica.columbus@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/29/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Reconciliation Contact	SVP Chief Accounting Officer		DeMoya	Cindy		7133384314					cindy.demoya@memorialhermann.org	929 Gessner Suite 1500		Houston	TX	77024	03/17/2020	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Reconciliation Contact (Secondary)	Director Financial Services		Powell	John		7139060870					john.powell@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/25/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Recovery Audit Contact	Chief Financial Officer	Mr.	Lenhart	Kurt		9374780674					Kurt.Lenhart@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/27/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	SNP Application Contact	VP Health Services		Surber	Melanie		4028700920					melanie.surber@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	SNP State Contact	Director	Ms.	McClure	Joi		7133386322					joi.mcclure@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	09/22/2023	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Surveillance Contact	Compliance Officer		Clark	Robert		7133386429					robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77079	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	System Contact	Manager, Business Solutions		Perez	Michael		7133384206					R.Michael.Perez@memorialhermann.org	929 Gessner #1500		Houston	TX	77024	07/05/2019	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Third Party Administrator (TPA) Liaison	VP, Pharmacy Operations		Ramirez, PharmD	Hector	W	7134876952					Hector.Ramirez@apex4health.com	24 Greenway Plaza, Suite 1150		Houston	TX	77046	12/16/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	User Access Contact	Compliance Officer		Clark	Robert		7133386429					Robert.clark@memorialhermann.org	929 Gessner, Suite 2500		Houston	TX	77079	01/02/2025	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Utilization Management Contact	VP of Health Services		Surber	Melanie		4028700920					melanie.surber@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77046	02/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7115	Utilization Review Contact	VP of Health Services		Surber	Melanie		4028700920					melanie.surber@apex4health.com	24 Greenway Plaza	Suite 1150	Houston	TX	77024	02/13/2024	2026	MEMORIAL HERMANN HEALTH PLAN	Local CCP	Memorial Hermann Health Plan	HMO/HMOPOS		Memorial Hermann Health System	578	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H7120	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.com	4500 Fort Jackson Blvd, Suite 140		Columbia	SC	29209	11/30/2025	2026	SENIOR LIFE SAN DIEGO,  INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H7120	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.com	4500 Fort Jackson Blvd, Suite 140		Columbia	SC	29209	11/30/2025	2026	SENIOR LIFE SAN DIEGO,  INC.	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H7123	Agent/Broker Compensation Data Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Backup User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		8006068648					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/17/2023	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Bid Audit Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Bid Audit Site Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Bid Primary Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	CAP Report Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	CEO - CMS Administrator Contact	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	CEO - Senior Official for Contracting	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		4124545559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Chief Operating Officer	Chief Operating Officer	Ms.	Jenkins	Mary Beth	L	4124547764					jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Chief Information Officer	Chief Information Officer	Mr	McCallister	Ed		4124547711					mccallisterew@upmc.edu	600 Grant St, 60th Floor		Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Chief Information Security Officer	VP, ISD	Mr	Haas	Scott		4124546162					haassm@upmc.edu	600 Grant St., 55th Floor		Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Complaints Tracking Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Contact for Fraud Investigations	Sr. Director Fraud & Abuse		Workman	Craig		4124545524					workmanc@upmc.edu	USX Tower, 47th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Corporate Mailing						4124547500					upmchp@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		8006068648					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/17/2023	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	DIR Contact	Director, Pharmacy Finance		Bovier	Jacqueline		4124547584					bovierjd@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	DIR Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Discount Program Payment Contact	Business Analyst III		Michalski	Jeff		4124545715				4124542110	michalskij@upmc.edu	USX Tower, 21st Floor	600 Grant Street	Pittsburgh	PA	15219	11/18/2024	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Emergency Part D Contact	Vice President, Customer Engagement & Enrollment		Palmerine	Anne		4129777828					palmerineac3@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Emergency Part D Contact (Secondary)	AVP, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	600 Grant Street		Pittsburgh	PA	15219	12/27/2023	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Encounter Data & Risk Adjustment Operations Contact	Director, Government Revenue		Plank	Tim		4124547747					planktm@upmc.edu	USX Tower, 36th Floor	600 Grant Street	Pittsburgh	PA	15219	10/28/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Enrollment Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	EOB Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Financial Audit Contact	Sr. Director, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Financial Reporting Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Formulary Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Formulary Contact (Secondary)	Manager, Clinical Pharmacy Medicare	Ms.	Ryan	Maggie		4124547086					ryanm7@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	05/13/2025	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	General Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	HIPAA Security Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		4124548589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Interoperability Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	02/16/2022	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	MA Appeals/Grievances Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	MA Claims Processing Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Marketing Contact	Director, Medicare Marketing		McVey	Alicia		4124545525					mcveyal@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Medical Director	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Medicare Coordinator	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Medicare Part D Opioid Overutilization Contact	Sr. Manager, Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Medication Therapy Management Contact	Sr. Manager Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Online Enrollment Center Contact (Back-up)	Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Online Enrollment Center Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Online Enrollment Center Contact (Primary)	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part C Application Contact	Project Manager	Mr.	Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part C Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Appeals	Manager, C&G		Richards	Rebecca						4124547920	richardsr3@upmc.edu	USX Tower, 42nd Floor	600 Grant Street	Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	4124540116				HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Appeals Contact (Secondary)	Manager, Pharmacy Compliance		Chaussinand	Matt							chaussinand@upmc.edu	600 Grant St., USX, 12th Floor		Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	4124545914				HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Benefits Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Claims Submission Contact	Director, Product Management		Etherton	Jim		5133163889					jbetherton@express-scripts.com	8990 Duke Drive		Mason	OH	45040	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	8003964139				HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Price File Contact (Back-up)	Sr. Manager, Government Programs		Dolfi	Amanda		6147613606					medicarewebsitefiles@express-scripts.com	USX Tower, 9th Floor	5151 Blazer Pkwy	Dublin	OH	43017	01/18/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Price File Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Price File Contact (Primary)	Director, Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107 St. #11202		Overland	KS	66207	07/28/2020	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Quality Assurance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Part D Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Patient Safety Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Payment Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Personal Health Record Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/18/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Pharmacy Director	Sr. Director, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	600 Grant Street		Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
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	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Dallas
H7123	PHR Beneficiary Contact																	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS	MyHealth	UPMC Health System	249	Yes	Active	4128032065				HMO - Health Maintenance Organization		C	Dallas
H7123	Physician Incentive Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Plan Directory Contact for Public Website			Marketing	Medicare		8773813765					upmchp@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Plan to Plan Reconciliation Contact	Business Analyst II		Michalski	Jeff		4124545715				4124542110	medicarereporting@upmc.edu	US Steel Tower, 600 Grant Street, 9th Floor	c/o UPMC Health Plan Attn: Aunika Hall P2P - 09-257	Pittsburgh	PA	15219	03/17/2025	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Processor Contact	Sr Director - Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Quality Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Reconciliation Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Reconciliation Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Recovery Audit Contact	Sr. Director, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	SNP Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	SNP State Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Surveillance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	System Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Third Party Administrator (TPA) Liaison	Business Analyst III		Michalski	Jeff		4124545715				4124542110	medicarereporting@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	11/18/2024	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Utilization Management Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7123	Utilization Review Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	01/16/2019	2026	UPMC HEALTH COVERAGE, INC.	Local CCP	UPMC for Life Complete Care	HMO/HMOPOS		UPMC Health System	249	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H7147	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H7147	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H7147	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H7147	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H7147	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H7147	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H7147	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF COLORADO INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H7147	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/30/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H7149	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	SNP State Contact	Executive Director, National Duals Program		Hughes	Angelique		2482700990					hughesa1@aetna.com	2 Town Square, Suite 275		Southfield	MI	48076	12/09/2025	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7149	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH INC. (PA)	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7151	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H7151	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H7151	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H7151	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H7151	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H7151	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H7151	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H7151	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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
H7195	Automated TrOOP Balance Transfer Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Backup User Access Contact	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	04/25/2017	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Best Available Evidence Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Bid Primary Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	CAP Report Contact for Public Website	CEO	Mrs.	Grimm	Lynn	M	7012500709	102			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	CEO - CMS Administrator Contact	CEO	Mrs.	Grimm	Lynn	M	7012500709	102			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	CEO - Senior Official for Contracting	CEO	Mrs.	Grimm	Lynn	M	7012500709	102			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Chief Financial Officer	CEO	Mrs.	Grimm	Lynn	M	7012500709	102			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Chief Operating Officer	Director of PACE Operations	Mrs.	Becker	Patricia	D	7012500709	222			7012500739	pbecker@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/09/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Chief Information Officer	Systems Security Officer	Mr.	Vasicek	Jeff		7012500709	114			7012500709	jvasicek@northlandhealth.com	2223 East Rosser		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Chief Information Security Officer	Systems Security Officer	Mr.	Vasicek	Jeff		7012500709	114			7012500709	jvasicek@northlandhealth.com	2223 East Rosser		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	CMS Casework Communication Contact	CEO	Mrs.	Grimm	Lynn	M	7012500709	102			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Complaints Tracking Contact	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Contact for Fraud Investigations	Compliance Officer	Mrs.	Harrison	Marlys		7017513050	103			7012500739	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Coordination of Benefits Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Corporate Mailing						7012500709				7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Customer Service Operations Contact	Director of PACE Operations	Mrs.	Becker	Patricia	D	7012500709	222			7012500739	pbecker@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/09/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	DIR Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	DIR Contact (Secondary)	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Discount Program Payment Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Emergency Part D Contact	Compliance Officer	Mrs.	Harrison	Marlys		7017513050	121			7012500739	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	12/21/2023	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Emergency Part D Contact (Secondary)	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	12/14/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Encounter Data & Risk Adjustment Operations Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Enrollment Contact	Outreach Coordinator/Enrollment Lead	Mrs.	Tisor	Garnet		7014567387				7014567389	gtisor@northlandhealth.com	830 2nd Ave E., Suite 212		Dickinson	ND	58601	10/21/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	EOB Transfer Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Financial Audit Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Financial Reporting Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Formulary Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Formulary Contact (Secondary)	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	General Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Government Relations Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	HIPAA Privacy Officer	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	HIPAA Security Officer	Systems Security Officer	Mr.	Vasicek	Jeff		7012500709	114			7012500739	jvasicek@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Interoperability Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	04/19/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	MA Appeals/Grievances Contact	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	MA Claims Processing Contact for Public Website	Outreach Coordinator/Enrollment Lead	Mrs.	Tisor	Garnet		7014567387				7014567389	gtisor@northlandhealth.com	830 2nd Ave E., Suite 212		Dickinson	ND	58601	10/21/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Marketing Contact	Outreach Coordinator/Enrollment Lead	Mrs.	Tisor	Garnet		7014567387				7014567389	gtisor@northlandhealth.com	830 2nd Ave E., Suite 212		Dickinson	ND	58601	10/21/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Medical Director	Medical Director	Dr.	Datz	Kurt		7012500709					kdatz@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Medicare Compliance Officer	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Medicare Coordinator	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Datz	Kurt		7012500709					kdatz@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	04/19/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Medication Therapy Management Contact	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Online Enrollment Center Contact (Primary)	Outreach Coordinator/Enrollment Lead	Mrs.	Tisor	Garnet		7014567387				7014567389	gtisor@northlandhealth.com	830 2nd Ave E., Suite 212		Dickinson	ND	58601	10/21/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part C Application Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part D Appeals	Compliance Officer	Mrs.	Harrison	Marlys						7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	8888838959	121			PACE - Nat		C	New York
H7195	Part D Appeals Contact (Secondary)	CEO	Mrs.	Grimm	Lynn	M					7017513053	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	04/23/2025	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	8888838959	102			PACE - Nat		C	New York
H7195	Part D Application Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part D Benefits Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part D Claims Submission Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part D Exceptions Contact	Compliance Manager	Mrs.	Harrison	Marlys						7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	8888838959	121			PACE - Nat		C	New York
H7195	Part D Exceptions Contact (Secondary)	CEO	Mrs.	Grimm	Lynn	M					7017513053	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58503	04/23/2025	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	8888838959	102			PACE - Nat		C	New York
H7195	Part D Price File Contact (Back-up)	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part D Price File Contact (Primary)	CEO	Mrs.	Grimm	Lynn	M	7012500709					lgrimm@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part D Quality Assurance Contact	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Part D Reporting Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Patient Safety Contact	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Payment Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Personal Health Record Contact	Director of PACE Operations	Mrs.	Becker	Patricia	D	7012500709	222			7012500739	pbecker@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/09/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Pharmacy Director	Medical Director	Dr.	Datz	Kurt		7012500709					kdatz@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Pharmacy Network Management Contact	Compliance Manager	Mrs.	Harrison	Marlys		7017513050	121			7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Pharmacy Network Management Contact (Secondary)	CEO	Mrs.	Grimm	Lynn	M	7017513050	102			7017513053	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58503	04/23/2025	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Pharmacy Technical Help Desk Contact	Compliance Manager	Mrs.	Harrison	Marlys						7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/03/2016	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	8888838959	121			PACE - Nat		C	New York
H7195	Pharmacy Technical Help Desk Contact (Secondary)	Compliance Manager	Mrs.	Harrison	Marlys						7017513053	mharrison@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active	8888838959	121			PACE - Nat		C	New York
H7195	PHR Beneficiary Contact																	01/07/2014	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE	Northland PACE Senior Care Services	Northland Healthcare Alliance	369	Yes	Active	8888838959				PACE - Nat		C	New York
H7195	Plan Directory Contact for Public Website	Outreach Coordinator/Enrollment Lead	Mrs.	Tisor	Garnet		7014567387				7014567389	gtisor@northlandhealth.com	830 2nd Ave E., Suite 212		Dickinson	ND	58601	10/21/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Plan to Plan Reconciliation Contact	CEO	Mrs.	Grimm	Lynn	M	7012500709					lgrimm@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Processor Contact	CEO	Mrs.	Grimm	Lynn	M	7012500709					lgrimm@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Quality Contact	Clinical Services Director	Mrs.	Sunwall	Laken		7012500709					lsunwall@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	05/09/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Reconciliation Contact	CEO	Mrs.	Grimm	Lynn	M	7012500709					lgrimm@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Recovery Audit Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Surveillance Contact	Systems Security Officer	Mr.	Vasicek	Jeff		7012500709	114			7012500709	jvasicek@northlandhealth.com	2223 East Rosser		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	System Contact	Systems Security Officer	Mr.	Vasicek	Jeff		7012500709	114			7012500709	jvasicek@northlandhealth.com	2223 East Rosser		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Third Party Administrator (TPA) Liaison	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	User Access Contact	CEO	Mrs.	Grimm	Lynn	M	7012500709					lgrimm@northlandhealth.com	2223 East Rosser Ave.		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Utilization Management Contact	Director of PACE Operations	Mrs.	Becker	Patricia	D	7012500709	222			7012500739	pbecker@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	05/09/2024	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7195	Utilization Review Contact	CEO	Mrs.	Grimm	Lynn		7012500709	103			7012500739	lgrimm@northlandhealth.com	2223 East Rosser Avenue		Bismarck	ND	58501	02/16/2022	2026	NORTHLAND PACE PROGRAM	National PACE	Northland PACE Senior Care Services	National PACE		Northland Healthcare Alliance	369	Yes	Active					PACE - Nat		C	New York
H7199	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H7199	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H7199	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H7199	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H7199	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H7199	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H7199	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H7199	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7199	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH  PLAN OF OREGON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H7220	Agent/Broker Compensation Data Contact	Director, Medicare Risk		Rau	Todd		3179632590				3179639800	trau@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Automated TrOOP Balance Transfer Contact	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Backup User Access Contact	Manager, Information Systems		Smith	Rachel		3174329357					rsmith55@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Best Available Evidence Contact	Member Services Director		Barrow	Nina		3179632591					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Bid Audit Site Contact	Compliance Program Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Bid Primary Contact	Product Manager, Innovation		Alexander	Kate		3179628719					kalexander5@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	CAP Report Contact for Public Website	Vice President of Legal and Compliance	Ms.	Korty	Tina		3179637830				3179639800	tkorty@iuhealth.org	950 N. Meridian S	Suite 400	Indianapolis	IN	46204	12/21/2021	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Chief Operating Officer	SVP & COO GBD	Mr.	Robert	Galle		8607193870					robert.galle@elevancehealth.com	108 Leigus Rd		Wallingford	CT	06492	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Chief Information Officer	Vice president & CIO GBD	Mr.	Brock	Jack		9728358900					jack.brock@anthem.com	1300 Amerigroup Way		Virginia Beach	VA	23464	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Chief Information Security Officer	Vice president & CIO GBD	Mr	Brock	Jack		9728358900					jack.brock@anthem.com	1300 Amerigroup Way		Virginia Beach	VA	23464	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	CMMI Model Point of Contact	Compliance Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St, 4th floor		Indianapolis	IN	46204	04/29/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	CMS Casework Communication Contact	Compliance Consultant Sr.		Roach	Denise		4633203502					dbogardus@iuhealth.org	220 Virginia Ave		Indianapolis	IN	46204	05/14/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Complaints Tracking Contact	Compliance Consultant Sr.		Roach	Denise		4633203502					dbogardus@iuhealth.org	220 Virginia Ave		Indianapolis	IN	46204	05/14/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Contact for Fraud Investigations	Compliance Officer		Korty	Tina		3173195701					tkorty@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/21/2021	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Coordination of Benefits Contact	Member Services Director		Barrow	Nina		3179622591					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Corporate Mailing						3179639797				3179639800	tkorty@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Customer Service Operations Contact	Member Services Director		Barrow	Nina		3179622591					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	08/25/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	DIR Contact (Secondary)	Executive Director - Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Discount Program Payment Contact	Finance Manager		Manship	Lisa		3179628898					lmanship1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	05/17/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Electronic Health Record Contact	Compliance Consultant Sr.		Roach	Denise		4633203502					dbogardus@iuhealth.org	220 Virginia Ave		Indianapolis	IN	46204	05/14/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	08/25/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Emergency Part D Contact (Secondary)	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	08/25/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Encounter Data & Risk Adjustment Operations Contact	Manager - Data Science and Clinical Insights		Nagle	Ken		5166397922					knagle1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	01/17/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	10/15/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	EOB Transfer Contact	Director - Claims Operations		Knotts	Dustin		3179632579				3179681233	dknotts@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Financial Audit Contact	Compliance Manager	Ms	Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	02/15/2023	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Financial Reporting Contact	Finance Manager		Manship	Lisa		3179628998					lmanship1@iuhealth.org	950 N Meridian St, 4th Floor	Suite 400	INDIANAPOLIS, IN	IN	46204	01/22/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Formulary Contact	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Formulary Contact (Secondary)			Etmoed	Lora		5718954913					lertmoed@evolenthealth.com	800 N Glebe Rd	Suite 500	Arlington	VA	22203	05/31/2023	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	General Contact	Compliance Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St, 4th floor	Suite 400	Indianapolis	IN	46204	04/29/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	HIPAA Security Officer	VP and Chief Information Security Officer	Mr.	Wilcox	Dustin		4632245212					dustin.wilcox@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Hospice Contact	Compliance Consultant		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St, 4th floor		Indianapolis	IN	46204	04/29/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Interoperability Contact	IS Director		Smith	Rachel		3174329357					rsmith55@iuhealth.org	950 N Meridian St, 4th Floor		INDIANAPOLIS, IN	IN	46204	05/31/2023	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	MA Appeals/Grievances Contact	Supervisor, Customer Solutions		Watson	Deborah		3179639785					dwatson3@iuhealth.org	950 N Meridian St	Suite 200	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	MA Claims Processing Contact for Public Website	Director - Claims Operations		Knotts	Dustin		3179632579				3179681233	dknotts@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	08/20/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Medical Director	Medical Director	Dr.	Bernhardt	Richard		3179639700					rbernhar@iuhealth.org	950 N Meridian St, Suite 600		Indianapolis	IN	46204	08/22/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	10/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Medicare Coordinator	Product Manager, Innovation		Alexander	Kate		3179628719					kalexander5@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Medicare Part D Opioid Overutilization Contact			Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	05/29/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	OffShore Subcontractor Contact	Compliance Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Online Enrollment Center Contact (Back-up)	Enrollment & Billing Manager		Porter	Asha		3179639801					aporter1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Online Enrollment Center Contact (Optional)	Member Services Director		Barrow	Nina		3179632591					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46208	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	10/15/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part C Application Contact	Product Manager, Innovation		Alexander	Kate		3179628719					kalexander5@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/22/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part C Reporting Contact	Compliance Consultant Sr.		Roach	Denise		4633203502					dbogardus@iuhealth.org	220 Virginia Ave		Indianapolis	IN	46204	05/14/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Appeals	Senior Director, Pharmacy Operations		Jones	Jessica							jjones@evolent.com	1812 N Moore Street	Suite 1705	Arlington	VA	22209	08/28/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5713853702				HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Appeals Contact (Secondary)			Johnson	H Chris							hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5713853711				HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Application Contact	Product Manager, Innovation		Alexander	Kate		3179628719					kalexander5@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/22/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Benefits Contact	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Claims Submission Contact	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Exceptions Contact	Senior Director, Pharmacy Operations		Jones	Jessica							jjones@evolent.com	1812 N Moore Street	Suite 1705	Arlington	VA	22209	08/28/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5713853702				HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Exceptions Contact (Secondary)			Johnson	H. Chris							hjohnson10@iuhealth.org	950 North Meridian St.	Suite 600	Indianapolis	IN	46204	08/28/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5713853711				HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Price File Contact (Back-up)	Compliance Program Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/25/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Price File Contact (Optional)	Compliance Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St, 4th floor		Indianapolis	IN	46204	04/29/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Price File Contact (Primary)	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Quality Assurance Contact	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Part D Reporting Contact	Compliance Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St, 4th floor		Indianapolis	IN	46204	04/29/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Patient Safety Contact	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Payment Contact	Manager - Financial Reporting & Budgeting		Manship	Lisa		3179628898				3179639800	lmanship1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	03/08/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Personal Health Record Contact	Customer Service Director		Barrow	Nina		3179622591					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	01/22/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Pharmacy Director	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Pharmacy Network Management Contact	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Pharmacy Network Management Contact (Secondary)	Compliance Program Manager		Chadd	Tammy		3179631915					tchadd@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/25/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Pharmacy Technical Help Desk Contact			Johnson	H. Chris							hjohnson10@iuhealth.org	950 North Meridian St.	Suite 600	Indianapolis	IN	46204	08/28/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8662825802				HMO - Health Maintenance Organization		C	Chicago
H7220	PHR Beneficiary Contact																	11/05/2019	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS	Indiana University Health Plans	Elevance Health, Inc.	1	Yes	Active	3179639748				HMO - Health Maintenance Organization		C	Chicago
H7220	Physician Incentive Contact	Director - Claims Operations		Knotts	Dustin		3179632579					dknotts@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	06/10/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Plan Directory Contact for Public Website	Member Services Director		Barrow	Nina		8004559776					nbarrow1@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	10/27/2021	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Plan to Plan Reconciliation Contact	Pharmacy Director		Johnson	H Chris		3179634844				3179639800	hjohnson10@iuhealth.org	950 N Meridian St, 4th Floor	Suite 400	INDIANAPOLIS, IN	IN	46204	01/22/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Processor Contact	Director - Claims Operations		Knotts	Dustin		3179632579				3179681233	dknotts@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	08/21/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Reconciliation Contact	Financial Services Manager		Manship	Lisa		3179628998					lmanship1@iuhealth.org	950 N Meridian St, 4th Floor	Suite 400	INDIANAPOLIS, IN	IN	46204	01/22/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Reconciliation Contact (Secondary)	Executive Director - Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	08/25/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Recovery Audit Contact	Compliance Consultant	Ms	Chadd	Tammy		3179631915				3179639800	tchadd@iuhealth.org	950 N Meridian St, 4th floor	Suite 400	Indianapolis	IN	46204	02/15/2023	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	SNP Application Contact			Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox Run Lane		Princeton	WI	54968	02/10/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	SNP State Contact			Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/10/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Surveillance Contact	Compliance Officer		Korty	Tina		3173195701					tkorty@iuhealth.org	950 N Meridian St	Ste 400	Indianapolis	IN	46204	05/31/2023	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	System Contact	Compliance Officer		Korty	Tina		3179637830					tkorty@iuhealth.org	950 N Meridian St	Suite 400	Indianapolis	IN	46204	01/16/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Third Party Administrator (TPA) Liaison	Executive Director -Pharmacy		Johnson	H Chris		3179634844					hjohnson10@iuhealth.org	950 N Meridian St	Suite 600	Indianapolis	IN	46204	12/14/2020	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	User Access Contact	Information Security Sr Advisor		Naffziger	Joan		3173453075					jnaffzig@iuhealth.org	200 Virginia Ave		Indianapolis	IN	46204	04/28/2025	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Utilization Management Contact	Utilization Management		Hartigan	Melissa		3174432438				3179639802	mhartigan@evolenthealth.com	950 N Meridian St	Suite 600	Indianapolis	IN	46204	05/26/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7220	Utilization Review Contact	Utilization Management		Hartigan	Melissa		3174432438				3179639802	mhartigan@evolenthealth.com	950 N Meridian St	Suite 600	Indianapolis	IN	46204	05/26/2022	2026	HealthKeepers, Inc.	Local CCP	Anthem HealthKeepers	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H7233	Automated TrOOP Balance Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Backup User Access Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Best Available Evidence Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	CAP Report Contact for Public Website	Executive Director	Ms	Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	CEO - CMS Administrator Contact	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	CEO - Senior Official for Contracting	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	PSoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Chief Financial Officer	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Chief Operating Officer	Executive Director	Ms	Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Chief Information Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Chief Information Security Officer	CITO	Mr	Osborne	David		9529834258					dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	CMS Casework Communication Contact	Quality Manager		Jackman	Joylyn		2406036010					jjackman@voa.org	831 Brightseat Rd		Hyattsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Complaints Tracking Contact	Quality Manager		Jackman	Joylyn		2406036010					jjackman@voa.org	831 Brightseat Rd		Hyattsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Contact for Fraud Investigations	Quality Manager		Jackman	Joylyn		2406036010					jjackman@voa.org	831 Brightseat Rd		Hyatsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Coordination of Benefits Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Customer Service Operations Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	DIR Contact (Secondary)	Director of Health Plan Operations		Gallagher	Tierney		9705950523				9708295842	tgallagher@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Discount Program Payment Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Emergency Part D Contact (Secondary)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Enrollment Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	General Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Government Relations Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	HIPAA Privacy Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	HIPAA Security Officer	CITO		Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	MA Appeals/Grievances Contact	Quality Manager		Jackman	Joylyn		2406036010					jjackman@voa.org	831 Brightseat Rd		Hyattsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	MA Claims Processing Contact for Public Website	Claims Administrator	Ms	Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Marketing Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	831 Brightseat Rd		Hyattsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Medical Director	Medical Director	Dr.	Arrendell	Crystal		7038556263					carrendell@voa.org	831 Brightseat Rd		Hyattsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Medicare Compliance Officer	Director of Quality	Ms	Peterson	Nora		9709643500				9705250166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Medicare Coordinator	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Medicare Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	11/15/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Medication Therapy Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part C Application Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part D Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H7233	Part D Application Contact	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part D Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part D Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part D Exceptions Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H7233	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H7233	Part D Price File Contact (Back-up)	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part D Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part D Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Part D Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Patient Safety Contact	Quality Manager		Jackman	Joylyn		2406036010					jjackman@voa.org	831 Brightseat Rd		Hyattsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Payment Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Personal Health Record Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Pharmacy Director	Vice President, Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Pharmacy Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Pharmacy Technical Help Desk Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H7233	Plan Directory Contact for Public Website	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Processor Contact	Claims Administrator		Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Quality Contact	Quality Manager		Jackman	Joylyn		2406036010					jjackman@voa.org	831 Brightseat Rd		Hyattsville	MD	20785	04/15/2025	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9709643500				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations		Nilsen	Eric		6124257858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/24/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Surveillance Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	System Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Third Party Administrator (TPA) Liaison	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	User Access Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Utilization Management Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7233	Utilization Review Contact	Executive Director		Fields	Kelly		3016733335				3016733336	kfields@voa.org	801 Brightseat Road, Suite 831		Hyattsville	MD	20785	10/28/2024	2026	VOANS SENIOR COMMUNITY CARE OF MARYLAND	National PACE	Senior CommUnity Care of Maryland	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7239	Agent/Broker Compensation Data Contact	Vice President of Medicare Sales	Mr.	Tolle	Rob		4699997675					Rob.Tolle@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Manosca	Nova		8587905873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Backup User Access Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Best Available Evidence Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Bid Audit Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Bid Audit Site Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Bid Primary Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	CAP Report Contact for Public Website	VP, Compliance & Risk Management		von Arx	Michael	A	7757709348					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	7757709348				HMO - Health Maintenance Organization		C	Boston
H7239	CEO - CMS Administrator Contact	CEO	Mr	Jemmoua	Kamal		7757709325					kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	CEO - Senior Official for Contracting	CEO	Mr.	Jemmoua	Kamal		7757709325					kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Chief Financial Officer	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Chief Operating Officer	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Chief Information Officer		Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Chief Information Security Officer	CISO - UHS	Mrs.	Sassaman	Kim		6103824858					kim.sassaman@uhsinc.com	367 S Gulph RD		King of Prussia	PA	19406	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	CMMI Model Point of Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	CMS Casework Communication Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Complaints Tracking Contact	Director of Operations		Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Contact for Fraud Investigations	SIU Investigator	Mrs.	Kast	Shannon		7754204840					Shannon.Kast@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Coordination of Benefits Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Corporate Mailing						7757709245					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Customer Service Operations Contact	Chief Operating Officer		Koltz	Patrick		7757709240					patrick.koltz@uhsinc.com	1510 Meadow Wood Ln		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	DIR Contact	CEO	Mr	Jemmoua	Kamal		6109924579				7757709360	kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	DIR Contact (Secondary)	Director Pharmacy	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Discount Program Payment Contact	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89052	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Electronic Health Record Contact	Director Health Services		Estipona	Steve		7757709462					steve.estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Emergency Part D Contact	Director Pharmacy	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Emergency Part D Contact (Secondary)	Pharmacy Liaison - Compliance		Harvey	Jonathan		7242945245					jonathan.harvey@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Employer Waiver Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Encounter Data & Risk Adjustment Operations Contact	Director of Quality Improvement		Martinez	Johanna		7757709524					johanna.martinez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Enrollment Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	EOB Transfer Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240				9999999999	Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Financial Audit Contact	Compliance Analyst	Mrs	Cortez	Adrienne		7757709300					phpregulatory@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Financial Reporting Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Formulary Contact	Sup Formulary Operations		Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Formulary Contact (Secondary)	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	General Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Government Relations Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	HIPAA Privacy Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	HIPAA Security Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Hospice Contact	Health Services Director		Estipona	Steve		7757709462					Steve.Estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Interoperability Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	MA Appeals/Grievances Contact	Director of Operations		Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	MA Claims Processing Contact for Public Website	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Marketing Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Medical Director	Chief Medical Director	Dr.	Biondi	Traci		7757701510					traci.biondi@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Medicare Compliance Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Medicare Coordinator	Compliance Analyst	Mrs.	Cortez	Adrienne		7757709300					PHPCompliance@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Medicare Part D Opioid Overutilization Contact	Audit Team		Audit Team	FA Part D		8587905846					FA_Part_D_Audit@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/03/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Medication Therapy Management Contact	Clinical Solutions Mgr II		Nguyen	Linh		8587906627					MTMP@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	OffShore Subcontractor Contact	VP Compliance and Risk Management	Mr.	von Arx	Michael		7757709245					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Online Enrollment Center Contact (Back-up)	Director of Medicare Sales	Ms.	Saintil	Adrienne		7757701564					Adrienne.Saintil@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Online Enrollment Center Contact (Optional)	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Online Enrollment Center Contact (Primary)	Vice President of Medicare Sales	Mr.	Tolle	Rob		4699997675					Rob.Tolle@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part C Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part C Reporting Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part D Appeals	Part D Appeals 1		and Grievances Team	Appeals							appealgrievancesmanagement@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587906584				HMO - Health Maintenance Organization		C	Boston
H7239	Part D Appeals Contact (Secondary)	Part D Appeals 2		Redd Guinto	Karen							karen.reddguinto@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587906584				HMO - Health Maintenance Organization		C	Boston
H7239	Part D Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part D Benefits Contact	Director of Pharmacy		Huang	David		3177528432					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part D Claims Submission Contact	Supervisor, GPS Operations		Distel	Chris		3302127994					PDE@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part D Exceptions Contact	Director Prior Authorization and Utilization Mgmt		Emoto	Junianne							Julianne.Emoto@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Boston
H7239	Part D Exceptions Contact (Secondary)	Pharmacist in Charge		deGuzman	Edwin							Edwin.deGuzman@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8582915494				HMO - Health Maintenance Organization		C	Boston
H7239	Part D Price File Contact (Back-up)	Medicare Part D Program MGR I		Niemi	Kristin		8587906455					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part D Price File Contact (Primary)	Medicare Part D Program Manager II		Keller	Shannon		8587907104					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part D Quality Assurance Contact	Director Pharmacy		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Part D Reporting Contact	Medicare Part D Project Manager		Scott	Susan		8587906565					MedicarePartDProjectManagers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Patient Safety Contact	Pharmacy Director	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Ren	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Payment Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Pharmacy Director	Pharmacy Director	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Ren	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Pharmacy Network Management Contact	Supervisor, Carrier Configuration		Montes	Melissa		6195995938					Melissa.Montes@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Pharmacy Network Management Contact (Secondary)	Manager, PNS & Claims Operations		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8445877389				HMO - Health Maintenance Organization		C	Boston
H7239	Pharmacy Technical Help Desk Contact (Secondary)	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8445877389				HMO - Health Maintenance Organization		C	Boston
H7239	Physician Incentive Contact	Director of Network Management	Jr	Maronde	James		7757709300					james.marondejr@uhsinc.com	639 Isbell Road Ste. 400		Reno	NV	89509	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Plan Directory Contact for Public Website	Marketing Director		Koltz	Danielle		7757709302					Danielle.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Processor Contact	Director, Medicare Programs		Davis-Jones	DeLona		8587906229					DeLona.Davis-Jones@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Quality Contact	Director of Quality Improvement		Martinez	Johanna		7757709524					johanna.martinez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Reconciliation Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Reconciliation Contact (Secondary)	Chief Finance Officer	Mr.	Hsieh	David		6103824858					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Recovery Audit Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	SNP Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	SNP State Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Surveillance Contact	Director of Operations	Ms.	Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	System Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Third Party Administrator (TPA) Liaison	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89052	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	User Access Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Utilization Management Contact	Manager, QA & Client Services		Nguyen	Quan		8587907151					Quan.nguyen@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7239	Utilization Review Contact	Dir PA Clinical Programs		McGurran	Shawn		8587906682					Shawn.McGurran@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF FLORIDA INC	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7262	Automated TrOOP Balance Transfer Contact	PACE Quality & Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Backup User Access Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Best Available Evidence Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Bid Primary Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	CAP Report Contact for Public Website	PACE Quality and Complinace Director	Ms	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active	3033059387				PACE - Nat		C	San Francisco
H7262	CEO - CMS Administrator Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	CEO - Senior Official for Contracting	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/22/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Chief Financial Officer	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/22/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Chief Operating Officer	Chief Operating Officer	Mr	Cooper	Brian		6196773820					BCooper@stpaulspace.org	328 Maple Street		San Diego	CA	92103	08/22/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Chief Information Officer	System Administrator	Mr.	Daghita	Anthony		3036645221					AnthonyDaghita@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	10/08/2024	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Chief Information Security Officer	System Administrator	Mr.	Daghita	Anthony		3036045221					AnthonyDaghita@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	10/08/2024	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	CMS Casework Communication Contact	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Complaints Tracking Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Contact for Fraud Investigations	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Coordination of Benefits Contact	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Corporate Mailing						3036045241					laurasalinas@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Customer Service Operations Contact	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/22/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	DIR Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	DIR Contact (Secondary)	Chief Executive and Financial Officer3	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Discount Program Payment Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Emergency Part D Contact	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Emergency Part D Contact (Secondary)	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Encounter Data & Risk Adjustment Operations Contact	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Enrollment Contact	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	EOB Transfer Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Financial Audit Contact	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Financial Reporting Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Formulary Contact	CMO	Dr.	Wensel	David		3039264733					DavidWensel@trucare.org	2593 Park Lane		Lafayette	CO	80026	03/12/2021	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	General Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Government Relations Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	HIPAA Privacy Officer	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	HIPAA Security Officer	System Administrator	Mr.	Daghita	Anthony		3036045221					anthonydaghita@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Interoperability Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	MA Appeals/Grievances Contact	PACE Quality/Compliance Manager	Ms.	Salinas	Laura		3034153478					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	MA Claims Processing Contact for Public Website	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Marketing Contact	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Medical Director	PACE Medical Director	Dr.	Marangola	Mary		3036650115					MaryMarangola@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Medicare Compliance Officer	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Medicare Coordinator	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Medicare Part D Opioid Overutilization Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Medication Therapy Management Contact	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part C Application Contact	Executive VP - TRU Community Care	Ms.	Black	Samantha		3036045206					SamanthaBlack@trucare.org	2594 Trailridge Dr. East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Appeals	PACE Quality/Compliance Director	Ms.	Salinas	Laura							LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active	3034153478				PACE - Nat		C	San Francisco
H7262	Part D Appeals Contact (Secondary)	PACE Executive Director	Ms.	Bowie	Heather						3034153451	HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active	8443507223				PACE - Nat		C	San Francisco
H7262	Part D Application Contact	Executive VP - TRU Community Care	Ms.	Black	Samantha		3036045206					SamanthaBlack@trucare.org	2594 Trailridge Dr. East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Benefits Contact	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Claims Submission Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478				3036045392	LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Exceptions Contact	PACE Executive Director	Ms.	Bowie	Heather							HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active	3037469368				PACE - Nat		C	San Francisco
H7262	Part D Price File Contact (Back-up)	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Price File Contact (Optional)	Chief Operating Officer	Mr.	Cooper	Brian		6196773820					BCooper@stpaulspace.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Price File Contact (Primary)	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Quality Assurance Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Part D Reporting Contact	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Patient Safety Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	04/16/2024	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Payment Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Personal Health Record Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Pharmacy Director	CMO	Dr.	Wensel	David		3039264733					DavidWensel@trucare.org	2593 Park Lane		Lafayette	CO	80026	03/12/2021	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Pharmacy Network Management Contact	CMO	Dr.	Wensel	David		3039264733					DavidWensel@trucare.org	2593 Park Lane		Lafayette	CO	80026	03/12/2021	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Pharmacy Network Management Contact (Secondary)	PACE Executive Director	Ms.	Bowie	Heather		3037469368					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Pharmacy Technical Help Desk Contact	PACE Medical Director	Ms.	Salinas	Laura							laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active	3039035388				PACE - Nat		C	San Francisco
H7262	PHR Beneficiary Contact																	06/18/2018	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE	TRU Community Care	TRU Community Care	655	Yes	Active	3036650115				PACE - Nat		C	San Francisco
H7262	Plan Directory Contact for Public Website	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Plan to Plan Reconciliation Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Processor Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Quality Contact	PACE Quality/Compliance Director	Ms.	Salinas	Laura		3034153478					LauraSalinas@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Reconciliation Contact	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Reconciliation Contact (Secondary)	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Recovery Audit Contact	Chief Executive and Financial Officer	Mr.	Vieu	George		6196213351					gvieu@triassolutions.org	328 Maple Street		San Diego	CA	92103	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Surveillance Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	System Contact	System Administrator	Mr.	Daghita	Anthony		3036045241					anthonydaghita@trucare.org	2593 Park Lane		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Third Party Administrator (TPA) Liaison	CFO	Mr.	Gresser	Scott		3036045241				3036045392	ScottGresser@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	User Access Contact	PACE Quality and Complinace Director	Ms.	Salinas	Laura		3033059387					laurasalinas@trucare.org	2594 Trailridge Drive East		Lafayette	CO	80026	08/28/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Utilization Management Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7262	Utilization Review Contact	PACE Executive Director	Ms.	Bowie	Heather		7206040674					HeatherBowie@trucare.org	2593 Park Lane		Lafayette	CO	80026	07/02/2025	2026	TRU COMMUNITY CARE	National PACE	TRU PACE	National PACE		TRU Community Care	655	Yes	Active					PACE - Nat		C	San Francisco
H7275	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Kansas City
H7275	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7275	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7284	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/14/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H7284	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024989871				PPO - BBA		C	Kansas City
H7284	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H7284	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024682494				PPO - BBA		C	Kansas City
H7284	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8008658715				PPO - BBA		C	Kansas City
H7284	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5025800475				PPO - BBA		C	Kansas City
H7284	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7284	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7296	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynertowrk.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Backup User Access Contact			Dunham	Tricia		3037804551					TDunham@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Best Available Evidence Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Bid Primary Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	CAP Report Contact for Public Website	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	CEO - CMS Administrator Contact	CEO	Mr	Bowen	Tim		3033986226					TBowen@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	CEO - Senior Official for Contracting	CEO	Mr	Bowen	Tim		3033986226					TBowen@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Chief Financial Officer	Chief Financial Officer	Mr	Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Chief Operating Officer		Ms	Petersen	Emily	D	7208142349					epetersen@care4denver.org	8289 E. Lowry Blvd		Denver	CO	80230	06/04/2025	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Chief Information Officer	CIO	Mr.	Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Chief Information Security Officer		Mr	Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	CMS Casework Communication Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Complaints Tracking Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Contact for Fraud Investigations	Vice President of Quality and Compliance		Mehnert	Patricia		3033986231					PMehnert@caresyynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Coordination of Benefits Contact	Executive Director of PACE Programs		Petersen	Emily	D	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Corporate Mailing						7208142349					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Customer Service Operations Contact	Executive Director of PACE Programs		Petersen	Emily	P	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	DIR Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Discount Program Payment Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Emergency Part D Contact	Vice President of Quality and Compliance		Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Enrollment Contact	Executive Director of PACE Programs		Petersen	Emily	D	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	EOB Transfer Contact	Executive Director of PACE Programs		Petersen	Emily	D	7208142354				3033810157	epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Financial Audit Contact	CFO	Mr	Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Financial Reporting Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Formulary Contact	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	General Contact	Vice President of Quality and Compliance		Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Government Relations Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	HIPAA Privacy Officer			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	HIPAA Security Officer			Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Interoperability Contact			Dunham	Tricia		3037804851					TDunham@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	MA Appeals/Grievances Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	MA Claims Processing Contact for Public Website	Executive Director of PACE Programs		Petersen	Emily	D	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Marketing Contact	Executive Director of PACE Programs		Petersen	Emily	D	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Medical Director	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Medicare Compliance Officer	Compliance Officer	Ms	Cooper	Savannah		7203461677					scooper@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	05/29/2025	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Medicare Coordinator	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Medication Therapy Management Contact	Medical Director	Dr.	L	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part C Application Contact			Mehnert	Patricia		3038955085					PMehnert@CareSynergyNetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/17/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part D Appeals			Mehnert	Patricia							PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active	1800321868				PACE - Nat		C	San Francisco
H7296	Part D Application Contact			Mehnert	Patricia		3038955085					PMehnert@CareSynergyNetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/17/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part D Benefits Contact	Executive Director of PACE Programs		Petersen	Emily	D	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part D Claims Submission Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part D Exceptions Contact	Executive Director of PACE Programs		Petersen	Emily	D						epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active	7208142354				PACE - Nat		C	San Francisco
H7296	Part D Price File Contact (Back-up)	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part D Price File Contact (Primary)	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part D Quality Assurance Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Part D Reporting Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Patient Safety Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Payment Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Pharmacy Director			Perri	Cheryl		4124490680	12209				cperri@granrx.com	105 Gamma Drive	Suite 100	Pittsburgh	PA	15238	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Pharmacy Network Management Contact			Perri	Cheryl		4124490680	12209				cperri@granrx.com	105 Gamma Drive	Suite 100	Pittsburg	PA	15238	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Pharmacy Technical Help Desk Contact			Perri	Cheryl							cperri@granrx.com	105 Gamma Drive	Suite	Pittsburg	PA	15238	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active	4124490680	12209			PACE - Nat		C	San Francisco
H7296	Plan Directory Contact for Public Website	Executive Director of PACE Programs		Petersen	Emily	D	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Plan to Plan Reconciliation Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Processor Contact	Chief Financial Officer		Alley	Brad		7208142154					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Quality Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Reconciliation Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Recovery Audit Contact	Compliance Officer	Ms	Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Surveillance Contact			Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	System Contact			Dunham	Tricia		3037804551					TDunham@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Third Party Administrator (TPA) Liaison			Bailey	Patty		5739706303					pbailey@innermark.com	PO Box 466		Ballwin	MO	63022	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	User Access Contact			Dunham	Tricia		3037804551					TDunham@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	08/29/2023	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Utilization Management Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7296	Utilization Review Contact	Director of Quality and Compliance		Cooper	Savannah		3033811234					scooper@caresynergynetwork.org	13650 E. Mississippi Ave.		Aurora	CO	80012	12/09/2024	2026	HOSPICE OF METRO DENVER, INC	National PACE	Colorado PACE	National PACE		Hospice of Metro Denver, Inc	862	Yes	Active					PACE - Nat		C	San Francisco
H7301	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/30/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H7301	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H7301	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H7301	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H7301	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H7301	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7301	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	COVENTRY HEALTH CARE OF ILLINOIS, INC.	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H7323	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H7323	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H7323	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H7323	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H7323	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H7323	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H7323	PHR Beneficiary Contact																	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H7323	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7323	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE NATIONAL HEALTH INSURANCE COMPANY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H7326	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H7326	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H7326	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H7326	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H7326	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H7326	PHR Beneficiary Contact																	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H7326	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7326	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF SOUTH CAROLINA, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7355	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H7355	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H7355	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H7355	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H7355	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H7355	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H7355	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H7355	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7355	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7366	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739					cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Best Available Evidence Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie	A	7206829848				3039961600	Lteter@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active	9096779517				PACE - Nat		C	Philadelphia
H7366	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	PBlair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Chief Financial Officer	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Chief Operating Officer	Market President	Ms.	Hopkins	Laura		7208127180				9094249948	lhopkins@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Chief Information Security Officer	Chief Information Security Officer	Mr.	Naus	Cole		7204564635				3039961600	mnaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	12/08/2023	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	CMS Casework Communication Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Complaints Tracking Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Coordination of Benefits Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Corporate Mailing						7207602984				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Customer Service Operations Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	DIR Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	General Contact	Director of Compliance		Martin	Jeremy		7208796016					jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Government Relations Contact	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Interoperability Contact	SVP, Application Systems		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/08/2023	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	MA Appeals/Grievances Contact	Director of Compliance		Martin	Jeremy		7208796016				3039961600	jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Appeals	Director of Compliance		Martin	Jeremy							jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H7366	Part D Appeals Contact (Secondary)	Director of Compliance		Martin	Jeremy						3039961600	jmartin@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H7366	Part D Application Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Exceptions Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H7366	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Philadelphia
H7366	Part D Price File Contact (Back-up)	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Quality Assurance Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/08/2023	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Part D Reporting Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Pharmacy Technical Help Desk Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H7366	PHR Beneficiary Contact																	12/08/2023	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Philadelphia
H7366	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Plan to Plan Reconciliation Contact	Financial and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	AKizewsk@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	12/08/2023	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Reconciliation Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Recovery Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	System Contact	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Third Party Administrator (TPA) Liaison	Director, PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	User Access Contact	Director of Compliance		Martin	Jeremy		7208796016					jmartin@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/16/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7366	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	CONCERTOHEALTH PACE OF LOS ANGELES, LLC	National PACE	InnovAge California PACE - Crenshaw	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H7379	Agent/Broker Compensation Data Contact	Director, Medicare Sales	Mr.	Trahan	Donald		4109987538					donald.trahan@carefirst.com	10455 Mill Run Circle	Mailstop OWML1	Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Automated TrOOP Balance Transfer Contact	Manager, Specialty Business	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Backup User Access Contact	Sr. Regulatory Medicare Compliance Analyst	Ms.	Incorvati	Laura		4106052405					Laura.Incorvati@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Best Available Evidence Contact	Manager, Enrollment	Ms.	Knox	Dorothea		4109985559					Dorothea.Knox@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Bid Audit Contact	Product Manager	Ms.	Franklin	Lisa		4109985647					Lisa.Franklin@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Bid Audit Site Contact	Product Manager	Ms.	Franklin	Lisa		4109985647					Lisa.Franklin@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Bid Primary Contact	Product Manager	Ms.	Franklin	Lisa		4109985647					Lisa.Franklin@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	CAP Report Contact for Public Website	Health Plan CEO	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Johnson	Ricardo		4105285789					ricardo.johnson@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	11/05/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Johnson	Ricardo		4105285789					ricardo.johnson@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	11/05/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Chief Financial Officer	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Chief Operating Officer	COO & SVP Government Programs	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/20/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Chief Information Officer	VP, IT Ops and Infrastructure	Ms.	Henderson	Dori		4109985656					Dori.Henderson@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Chief Information Security Officer	Chief Information Security Officer	Mr.	Suarez	Roberto		4109985716					Roberto.Suarez@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	CMMI Model Point of Contact	Health Plan CEO	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	CMS Casework Communication Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Complaints Tracking Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Contact for Fraud Investigations	Director, SIU	Ms.	Kennedy	Elizabeth		4105287067					elizabeth.kennedy@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Coordination of Benefits Contact	VP, Government Programs	Ms.	Toland	Cheryl		4109985107					CFGroupMA@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/25/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Corporate Mailing						4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Customer Service Operations Contact	Manager, Operations	Ms.	Boer	Kelsey		4109985353					Kelsey.Boer@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	DIR Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	DIR Contact (Secondary)	Manager, Specialty Services	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Discount Program Payment Contact	Senior Business Analyst	Ms.	Harris	Amanda		4105287839					Amanda.Harris@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/29/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Electronic Health Record Contact	Health Plan CEO	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Emergency Part D Contact	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Emergency Part D Contact (Secondary)	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Employer Waiver Contact	Director of Operations	Ms.	Gonce	Angie		4109987561					angie.gonce@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Encounter Data & Risk Adjustment Operations Contact	VP, Risk Adjustment, Stars, Quality	Ms.	Haynes	Liz		4104692145					Liz.Haynes@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Enrollment Contact	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	EOB Transfer Contact	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107				4109987534	Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Financial Audit Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Financial Reporting Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Formulary Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Atueyi	Ifeoma		4109986386					Ifeoma.Atueyi@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/25/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	General Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Government Relations Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	HIPAA Privacy Officer	Dir, Privacy & Compliance	Ms.	Gregory	Lauren		4105285066					lauren.gregory@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	HIPAA Security Officer	Chief Information Security Officer	Mr.	Suarez	Roberto		4109985716					Roberto.Suarez@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Hospice Contact	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	10455 Mill Run Circle		Owing Mills	MD	21117	09/14/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Interoperability Contact	VP, Enterprise Arch. & Integr.	Mr.	Heyl	Bob		2026806682					Bob.Heyl@carefirst.com	840 First Street, NE		Washington	DC	20065	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	MA Appeals/Grievances Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	MA Claims Processing Contact for Public Website			Services	Member		8552905744					Cheryl.Toland@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Marketing Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Medical Director	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	09/14/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	12/07/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Medicare Coordinator	Sr. Regulatory Compliance Analyst	Ms.	Incorvati	Laura		4106052405					laura.incorvati@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/14/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Medication Therapy Management Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Online Enrollment Center Contact (Back-up)	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Online Enrollment Center Contact (Primary)	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	06/25/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part C Application Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part C Reporting Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Appeals	Manager, Clinical Operations	Ms.	Beyda	Trista						7326914838	_REReconsideration@cvscaremark.com	3424 William Penn Hwy,		Pittsburg	PA	15235	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	8889700917				PPO - BBA		C	Chicago
H7379	Part D Appeals Contact (Secondary)	Medicare Appeals Analyst	Ms.	Gabor-Lyon	Pam						7326914838	Trista.Beyda@cvshealth.com	3424 William Penn Hwy		Pittsburgh	PA	15235	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	8889700917				PPO - BBA		C	Chicago
H7379	Part D Application Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Benefits Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Claims Submission Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Exceptions Contact	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi							Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	4105285053				PPO - BBA		C	Chicago
H7379	Part D Exceptions Contact (Secondary)	Clinical Pharmacist	Ms	Lee	Catherine							Catherine.Lee@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	4105287033				PPO - BBA		C	Chicago
H7379	Part D Price File Contact (Back-up)	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Price File Contact (Optional)		Mr.	Loveland	Chet		4806064823					Chet.Loveland@cvshealth.com	9501 E. Shea Blvd.  MC 121		Scottsdale	AZ	85260	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Price File Contact (Primary)	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Quality Assurance Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Part D Reporting Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Patient Safety Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Payment Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Personal Health Record Contact	CEO, Medicare-Medicaid		Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Pharmacy Director	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi		4105285053					Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Pharmacy Network Management Contact	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Pharmacy Network Management Contact (Secondary)	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi		4105285303					Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Pharmacy Technical Help Desk Contact	Director Pharmacy Government Programs	Mr.	Nardone	Mark							Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	8666934620				PPO - BBA		C	Chicago
H7379	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Dir. , Pharm Eval & Oversight	Ms.	Poplawski	Mandi							Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active	8666934620				PPO - BBA		C	Chicago
H7379	PHR Beneficiary Contact																	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO	CareFirst BlueCross Blue Shield Medicare Advantage	CareFirst, Inc.	45	Yes	Active	8552905744				PPO - BBA		C	Chicago
H7379	Physician Incentive Contact	Manager, Payment Transformation	Mr.	Coffey	Nathan		4104692167					Nathan.Coffey@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Plan Directory Contact for Public Website			Services	Member		8552905744					Cheryl.Toland@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Plan to Plan Reconciliation Contact	Financial Analyst	Mr.	Murry	Kyle		4106052401					Kyle.Murry@Carefirst.com	P.O. Box 782085		Philadelphia	PA	191781637	08/21/2025	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Processor Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Quality Contact	Director, Quality	Ms.	Attia	Carol		4105982895					Carol.Attia@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	12/30/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Reconciliation Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Reconciliation Contact (Secondary)	Director, Pharmacy Services	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Surveillance Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	System Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Third Party Administrator (TPA) Liaison	Senior Accountant	Ms.	Mitchell	Patrice	R	4109985273					patrice.mitchell@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	User Access Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/08/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Utilization Management Contact	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	10455 Mill Run Circle		Owing Mills	MD	21117	09/14/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7379	Utilization Review Contact	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	10455 Mill Run Circle		Owing Mills	MD	21117	09/14/2024	2026	CAREFIRST ADVANTAGE PPO, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage	Local PPO		CareFirst, Inc.	45	Yes	Active					PPO - BBA		C	Chicago
H7389	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H7389	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H7389	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H7389	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H7389	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H7389	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H7389	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7389	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HealthSpring Life & Health Insurance Company, Inc.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H7397	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H7397	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H7397	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H7397	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H7397	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H7397	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H7397	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H7397	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7397	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7435	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H7435	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H7435	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H7435	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H7435	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337501800				HMO - Health Maintenance Organization		C	Denver
H7435	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/11/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337501800				HMO - Health Maintenance Organization		C	Denver
H7435	PHR Beneficiary Contact																	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H7435	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7435	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H7464	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Best Available Evidence Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/13/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Chief Information Officer	Business Segment CIO	Mr.	Chakravadhanula	Dhaveji		6024627390					dhaveji_s_chakravadhanula@optum.com	410 N Scottsdale Road	Suite 1500	Tempe	AZ	85281	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Enrollment Contact	Manager, Enrollment & Eligibility		Asselin	Krista		7633611104					krista_asselin@uhc.com	PO Box 9472		Minneapolis	MN	55440	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Financial Reporting Contact	VP, Finance		Walczak	Rachel		9529314930					rachel.walczak@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Marketing Contact	Assoc. Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Medical Director	Medical Director	Dr.	Medi	Sai		7134443235					sai_medi@uhc.com	2775 Cross Roads Blvd		Grand Junction	CO	81506	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Online Enrollment Center Contact (Back-up)	Sr. Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				HMO - Health Maintenance Organization		C	Boston
H7464	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H7464	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				HMO - Health Maintenance Organization		C	Boston
H7464	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				HMO - Health Maintenance Organization		C	Boston
H7464	Plan Directory Contact for Public Website			Customer Service	UHC		8664801086					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Utilization Management Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7464	Utilization Review Contact	Manager, Utilization Management		Kitka	Tiffany		9702447779					tiffany.kikta@uhc.com	PO Box 10600		Grand Junction	CO	81502	11/14/2025	2026	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	Local CCP	UnitedHealthcare	HMO/HMOPOS		UnitedHealth Group, Inc.	239	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7469	Automated TrOOP Balance Transfer Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Backup User Access Contact	Executive Director	Mrs.	Rees	Karen		9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/02/2025	2026	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	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/02/2025	2026	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	Bid Primary Contact	Executive Director	Mrs.	Rees	Karen		9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/02/2025	2026	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	CAP Report Contact for Public Website	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/02/2025	2026	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	CEO - CMS Administrator Contact	CEO	Mrs.	Ponder-Stansel	Susan		9044076363					ceo@aliviacare.com	4266 Sunbeam Rd.		Jacksonville	FL	32257	07/10/2024	2026	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	CEO - Senior Official for Contracting	CEO	Ms.	Ponder-Stansel	Susan		9044076363					ceo@aliviacare.com	4266 Sunbeam Rd.		Jacksonville	FL	32257	09/25/2024	2026	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	CFO	Mr.	Marsh	Skip		9044076329					skip.marsh@aliviacare.com	4266 Sunbeam Rd.		Jacksonville	FL	32257	01/20/2025	2026	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 Operating Officer	COO	Mr.	Stevenson	Kenny		9044075033					kenny.stevenson@aliviacare.com	4266 Sunbeam Rd.		Jacksonville	FL	32257	07/10/2024	2026	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 Information Officer	Chief Information Officer	Mr.	Helinsky	Michael		9042685200					michael.helinsky@aliviacare.com	4266 Sunbeam Road		Jacksonville	FL	32257	08/16/2023	2026	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 Information Security Officer		Mr.	Helinsky	Michael		9042685200					michael.helinsky@aliviacare.com	4266 Sunbeam Road		Jacksonville	FL	32257	08/16/2023	2026	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	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/02/2025	2026	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	Complaints Tracking Contact	Quality Improvement		Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/02/2025	2026	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	Contact for Fraud Investigations	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/02/2025	2026	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	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Corporate Mailing						9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/02/2025	2026	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	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/02/2025	2026	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	DIR Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	DIR Contact (Secondary)	Executive Director		Rees	Karen		9044280400					krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/02/2025	2026	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	Discount Program Payment Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Emergency Part D Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400					mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Emergency Part D Contact (Secondary)	Executive Director		Rees	Karen		9044280400					krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/02/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Enrollment Contact	Executive Director	Mrs.	Rees	Karen		9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/02/2025	2026	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	EOB Transfer Contact	Health Plan Manager	Mr.	Durrance	Marc		9044909162				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Financial Audit Contact	Executive Director	Ms.	Rees	Karen		9045446262					krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32257	09/25/2024	2026	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	Financial Reporting Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Formulary Contact	Medical Director	Dr.	El-Salawy	Sherif		9044280400				9044280404	selsalawy@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	08/11/2025	2026	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	General Contact	Executive Director	Mrs.	Rees	Karen		9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/02/2025	2026	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	Executive Director	Mrs.	Rees	Karen		7272183166					krees1@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/02/2025	2026	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	HIPAA Privacy Officer	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	amith2@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	HIPAA Security Officer	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Interoperability Contact	CIO	Mr.	Helinsky	Michael		9044280400				9044280404	michael.helinsky@aliviacare.com	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	MA Appeals/Grievances Contact	Quality Improvement	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/12/2025	2026	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	MA Claims Processing Contact for Public Website	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Marketing Contact	Executive Director	Mrs.	Rees	Karen	A	9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/12/2025	2026	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	Medical Director	Medical Director	Dr	El-Salawy	Sherif		9044280400				9044280404	selsalawy@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	08/11/2025	2026	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	Mrs.	Smith	Adria		9044280400	232				asmith2@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Coordinator	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr	El-Salawy	Sherif		9044280400				9044280404	selsalawy@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	08/11/2025	2026	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	Medication Therapy Management Contact			Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	08/11/2025	2026	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 C Application Contact	Executive Director	Mrs.	Rees	Karen		9045446262				9044280404	krees1@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	09/25/2024	2026	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 Appeals	Health Plan Manager	Mr.	Durrance	Marc						9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active	9044280400				PACE - Nat		C	Atlanta
H7469	Part D Appeals Contact (Secondary)	Executive Director	Mrs.	Rees	Karen							krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active	9044280400				PACE - Nat		C	Atlanta
H7469	Part D Application Contact	Executive Director	Mrs.	Rees	Karen	A	9044280400					krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Benefits Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Claims Submission Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Health Plan Manager	Mr.	Durrance	Marc	D					9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active	9044280400				PACE - Nat		C	Atlanta
H7469	Part D Exceptions Contact (Secondary)	Executive Director	Mrs.	Rees	Karen							krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active	9044280400				PACE - Nat		C	Atlanta
H7469	Part D Price File Contact (Back-up)	Health Plan Manager	Mr.	Durrance	Marc		9044280400					mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Price File Contact (Primary)	Executive Director	Mrs.	Rees	Karen		9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Quality Assurance Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Reporting Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Patient Safety Contact	Quality Manager		Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	08/11/2025	2026	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	Payment Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Director	Medical Director	Dr.	El-Salawy	Sherif		9044280400					selsalawy@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	08/11/2025	2026	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 Network Management Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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 Network Management Contact (Secondary)	Executive Director	Mrs.	Rees	Karen	A	9044280400					krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Health Plan Manager	Mr.	Durrance	Marc						9044280404	mdurrance@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/12/2025	2026	PACE PARTNERS OF NORTHEAST FLORIDA, INC.	National PACE	PACE Partners of Northeast Florida	National PACE		Community Hospice of Northeast Florida, Inc.	720	Yes	Active	9044280400				PACE - Nat		C	Atlanta
H7469	Plan Directory Contact for Public Website	Executive Director	Mrs.	Rees	Karen	A	9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Plan to Plan Reconciliation Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Processor Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Quality Contact	Quality Improvement	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/12/2025	2026	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	Reconciliation Contact	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Reconciliation Contact (Secondary)	Executive Director	Mrs.	Rees	Karen	A	9044280400					krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Recovery Audit Contact	Compliance	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/12/2025	2026	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	Surveillance Contact	Executive Director	Mrs.	Rees	Karen	A	9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Boulevard		Jacksonville	FL	32205	01/12/2025	2026	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	System Contact	Executive Director	Mrs.	Rees	Karen	A	9044280400				9044280404	krees1@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Third Party Administrator (TPA) Liaison	Health Plan Manager	Mr.	Durrance	Marc		9044280400				9044280404	mdurrance@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	User Access Contact	Quality Manager	Mrs.	Smith	Adria		9044280400				9044280404	asmith2@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	01/12/2025	2026	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	Utilization Management Contact	Medical Director	Dr	El-Salawy	Sherif		9044280400				9044280404	selsalawy@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	08/11/2025	2026	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	Utilization Review Contact	Medical Director	Dr	El-Salawy	Sherif		9044280400					selsalawy@thepaceplace.org	5450 Ramona Blvd		Jacksonville	FL	32205	08/11/2025	2026	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
H7471	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H7471	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H7471	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H7471	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H7471	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H7471	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H7471	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H7471	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7471	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF INDIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H7501	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		8587906250				8587906052	PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Backup User Access Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/24/2023	2026	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		Macias-Garcia	Monica		7144681077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Bid Primary Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/29/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	CAP Report Contact for Public Website	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Hunn	Michael		7142729639					michael.hunn@caloptima.org	505 City Parkway West		Orange	CA	92868	01/06/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Hunn	Michael		6579001481					michael.hunn@caloptima.org	505 City Parkway West		Orange	CA	92868	03/08/2022	2026	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		6572356935					nhuang@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Chief Operating Officer	Chief Operating Officer	Ms.	Kim	Yunkyung		7149238834					yunkyung.kim@caloptima.org	505 City Parkway West		Orange	CA	92868	12/21/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Chief Information Officer	Chief Information Officer	Ms.	Linder	Kathleen		7144759291					kathleen.linder@caloptima.org	505 City Parkway West		Orange	CA	92868	01/17/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Chief Information Security Officer	Sr. Director Information Security Officer	Mr.	Steele	James		7144976046					james.steele@caloptima.org	505 City Parkway West		Orange	CA	92868	01/16/2025	2026	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	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Complaints Tracking Contact	QI Manager		Robinson	Jennifer		7142468693					jennifer.robinson@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Contact for Fraud Investigations	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369004					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	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		7142468878					COBinquiries@caloptima.org	505 City Parkway West		Orange	CA	92868	04/21/2022	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Corporate Mailing						6572356994					aphillips@caloptima.org	505 City Parkway West		Orange	CA	92868	05/06/2021	2026	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		Macias-Garcia	Monica		7144681077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	DIR Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	DIR Contact (Secondary)	Program Manager		Kurth	Jennifer		7142468767					jkurth@caloptima.org	505 City Parkway West		Orange	CA	92868	11/01/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Discount Program Payment Contact	Manager, Accounting		Hoang	Ally		7147966133					ally.hoang@caloptima.org	505 City Parkway West		Orange	CA	92868	06/09/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Emergency Part D Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646					Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Emergency Part D Contact (Secondary)	Manager, Pharmacy Management		Pham	Jacqueline		7143473206					jpham@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Encounter Data & Risk Adjustment Operations Contact	Manager, Encounters		Dabu	Lorena		7142468486					ldabu@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Enrollment Contact	Supervisor Member Outreach & Education PACE		Cao	Anh Thu		7147235185					anhthu.cao@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	04/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	EOB Transfer Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Financial Audit Contact	Director, Regulatory Affairs & Compliance Medicare	Ms.	Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Financial Reporting Contact	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Formulary Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	General Contact	Director, Regulatory Affairs & Compliance		Phillips	Annie		6572369004					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	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		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/29/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	HIPAA Privacy Officer	Director, Privacy		Royal	Eric		6579001313					eric.royal@caloptima.org	505 City Parkway West		Orange	CA	92868	07/31/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	HIPAA Security Officer	Director, Privacy		Royal	Eric		6579001313					eric.royal@caloptima.org	505 City Parkway West		Orange	CA	92868	07/31/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Interoperability Contact	IT Project Manager, Sr		DeFrain	Phil		7142468477					pdefrain@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	MA Appeals/Grievances Contact	QI Manager		Robinson	Jennifer		7142468693					jennifer.robinson@caloptima.org	505 City Parkway West	13300 Garden Grove Boulevard	Orange	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	MA Claims Processing Contact for Public Website	Director, Claims Administration		Tungol	Cesar		7147966141					ctungol@caloptima.org	505 City Parkway West		Orange	CA	92868	12/10/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Marketing Contact	Supervisor Member Outreach & Education PACE		Cao	Anh Thu		7147235185					anhthu.cao@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	04/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Medical Director	Medical Director	Dr.	Frisch	Donna		7147148974					donna.frisch@caloptima.org	505 City Parkway West		Orange	CA	92868	04/27/2023	2026	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		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Medicare Coordinator	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Medication Therapy Management Contact	Manager, Clinical Pharmacy Management		Ghazanfarpour	Nicki		7147966166				7147966649	nghazanfarpour@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	OffShore Subcontractor Contact	Director, Regulatory Affairs & Compliance Medicare		Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Part C Application Contact	Director of PACE		Macias-Garcia	Monica		7144681077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	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 Appeals	Manager, Pharmacy Management		Nguyen	Kendrix						7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active	7142468646				PACE - Nat		C	San Francisco
H7501	Part D Appeals Contact (Secondary)	Manager, Pharmacy Management		Pham	Jacqueline							jpham@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active	7143473206				PACE - Nat		C	San Francisco
H7501	Part D Application Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	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 Benefits Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	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 Claims Submission Contact			Rivera-Aquino	Denisse		8582915269					PDE@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2026	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	Manager, Pharmacy Management		Nguyen	Kendrix						7149542313	Kendrixnguyen@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active	7142468646				PACE - Nat		C	San Francisco
H7501	Part D Price File Contact (Back-up)	Medicare Part D Manager		Keller	Shanon		8587906455				8587906038	planfindercommunications@medImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/16/2021	2026	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 Price File Contact (Optional)	Medicare Part D Manager		Keller	Shanon		8587906455				8587906038	planfindercommunications@medImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	04/16/2021	2026	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 Price File Contact (Primary)	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	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 Quality Assurance Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	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 Reporting Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Patient Safety Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Payment Contact	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Personal Health Record Contact	Director of PACE		Macias-Garcia	Monica		7144681077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Pharmacy Director	Chief Medical Officer	Dr.	Pitts	Richard		7142468491					richard.pitts@caloptima.org	505 City Parkway West		Orange	CA	92868	01/17/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Pharmacy Network Management Contact	Manager, PNS & Claims Operations		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Pharmacy Network Management Contact (Secondary)	Pharmacist, Pharmacy Management		Vigil	Susan		7142908940				7143383169	svigil@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	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	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active	8008100554				PACE - Nat		C	San Francisco
H7501	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Management		Nguyen	Kendrix						7149542313	Kendrixnguyen@caloptima.org	CalOptima	505 City Parkway West	Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active	7142468646				PACE - Nat		C	San Francisco
H7501	Plan Directory Contact for Public Website	Director of PACE		Macias-Garcia	Monica		7144681077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Plan to Plan Reconciliation Contact	Controller		Kaing	Jason		6579001373					p2p@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Processor Contact	Director, Medicare Programs		Davis-Jones	De'Lona	M	8587906229					DeLona.Davis-Jones@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Quality Contact	QI Manager		Robinson	Jennifer		7142468693					jennifer.robinson@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Reconciliation Contact	Manager, Pharmacy Management		Nguyen	Kendrix		7142468646				7149542313	Kendrixnguyen@caloptima.org	505 City Parkway West		Orange	CA	92868	01/13/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Reconciliation Contact (Secondary)	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Recovery Audit Contact	Director, Regulatory Affairs & Compliance Medicare	Ms.	Phillips	Annie		6572369044					medicarecomplianceofficer@caloptima.org	505 City Parkway West		Orange	CA	92868	10/31/2025	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Surveillance Contact	Director of PACE		Macias-Garcia	Monica		7144681077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	System Contact	Director of PACE		Macias-Garcia	Monica		7144681077					monica.macias@caloptima.org	13300 Garden Grove Boulevard		Garden Grove	CA	92843	03/28/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Third Party Administrator (TPA) Liaison	Controller		Kaing	Jason		6579001373					jason.kaing@caloptima.org	505 City Parkway West		Orange	CA	92868	01/25/2024	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	User Access Contact	Manager		Gomez	Gisela		7142468757					ggomez@caloptima.org	505 City Parkway West		Orange	CA	92868	02/13/2019	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Utilization Management Contact	Medical Director	Dr.	Frisch	Donna		7147148974					donna.frisch@caloptima.org	505 City Parkway West		Orange	CA	92868	11/02/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7501	Utilization Review Contact	Medical Director	Dr.	Frisch	Donna		7147148974					donna.frisch@caloptima.org	505 City Parkway West		Orange	CA	92868	11/02/2023	2026	ORANGE COUNTY HEALTH AUTHORITY	National PACE	CalOptima PACE	National PACE		Orange County Health Authority	39	Yes	Active					PACE - Nat		C	San Francisco
H7511	Agent/Broker Compensation Data Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Backup User Access Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Bid Audit Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	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	Bid Audit Site Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	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	Bid Primary Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8007525863				HMO - Health Maintenance Organization		C	Dallas
H7511	CEO - CMS Administrator Contact	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	CEO - Senior Official for Contracting	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	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	Chief Financial Officer	Mr.	Custis	Stephen		6129649158					Stephen.Custis@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	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 Operating Officer	Vice President of Operations	Ms.	Foemmel	Sara		7153836634					foemmel.sara@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	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 Information Officer	Cheif Information Officer	Mr.	Reimer	Brad		6053287937					Brad.Reimer@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Information Security Officer	Vice President - Information Security Officer	Ms.	Hogstad	Kimberly		6053287410					Kimberly.Hogstad@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	CMMI Model Point of Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Complaints Tracking Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Contact for Fraud Investigations	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Corporate Mailing						8007525863					memberservices@sanfordhealth.org	PO BOX 91110		Sioux Falls	SD	57109	08/28/2024	2026	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		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	DIR Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/24/2025	2026	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	DIR Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Discount Program Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Emergency Part D Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Emergency Part D Contact (Secondary)	Senior Pharmacist	Mr.	Reuman	Reed		6053122761					Reed.Reuman@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Employer Waiver Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Enrollment Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	EOB Transfer Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		6053287182				6053286811	Aleesa.Jansick@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Financial Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	09/24/2025	2026	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	Financial Reporting Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	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	Formulary Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Formulary Contact (Secondary)	Principal Pharmacy Benefits Specialist		Chen	Honghua		2242312740					Christine.Chen2@optum.com	1600  McConnor Parkway	Suite 201	Schaumburg	IL	601736801	08/28/2024	2026	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	General Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	07/30/2025	2026	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	Head of Government Affairs	Mr.	Wheeler	Dylan		6053287186					Dylan.Wheeler@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	HIPAA Privacy Officer	Lead Privacy Officer	Ms.	Sundby	Jennifer		6053625407					Jennifer.Sundby@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	HIPAA Security Officer	Information Security Compliance Officer	Mr.	Otte	Brody		6053126563					Brody.Otte@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Interoperability Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	MA Appeals/Grievances Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	MA Claims Processing Contact for Public Website	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Marketing Contact	Director of Marketing	Ms.	McCloskey	Diana		6053122762					Diana.Mccloskey@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Medical Director	Chief Medical Officer	Dr.	Faber	Kevin		6053287192					Kevin.Faber@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Coordinator	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	02/07/2025	2026	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	Medication Therapy Management Contact	Clinical Program Manager	Ms.	Liaqat	Tazeen		6305440541					Tazeen.liaqat@optum.com	1240 South Pine Island Rd.		Plantation	FL	33324	08/28/2024	2026	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	OffShore Subcontractor Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Online Enrollment Center Contact (Back-up)	Manager of Inside Sales	Mr.	Arnett	Jack		6053286886					Jack.Arnett@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Online Enrollment Center Contact (Optional)	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Online Enrollment Center Contact (Primary)	Director of Medicare Programs	Mr.	Ovenden	Nathan		6053122606					Nathan.Ovenden@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 C Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 C Reporting Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Appeals	Manager, Prior Authorization Appeals	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H7511	Part D Appeals Contact (Secondary)	Pharmacy Technician, PA Appeals	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H7511	Part D Application Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Benefits Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Claims Submission Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H7511	Part D Exceptions Contact (Secondary)	Pharmacy Technician, PA	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H7511	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms.	Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	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 Price File Contact (Optional)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Price File Contact (Primary)	Senior Business Analyst	Ms.	Lam	Annie		6124286588					Annie.Lam@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	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 Quality Assurance Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Reporting Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Patient Safety Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Personal Health Record Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Director	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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 Network Management Contact	Manager, Retail Network Operations	Mr.	Perez	Felix		7632833503					Felix.Perez@optum.com	1600 McConnor Parkway , IL 601736801		Schaumburg	IL	601736801	08/28/2024	2026	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 Network Management Contact (Secondary)	Manager, Retail Network Operations	Ms.	Ashby	Jolynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	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	Pharmacy Technical Help Desk	Sr.	Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	08/28/2024	2026	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8446429090				HMO - Health Maintenance Organization		C	Dallas
H7511	PHR Beneficiary Contact																	08/28/2024	2026	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS	Sanford Health Plan	Sanford Health	740	Yes	Active	8882786485				HMO - Health Maintenance Organization		C	Dallas
H7511	Physician Incentive Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Plan Directory Contact for Public Website	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Processor Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Quality Contact	Director of Quality and STARS Strategy	Ms.	Kanta	Misty		6053122788					Misty.Kanta@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Reconciliation Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Recovery Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	SNP Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	SNP State Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Surveillance Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	System Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Third Party Administrator (TPA) Liaison	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	User Access Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Utilization Management Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Utilization Review Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Medical Director	Medical Director	Mr	Haake	Karl		9132951245					karl.haake@sunflowerhealthplan.com	77 West Wacker Drive, 14th Floor		Chicago	IL	60601	03/30/2021	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/18/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H7512	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H7512	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H7512	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H7512	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H7512	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H7512	PHR Beneficiary Contact																	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8665498289				PPO - BBA		C	Denver
H7512	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7512	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY MICHIGAN	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H7518	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H7518	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H7518	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H7518	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H7518	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H7518	PHR Beneficiary Contact																	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H7518	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7518	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H7522	Agent/Broker Compensation Data Contact	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Automated TrOOP Balance Transfer Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Best Available Evidence Contact	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Bid Audit Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Bid Audit Site Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Bid Primary Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	CEO - CMS Administrator Contact	President	Mr	Rivera Cardona	Ricardo		7876330707				7873004886	ricardo.rivera-cardona@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	CEO - Senior Official for Contracting	President Medicare Programs	Ms	Dailey	Aimee	K	7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd	Maildrop VA28	Norfolk	VA	23502	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Chief Financial Officer	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Chief Operating Officer	Staff VP Operations Management	Ms	Garcia	Vilmari		7874478131				7873004886	vilmari.garcia@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Chief Information Officer	CIO	Mr.	Molinary	Rachid		7872496365				9395451239	rachid.molinary@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Chief Information Security Officer	Director II Technology	Mr.	Arill	Juan		7875016127				7879991726	juan.arill@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	CMMI Model Point of Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	CMS Casework Communication Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Complaints Tracking Contact	Director Grievances & Appeals	Ms.	Rodriguez	Janice		9397173509				7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Contact for Fraud Investigations	Compliance Director	Ms.	Olivo Gonzalez	Ana		7874480003				7876253356	Ana.olivo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Coordination of Benefits Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Corporate Mailing						8132951367					marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Customer Service Operations Contact	Director II Customer Care	Ms.	Iglesias	Morayma		7876002047					morayma.iglesias-sustache@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	DIR Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	DIR Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Discount Program Payment Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Electronic Health Record Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active	8663335470	52259			PPO - BBA		C	Chicago
H7522	Emergency Part D Contact	Staff VP Clinical & Spec Pharmacy	Ms	Morant	Iris		7873797592				8337404081	iris.morant-rodriguez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Emergency Part D Contact (Secondary)	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Employer Waiver Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Encounter Data & Risk Adjustment Operations Contact	Staff VP Risk Adjustment	Mr	Kaplun	Alex		7866067836					akaplun@mmmhc.com	350 Avenida Chardon Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Enrollment Contact	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	EOB Transfer Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493				8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Financial Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367				7876253356	MedicareCO@anthem.com	4200 W. Cypress St.		Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Financial Reporting Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Formulary Contact	Clinical Pharmacy Prog Dir (US)	Dr.	Lazaro	Maria	I	7876756858				8337404081	maria.lazaro@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/26/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Formulary Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	General Contact	Director II Compliance	Ms.	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	HIPAA Security Officer	Director II Technology	Mr.	Arill	Juan		7875016127				7879991726	juan.arill@mmmhc.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Hospice Contact	Director Pharmacy UM	Mrs	Albors	Gabriela		7872494544	58670			8337404081	Gabriela.Albors-Rivera@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	MA Appeals/Grievances Contact	Director Grievances & Appeals	Ms.	Rodriguez	Janice		9397173509				7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	MA Claims Processing Contact for Public Website	Staff VP Operations Management	Mr	Salinas	Gonzalo		7873832706				7879992177	Gonzalo.Salinas@mso-pr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Marketing Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Medical Director	Staff VP Medical Director	Dr.	Rosso	Diego		7874478148				7873005523	diego.rosso@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Medicare Part D Opioid Overutilization Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Medication Therapy Management Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	OffShore Subcontractor Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Online Enrollment Center Contact (Back-up)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Online Enrollment Center Contact (Primary)	Director II Membership	Ms.	Suarez	Yamile		7874069767				7879992199	Yamile.Suarez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Appeals	Director Grievances & Appeals	Ms.	Rodriguez	Janice						7876202390	janice.rodriguez@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active	8663335470	52537			PPO - BBA		C	Chicago
H7522	Part D Appeals Contact (Secondary)	Staff VP Medical Director	Dr.	Rosso	Diego						7873005523	Diego.Rosso@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active	8663335470	58722			PPO - BBA		C	Chicago
H7522	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@anthem.com	N5108 Fox River Lane		Princeton	WI	54968	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Benefits Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493	58679			8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Claims Submission Contact	Dir PBM Compliance	Mrs	Frederique	Christina		7872052493	58679			8337404081	christina.frederique@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Exceptions Contact	Director Pharmacy UM	Mrs	Albors	Gabriela						8337404081	gabriela.albors-rivera@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active	8663335470	58670			PPO - BBA		C	Chicago
H7522	Part D Exceptions Contact (Secondary)	Director Pharmacy Operations	Ms.	Ramos	Sara						8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active	8663335470	58660			PPO - BBA		C	Chicago
H7522	Part D Price File Contact (Back-up)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Price File Contact (Optional)	VP Government Programs Services		Davis	Daniel		6304877033					daniel.davis@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094838	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Price File Contact (Primary)	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Quality Assurance Contact	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Patient Safety Contact	Director Pharmacy Operations	Ms.	Ramos	Sara		7874132083				8337404081	sara.ramos-gonzalez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	08/21/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Payment Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Personal Health Record Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Pharmacy Director	Staff VP Clinical & Spec Pharmacy	Ms	Morant	Iris		7873797592				8337404081	iris.morant-rodriguez@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Pharmacy Network Management Contact	AVP Network Strategy	Mr	Baker	David		8167833834					david.baker@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094830	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Pharmacy Network Management Contact (Secondary)	Director Pharmacy Operations	Mr	Mercado Toro	Jose		7879257029	58679			8337404081	jose.mercado-toro@mso-pr.com	350 Avenida Chardon, Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Pharmacy Technical Help Desk Contact	Manager II Pharmacy Benefit	Mrs	Rivera	Erika						8337404081	erika.riveraserrano@mmmhc.com	PO BOX 71114		San Juan	PR	009368014	06/27/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active	8552019936				PPO - BBA		C	Chicago
H7522	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Operations	Toro	Mercado Toro	Jose						8337404081	jose.mercado-toro@mso-pr.com	PO BOX 71114		San Juan	PR	009368014	06/27/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active	8552019936				PPO - BBA		C	Chicago
H7522	PHR Beneficiary Contact																	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO	MMM Healthcare, Inc.	Elevance Health, Inc.	1	Yes	Active	8663335470				PPO - BBA		C	Chicago
H7522	Physician Incentive Contact	Director II Finance	Ms.	Perez	Mireya		7874484061				7873005502	Mireya.perez@mso-pr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Plan Directory Contact for Public Website	Director II Customer Care	Ms.	Iglesias	Morayma		8666766060					morayma.iglesias-sustache@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Plan to Plan Reconciliation Contact	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Processor Contact	VP Government Programs Services		Davis	Daniel		6304877033					daniel.davis@abarcahealth.com	Abarca Health LLC	1606 Ave. Ponce de Leon	San Juan	PR	009094838	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Quality Contact	Director II-GBD Quality Management	Ms.	Miranda	Ana	B	7872218738				7873005510	Ana.olivo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Reconciliation Contact	RVP Goverment Finance	Mr.	Gonzalez Cuadrado	Agustin		7876089270				7873004886	agustin.gonzalez-cuadrado@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Reconciliation Contact (Secondary)	Compliance Director	Ms.	Falcon	Cynthia		7876002822				7876253356	Cynthia.Falcon-Mejias@mmmhc.com	350 Ave Chardon, Torre Chardon	Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Recovery Audit Contact	Director II Compliance	Ms.	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	SNP Application Contact	Product Development Manager	Ms	Martinez	Viviana		7874849559				7876253356	viviana.martinez-lanza@mmmhc.com	PO Box 71114		San Juan	PR	009368014	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Surveillance Contact	Director II Compliance		Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon Torre Chardon, Suite 500		San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	System Contact	Director II Compliance	Ms	Hiraldo	Marieva		7872231672				7876253356	marieva.hiraldo@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Third Party Administrator (TPA) Liaison	Mgr Fin Acctg/Rptg/Analysis	Mr.	Serrano Figueroa	Juan		7873987704					Juan.Serrano@mmmhc.com	PO Box 71114		San Juan	PR	00936	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Utilization Management Contact	Staff VP Total Health Mgmt.	Mrs	Gonzalez Suarez	Nilsa		7872218350				7879992177	Nilsa.Gonzalez-Suarez@inhealthpr.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	009182137	02/03/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7522	Utilization Review Contact	Medical Director	Dr.	Guardiola	Benjamin		7876002889				7873005523	benjamin.guardiola-rivera@mmmhc.com	350 Avenida Chardon	Torre Chardon, Suite 500	San Juan	PR	00918	05/08/2025	2026	MMM HEALTHCARE, LLC	Local CCP	Medicare y Mucho Mas (MMM)	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H7524	Agent/Broker Compensation Data Contact	Manager, Broker Administration and Operations		McBride	Kelly		5857396683					Kelly.McBride@Excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Automated TrOOP Balance Transfer Contact	Supervisor, Medicare Operations		Matecki	Lisa		7166145722					Lisa.Matecki@excellus.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	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	Chicago
H7524	Backup User Access Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		7168574435				7168576160	medicare.reconciliation.unit@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	Bid Audit Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	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	Chicago
H7524	Bid Audit Site Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	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	Chicago
H7524	Bid Primary Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	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	Chicago
H7524	CAP Report Contact for Public Website	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	CEO - CMS Administrator Contact	Executive Vice President & Chief Financial Officer	Mr	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	CEO - Senior Official for Contracting	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	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	Chicago
H7524	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Chief Operating Officer	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	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	Chicago
H7524	Chief Information Officer	SVP & Chief Info Data Digital Officer	Ms	Langston	Cindy		5853276529					Cindy.Langston@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Chief Information Security Officer	Vice President, Chief Information Security Officer	Mr.	Pickup	Jason		5853397620	25511				Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	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	Chicago
H7524	Complaints Tracking Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	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	Chicago
H7524	Contact for Fraud Investigations	Corporate Director of Special Investigations		Paris	Meg		5852384425				5854536346	Meg.Paris@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Coordination of Benefits Contact	Manager, Analysis and Recovery		May	Mary		3157928873					Mary.May@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	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	Chicago
H7524	Corporate Mailing						5852384505					CCiardi@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		5853996683					Alexander.Levi@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	DIR Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	DIR Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	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	Chicago
H7524	Discount Program Payment Contact	Director Financial Operations		McCullough	Shandell		5852384672					Shandell.McCullough@excellus.com	165 Court Street		Rochester	NY	14647	05/20/2024	2026	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	Chicago
H7524	Emergency Part D Contact	Executive Vice President & Chief Financial Officer		Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court St		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Rocco	Darlene		5852613857				8778125306	Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment Data Analytics		Palmer	Benjamin		3156717270					Benjamin.Palmer@excellus.com	333 Butternut Drive		Dewitt	NY	13214	01/22/2024	2026	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	Chicago
H7524	Enrollment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	EOB Transfer Contact	Strategic Pharmacy Change Manager		Ammons	Andrea		5853397986				8778125306	Andrea.Ammons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Financial Audit Contact	Director, Regulatory Auditing & Medicare Oversight	Mrs	Knappen	Heather		5857390661					heather.knappen@excellus.com	165 Court Street		Rochester	NY	14647	11/11/2025	2026	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	Chicago
H7524	Financial Reporting Contact	Manager, Medicare and SN Finance		Stalzer	Virginia		5852384428					Virginia.Stalzer@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Formulary Contact	Medicare Part D Formulary Manager		Woodruff	Eric		7167832740					Eric.Woodruff@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	Formulary Contact (Secondary)	Medicare Part D Formulary Manager		Banaszak	Danielle		7166145704					Danielle.Banaszak@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	General Contact	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	HIPAA Privacy Officer	VP, Ethics & Privacy Officer		Hill	Timothy	J	3158771234					Timothy.Hill@excellus.com	333 Butternut Drive		Dewitt	NY	13214	01/22/2024	2026	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	Chicago
H7524	HIPAA Security Officer	Vice President, Chief Information Security Officer		Pickup	Jason		5853397620					Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Hospice Contact	Director, Pharmacy Utilization Management		Khan	Joe		7168437881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	Interoperability Contact	Strategic Porfolio Management		Meek	Shauna		5852384570					Shauna.Meek@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	MA Appeals/Grievances Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Rafael.Gomez@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	MA Claims Processing Contact for Public Website	Manager, Customer Operations		Amato	Heather		7162505162					Heather.Amato@Univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	Marketing Contact	Marketing Manager		Reardon	Elizabeth		5853276504					Elizabeth.Reardon@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Medical Director	Senior VP and Corporate Medical Director		Cohen	Stephen		5854536366					Stephen.Cohen@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Medicare Coordinator	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Medicare Part D Opioid Overutilization Contact	Quality Improvement Clinical Pharmacist		Morano	Melissa		7166145705					melissa.morano@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	06/20/2024	2026	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	Chicago
H7524	Medication Therapy Management Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Online Enrollment Center Contact (Back-up)	Enrollment Operation Project Manager II		Abiusi	Amy		7164408638					Amy.Abiusi@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	Online Enrollment Center Contact (Optional)	Manager, EDI & Enrollment Governance		Field	Eric		3154360215					Eric.Field@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	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	Chicago
H7524	Online Enrollment Center Contact (Primary)	Enrollment Operations Analyst II		Conway	Michael		7165738029					Michael.Conway@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	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	Chicago
H7524	Part C Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					Kelli.McParlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	Part C Reporting Contact	Medicare Compliance Program Administrator		Dewa	Renate		3155732791					Renate.Dewa@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Part D Appeals	Compliance Program Administrator III		Gomez	Rafael							Rafael.Gomez@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	7168576226				HMO - Health Maintenance Organization		C	Chicago
H7524	Part D Appeals Contact (Secondary)	Manager of Advocacy and Compliance Ops		Casillo	Lynda							Lynda.Casillo@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	7168576146				HMO - Health Maintenance Organization		C	Chicago
H7524	Part D Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					Kelli.McParlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	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	Chicago
H7524	Part D Benefits Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Part D Claims Submission Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Part D Exceptions Contact	Director, Pharmacy Utiization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	7168437881				HMO - Health Maintenance Organization		C	Chicago
H7524	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Brayer	Hayden							Hayden.Brayer@excellus.Com	165 Court Street		Rochester	NY	14647	04/01/2025	2026	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	5854536416				HMO - Health Maintenance Organization		C	Chicago
H7524	Part D Price File Contact (Back-up)	Pharmacy Product Ops Specialist		DuVall	Amanda		7168576177					Amanda.DuVall@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	12/04/2024	2026	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	Chicago
H7524	Part D Price File Contact (Optional)	Director of Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107th St.	#11202	Overland Park	KS	66207	01/22/2024	2026	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	Chicago
H7524	Part D Price File Contact (Primary)	Pharmacy Product Ops Specialist		Ciaramaglia	Shannon		5852384506					shannon.ciaramaglia@excellus.com	165 Court Street		Rocheser	NY	14647	01/22/2024	2026	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	Chicago
H7524	Part D Quality Assurance Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Part D Reporting Contact	Medicare Compliance Program Administrator		Dewa	Renate		3155732791					Renate.Dewa@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Patient Safety Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Payment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Pharmacy Director	Director, Pharmacy Operations		Rocco	Darlene		5853277544					Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		5853277530				5853396640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Pharmacy Network Management Contact (Secondary)	Network Account Directory Retail Strategy and Cont		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		ST Louis	MO	63121	01/22/2024	2026	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	Chicago
H7524	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	01/22/2024	2026	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H7524	Pharmacy Technical Help Desk Contact (Secondary)	SR Director Goverment Programs, Medicare		Gibson	Sharon							SGGibson@Express-scripts.Com	One Express Way		St Louis	MO	63121	01/22/2024	2026	EXCELLUS HEALTH PLAN COMMUNITY CARE LLC	Local CCP	Excellus Health Plan Community Care LLC	HMO/HMOPOS		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H7524	Physician Incentive Contact	VBP Clinical Programs Manager		Ferris	Laura		3152435765				3156716752	Laura.Ferris@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	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	Chicago
H7524	Plan Directory Contact for Public Website	Manager, Medicare Compliance		Spitler	Tracy		5852383644					Tracy.Spitler@Excellus.com	165 Court Street		Rochester	NY	14647	08/28/2025	2026	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	Chicago
H7524	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		5856492768					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Processor Contact	SR Directory Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St Louis	MO	63121	01/22/2024	2026	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	Chicago
H7524	Quality Contact	Manager, HCI Governance		Alexander	Elizabeth	C	5857520776					elizabeth.alexander@excellus.com	165 Court Street		Rochester	NY	14647	10/28/2024	2026	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	Chicago
H7524	Reconciliation Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	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	Chicago
H7524	Recovery Audit Contact	Manager Financial Compliance	Mr.	Mau	Ahren		5854785535					Ahren.Mau@excellus.com	165 Court St		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	SNP Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					kelli.mcparlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/21/2022	2026	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	Chicago
H7524	Surveillance Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	System Contact	VP and Chief Apps Officer		Kay	Carolanne		5854142258					Carolanne.Kaye@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	Third Party Administrator (TPA) Liaison	Financial Analyst		McManus	Michael		5853397789					Michael.Mcmanus@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	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	Chicago
H7524	User Access Contact	Medicare Compliance Program Administrator		Conte	Elva		7168437805					Elva.Conte@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	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	Chicago
H7524	Utilization Management Contact	Clinical Operations Accreditation & Compliance		Burnop	Elizabeth		3152721088					Elizabeth.Burnop@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	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	Chicago
H7524	Utilization Review Contact	Clinical Operations Accreditation & Compliance		Burnop	Elizabeth		3152721088					Elizabeth.Burnop@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	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	Chicago
H7557	Agent/Broker Compensation Data Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Automated TrOOP Balance Transfer Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Backup User Access Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Best Available Evidence Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Bid Audit Contact			Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Bid Audit Site Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Bid Primary Contact		Mr.	Granow	Les		5614440709					Les.Granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	CAP Report Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	CEO - CMS Administrator Contact		Mr.	Lerer	Ben		5614440780					Ben.lerer@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H7557	CEO - Senior Official for Contracting		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Chief Financial Officer		Mr.	Granow	Les		5614440709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Chief Operating Officer		Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Chief Information Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Chief Information Security Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	CMS Casework Communication Contact			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Complaints Tracking Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Contact for Fraud Investigations			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Coordination of Benefits Contact		Ms.	Crowl	Lacey		7657921412					Lacey.crowl@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Corporate Mailing						5616901134					compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Customer Service Operations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	DIR Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H7557	DIR Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Discount Program Payment Contact		Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	Longevity Health Plan	485 Madison Avenue Suite 202	New York	NY	10022	05/30/2025	2026	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	Seattle
H7557	Electronic Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Emergency Part D Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Emergency Part D Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Encounter Data & Risk Adjustment Operations Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Enrollment Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	EOB Transfer Contact		Ms.	Socoski	Beth		5616901134				5616901134	Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Financial Audit Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Financial Reporting Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Formulary Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Formulary Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	General Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Government Relations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	HIPAA Privacy Officer	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	HIPAA Security Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Hospice Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Interoperability Contact	CIO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	MA Appeals/Grievances Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	MA Claims Processing Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Marketing Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Medical Director		Mr.	Orgain	Javette		3127206656					javette.orgain@longevityhealthplan.com	Longevity Health Plan	1611 Church Street	Evanston	IL	60201	05/30/2025	2026	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	Seattle
H7557	Medicare Compliance Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Medicare Coordinator	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Medicare Part D Opioid Overutilization Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Medication Therapy Management Contact		Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	OffShore Subcontractor Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part C Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part C Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H7557	Part D Appeals Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H7557	Part D Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part D Benefits Contact		Mr.	Latko	Jeff		6363352997					JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H7557	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		8002040016					Rosario_dovico@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H7557	Part D Exceptions Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H7557	Part D Price File Contact (Back-up)	Product Manager Advisor	Ms.	Williams	Stephanie		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part D Price File Contact (Optional)	Medicare Compliance Director	Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part D Price File Contact (Primary)	sr mgr, Government Programs		Dolfi	Amanda		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part D Quality Assurance Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Part D Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Patient Safety Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Payment Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Personal Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Pharmacy Director	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		8002040016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Pharmacy Network Management Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						8882358551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H7557	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Account Manager	Ms.	Lennox	Melyssa							Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF MICHIGAN, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H7557	Physician Incentive Contact		Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Plan Directory Contact for Public Website	Medicare Compliance Director	Ms.	Socoski	Beth		8883133609					Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Plan to Plan Reconciliation Contact		Ms.	Ajayi	Bisi		5616328915					bisi.ajayi@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Processor Contact		Mr.	Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Quality Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Reconciliation Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Reconciliation Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Recovery Audit Contact	VP Compliance	Ms.	Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	SNP Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	SNP State Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Surveillance Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	System Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Third Party Administrator (TPA) Liaison	COO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	User Access Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Utilization Management Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7557	Utilization Review Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H7598	Agent/Broker Compensation Data Contact	Sales Manager		Simon	Kira		7158522051					ksimon@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	07/31/2024	2026	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	Automated TrOOP Balance Transfer Contact	Sr. Pharmacy Manager		Schumm	Brian		8003443405	733326				Brian_Schumm@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/06/2024	2026	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	Backup User Access Contact	Government Programs Manager		Starck	Sara		7158522083					sstarck@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	07/31/2024	2026	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	Clinical Pharmacist	Mr.	Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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	Bid Audit Contact	Chief Financial Officer	Mr.	Tanner	Robert		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Bid Primary Contact	Chief Financial Officer	Mr.	Tanner	Robert		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	CAP Report Contact for Public Website	Chief Information Officer		Rice	Curt		7158525714					crice@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	10/30/2023	2026	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	CEO - CMS Administrator Contact	CEO and General Manager	Ms.	North	Sarah		7158522090					snorth@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	CEO - Senior Official for Contracting	CEO and General Manager	Ms.	North	Sarah		7158522090					snorth@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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 Operating Officer	CEO and General Manager	Ms.	North	Sarah		7158522090					snorth@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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 Information Officer	Chief Information Officer	Mr.	Rice	Curt		7158525714					crice@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	10/30/2023	2026	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 Information Security Officer	Chief Information Officer	Mr.	Rice	Curt		7158525714					crice@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	10/30/2023	2026	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		7158525721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Complaints Tracking Contact	Director of Compliance		Parker	Shawna		7159726097					sparker@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	07/31/2024	2026	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	Contact for Fraud Investigations	Coding Supervisor	Mrs.	Johnson	Melissa		7159726073					mjohnson@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	Director of Member and Provider Services		Johnson	Kirk		7158522618					kjohnson@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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	Corporate Mailing						7158522618				7158367683	dspurlock@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/20/2022	2026	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	Director of Member and Provider Services		Johnson	Kirk		7158522618				7158367683	kjohnson@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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	DIR Contact	Clinical Pharmacist	Mr.	Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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	DIR Contact (Secondary)	Government Programs Manager		Starck	Sara	C	7158522083					sstarck@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	01/14/2025	2026	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	Discount Program Payment Contact	Chief Financial Officer	Mr.	Tanner	Robert		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Electronic Health Record Contact	Chief Information Officer		Rice	Curt		7158525714					crice@group-health.com	2503 N. Hillcrest Parkway		Altoona	WI	54720	10/30/2023	2026	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	Emergency Part D Contact	Clinical Pharmacist		Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Parkway		Altoona	WI	54720	06/24/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Scrum Master		Johnson	Heather		7158522026					hjohnson@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/30/2023	2026	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	Enrollment Contact	Sales Manager		Simon	Kira		7158522051					ksimon@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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	EOB Transfer Contact	Director of Member and Provider Services		Johnson	Kirk		7158522618				7158367683	kjohnson@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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	Financial Audit Contact	Controller	Ms.	Lieberg	Michelle		5344292870					mlieberg@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Tanner	Robert		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Formulary Contact	Clinical Pharmacist		Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	General Contact	Government Programs Manager		Starck	Sara		7158522083					sstarck@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	07/24/2024	2026	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	Director of Government Programs		McConaughey	Christina		7158522039					cmcconaughey@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	11/24/2025	2026	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	HIPAA Privacy Officer	Director of Compliance		Parker	Shawna		7159726097					sparker@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	07/31/2024	2026	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	HIPAA Security Officer	Director of Compliance		Parker	Shawna		7159726097					sparker@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	07/31/2024	2026	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		7158525721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Interoperability Contact	Chief Information Officer		Rice	Curt		7158525714					crice@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	MA Appeals/Grievances Contact	Appeals Specialist		Hatleli	Laura		7158522082					lhatleli@grouphealth.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	04/11/2023	2026	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	MA Claims Processing Contact for Public Website	Claims and Quality Assurance Manager		Gale	Desi		7158525715					dgale@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	Marketing Contact	Director of Marketing		Yang	Adam		7158522984					ayang@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Medical Director	Chief Medical Officer		Bauer	Michele		7158525721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Government Programs Manager	Ms.	Starck	Sara		7158522083					sstarck@group-health.com	2503 N. Hillcrest Pkwy		Altoona, WI 54720-2569	WI	54720	11/24/2025	2026	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 Coordinator	Government Programs Project Manager		Schemenauer	Jennifer		7158522084					jschemenauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	11/24/2025	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist		Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/30/2023	2026	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	Medication Therapy Management Contact	Clinical Pharmacist		Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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	Online Enrollment Center Contact (Primary)	Government Programs Manager		Starck	Sara	C	7158522083					sstarck@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	10/28/2024	2026	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 C Application Contact	Government Programs Manager		Starck	Sara		7158522083					sstarck@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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 C Reporting Contact	Manager of Government Programs		Starck	Sara		7158522083					sstarck@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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 Appeals	Sr. Manager - Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/14/2025	2026	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	5132920563				HMO - Health Maintenance Organization		C	Chicago
H7598	Part D Appeals Contact (Secondary)	Sr. Manager - Pharmacy Prior Authorization		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	07/16/2024	2026	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	8607877981				HMO - Health Maintenance Organization		C	Chicago
H7598	Part D Application Contact	Government Programs Manager		Starck	Sara		7158522083					sstarck@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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 Benefits Contact	Clinical Pharmacist		Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/24/2025	2026	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 Claims Submission Contact	Claims and Quality Assurance Manager		Gale	Desi		7158525715					dgale@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	Sr. Manager - Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/14/2025	2026	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	5132920563				HMO - Health Maintenance Organization		C	Chicago
H7598	Part D Price File Contact (Back-up)	Sr. Manager Regulated Markets	Ms.	Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/06/2024	2026	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 Price File Contact (Optional)	Manager Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	06/06/2024	2026	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 Price File Contact (Primary)	Chief Financial Officer	Mr.	Tanner	Robert		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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 Quality Assurance Contact	Quality Improvement Manager		Hanson	Taylor		7158522994					thanson@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/20/2022	2026	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 Reporting Contact	Manager of Government Programs		Starck	Sara		7158522083					sstarck@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	Patient Safety Contact	Chief Medical Officer		Bauer	Michele		7158525721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Payment Contact	Controller		Lieberg	Michelle		5344292870					mlieberg@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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 Director	Clinical Pharmacist		Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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 Network Management Contact	Network Account Director		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	06/06/2024	2026	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	Director, Customer Service		Monroe	LaTasha							LaTasha_Monroe@express-scripts.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	12/17/2024	2026	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	8009221557				HMO - Health Maintenance Organization		C	Chicago
H7598	Plan Directory Contact for Public Website	Director of Marketing		Yang	Adam		7158522984					ayang@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Tanner	Robert		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Processor Contact	Claims and Quality Assurance Manager		Gale	Desi		7158525715					dgale@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	Quality Contact	Quality Improvement Manager		Hanson	Taylor		7158522994					thanson@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	10/20/2022	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Tanner	Robert		7158522064				7158367683	btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Tanner	Robert		7158522064					btanner@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	SNP Application Contact	Government Programs Manager		Starck	Sara		7158522083					sstarck@group-health.com	2503 N. Hillcrest Parkway		Altoona	WI	54720	06/24/2025	2026	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	Surveillance Contact	Chief Information Officer		Rice	Curt		7158525714					crice@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	10/30/2023	2026	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	System Contact	Chief Information Officer		Rice	Curt		7158525714					crice@group-health.com	2503 N Hillcrest Pkwy		Altoona	WI	54720	10/30/2023	2026	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	Third Party Administrator (TPA) Liaison	Clinical Pharmacist		Rau	Dakota		7158525783					drau@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/30/2025	2026	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	User Access Contact	Director of Government Programs		McConaughey	Christina		7158522039					cmcconaughey@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	06/06/2024	2026	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	Utilization Management Contact	Chief Medical Officer		Bauer	Michele		7158525721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Utilization Review Contact	Chief Medical Officer		Bauer	Michele		7158525721					mbauer@group-health.com	2503 N. Hillcrest Pkwy		Altoona	WI	54720	05/04/2022	2026	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	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Kansas City
H7605	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Kansas City
H7605	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	Kansas City
H7605	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7605	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TENNESSEE INC	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H7607	Agent/Broker Compensation Data Contact	President	Mr.	Greene	Richard		7144225089					Richard.Greene@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Automated TrOOP Balance Transfer Contact			Rivera-Aquino	Denisse		8582915269					draquino@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	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	Chicago
H7607	Backup User Access Contact	CISO	Mr.	Nabours	John		7146508689					john.nabours@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Best Available Evidence Contact	COO		Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Bid Audit Contact	Actuary	Mr.	Sun	Sunny		5628888801	8800				Sunny.Sun@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Bid Audit Site Contact	Actuary	Mr.	Sun	Sunny		5628888801	8800				Sunny.Sun@ccmpad.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Bid Primary Contact	Actuary	Mr.	Sun	Sunny		5628888801	8800				Sunny.Sun@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	CAP Report Contact for Public Website	COO		Ramsey	Erin	R	9492911387					Erin.Ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	CEO - CMS Administrator Contact	President	Mr.	Greene	Richard		7147857939					richard.greene@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	CEO - Senior Official for Contracting	President	Mr.	Greene	Richard		7147857939					richard.greene@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Chief Financial Officer	CFO	Mr.	Bellamy	Chris		7148904330					chris.bellamy@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Chief Operating Officer	COO	Ms.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Chief Information Officer	Sr. Director Data and Analytics	Ms	Norris	Tami		6265149146					tami.norris@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	06/05/2025	2026	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	Chicago
H7607	Chief Information Security Officer	CISO	Mr.	Nabours	John		7146508689					john.nabours@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	CMMI Model Point of Contact	COO		Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	CMS Casework Communication Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Complaints Tracking Contact	Manager, A&G	Ms.	Sprague	Ashlee		7146508768					ashlee.sprague@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Contact for Fraud Investigations	Director, SIU	Mr.	Barlahan	Andrei		7146508691					andrei.barlahan@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Coordination of Benefits Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Corporate Mailing						9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Customer Service Operations Contact	Manager, A&G	Ms.	Sprague	Ashlee		7146508768					ashlee.sprague@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	DIR Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	DIR Contact (Secondary)	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Discount Program Payment Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Electronic Health Record Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Emergency Part D Contact	Compliance Officer	Ms.	Coleman	Sabrina	M	9143271439					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Emergency Part D Contact (Secondary)	COO		Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Employer Waiver Contact	COO		Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment & Encounter Data	Ms.	Naithani	Pooja		7146508771					pooja.naithani@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Enrollment Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	EOB Transfer Contact	COO	Mrs.	Ramsey	Erin	R	9492911387				6572764714	erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Financial Audit Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Financial Reporting Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Formulary Contact			Nyawablia	Christina		8587906297					Christina.Nyawabila@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	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	Chicago
H7607	Formulary Contact (Secondary)	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	General Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Government Relations Contact	COO		Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	HIPAA Privacy Officer	Compliance Officer	Ms.	Coleman	Sabrina	M	9143271439					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	HIPAA Security Officer	CISO	Mr.	Nabours	John		7146508689					john.nabours@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Hospice Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Interoperability Contact	Sr. Director Data and Analytics	Ms.	Norris	Tami		6265149146					tami.norris@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	06/05/2025	2026	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	Chicago
H7607	MA Appeals/Grievances Contact	Manager, A&G	Ms.	Sprague	Ashlee		7146508768					ashlee.sprague@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	MA Claims Processing Contact for Public Website	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Marketing Contact	Compliance Internal Auditor	Mrs.	Crandall	Lauren		5628888801	8952				lauren.crandall@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	06/05/2025	2026	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	Chicago
H7607	Medical Director	Chief Clinical Officer	Dr.	Siddiq	Khaliq		6265149123					khaliq.siddiq@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Medicare Compliance Officer	VP, Audit & Compliance Officer	Mrs.	Coleman	Sabrina		9143271439					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Medicare Coordinator	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Medicare Part D Opioid Overutilization Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Medication Therapy Management Contact	Pharmacy Director	Mrs.	Shin	Sally		5628888801	8810				sally.shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	06/05/2025	2026	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	Chicago
H7607	OffShore Subcontractor Contact	Compliance Officer	Mrs.	Coleman	Sabrina	M	6265149140					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Online Enrollment Center Contact (Back-up)	Director of Member Experience	Mr.	Haggard	Steven		5628888801	8803				steven.haggard@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Online Enrollment Center Contact (Optional)	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Online Enrollment Center Contact (Primary)	COO	Mrs.	Ramsey	Erin	R	9492911387				6572764714	erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part C Application Contact	Compliance Officer	Mrs.	Coleman	Sabrina	M	9143271439					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part C Reporting Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part D Appeals			Martin	Dawn							AppealGrievancesManagement@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	8587907118				HMO - Health Maintenance Organization		C	Chicago
H7607	Part D Appeals Contact (Secondary)	Director of Pharmacy	Ms.	Shin	Sally							sally.shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	8332839888				HMO - Health Maintenance Organization		C	Chicago
H7607	Part D Application Contact	Compliance Officer	Ms.	Coleman	Sabrina	M	9143271439					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part D Benefits Contact	Pharmacy Director	Ms.	Shin	Sally		5628888801	8810				sally.shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part D Claims Submission Contact	Pharmacy Director	Ms.	Shin	Sally		5628888801	8810				Sally.Shin@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part D Exceptions Contact			Martin	Dawn							AppealGrievancesManagement@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	8587907118				HMO - Health Maintenance Organization		C	Chicago
H7607	Part D Exceptions Contact (Secondary)	Pharmacy Director		Shin	Sally							sally.shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	8332839888				HMO - Health Maintenance Organization		C	Chicago
H7607	Part D Price File Contact (Back-up)			Niemi	Kirstin		8587906455					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	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	Chicago
H7607	Part D Price File Contact (Optional)	Pharmacy Director		Shin	Sally		5628888801	8810				sally.shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part D Price File Contact (Primary)	Pharmacy Director	Ms.	Shin	Sally		5628888801	8810				Sally.Shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part D Quality Assurance Contact	Pharmacy Director	Ms.	Shin	Sally		5628888801	8810				Sally.Shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Part D Reporting Contact			MacLochlainn	Tine		8587907031					MedicarePartDProjectManagers@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	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	Chicago
H7607	Patient Safety Contact	Compliance Officer	Mrs.	Coleman	Sabrina		6265149140					sabrina.coleman@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	06/05/2025	2026	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	Chicago
H7607	Payment Contact	Controller	Ms.	Ngo	Van		7146508695					van.ngo@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Personal Health Record Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Pharmacy Director	Director of PHarmacy	Dr.	Shin	Sally		6265149123					Sally.Shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Pharmacy Network Management Contact			Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	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	Chicago
H7607	Pharmacy Network Management Contact (Secondary)	Compliance, Delegation Oversight Manager	Mrs.	Lucero	Stephanie		5628888801	8795				stephanie.lucero@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	06/05/2025	2026	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	Chicago
H7607	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services.		Brewer	Kathy							CustomerService@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	8009263004				HMO - Health Maintenance Organization		C	Chicago
H7607	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Director	Ms.	Shin	Sally							sally.shin@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	CLEVER CARE OF GOLDEN STATE, INC.	Local CCP	Clever Care Health Plan	HMO/HMOPOS		Clever Care Health Plan, Inc.	750	Yes	Active	8332839888				HMO - Health Maintenance Organization		C	Chicago
H7607	Physician Incentive Contact	COO		Ramsey	Erin		9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8333888168					csr@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Plan to Plan Reconciliation Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Processor Contact		Mr.	Davis-Jones	DeLona	S	8587906229					MedicarePartDProjectManagers@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	05/08/2025	2026	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	Chicago
H7607	Quality Contact	VP Quality HEDIS Risk		Naithani	Pooja		6265149123				6572764714	Pooja.Naithani@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Reconciliation Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Reconciliation Contact (Secondary)	COO	Mrs.	Ramsey	Erin	R	9492911387					Erin.Ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Recovery Audit Contact	Controller	Ms.	Ngo	Van		7146508695					Van.Ngo@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	SNP Application Contact	COO		Ramsey	Erin		9492911387					erin.ramsey@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	SNP State Contact	COO		Ramsey	Erin		9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Surveillance Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	System Contact	COO	Mrs.	Ramsey	Erin	R	9492911387				6572764714	erin.ramsey@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Third Party Administrator (TPA) Liaison	Mgr, Financial Planning & Analysis	Mr.	Hoang	Tom		7144675689					tom.hoang@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	User Access Contact	COO	Mrs.	Ramsey	Erin	R	9492911387					erin.ramsey@ccmapd.com	7711 Center Ave.	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Utilization Management Contact	Director of UM		Isom	Patricia		6265149123					Patricia.Isom@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7607	Utilization Review Contact	Chief Medical Officer	Dr.	Siddiq	Khaliq		6265149123					khaliq.siddiq@ccmapd.com	7711 Center Ave	Suite 100	Huntington Beach	CA	92647	05/08/2025	2026	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	Chicago
H7617	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/14/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H7617	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024989871				PPO - BBA		C	Kansas City
H7617	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8593219075				PPO - BBA		C	Kansas City
H7617	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5024682494				PPO - BBA		C	Kansas City
H7617	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	8008658715				PPO - BBA		C	Kansas City
H7617	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active	5025800475				PPO - BBA		C	Kansas City
H7617	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7617	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	EMPHESYS INSURANCE COMPANY	Local CCP	Humana	Local PPO		Humana Inc.	128	Yes	Active					PPO - BBA		C	Kansas City
H7619	Automated TrOOP Balance Transfer Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728588					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Backup User Access Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Bid Primary Contact	Manager of Health Plan Operations		DeRitis	Sandra		6095728588					SDERITIS@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	02/20/2024	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	CAP Report Contact for Public Website	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	CEO - CMS Administrator Contact	Executive Director	Ms	Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	CEO - Senior Official for Contracting	Executive Director	Ms.	Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite  1400	Atlantic City	NJ	08401	04/30/2025	2026	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	Finance Director FQHC	Mr.	Apgar	Chris		6095726006					capgar@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Operating Officer	Executive Director	Ms.	Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08226	04/30/2025	2026	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 Information Officer	Executive Director	Ms.	Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08226	04/30/2025	2026	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 Information Security Officer	Finance Director FQHC	Mr.	Apgar	Chris		6095726006					capgar@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Complaints Tracking Contact	Quality Coordinator	Ms.	Lorge	Stacie		6095728588					slorge@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Contact for Fraud Investigations	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Corporate Mailing						6095728588					Sandra.Festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	05/19/2023	2026	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	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	DIR Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	DIR Contact (Secondary)	Finance Director FQHC	Mr.	Apgar	Chris		6095726006					capgar@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Discount Program Payment Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728588					SDERITIS@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Emergency Part D Contact	Medical Director	Dr.	Lipshutz	Robert		6095728588					rlipshutz@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	10/18/2023	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Emergency Part D Contact (Secondary)	Health Plan Operations Manager		DeRitis	Sandra		6095728588					SDERITIS@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Encounter Data & Risk Adjustment Operations Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728588					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Enrollment Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728588					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	EOB Transfer Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728588				6095728589	sderitis@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Financial Audit Contact	Finance Director FQHC	Mr.	Apgar	Chris		6095726006					capgar@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Financial Reporting Contact	Finance Director FQHC	Mr.	Apgar	Chris		6095726006					capgar@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Formulary Contact	Clinical Pharmacist	Mr.	Haddad	George		6095728588					ghaddad@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Formulary Contact (Secondary)	Health Plan Operations Manager		DeRitis	Sandra		6095728588					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	General Contact	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	HIPAA Privacy Officer	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	HIPAA Security Officer	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Interoperability Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave	Ste 1400	Atlantic CIty	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	MA Appeals/Grievances Contact	Quality Coordinator	Ms.	Lorge	Stacie		6095728588					slorge@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	MA Claims Processing Contact for Public Website	Health Plan Operations Manager		DeRitis	Sandra		6095728588					SDERITIS@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Marketing Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Medical Director	Medical Director	Dr.	Lipsutz	Robert		6095728588					rlipshutz@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	10/18/2023	2026	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	Health Plan Operations Manager	Ms.	DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Coordinator	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist	Mr.	Haddad	George		6095728588					ghaddad@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Medication Therapy Management Contact	Clinical Pharmacist	Mr.	Haddad	George		6095728588					ghaddad@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	OffShore Subcontractor Contact	Executive Director		DeRitis	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Online Enrollment Center Contact (Back-up)	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Online Enrollment Center Contact (Optional)	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Online Enrollment Center Contact (Primary)	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 C Application Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	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 Appeals	Health Plan Operations Manager		DeRitis	Sandra							sderitis@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	6095728641				PACE - Nat		C	New York
H7619	Part D Appeals Contact (Secondary)	Clinical Pharmacist	Mr.	Haddad	George							ghaddad@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	6095728588				PACE - Nat		C	New York
H7619	Part D Application Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Benefits Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Claims Submission Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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	Health Plan Operations Manager		DeRitis	Sandra							sderitis@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	6095728641				PACE - Nat		C	New York
H7619	Part D Exceptions Contact (Secondary)	Clinical Pharmacist	Mr.	Haddad	George							ghaddad@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	6095728588				PACE - Nat		C	New York
H7619	Part D Price File Contact (Back-up)	Health Plan Operations Manager		DeRitis	Sandra		6095728588					SDERITIS@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Price File Contact (Optional)			Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/10/2025	2026	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 Price File Contact (Primary)	Clinical Pharmacist	Mr.	Haddad	George		6095728588					ghaddad@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Quality Assurance Contact	Quality Coordinator		Lorge	Stacie		6095728588					slorge@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Reporting Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Patient Safety Contact	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Payment Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Personal Health Record Contact	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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 Director	Medical Director	Dr.	Lipshutz	Robert		6095728588					rlipshutz@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	10/18/2023	2026	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 Network Management Contact	Medical Director	Dr.	Lipshutz	Robert		6095728588					rlipshutz@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	10/18/2023	2026	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 Network Management Contact (Secondary)	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	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	Clinical Pharmacist	Mr.	Haddad	George							ghaddad@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	6095728588				PACE - Nat		C	New York
H7619	Pharmacy Technical Help Desk Contact (Secondary)	Medical Director	Dr.	Lipshutz	Robert							rlipshutz@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active	6095728588				PACE - Nat		C	New York
H7619	PHR Beneficiary Contact																	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE	AtlantiCare LIFE Connection	AtlantiCare Health Services, Inc.	683	Yes	Active	6095728588				PACE - Nat		C	New York
H7619	Plan Directory Contact for Public Website	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Avenue	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Plan to Plan Reconciliation Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728588					SDERITIS@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Processor Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Quality Contact	Quality Coordinator	Ms.	Lorge	Stacie		6095728588					slorge@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Reconciliation Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Reconciliation Contact (Secondary)	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Recovery Audit Contact	Finance Director FQHC	Mr.	Apgar	Chris		6095726006					capgar@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Surveillance Contact	Executive Director		Festa	Sandra		6095728588					sfesta@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	System Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Third Party Administrator (TPA) Liaison	Health Plan Operations Manager		DeRitis	Sandra		6095728588					SDERITIS@atlanticare.org	1401 Atlantic Ave	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	User Access Contact	Executive Director		Festa	Sandra		6095728588					sandra.festa@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	04/30/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Utilization Management Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7619	Utilization Review Contact	Health Plan Operations Manager		DeRitis	Sandra		6095728641					sderitis@atlanticare.org	1401 Atlantic Ave.	Suite 1400	Atlantic City	NJ	08401	07/08/2025	2026	ATLANTICARE HEALTH SERVICES, INC.	National PACE	AtlantiCare LIFE Connection	National PACE		AtlantiCare Health Services, Inc.	683	Yes	Active					PACE - Nat		C	New York
H7620	Agent/Broker Compensation Data Contact	Director of Communications and Marketing		Worley Marselian	Nicolette		8056859525	1993				nworleymarselian@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Backup User Access Contact	Compliance Manager		Bartee	Allison		8056859525	1093				abartee@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Best Available Evidence Contact	Director, Member Services		Buben	Eric		8056859525	1661				ebuben@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Bid Audit Contact	Audits, Monitoring, and Oversight Director		Shah	Puja		8056859525	1098				pshah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Bid Audit Site Contact	Audits, Monitoring, and Oversight Director		Shah	Puja		8056859525	1098				pshah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Bid Primary Contact	Medicare Director		Garcia	Hector		8056859525	5372				hgarcia@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	CAP Report Contact for Public Website	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active	8778141861				HMO - Health Maintenance Organization		C	Atlanta
H7620	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Owen	Marina		8056859525	1013				mowen@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Owen	Marina		8056859525	1013				mowen@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Chief Financial Officer	Chief Financial Officer	Ms.	Bishop	Kashina		8056859525	1090				kbishop@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Chief Operating Officer	Chief Operating Officer	Ms.	Kantheti	Kaliki		8056859525	5392				kkantheti@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	04/11/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Chief Information Officer	Chief Information Officer	Mr.	Moore	Darin		8056859525	1905				dmoore@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Chief Information Security Officer	Chief Compliance and Fraud Prevention Officer	Ms.	Kim	Karen		8056859525	1975				kkim@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	CMMI Model Point of Contact	Medicare Director		Garcia	Hector		8056859525	5372				hgarcia@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	CMS Casework Communication Contact	Medicare Grievance and Appeals Manager		Ragland	Tameka		8056859525	5389				tragland@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Complaints Tracking Contact	Medicare Grievance and Appeals Manager		Ragland	Tameka		8056859525	5389				tragland@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Contact for Fraud Investigations	Compliance Director & Privacy Officer		Vitocruz	Krisza		8056859525	1066				kvitocruz@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Coordination of Benefits Contact	Manager, Payment Integrity & Recoveries		Matthews	Cody		8056859525	1087				cmatthews@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Corporate Mailing						8056859525					MSsupport@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Customer Service Operations Contact	Director, Member Services		Buben	Eric		8056859525	1661				ebuben@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	DIR Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	DIR Contact (Secondary)	Pharmacy Associate Director		Lamaa	Tina		8056859525	5529				tlamaa@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	05/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Discount Program Payment Contact	Chief Financial Officer		Bishop	Kashina		8056859525	1090				kbishop@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	12/03/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Electronic Health Record Contact	IT Development Director		Roszkowiak	John		8056859525	1019				jroszkowiak@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Emergency Part D Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Emergency Part D Contact (Secondary)	Pharmacy Associate Director		Lamaa	Tina		8056859525	5529				tlamaa@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	05/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Manager		Bodnar	Brian		8056859525	5487				bbodnar@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Enrollment Contact	Director, Member Services		Buben	Eric		8056859525	1661				ebuben@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	EOB Transfer Contact	Director of Claims Operations		Ashburn	Gary		8056859525	1953			8056818279	gashburn@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Financial Audit Contact	Audits, Monitoring, and Oversight Director	Ms.	Shah	Puja		8056859525	1098				pshah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Financial Reporting Contact	Accounting Director		Sim	Amy		8056859525	1064				asim@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Formulary Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Formulary Contact (Secondary)	Pharmacy Associate Director		Lamaa	Tina		8056859525	5529				tlamaa@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	05/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	General Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Government Relations Contact	Director of Administrative Services		Madrid	Kaleb		8056859525	1941				kmadrid@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	HIPAA Privacy Officer	Compliance Director & Privacy Officer		Vitocruz	Krisza		8056859525	1066				kvitocruz@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	HIPAA Security Officer	Compliance Director & Privacy Officer		Vitocruz	Krisza		8056859525	1066				kvitocruz@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Hospice Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Interoperability Contact	IT Development Director		Roszkowiak	John		8056859525	1019				jroszkowiak@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	MA Appeals/Grievances Contact	Director, Member Services		Buben	Eric		8056859525	1661				ebuben@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	MA Claims Processing Contact for Public Website	Director of Claims Operations		Ashburn	Gary		8056859525	1953				gashburn@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Marketing Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Medical Director	Chief Medical Officer	Ms.	Heinert	Maya		8056859525	5350				mheinert@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Medicare Compliance Officer	Chief Compliance and Fraud Prevention Officer	Ms.	Kim	Karen		8056859525	1975				kkim@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Medicare Coordinator	Medicare Director		Garcia	Hector		8056859525	5372				hgarcia@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Medication Therapy Management Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Online Enrollment Center Contact (Back-up)	Associate Director, Member Services		Rodriguez	Elia		8056859525	1656				emrodriguez@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	11/03/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Online Enrollment Center Contact (Primary)	Director, Member Services		Buben	Eric		8056859525	1661				ebuben@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part C Application Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part C Reporting Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Appeals	Director, Member Services		Buben	Eric							ebuben@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active	8056859525	1661			HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Appeals Contact (Secondary)	Medicare Grievance and Appeals Manager		Ragland	Tameka							tragland@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	02/14/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active	8056859525	5389			HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Application Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Benefits Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Claims Submission Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Exceptions Contact	Director of Pharmacy Services		Januska	Jeff							jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active	8056859525	1635			HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Exceptions Contact (Secondary)	Pharmacy Associate Director		Lamaa	Tina							tlamaa@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	05/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active	8778141861				HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Price File Contact (Back-up)	Pharmacy Associate Director		Lamaa	Tina		8056859525	5529				tlamaa@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	05/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Price File Contact (Primary)	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Quality Assurance Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Part D Reporting Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Patient Safety Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Payment Contact	Accounting Director		Sim	Amy		8056859525	1064				asim@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Personal Health Record Contact	Compliance Director & Privacy Officer		Vitocruz	Krisza		8056859525	1066				kvitocruz@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Pharmacy Director	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Pharmacy Network Management Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Pharmacy Network Management Contact (Secondary)	Pharmacy Associate Director		Lamaa	Tina		8056859525	5529				tlamaa@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	05/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active	8337260676				HMO - Health Maintenance Organization		C	Atlanta
H7620	PHR Beneficiary Contact																	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS	CenCal Health	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active	8778141861				HMO - Health Maintenance Organization		C	Atlanta
H7620	Physician Incentive Contact	Director of Quality and Population Health		Geeb	Lauren		8056859525	1623				lgeeb@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Plan Directory Contact for Public Website			Health	CenCal		8778141861					MSsupport@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Plan to Plan Reconciliation Contact	Director of Pharmacy Services		Januska	Jeff		8056859525	1635				jjanuska@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Processor Contact	Director of Claims Operations		Ashburn	Gary		8056859525	1953				gashburn@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Quality Contact	Director of Quality and Population Health		Geeb	Lauren		8056859525	1623				lgeeb@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Reconciliation Contact	Director, Financial Analysis		Louwerens	Jamie		8056859525	9332				jlouwerens@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Reconciliation Contact (Secondary)	Risk Adjustment Manager		Bodnar	Brian		8056859525	5487				bbodnar@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/16/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Recovery Audit Contact	Audits, Monitoring, and Oversight Director	Ms.	Shah	Puja		8056859525	1098				pshah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	SNP Application Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	SNP State Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Surveillance Contact	Director of Communications and Marketing		Worley Marselian	Nicolette		8056859525	1993				nworleymarselian@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/17/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	System Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Third Party Administrator (TPA) Liaison	Accounting Director		Sim	Amy		8055621064					asim@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	12/03/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	User Access Contact	Medicare Compliance Manager		Pessah	Sheryl		8056859525	5365				spessah@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	03/13/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Utilization Management Contact	Dual Special Needs Clinical Programs (D-SNP) Direc		Flores	Cammie		8056859525	1685				cflores@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7620	Utilization Review Contact	Dual Special Needs Clinical Programs (D-SNP) Direc		Flores	Cammie		8056859525	1685				cflores@cencalhealth.org	4050 Calle Real		Santa Barbara	CA	93110	01/22/2025	2026	SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA CENCAL HEALTH	Local CCP	CenCal CareConnect	HMO/HMOPOS		SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	870	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H7635	Agent/Broker Compensation Data Contact	Director of Marketing, Sales and Outreach	Ms.	Carcieri	Lisa		4014596008					lcarcieri@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Backup User Access Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Best Available Evidence Contact	Director of Business Services	Ms.	Sullivan	Kari		4014596612					ksullivan2@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Bid Audit Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Bid Audit Site Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Bid Primary Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	CAP Report Contact for Public Website	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Marino	Peter		4014596141					pmarino@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Marino	Peter		4014596141					pmarino@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Chief Financial Officer	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Chief Operating Officer	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Chief Information Officer	Chief Information Officer-Vice President	Mr.	Dibiasio	Steven		4014278825					sdibiasio@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Chief Information Security Officer	Enterprise Risk and Information Security Officer	Mr.	Francis Jr	Robert		4014435989					rfrancis@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	CMS Casework Communication Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Complaints Tracking Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Contact for Fraud Investigations	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Coordination of Benefits Contact	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Corporate Mailing						4018893145	0				lgoncalves@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Customer Service Operations Contact	Manager of Member Services	Mr.	Barnett	Ronald		4014596110					rbarnett@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	DIR Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	DIR Contact (Secondary)	Director of Financial Reporting	Ms.	Miha	Mihaela		4014435931					mmiha@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Discount Program Payment Contact	Lead Accounting Systems Analyst	Mr.	Capece	Corey	W	4015244361					ccapece@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Emergency Part D Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Emergency Part D Contact (Secondary)	Manager of Regulatory  Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Enrollment Contact	Director of Business Services	Ms.	Sullivan	Kari		4014596612					ksullivan2@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	EOB Transfer Contact	Chief Operating Officer	Ms.	Carlson	Karen		4014596633				4014596021	kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Financial Audit Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014279164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Financial Reporting Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014279164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Formulary Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Formulary Contact (Secondary)	Manager of Regulatory Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	General Contact	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Government Relations Contact	Chief Growth Officer	Mr.	Burnett	David		4014596161					dburnett@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	HIPAA Privacy Officer	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	HIPAA Security Officer	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Hospice Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Interoperability Contact	Chief Information Officer-Vice President	Mr.	Dibiasio	Steven		4014278825					sdibiasio@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	MA Appeals/Grievances Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	MA Claims Processing Contact for Public Website	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Marketing Contact	Director of Marketing, Sales and Outreach	Ms.	Carcieri	Lisa		4014596008					lcarceri@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Medical Director	Medical Director	Dr.	Ottiano	Chris		4014596168					cottiano@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Medicare Compliance Officer	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Medicare Coordinator	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Medicare Part D Opioid Overutilization Contact	Manager of Regulatory  Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Medication Therapy Management Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part C Application Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4014278875					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part C Reporting Contact	Operations Oversight Manager	Ms.	Lopez	Alicia	M	4017237761					alopez@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Appeals	Supervisor, Operations	Ms.	Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Boston
H7635	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Boston
H7635	Part D Application Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Benefits Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Claims Submission Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Exceptions Contact	Vice President of Pharmacy	Mr.	Lorson	Mark							mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	4014596640				HMO - Health Maintenance Organization		C	Boston
H7635	Part D Exceptions Contact (Secondary)	Manager of Regulatory  Pharmacy and Oversight	Mr.	Broccoli	David							dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	4014276785				HMO - Health Maintenance Organization		C	Boston
H7635	Part D Price File Contact (Back-up)		Ms.	Scott	Sarah		4806064873					sarah.scott@cvshealth.com	CVS Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Price File Contact (Optional)		Ms.	Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	CVS Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Price File Contact (Primary)			Loveland	Chet		4806064865					chet.loveland@cvshealth.com	CVS Caremark	9501 E Shea Blvd	Scottsdale	AZ	85260	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Quality Assurance Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Part D Reporting Contact	Operations Oversight Manager	Ms.	Lopez	Alicia		4017237761					alopez@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Patient Safety Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Payment Contact	Chief Financial Officer	Ms.	Sears	Michelle		4014278164					msears@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Pharmacy Director	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Pharmacy Network Management Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Pharmacy Network Management Contact (Secondary)	Manager of Regulatory Pharmacy and Oversight	Mr.	Broccoli	David		4014276785					dbroccoli@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Pharmacy Technical Help Desk Contact	AVP Customer Care	Mr.	Jackson	Scott							scott.jackson@cvshealth.com	CVS Caremark Pharmacy Help Desk	445 Great Circle Blvd.	Nashville	TN	37228	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H7635	Pharmacy Technical Help Desk Contact (Secondary)	Vice President of Pharmacy	Mr.	Lorson	Mark							mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active	4014596640				HMO - Health Maintenance Organization		C	Boston
H7635	Plan Directory Contact for Public Website	Director of Marketing, Sales and Outreach	Ms.	Carcieri	Lisa		4014596008					lcarceri@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Plan to Plan Reconciliation Contact	Senior Manager of Financial Analysis	Mr.	Milton	Bryan		4014276726					bmilton@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Processor Contact	Chief Operating Officer	Ms.	Carlson	Karen		4014596633					kcarlson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Quality Contact	Director of Quality & Grievance and Appeals	Ms.	Elias	Cesarina		4014596087					celias@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Reconciliation Contact	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Reconciliation Contact (Secondary)	Senior Manager of Financial Analysis	Mr.	Milton	Bryan		4014276726					bmilton@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Recovery Audit Contact	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	SNP Application Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Surveillance Contact	Vice President Medicare-Medicaid Integration	Mr.	Cooper	Mark		4018893145					mcooper@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	System Contact	System Administrator	Mrs.	Phouthavong	Maria		4014596119					mphouthavong@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Third Party Administrator (TPA) Liaison	Vice President of Pharmacy	Mr.	Lorson	Mark		4014596640					mlorson@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	User Access Contact	Compliance & Privacy Officer	Ms.	Switzer	Kristen		4014596162					kswitzer@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	01/31/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Utilization Management Contact	Medical Director	Dr.	Ottiano	Chris		4014596168					cottiano@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7635	Utilization Review Contact	Medical Director	Dr.	Ottiano	Chris		4014596168					cottiano@nhpri.org	910 Douglas Pike		Smithfield	RI	02917	02/06/2025	2026	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	Local CCP	Neighborhood Health Plan of Rhode Island	HMO/HMOPOS		NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	530	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7656	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Best Available Evidence Contact	Executive Director	Ms	Yang	Chue		5594145001					cyang@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	CAP Report Contact for Public Website	Executive Director	Ms.	Yang	Chue		7327164600				7325923501	cyang@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	04/22/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	CMS Casework Communication Contact	Executive Director	Ms	Yang	Chue		5594145001					cyang@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Customer Service Operations Contact	Executive Director	Ms	Yang	Chue		5594145001					cyang@boldagepace.com	4837 E McKinley Avenue	Suite B	Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Formulary Contact	Finance Specialist		Partlow	Jennie		6406501565					jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	General Contact	Executive Director	Ms	Yang	Chue		5594145001					cyang@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation		Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Medical Director	Medical Director	Dr	Fernando	Earl Don		5594145001					edonfernando@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Medicare Coordinator	Executive Director	Ms	Yang	Chue		5594145001					cyang@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Medication Therapy Management Contact	Medical Director	Dr	Fernando	Earl Don		5594145001					edonfernando@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part D Appeals	Director of Compliance	Ms	Cooper	Wanda							wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active	2675751196				PACE - Nat		C	New York
H7656	Part D Appeals Contact (Secondary)	Chief Health Plan Operations		Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active	7328063224				PACE - Nat		C	New York
H7656	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part D Exceptions Contact	Medical Director	Dr	Fernando	Earl Don							edonfernando@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active	5594145001				PACE - Nat		C	New York
H7656	Part D Exceptions Contact (Secondary)	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	09/11/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active	9548395000				PACE - Nat		C	New York
H7656	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part D Quality Assurance Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Patient Safety Contact	Medical Director	Dr	Fernando	Earl Don		5594145001					edonfernando@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Pharmacy Director	Medical Director	Dr	Fernando	Earl Don		5594145001					edonfernando@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active	8558012653				PACE - Nat		C	New York
H7656	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active	8558012653				PACE - Nat		C	New York
H7656	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Plan to Plan Reconciliation Contact	Financial Specialist		Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Surveillance Contact	Executive Director	Ms	Yang	Chue		5594145001					cyang@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/03/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	User Access Contact	Business Administrator		Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7656	Utilization Review Contact	Executive Director	Ms	Yang	Chue		5594145001					cyang@boldagepace.com	4837 E McKinley Avenue		Fresno	CA	93703	09/24/2024	2026	VALLEY PACE, LLC	National PACE	BoldAge PACE	National PACE		Valley PACE, LLC	836	Yes	Active					PACE - Nat		C	New York
H7660	Automated TrOOP Balance Transfer Contact	Director Financial Management	Mr.	Hamm	David	A	7247761100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/14/2024	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Backup User Access Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	03/10/2020	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Bid Primary Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	CAP Report Contact for Public Website	Director Quality Assurance and education	Mr.	Hankey	Laura		4123561668				7243022091	laura.hankey@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	08/04/2020	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	CEO - CMS Administrator Contact	CEO	Mr	Hamm	David	A	7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/19/2023	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	CEO - Senior Official for Contracting	CEO	Mr	Hamm	David	A	7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/19/2023	2026	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		7247761100					jeffrey.carraway@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	02/02/2018	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Chief Operating Officer	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	04/19/2023	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Chief Information Officer	VP Technology and Quality	Mr	Lamb	Charles		7247209202					charles.lamb@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	11/06/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Chief Information Security Officer	VP Technology and Quality	Mr	Lamb	Charles		7247209202					charles.lamb@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/08/2019	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Complaints Tracking Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Contact for Fraud Investigations	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Corporate Mailing						4123561668					leslie.kisow@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	06/07/2023	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	DIR Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	DIR Contact (Secondary)	Accounting Manager		Cionni	Jane		7247422202					maryjane.cionni@lutheranseniorlife.org	1323 Freedom Rd		Cranberry Township	PA	16066	01/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Discount Program Payment Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/21/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Emergency Part D Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Emergency Part D Contact (Secondary)	Accounting Manager	Ms	Cionni	Jane		3042810400					maryjane.cionni@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	01/13/2025	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Encounter Data & Risk Adjustment Operations Contact	Director Financial Management		Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	03/10/2020	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Enrollment Contact	Accounting Manager	Ms.	Cionni	Jane		7247422202					maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	01/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	EOB Transfer Contact	Director Financial Management	Mr.	Hamm	David		7247422226				7247722960	dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Financial Audit Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Financial Reporting Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Formulary Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	10/03/2022	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	General Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	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		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	HIPAA Privacy Officer	Compliance Officer	Ms.	Kaminski	Leean		7247422295					leean.kaminski@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/16/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	HIPAA Security Officer	Director MIS	Mr.	Gilson	Dennis		7246254841					dennis.gilson@lutheranseniorlife.org	500 Wittenberg Way	P. O. Box 928	Mars	PA	16046	08/09/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Interoperability Contact	Director Financial Management		Hamm	David		7247761100					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	12/16/2024	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	MA Appeals/Grievances Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	MA Claims Processing Contact for Public Website	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Marketing Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Medical Director	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	10/03/2022	2026	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		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Medicare Coordinator	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	10/23/2022	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Medication Therapy Management Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	10/03/2022	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part C Application Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part D Appeals	Director Financial Management	Mr.	Hamm	David							dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422226				PACE - Nat		C	Philadelphia
H7660	Part D Application Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	04/21/2017	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part D Benefits Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/16/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part D Claims Submission Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/16/2016	2026	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	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active	7247422226				PACE - Nat		C	Philadelphia
H7660	Part D Price File Contact (Back-up)	Accounting Manager	Ms.	Cionni	Jane		7247422202					Maryjane.cionni@lutheranseniorlife.org	1323 Freedom Road		Cranberry Township	PA	16066	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part D Price File Contact (Primary)	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/16/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part D Quality Assurance Contact	Director Quality Assurance and education	Mr.	Hankey	Laura		4123561668					laura.hankey@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Part D Reporting Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/16/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Patient Safety Contact	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	10/03/2022	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Payment Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Pharmacy Director	Medical Director	Dr.	Hanna	Abeer		7242875433					abeer.hanna@lutheranseniorlife.org	231 Diamond St		Butler	PA	16001	10/03/2022	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Pharmacy Network Management Contact	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	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	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active	7243785400				PACE - Nat		C	Philadelphia
H7660	Plan Directory Contact for Public Website	Executive Director	Ms	Kisow	Leslie		7247761100					leslie.kisow@lutheranseniorlife.org	740 Blackburn Road		Sewickley	PA	15143	11/22/2021	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Plan to Plan Reconciliation Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Processor Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Quality Contact	Director Quality Assurance and education	Mr.	Hankey	Laura		4123561668					laura.hankey@lutheranseniorlife.org	740 Blackburn Rd, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Reconciliation Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Recovery Audit Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Surveillance Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	System Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	08/10/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Third Party Administrator (TPA) Liaison	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	191 Scharberry Lane		Mars	PA	16046	05/21/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	User Access Contact	Director Financial Management	Mr.	Hamm	David		7247422226					dave.hamm@lutheranseniorlife.org	Lutheran SeniorLife	191 Scharberry Lane	Mars	PA	16046	08/09/2016	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Utilization Management Contact	Utilization Review Coordinator	Ms.	Nemec	Dawn		4123561653					dawn.nemec@lutheranseniorlife.org	740 Blackburn Road, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7660	Utilization Review Contact	Utilization Review Coordinator	Ms.	Nemec	Dawn		4123561653					dawn.nemec@lutheranseniorlife.org	740 Blackburn Road, Suite 300		Sewickley	PA	15143	04/08/2019	2026	VIECARE BEAVER, LLC	National PACE	LIFE Beaver and Lawrence Counties	National PACE		Lutheran SeniorLife	352	Yes	Active					PACE - Nat		C	Philadelphia
H7670	Agent/Broker Compensation Data Contact	Director of Sales Operations	Ms.	LaPlant	Brandi		7747011604					brandi.laplant@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Automated TrOOP Balance Transfer Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Backup User Access Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Best Available Evidence Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Bid Audit Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Bid Audit Site Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Bid Primary Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	CAP Report Contact for Public Website	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	CEO - CMS Administrator Contact	CEO	Ms.	Latorre	Sarah		5087698977					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/24/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	CEO - Senior Official for Contracting	CEO	Ms.	Latorre	Sarah		5087698977					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/24/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Chief Financial Officer	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Chief Operating Officer	CEO (for VP Ops)	Ms.	Latorre	Sarah		5087935401					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Chief Information Officer	IT Director	Mr.	Carey	Cameron		7747011604					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/26/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Chief Information Security Officer	IT Director	Mr.	Carey	Cameron		7747011604					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/26/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	CMMI Model Point of Contact	CEO	Ms.	Latorre	Sarah		5087698977					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/24/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	CMS Casework Communication Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Complaints Tracking Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Contact for Fraud Investigations	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Coordination of Benefits Contact	Claims Manager (for VP Ops)	Ms.	Green	Rose		7747011176					rose.green@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Corporate Mailing						5087935401					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Customer Service Operations Contact	Vice President	Mr.	Velten	Steve		8164357408					svelten@dsthealth.com	210 W 10th St		Kansas	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	DIR Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.nataraja@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	DIR Contact (Secondary)	Chief Financial Officer	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Discount Program Payment Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Emergency Part D Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Emergency Part D Contact (Secondary)	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					Susan.Jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01605	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Encounter Data & Risk Adjustment Operations Contact	Director, Business Systems Analysis	Ms.	Pedigo	Anne		6157723229					anne.pedigo@sscinc.com	210 W. 10th Street		Kansas CIty	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Enrollment Contact	Operations Manager	Ms.	Wheeler	Jackelin		7747011160					jackelin.wheeler@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	EOB Transfer Contact	Vice President	Mr.	Velten	Steve		8164357408				3607211381	svelten@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Financial Audit Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Financial Reporting Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01605	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Formulary Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01605	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Formulary Contact (Secondary)	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	General Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Government Relations Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01605	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	HIPAA Privacy Officer	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01605	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	HIPAA Security Officer	IT Director	Mr.	Carey	Cameron		9789356216					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01605	03/03/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Hospice Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Interoperability Contact	IT Director	Mr.	Carey	Cameron		9789356216					cam.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01605	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	MA Appeals/Grievances Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	MA Claims Processing Contact for Public Website	Vice President	Mr.	Velten	Steve		8164357408					svelten@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Marketing Contact	Marketing Director	Ms.	Grier	Maureen		7814929832					maureen.grier@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Medical Director	Chief Medical Officer	Dr.	Gelman	Gennady		9789356216					gennady.gelman@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Milbrook St		Worcester	MA	01605	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Medicare Coordinator	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Medicare Part D Opioid Overutilization Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Medication Therapy Management Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	OffShore Subcontractor Contact	Compliance Auditor and Analyst	Ms.	Wiggins	Olivia		7747011427					olivia.wiggins@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	11/07/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Online Enrollment Center Contact (Primary)	Operations Manager	Ms.	Wheeler	Jackelin		7747011160					jackelin.wheeler@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part C Application Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part C Reporting Contact	Operations Support Spoecialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Appeals	Sr Manager of Pharmacy Part D	Ms.	Jones	Susan							susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	03/03/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	7747011720				HMO - Health Maintenance Organization		C	Boston
H7670	Part D Appeals Contact (Secondary)	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan							susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	7747011720				HMO - Health Maintenance Organization		C	Boston
H7670	Part D Application Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Benefits Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Claims Submission Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Exceptions Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan							susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	7747011720				HMO - Health Maintenance Organization		C	Boston
H7670	Part D Exceptions Contact (Secondary)	Sr Manager of Pharmacy Part D	Ms.	Jones	Susan							susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/21/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	7747011720				HMO - Health Maintenance Organization		C	Boston
H7670	Part D Price File Contact (Back-up)	Vice President, Compliance & Contracting	Mr.	Cone	Mark		8168436461					mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Price File Contact (Optional)	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Price File Contact (Primary)	Vice President, Compliance & Contracting	Mr.	Cone	Mark		8168436461					mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Quality Assurance Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Part D Reporting Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Patient Safety Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Payment Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Pharmacy Director	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Pharmacy Network Management Contact	VP Account Management II	Mr.	Nagy	Don		6123186111					don.nagy@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Pharmacy Technical Help Desk Contact	Sr. Manager, CDAG, Medicare Part D	Mr.	DiBiase	Joe							joe.dibiase@primetherapeutics.com	P.O. Box 64806		St. Paul	MN	551640811	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	8778654624				HMO - Health Maintenance Organization		C	Boston
H7670	Pharmacy Technical Help Desk Contact (Secondary)	Account Manager Health Plans		Muhammad	Atiyya							atiyya.muhammad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	10/23/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active	8778654624				HMO - Health Maintenance Organization		C	Boston
H7670	Plan Directory Contact for Public Website	Marketing Director	Ms.	Greer	Maureen		7747011213					maureen.greer@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Plan to Plan Reconciliation Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Processor Contact	Vice President	Mr.	Velten	Steve		8164357408					svelten@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Quality Contact	Director of Quality	Ms.	Botello	Grace		7747011727					grace.botello@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Reconciliation Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Recovery Audit Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Surveillance Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	System Contact	IT Director	Mr.	Carey	Cameron		9789356216					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	03/03/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Third Party Administrator (TPA) Liaison	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	User Access Contact	IT Director	Mr.	Carey	Cameron		9789356216					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	03/03/2024	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Utilization Management Contact	Operations Support Services	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7670	Utilization Review Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	HMO/HMOPOS		Central Mass Health Holding LLC	773	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7678	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H7678	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H7678	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H7678	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H7678	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H7678	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF TEXAS, INC.	Local CCP	Molina Healthcare of Texas, Inc.	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H7678	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Agent/Broker Compensation Data Contact	Vice President of Medicare Sales	Mr.	Tolle	Rob		4699997675					Rob.Tolle@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Manosca	Nova		8587905873					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Backup User Access Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Best Available Evidence Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Bid Audit Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Bid Audit Site Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Bid Primary Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	CAP Report Contact for Public Website	VP, Compliance & Risk Management		von Arx	Michael	A	7757709348					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	7757709348				HMO - Health Maintenance Organization		C	Boston
H7680	CEO - CMS Administrator Contact	CEO	Mr	Jemmoua	Kamal		7757709325					kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	CEO - Senior Official for Contracting	CEO	Mr.	Jemmoua	Kamal		7757709325					kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Chief Financial Officer	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Chief Operating Officer	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Chief Information Officer		Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Chief Information Security Officer	CISO - UHS	Mrs.	Sassaman	Kim		6103824858					kim.sassaman@uhsinc.com	367 S Gulph RD		King of Prussia	PA	19406	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	CMMI Model Point of Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	CMS Casework Communication Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Complaints Tracking Contact	Director of Operations		Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Contact for Fraud Investigations	SIU Investigator	Mrs.	Kast	Shannon		7754204840					Shannon.Kast@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Coordination of Benefits Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Corporate Mailing						7757709245					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Customer Service Operations Contact	Chief Operating Officer		Koltz	Patrick		7757709240					patrick.koltz@uhsinc.com	1510 Meadow Wood Ln		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	DIR Contact	CEO	Mr	Jemmoua	Kamal		6109924579				7757709360	kamal.jemmoua@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	DIR Contact (Secondary)	Director Pharmacy	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Discount Program Payment Contact	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89052	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Electronic Health Record Contact	Director Health Services		Estipona	Steve		7757709462					steve.estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Emergency Part D Contact	Director Pharmacy	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Emergency Part D Contact (Secondary)	Pharmacy Liaison - Compliance		Harvey	Jonathan		7242945245					jonathan.harvey@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Employer Waiver Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Encounter Data & Risk Adjustment Operations Contact	Director of Quality Improvement		Martinez	Johanna		7757709524					johanna.martinez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Enrollment Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	EOB Transfer Contact	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240				9999999999	Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Financial Audit Contact	Compliance Analyst	Mrs	Cortez	Adrienne		7757709300					phpregulatory@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Financial Reporting Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Formulary Contact	Sup Formulary Operations		Nyawabila	Christina		8587906297					FMT@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Formulary Contact (Secondary)	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	General Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Government Relations Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	HIPAA Privacy Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	HIPAA Security Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Hospice Contact	Health Services Director		Estipona	Steve		7757709462					Steve.Estipona@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Interoperability Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	MA Appeals/Grievances Contact	Director of Operations		Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	MA Claims Processing Contact for Public Website	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Marketing Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Medical Director	Chief Medical Director	Dr.	Biondi	Traci		7757701510					traci.biondi@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Medicare Compliance Officer	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Medicare Coordinator	Compliance Analyst	Mrs.	Cortez	Adrienne		7757709300					PHPCompliance@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Medicare Part D Opioid Overutilization Contact	Audit Team		Audit Team	FA Part D		8587905846					FA_Part_D_Audit@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/02/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Medication Therapy Management Contact	Clinical Solutions Mgr II		Nguyen	Linh		8587906627					MTMP@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	OffShore Subcontractor Contact	VP Compliance and Risk Management	Mr.	von Arx	Michael		7757709245					michael.vonarx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Online Enrollment Center Contact (Back-up)	Director of Medicare Sales	Ms.	Saintil	Adrienne		7757701564					Adrienne.Saintil@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Online Enrollment Center Contact (Optional)	Chief Operating Officer	Mr.	Koltz	Patrick		7757709240					Patrick.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Online Enrollment Center Contact (Primary)	Vice President of Medicare Sales	Mr.	Tolle	Rob		4699997675					Rob.Tolle@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part C Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part C Reporting Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part D Appeals	Part D Appeals 1		and Grievances Team	Appeals							appealgrievancesmanagement@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587906584				HMO - Health Maintenance Organization		C	Boston
H7680	Part D Appeals Contact (Secondary)	Part D Appeals 2		Redd Guinto	Karen							karen.reddguinto@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587906584				HMO - Health Maintenance Organization		C	Boston
H7680	Part D Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part D Benefits Contact	Director of Pharmacy		Huang	David		3177528432					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part D Claims Submission Contact	Supervisor, GPS Operations		Distel	Chris		3302127994					PDE@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part D Exceptions Contact	Director Prior Authorization and Utilization Mgmt		Emoto	Junianne							Julianne.Emoto@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	Boston
H7680	Part D Exceptions Contact (Secondary)	Pharmacist in Charge		deGuzman	Edwin							Edwin.deGuzman@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8582915494				HMO - Health Maintenance Organization		C	Boston
H7680	Part D Price File Contact (Back-up)	Medicare Part D Program MGR I		Niemi	Kristin		8587906455					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part D Price File Contact (Primary)	Medicare Part D Program Manager II		Keller	Shannon		8587907104					planfindercommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part D Quality Assurance Contact	Director Pharmacy		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Part D Reporting Contact	Medicare Part D Project Manager		Scott	Susan		8587906565					MedicarePartDProjectManagers@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Patient Safety Contact	Pharmacy Director	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Ren	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Payment Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Pharmacy Director	Pharmacy Director	Mr.	Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Ren	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Pharmacy Network Management Contact	Supervisor, Carrier Configuration		Montes	Melissa		6195995938					Melissa.Montes@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Pharmacy Network Management Contact (Secondary)	Manager, PNS & Claims Operations		Burke	Sharon		8587907148					Sharon.Burke@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8445877389				HMO - Health Maintenance Organization		C	Boston
H7680	Pharmacy Technical Help Desk Contact (Secondary)	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active	8445877389				HMO - Health Maintenance Organization		C	Boston
H7680	Physician Incentive Contact	Director of Network Management	Jr	Maronde	James		7757709300					james.marondejr@uhsinc.com	639 Isbell Road Ste. 400		Reno	NV	89509	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Plan Directory Contact for Public Website	Marketing Director		Koltz	Danielle		7757709302					Danielle.Koltz@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Processor Contact	Director, Medicare Programs		Davis-Jones	DeLona		8587906229					DeLona.Davis-Jones@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Quality Contact	Director of Quality Improvement		Martinez	Johanna		7757709524					johanna.martinez@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Reconciliation Contact	Chief Financial Officer	Mr.	Hsieh	David		6103823300					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Reconciliation Contact (Secondary)	Chief Finance Officer	Mr.	Hsieh	David		6103824858					david.hsieh@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Recovery Audit Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	SNP Application Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	SNP State Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Surveillance Contact	Director of Operations	Ms.	Revada	Liz		7757709207					liz.revada@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	System Contact	Director, IT Applications	Mr.	Silva	Daniel		6199319852					Daniel.silva@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Third Party Administrator (TPA) Liaison	Pharmacy Director		Huang	David		7757709229					david.huang@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89052	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	User Access Contact	VP of Compliance & Risk Management	Mr.	von Arx	Michael	A	7757709348					Michael.vonArx@uhsinc.com	1510 Meadow Wood Lane		Reno	NV	89502	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Utilization Management Contact	Manager, QA & Client Services		Nguyen	Quan		8587907151					Quan.nguyen@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7680	Utilization Review Contact	Dir PA Clinical Programs		McGurran	Shawn		8587906682					Shawn.McGurran@MedImpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	06/04/2025	2026	PROMINENCE HEALTHFIRST OF TEXAS	Local CCP	Prominence Health Plan	HMO/HMOPOS		Universal Health Services, Inc.	587	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Automated TrOOP Balance Transfer Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Best Available Evidence Contact	Senior Director,Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Chief Information Officer	VP, Information Technology	Mr.	Putila	Matt		4122554163					mputila@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	CMMI Model Point of Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					Aaron.Laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	08/02/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	CMS Casework Communication Contact	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Complaints Tracking Contact	Sr. Quality Analyst, A&G	Ms.	Barbagallo	Toni Marie		4122557287					tbarbagallo@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Contact for Fraud Investigations	Director, Fraud, Waste and Abuse	Dr.	Berdell	Melissa		4126907432					mberdell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Coordination of Benefits Contact	Sr. Director, Operations	Ms.	Magliocco	Michelle		4122554810					COB-TPLMedicare@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Corporate Mailing						4122554640					medicareassured@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Customer Service Operations Contact	Manager Business Operations	Mr.	Hartman	Josh		8006855209					jhartman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	DIR Contact	Vice President, Accounting & Reporting		Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	Fifth Avenue Place		Pittsburgh	PA	15222	08/02/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager	Ms.	Stetson	Kelsey		4125445816					Kelsey.Stetson@highmarkhealth.org	120 Fifth Avenue	120 Fifth Avenue	Pittsburgh	PA	15222	08/02/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Emergency Part D Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4122558830				8889188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Emergency Part D Contact (Secondary)	Senior Compliance Analyst	Mr.	Woods	Shane		4129188763					Shane.Woods@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	09/18/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Encounter Data & Risk Adjustment Operations Contact	Senior Encounters Analyst	Mr.	McKay	Douglas		4129188447					GHP_Medicare_Encounters@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Enrollment Contact	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	EOB Transfer Contact	SVP, Operations	Mr.	Burgess	James		4122551318				4122551318	jburgess@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Financial Audit Contact	VP, Controller	Mr.	Cogan	Chris		4122554693					CCogan@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Formulary Contact	Pharmacy Relations & Formulary Specialist	Ms.	Stein	Victoria		1412255725					vstein@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Formulary Contact (Secondary)			McDonnell	Kallyn		4129188692					KMcDonnell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					justine.patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Hospice Contact	Supervisor, Pharmacy Call Center	Mr.	Woods	Shane		4129188763					SWoods2@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Interoperability Contact	VP,  Data Analytics & Strategy	Mr.	Castle	Brian		4129188449					bcastle@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	MA Appeals/Grievances Contact	Senior Director, Operations		Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	MA Claims Processing Contact for Public Website	SVP, Operations	Mr.	Burgess	James		4122551318					jburgess@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Medical Director	Senior Medical Director	Dr.	Reddy	Lakshmi		4124206517					lakshmi.reddy@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Medicare Part D Opioid Overutilization Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Medication Therapy Management Contact	Senior Director,  Stars Quality	Dr.	Serrano	Daniel	N	4129188572					dserrano@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Online Enrollment Center Contact (Back-up)	Manager, Enrollment, Systems Admin/Enrollment	Ms.	Blumentritt	Kristen		4122554172					KBlumentritt@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	08/02/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Online Enrollment Center Contact (Primary)	Senior Director, Operations	Ms.	Magliocco	Michelle		4122554810					mmagliocco@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part C Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	07/02/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Appeals	Supervisor, Medicare Appeals		Earlewine	Melissa							mearlewine@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4122557203				HMO - Health Maintenance Organization		C	Boston
H7710	Part D Appeals Contact (Secondary)	Manager, Appeals		Wright	Kristie							kwright@highmarkwholecare.com	Four Gateway Center	444 Liberty Avenue, Suite 2100	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4124206431				HMO - Health Maintenance Organization		C	Boston
H7710	Part D Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/03/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Benefits Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				8882452049	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Claims Submission Contact	Dir Initiative Mgt	Mr.	Smith	Cory		4129188825					csmith@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Exceptions Contact	VP, Pharmacy	Mr.	Yarnell	Eric						8882452049	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4129188830				HMO - Health Maintenance Organization		C	Boston
H7710	Part D Exceptions Contact (Secondary)	Director, Pharmacy Clinical Operations	Ms.	Nogrady	Lisa							lnogrady@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	4122554256				HMO - Health Maintenance Organization		C	Boston
H7710	Part D Price File Contact (Back-up)	Director,  Pharmacy Business Operations	Ms.	Funkhouser	Christina		4122157123					cfunkhouser@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Price File Contact (Optional)	Program Manager, Pharmacy Quality		Michael	Alisa		4126907028					Alisa.Michael@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	01/23/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Price File Contact (Primary)	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Quality Assurance Contact	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsbugh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Patient Safety Contact	Vice President, Pharmacy Business Administration	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Payment Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/02/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Pharmacy Director	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830				4129188830	eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Pharmacy Network Management Contact	Director,  Pharmacy Business Operations	Ms.	Funkhouser	Christina		4122157123					cfunkhouser@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Pharmacy Network Management Contact (Secondary)	VP, Pharmacy	Mr.	Yarnell	Eric		4129188830					eric.yarnell@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Pharmacy Technical Help Desk Contact			Pharmacy Help Desk	CVS								Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	11/21/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Boston
H7710	Pharmacy Technical Help Desk Contact (Secondary)	VP, Pharmacy		Yarnell	Eric						4129188830	eric.yarnell@highmark.com	Four Gateway Center	444 Liberty Ave, Ste 2100	Pittsburgh	PA	15222	04/11/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active	8006855209				HMO - Health Maintenance Organization		C	Boston
H7710	Physician Incentive Contact	Senior Director, Stars Quality	Mr.	O'Donnell	William		4129188572					wodonnell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Plan Directory Contact for Public Website	Manager Business Operations	Mr.	Hartman	Josh		8006855209					jhartman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Plan to Plan Reconciliation Contact	Manager, Operational Accounting		Stehr	Brett		7173022748					P2PRecon@highmark.com	Attn: Cashier	PO Box 898820	Camp Hill	PA	17089	11/18/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Processor Contact	Director, Claims Processing	Ms.	Goheen	Theresa		4129188706					tgoheen@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Quality Contact	Interim Director, Quality Improvement	Ms.	Uncapher	Patricia		4129188790					puncapher@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Reconciliation Contact	VP, Controller		Cogan	Chris		4122554693					CCogan@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Recovery Audit Contact	Director, Fraud, Waste and Abuse	Dr.	Berdell	Melissa		4126907432					mberdell@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	SNP Application Contact	Senior Director, Medicare Product	Mr.	Laverick	Aaron	H	4122557195					aaron.laverick@highmark.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	07/02/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	SNP State Contact	Senior Risk Partner	Ms.	Bach	Vicki		4125441549					Vicki.Bach@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	01/27/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Third Party Administrator (TPA) Liaison	Senior Financial Analyst		Trautvetter	Jill		4122557132					jtrautvetter@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Utilization Management Contact	Director, Clinical Operations	Ms.	Layman	Katrina		4122554173					klayman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7710	Utilization Review Contact	Director, Clinical Operations	Ms.	Layman	Katrina		4122554173					klayman@highmarkwholecare.com	Fifth Avenue Place	120 Fifth Avenue	Pittsburgh	PA	15222	01/19/2024	2026	HIGHMARK BCBSD, INC.	Local CCP	Highmark Blue Cross Blue Shield	HMO/HMOPOS		Highmark Health	123	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H7725	Automated TrOOP Balance Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Backup User Access Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Best Available Evidence Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	CAP Report Contact for Public Website	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	CEO - CMS Administrator Contact	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	psoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	CEO - Senior Official for Contracting	Senior Vice President of Healthcare	Mr	Soczynski	Paul		4144068843				9529417097	psoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Chief Financial Officer	Regional Vice President, PACE Operations	Mr.	Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Chief Operating Officer	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Chief Information Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Chief Information Security Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	CMS Casework Communication Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Complaints Tracking Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Contact for Fraud Investigations	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Coordination of Benefits Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Customer Service Operations Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9709643556				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	DIR Contact (Secondary)	Director of Health Plan Operations		Gallagher	Tierney		9705950523				9708295842	tgallagher@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/09/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Discount Program Payment Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Emergency Part D Contact (Secondary)	Vice President of Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Enrollment Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	General Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Government Relations Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	HIPAA Privacy Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	HIPAA Security Officer	Chief Information & Technology Officer	Mr	Osborne	David		6124287900				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	MA Appeals/Grievances Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	MA Claims Processing Contact for Public Website	Claims Administrator		Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Marketing Contact	Executive Director		Booker	Chiquita		5023142059				5026767517	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Medical Director	Medical Director		Brennan	Megan		5026767516				5026767517	mbrennan@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Medicare Compliance Officer	Director of Quality	Ms	Peterson	Nora		9709643500				9705250166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Medicare Coordinator	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Medicare Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	06/12/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Medication Therapy Management Contact	Regulatory Compliance Coordinator	Ms.	Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	06/12/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part C Application Contact	Executive Director		Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th Street		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H7725	Part D Appeals Contact (Secondary)	Executive Director	Ms	Booker	Chiquita						9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	02/21/2023	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active	9529410305				PACE - Nat		C	Atlanta
H7725	Part D Application Contact	Regional Vice President, PACE Operations		Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Exceptions Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H7725	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active	9705087737				PACE - Nat		C	Atlanta
H7725	Part D Price File Contact (Back-up)	Vice President of Quality and Compliance		Howell	Keith		9709643500				9705250166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Price File Contact (Optional)	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	02/21/2023	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Part D Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Patient Safety Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	11/07/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Payment Contact	Regional Vice President, PACE Operations	Mr.	Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Personal Health Record Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Pharmacy Director	Vice President of Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Pharmacy Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Pharmacy Technical Help Desk Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H7725	Plan Directory Contact for Public Website	Executive Director		Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th Street		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Processor Contact	Claims Administrator		Ford	Jill		9705087711				9529410428	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Quality Contact	Quality and Compliance Manager		Erwin	Andi		5026767516				5026767517	aerwin@voa.org	960 S. 4th St.		Louisville	KY	40203	12/09/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529417097	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Surveillance Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	System Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Third Party Administrator (TPA) Liaison	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	User Access Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Utilization Management Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7725	Utilization Review Contact	Executive Director	Ms	Booker	Chiquita		9529410305				9529410428	cbooker@voa.org	960 S. 4th St.		Louisville	KY	40203	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF JEFFERSON COUNTY	National PACE	Senior CommUnity Care of Jefferson County	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H7766	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H7766	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Atlanta
H7766	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H7766	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H7766	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Atlanta
H7766	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H7766	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Atlanta
H7766	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7766	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H7777	Automated TrOOP Balance Transfer Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Backup User Access Contact	Director of Care Management	Mrs	Baker	Lori		5135696748					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Best Available Evidence Contact	Director of Care Management	Mrs	Baker	Lori		5135696748					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Bid Primary Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	CAP Report Contact for Public Website	President and CEO	Mrs	Mattson	Gayle		5135696750					gayle_mattson@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active	5132469227				PACE - Nat		C	Chicago
H7777	CEO - CMS Administrator Contact	President and CEO	Mrs	Mattson	Gayle		5132469227					gayle_mattson@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	12/04/2024	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	CEO - Senior Official for Contracting	President and CEO	Mrs	Mattson	Gayle		5132469227					gayle_mattson@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	12/04/2024	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Chief Financial Officer	Chief Financial Officer	Mr.	Anderson	Todd		5138627223					todd_anderson@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Chief Operating Officer	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Chief Information Officer	CIO	Mrs	Peters	Donna		5132464842					donna_peters@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/25/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Chief Information Security Officer	CIO	Mrs	Allender	Greg		5135696750					greg_allender@trihealth.com	10475 Montgomery Road		Montgomery	OH	45242	03/25/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	CMS Casework Communication Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Complaints Tracking Contact	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	08/06/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Contact for Fraud Investigations	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Coordination of Benefits Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Corporate Mailing						5135696750				5135696750	heather_hargis@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	12/04/2024	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Customer Service Operations Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	DIR Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Discount Program Payment Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Emergency Part D Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Encounter Data & Risk Adjustment Operations Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Enrollment Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	EOB Transfer Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170				5138627170	georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Financial Audit Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Financial Reporting Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Formulary Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	General Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Government Relations Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	HIPAA Privacy Officer	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	08/06/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	HIPAA Security Officer	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	08/06/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Interoperability Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	MA Appeals/Grievances Contact	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	08/06/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	MA Claims Processing Contact for Public Website	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Marketing Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Medical Director	Medical Director	Dr	Trice	Laura		5138627223					laura_trice@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Medicare Compliance Officer	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	08/06/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Medicare Coordinator	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Medicare Part D Opioid Overutilization Contact	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	08/06/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Medication Therapy Management Contact	VP Pharmacy Services	Mrs	Cobb	Amy		5135696750					amy_cobb@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/25/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part C Application Contact	Director of Care Management	Mrs	Baker	Lori		5135696748					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part D Appeals	Director of Care Management	Mrs	Baker	Lori							lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active	5135696750				PACE - Nat		C	Chicago
H7777	Part D Application Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part D Benefits Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part D Claims Submission Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part D Exceptions Contact	Finance Director	Ms.	Nicewonger	Georgia							georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active	5138627170				PACE - Nat		C	Chicago
H7777	Part D Price File Contact (Back-up)	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part D Price File Contact (Primary)	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part D Quality Assurance Contact	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Part D Reporting Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Patient Safety Contact	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Payment Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Pharmacy Director	VP Pharmacy Services	Mrs	Cobb	Amy		5135696750					amy_cobb@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/25/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Pharmacy Network Management Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Pharmacy Technical Help Desk Contact	Pharmacist	Dr	Mueller	Justi							justi_mueller@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active	5138627223				PACE - Nat		C	Chicago
H7777	Plan Directory Contact for Public Website	Project Manager	Mrs	Hargis	Heather		5135696750					heather_hargis@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	12/04/2024	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Plan to Plan Reconciliation Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Processor Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Quality Contact	Compliance, Privacy, and QI	Mrs	Grimes	Rebecca	W	5138627223					Rebecca_Grimes@trihealth.com	4850 Smith Rd		Cincinnati	OH	45202	08/06/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Reconciliation Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Recovery Audit Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Surveillance Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	System Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Third Party Administrator (TPA) Liaison	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	User Access Contact	Finance Officer	Ms.	Nicewonger	Georgia		5138627170					Georgia_nicewonger@trihealth.com	4850 Smith Rd		Cincinnati	OH	45212	09/17/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Utilization Management Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7777	Utilization Review Contact	Director of Care Management	Mrs	Baker	Lori		5135696750					lori_baker@trihealth.com	625 Eden Park Dr 10th floor		Cincinnati	OH	45202	03/24/2025	2026	TRIHEALTH G, LLC	National PACE	PACE of Cincinnati	National PACE		TriHealth, Inc.	233	Yes	Active					PACE - Nat		C	Chicago
H7779	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8443211763				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	DIR Contact	Manager, Health Plans Finance		Parkin	Frank		2038148504					fparkin@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	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	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4057066535				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8443211763				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8443211763				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Coordinator	Executive Director	Ms.	Voigtmann	Kari		6156036996				8442805360	kvoigtmann@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	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	Medication Therapy Management Contact	Director of Clinical Programs	Mr	Poore	Richard		6036285133					rpoore@healthdialog.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	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	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H7779	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H7779	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Appeals Supervisor Clinical Operations	Ms.	McCauley	Angela						3304058081	Appeals@Elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H7779	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H7779	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/17/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Christophe		3304864910					cwentz@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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 Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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 Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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@Elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8335026757				HMO - Health Maintenance Organization		C	Dallas
H7779	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn							lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN, INC.	Local CCP	American Health Advantage of Tennessee	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8334786370				HMO - Health Maintenance Organization		C	Dallas
H7779	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8443211763				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	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	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	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	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	SNP State Contact	Executive Director	Ms.	Voigtmann	Kari		6156036996				8442805360	kvoigtmann@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	4805480643				PPO - BBA		C	New York
H7787	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8609024668				PPO - BBA		C	New York
H7787	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	4805480643				PPO - BBA		C	New York
H7787	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8609024668				PPO - BBA		C	New York
H7787	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8009221557				PPO - BBA		C	New York
H7787	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8603389867				PPO - BBA		C	New York
H7787	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7787	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7810	Automated TrOOP Balance Transfer Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/22/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Backup User Access Contact	Chief Information Officer		Pedroza	Manuel		6616353050	2172				manuel.pedroza@clinicalsierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/22/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Best Available Evidence Contact	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/22/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Bid Primary Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	CAP Report Contact for Public Website	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending	8552787223				PACE - Nat		C	San Francisco
H7810	CEO - CMS Administrator Contact	Chief of PACE	Mr.	West	Jason		6618160857					Jason.West@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	CEO - Senior Official for Contracting	Chief of PACE	Mr.	West	Jason		6618160857					Jason.West@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Chief Financial Officer	Chief Financial Officer	Mr.	Sidhu	Harjeet		6616353050					harjeet.sidhu@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Chief Operating Officer	Chief Administrative Officer	Ms.	Pruitt	Magdalena		6616353050	2379				magdalena.pruitt@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Chief Information Officer	Chief Information Officer	Mr.	Pedroza	Manuel		6616353050	2172				manuel.pedroza@clinicalsierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Chief Information Security Officer	Chief Information Officer	Mr.	Pedroza	Manuel		6616353050	2172				manuel.pedroza@clinicalsierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	CMS Casework Communication Contact	Director Clinical Quality, Nursing & Patient Expe		Culbertson	Jennifer		6616353050					jennifer.culbertson@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Complaints Tracking Contact	Director Clinical Quality, Nursing & Patient Expe		Culbertson	Jennifer		6616353050					jennifer.culbertson@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Contact for Fraud Investigations	Compliance and Risk Manager		Salazar	Nayeli		6616353050	2295				nelly.salazar@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Coordination of Benefits Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Corporate Mailing						6615695092					allison.kundrata@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Customer Service Operations Contact	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 002	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	DIR Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	DIR Contact (Secondary)	Chief of PACE		West	Jason		6618160857					Jason.West@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Discount Program Payment Contact	Chief Financial Officer		Sidhu	Harjeet		6616353050					harjeet.sidhu@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Emergency Part D Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Emergency Part D Contact (Secondary)	Chief of PACE		West	Jason		6618160857					Jason.West@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Sidhu	Harjeet		6616353050					harjeet.sidhu@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Enrollment Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	EOB Transfer Contact	Chief of PACE		West	Jason		6618160857				6617204001	Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Financial Audit Contact	Chief Financial Officer	Mr.	Sidhu	Harjeet		6616353050					harjeet.sidhu@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Financial Reporting Contact	Chief Financial Officer		Sidhu	Harjeet		6616353050					harjeet.sidhu@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Formulary Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Formulary Contact (Secondary)	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	General Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Government Relations Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	HIPAA Privacy Officer	Compliance and Risk Manager		Salazar	Nayeli		6616353050	2295				nelly.salazar@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	HIPAA Security Officer	Compliance and Risk Manager		Salazar	Nayeli		6616353050	2295				nelly.salazar@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Interoperability Contact	Chief Information Officer		Pedroza	Manuel		6616353050	2172				manuel.pedroza@clinicalsierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	MA Appeals/Grievances Contact	Compliance and Risk Manager		Salazar	Nayeli		6616353050	2295				nelly.salazar@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	MA Claims Processing Contact for Public Website	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Marketing Contact	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Medical Director	Chief Medical Officer		Ayala-Rodriguez	Irving		6618351240	2128				irving.ayala.rodriguez@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Medicare Compliance Officer	Compliance and Risk Manager	Ms.	Salazar	Nayeli		6616353050	2295				nelly.salazar@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Medicare Coordinator	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Medication Therapy Management Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	OffShore Subcontractor Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Online Enrollment Center Contact (Back-up)	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Online Enrollment Center Contact (Optional)	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Online Enrollment Center Contact (Primary)	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part C Application Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Appeals	Director of Pharmacy		Bhakta	Dixit							dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending	6616162133				PACE - Nat		C	San Francisco
H7810	Part D Appeals Contact (Secondary)	Compliance and Risk Manager		Salazar	Nayeli							nelly.salazar@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending	6616353050	22295			PACE - Nat		C	San Francisco
H7810	Part D Application Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Benefits Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Claims Submission Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Exceptions Contact	Director of Pharmacy		Bhakta	Dixit							dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending	6616162133				PACE - Nat		C	San Francisco
H7810	Part D Exceptions Contact (Secondary)	Chief of PACE		West	Jason							Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending	6618160857				PACE - Nat		C	San Francisco
H7810	Part D Price File Contact (Back-up)	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Price File Contact (Optional)	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Price File Contact (Primary)	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Quality Assurance Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Part D Reporting Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Patient Safety Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Payment Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Personal Health Record Contact	Chief Information Officer		Pedroza	Manuel		6616353050	2172				manuel.pedroza@clinicalsierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Pharmacy Director	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Pharmacy Network Management Contact	Director of Pharmacy		Bhakta	Dixit		6616162133					dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Pharmacy Network Management Contact (Secondary)	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Pharmacy Technical Help Desk Contact	Director of Pharmacy		Bhakta	Dixit							dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending	6616162133				PACE - Nat		C	San Francisco
H7810	Pharmacy Technical Help Desk Contact (Secondary)	Director of Pharmacy		Bhakta	Dixit							dixit.bhakta@clinicalsierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending	6616162133				PACE - Nat		C	San Francisco
H7810	PHR Beneficiary Contact																	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE	Clinica Sierra Vista PACE	Clinica Sierra Vista	854	Yes	Pending	8552787223				PACE - Nat		C	San Francisco
H7810	Plan Directory Contact for Public Website	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Plan to Plan Reconciliation Contact	Chief Financial Officer		Sidhu	Harjeet		6616353050					harjeet.sidhu@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Processor Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Quality Contact	Director Clinical Quality, Nursing & Patient Expe		Culbertson	Jennifer		6616353050					jennifer.culbertson@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Reconciliation Contact	Chief Financial Officer		Sidhu	Harjeet		6616353050					harjeet.sidhu@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Reconciliation Contact (Secondary)	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Recovery Audit Contact	Compliance and Risk Manager	Ms.	Salazar	Nayeli		6616353050	2295				nelly.salazar@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Surveillance Contact	Director of Communications and Community Outreach		Pinedo	Christhian		6616353050	2104				christhian.pinedotorres@clinicasierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	System Contact	Chief Information Officer		Pedroza	Manuel		6616353050	2172				manuel.pedroza@clinicalsierravista.org	1430 Truxton Avenue	Suite 200	Bakersfield	CA	93301	06/23/2024	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Third Party Administrator (TPA) Liaison	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	User Access Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Utilization Management Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7810	Utilization Review Contact	Chief of PACE		West	Jason		6618160857					Jason.West@clinicasierravista.org	1430 Truxton Avenue	Suite 400	Bakersfield	CA	93301	06/13/2025	2026	CLINICA SIERRA VISTA	National PACE	Clinica Sierra Vista PACE	National PACE		Clinica Sierra Vista	854	Yes	Pending					PACE - Nat		C	San Francisco
H7813	Agent/Broker Compensation Data Contact	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	Automated TrOOP Balance Transfer Contact	Director of Revenue and Claims Management		Hernandez	Milexys		5856830811					milexys.hernandez@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/16/2024	2026	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	Backup User Access Contact	COO		Marble	Sharon		5853471215					sharon.marble@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	Director of Revenue and Claims Management		Hernandez	Milexys		5856830811					milexys.hernandez@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	Bid Audit Contact	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Bid Primary Contact	CFO		Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd.		Webster	NY	14580	08/12/2024	2026	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	CAP Report Contact for Public Website	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	CEO - CMS Administrator Contact	CEO	Mr	Sewnauth	Andrew		5853471070					andrew.sewnauth@cdslt.org	860 Hard Rd.		Webster	NY	14580	06/05/2023	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Sewnauth	Andrew		5853471070					andrew.sewnauth@cdslt.org	860 Hard Rd.		Webster	NY	14580	06/05/2023	2026	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	CFO	Mr	Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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 Operating Officer	COO	Ms	Marble	Sharon		5853471215					sharon.marble@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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 Information Officer	VP of IT	Mr.	Marinaccio	Damian		5853471228					damian.marinaccio@cdslt.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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 Information Security Officer	Manager of Information Security	Mr.	Ricketts	Stephen		5853471945					stephen.ricketts@cdslt.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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		5853471215					sharon.marble@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	Complaints Tracking Contact	VP of Quality & Compliance		Frederico	Diane		5853471924					diane.frederico@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	Contact for Fraud Investigations	VP of Quality & Compliance		Frederico	Diane		5853471924					diane.frederico@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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		5853471215					sharon.marble@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Corporate Mailing						5853471215					sharon.marble@icirclecny.org	860 Hard Rd		Webster	NY	14580	01/31/2022	2026	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		5853471923					becky.ortiz@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	DIR Contact	Manager Health Plans Finance		Parkin	Frank		2038148504					fparkin@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	08/16/2024	2026	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	DIR Contact (Secondary)	Director, Reporting and Analytics, Govt. Programs		Campbell	Tim		9547672633					tcampbell@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	08/16/2024	2026	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	Discount Program Payment Contact	CFO		Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd.		Webster	NY	14580	08/12/2024	2026	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	Emergency Part D Contact	Director of Pharmacy, CDSRx		Miller	Lucas		5856385499					lucas.miller@cdsrx.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	CFO		Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd.		Webster	NY	14580	08/12/2024	2026	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	Enrollment Contact	Manager of Enrollment & Member Services		Ortiz	Becky		5853471923					becky.ortiz@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	EOB Transfer Contact	Director of Revenue and Claims Management		Hernandez	Milexys		5856830811				8443275551	milexys.hernandez@icirclecny.org	860 Hard Rd.		Webster	NY	14580	08/12/2024	2026	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	Financial Audit Contact	CFO	Mr.	Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	Financial Reporting Contact	CFO		Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd.		Webster	NY	14580	08/12/2024	2026	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	Formulary Contact	Manager, Formulary Administration and Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/12/2024	2026	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	Formulary Contact (Secondary)	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Road		Webster	NY	14580	08/12/2024	2026	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	General Contact	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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		5853136427					andrea.valk@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	HIPAA Privacy Officer	VP of Quality & Compliance		Frederico	Diane		5853471924					diane.frederico@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	HIPAA Security Officer	Manager of Information Security		Ricketts	Stephen		5853471245					stephen.ricketts@cdslt.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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		5853471215					sharon.marble@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Interoperability Contact	Director of Applications and Data		Beck	Erik		5852591066					erik.beck@cdslt.org	860 Hard Rd		Webster	NY	14580	08/16/2024	2026	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	MA Appeals/Grievances Contact	VP of Quality & Compliance		Frederico	Diane		5853471924					diane.frederico@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	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	MA Claims Processing Contact for Public Website	Director of Revenue and Claims Management		Hernandez	Milexys		8444247253					icircleclaims@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	Marketing Contact	Director of Provider Relations		Marble	Sharon		5853471215					sharon.marble@icirclecny.org	860 Hard Rd		Webster	NY	14580	09/02/2022	2026	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	Medical Director	CMO	Dr.	Haas	Joel		5853471248					joel.haas@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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		5853471924					diane.frederico@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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 Coordinator	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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 Part D Opioid Overutilization Contact	Director of Pharmacy, CDSRx		Miller	Lucas		5856385499					lucas.miller@cdsrx.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	Medication Therapy Management Contact	VP Pharmacy Solutions		Miller	Holly		3302931916					hmiller@healthdialog.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	03/28/2022	2026	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 C Application Contact	COO		Marble	Sharon		5853471215					sharon.marble@icirclecny.org	860 Hard Road		Webster	NY	14580	03/28/2022	2026	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 C Reporting Contact	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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 Appeals	VP of Quality & Compliance		Frederico	Diane							diane.frederico@icirclecny.org	860 Hard Rd.		Webster	NY	14580	03/28/2022	2026	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active	8557753778				HMO - Health Maintenance Organization		C	New York
H7813	Part D Application Contact	COO		Marble	Sharon		5853471215					sharon.marble@icirclecny.org	860 Hard Road		Webster	NY	14580	03/28/2022	2026	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 Benefits Contact	Director of Pharmacy, CDSRx		Miller	Lucas		5856385499					lucas.miller@cdsrx.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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 Claims Submission Contact			Meyocks	Kristen		9547672690					kmeyocks@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/09/2022	2026	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	Pharmacy Supervisor, Coverage Determinations		Larkins, PharmD	Casey							clarkins@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	08/16/2024	2026	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active	3302859685				HMO - Health Maintenance Organization		C	New York
H7813	Part D Price File Contact (Back-up)	Financial Analyst III		Wentz	Christophe		3308886988					cwentz@elixirsolutions.com	8957 Canyon Falls Blvd.		Twinsburg	OH	44087	06/14/2023	2026	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 Price File Contact (Primary)	Sr. Financial Manager Reporting & Analytics		Campbell	Tim		3308886988					tcampbell@elixirsolutions.com	8957 Canyon Falls Blvd.		Twinsburg	OH	44087	06/14/2023	2026	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 Quality Assurance Contact	Director of Pharmacy, CDSRx		Miller	Lucas		5856385499					lucas.miller@cdsrx.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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 Reporting Contact	Director of Pharmacy, CDSRx		Miller	Lucas		5856385499					lucas.miller@cdsrx.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	Patient Safety Contact	VP of Quality & Compliance		Frederico	Diane		5853471924					diane.frederico@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Payment Contact	CFO		Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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 Director	Director of Pharmacy, CDSRx		Miller	Lucas		5856385499					lucas.miller@cdsrx.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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 Network Management Contact	Director Pharmacy Network Development & Operations		Profio	Lauren		3304864864				3304058094	lprofio@elixirsolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	05/31/2022	2026	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	7835 Freedom Avenue NW		North Canton	OH	44721	08/16/2024	2026	ICIRCLE SERVICES OF THE FINGER LAKES, INC.	Local CCP	iCircle Services of the Finger Lakes, Inc	HMO/HMOPOS		CDS Monarch, Inc.	756	Yes	Active	8336821192				HMO - Health Maintenance Organization		C	New York
H7813	Plan Directory Contact for Public Website	Associate Director of Enrollment and Member Svcs		Ortiz	Becky		8444247253					memberservices@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/16/2024	2026	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	Plan to Plan Reconciliation Contact	Manager of Enrollment & Member Services		Ortiz	Becky		5853471923					becky.ortiz@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Processor Contact	Director of Revenue and Claims Management		Hernandez	Milexys		5856830811					milexys.hernandez@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	Quality Contact	VP of Quality & Compliance		Frederico	Diane		5853471924					diane.frederico@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Reconciliation Contact	Manager of Enrollment & Member Services		Ortiz	Becky		5853471923					becky.ortiz@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Recovery Audit Contact	CFO	Mr.	Kotsch	Stephan		5853471201					stephan.kotsch@icirclecny.org	860 Hard Rd		Webster	NY	14580	08/12/2024	2026	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	SNP Application Contact	COO		Marble	Sharon		5853471215					sharon.marble@icirclecny.org	860 Hard Road		Webster	NY	14580	03/28/2022	2026	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	Surveillance Contact	VP of Quality & Compliance		Frederico	Diane		5853471924					diane.frederico@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	System Contact	VP of IT		Marinaccio	Damian		5853471228					damian.marinaccio@cdslt.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Third Party Administrator (TPA) Liaison	Director of Provider Contracting & Network Managem		Granger	Jennifer		5852784516					jennifer.granger@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	User Access Contact	EVP of Government Relations and Corporate Planning		Valk	Andrea		5853136427					andrea.valk@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Utilization Management Contact	Manager of Utilization Management		Ross	Millissa		5857388902					millissa.ross@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Utilization Review Contact	Manager of Utilization Management		Ross	Millissa		5857388902					millissa.ross@icirclecny.org	860 Hard Rd		Webster	NY	14580	03/28/2022	2026	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	Finance Director	Mrs.	Johnson	Stephanie		3148977007					stephanie.johnson@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Backup User Access Contact	Finance Director	Mrs.	Johnson	Stephanie		3148977007					stephanie.johnson@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Best Available Evidence Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Bid Primary Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	CAP Report Contact for Public Website	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	CEO - CMS Administrator Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	CEO - Senior Official for Contracting	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Chief Financial Officer	CFO	Mr.	Sneed	Chad		3144462475					Chad.Sneed@evertrueliving.org	1150 Hanley Industrial Ct.		Saint Louis	MO	63144	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Chief Operating Officer	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Chief Information Officer	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Chief Information Security Officer	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	CMS Casework Communication Contact	Operations Director	Mrs.	Butler	Diana		3148977005					diana.butler@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Complaints Tracking Contact	Operations Director	Mrs.	Butler	Diana		3148977005					diana.butler@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Contact for Fraud Investigations	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Coordination of Benefits Contact	Finance Director	Mrs.	Johnson	Stephanie		3148977007					stephanie.johnson@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	03/18/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Corporate Mailing						3142628255					Colleen.Bottens@LSSLiving.org	1150 Hanley Industrial Ct.		St. Louis	MO	63144	02/27/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Customer Service Operations Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	DIR Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	DIR Contact (Secondary)	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Discount Program Payment Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Emergency Part D Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Emergency Part D Contact (Secondary)	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Enrollment Contact	Business Development Director	Mrs.	Morgan	Jen		3148166141					jen.morgan@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	03/18/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	EOB Transfer Contact	Executive Director	Mr.	Redman	Drew	A	3143974215				3149685590	drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Financial Audit Contact	CFO	Mr.	Sneed	Chad		3144462475					Chad.Sneed@LSSLiving.org	1150 Hanley Industrial Ct.		Saint Louis	MO	63144	02/27/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Financial Reporting Contact	CFO		Sneed	Chad		3144462475	30007				Chad.Sneed@LSSLiving.org	1150 Hanley Industrial Ct.		Saint Louis	MO	63144	02/27/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Formulary Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	General Contact	Operations Director	Mrs.	Butler	Diana		5733553871					diana.butler@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	03/18/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Government Relations Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	HIPAA Privacy Officer	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	HIPAA Security Officer	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Interoperability Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	MA Appeals/Grievances Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	MA Claims Processing Contact for Public Website	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Marketing Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Medical Director	Medical Director		Lin	Walter		3148977223					Cyndi.young@lssliving.org	5035 MANCHESTER AVE		St. Louis	MO	63110	04/25/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Medicare Compliance Officer	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Medicare Coordinator	Executive Director	Mrs.	Johnson	Stephanie		3148977007					stephanie.johnson@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	03/18/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Medicare Part D Opioid Overutilization Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Medication Therapy Management Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Online Enrollment Center Contact (Primary)	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part C Application Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Appeals	Executive Director	Mr.	Redman	Drew	A						drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active	3143974215				PACE - Nat		C	Kansas City
H7831	Part D Application Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Benefits Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Claims Submission Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Exceptions Contact	Executive Director	Mr.	Redman	Drew	A						drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active	3143974215				PACE - Nat		C	Kansas City
H7831	Part D Price File Contact (Back-up)	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Price File Contact (Primary)	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Quality Assurance Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Part D Reporting Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Patient Safety Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Payment Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Pharmacy Director	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Pharmacy Network Management Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Pharmacy Technical Help Desk Contact	Executive Director	Mr.	Redman	Drew	A						drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active	3143974215				PACE - Nat		C	Kansas City
H7831	Plan Directory Contact for Public Website	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Plan to Plan Reconciliation Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Processor Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Quality Contact	Quality & Compliance Director	Mrs.	Howard	Tiffaney		3144012459					tiffaney.howard@evertrueliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/15/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Reconciliation Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Recovery Audit Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Surveillance Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	System Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Third Party Administrator (TPA) Liaison	Director of Community Finance		Johnson	Stephanie	A	3148977007					stephanie.johnson@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	06/23/2025	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	User Access Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Utilization Management Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7831	Utilization Review Contact	Executive Director	Mr.	Redman	Drew	A	3143974215					drew.redman@lssliving.org	5035 Manchester Ave		Saint Louis	MO	63110	07/11/2024	2026	PRIME ACQUISITIONS, LLC	National PACE	EverTrue PACE	National PACE		Midwest Christian Villages, Inc.	781	Yes	Active					PACE - Nat		C	Kansas City
H7849	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	4805480643				PPO - BBA		C	New York
H7849	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8609024668				PPO - BBA		C	New York
H7849	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	4805480643				PPO - BBA		C	New York
H7849	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8609024668				PPO - BBA		C	New York
H7849	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8009221557				PPO - BBA		C	New York
H7849	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active	8603389867				PPO - BBA		C	New York
H7849	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7849	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	New York
H7855	Automated TrOOP Balance Transfer Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/19/2025	2026	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	Backup User Access Contact	COO		Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/19/2025	2026	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	Bid Primary Contact	Health Plan Specialist	Ms	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	CAP Report Contact for Public Website	COO	Ms.	Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	8187743371				PACE - Nat		C	San Francisco
H7855	CEO - CMS Administrator Contact	CEO and President	Mr.	Surowitz	Dale		8189422295				8187743020	dale.surowitz@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/02/2020	2026	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	CEO - Senior Official for Contracting	CEO and President	Mr.	Surowitz	Dale		8189422295				8187743020	dale.surowitz@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/02/2020	2026	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		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/03/2022	2026	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 Operating Officer	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/03/2025	2026	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 Information Officer	Director of Information Services	Mr.	Lopez	Rey		8187743350				8187743389	rey.lopez@jha.org	7150 Tampa Ave.		Reseda	CA	91335	05/19/2025	2026	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 Information Security Officer	DIrector of Information Services	Mr.	Lopez	Rey		8187743350				8187743389	rey.lopez@jha.org	7150 Tampa Ave		Reseda	CA	91335	05/19/2025	2026	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	COO	Mr.	Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Complaints Tracking Contact	COO		Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Contact for Fraud Investigations	COO		Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/19/2025	2026	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	Corporate Mailing						8186548643				8187745907	kim.stratman@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/03/2025	2026	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	COO	Ms.	Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	DIR Contact	Health Plan Specialist		Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	DIR Contact (Secondary)	COO		Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Discount Program Payment Contact	Health Plan Specialist		Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa		Reseda	CA	91335	03/06/2025	2026	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	Emergency Part D Contact	COO		Stepanians	Larissa		8187743371					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Emergency Part D Contact (Secondary)	COO		Stepanians	Larissa		8184300709					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/03/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Enrollment Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	EOB Transfer Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	Financial Audit Contact	CFO	Mrs.	Ruditsky	Crystal		8187743336				8187745907	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/04/2025	2026	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	Financial Reporting Contact	CFO	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/04/2021	2026	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	Formulary Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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	Formulary Contact (Secondary)	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	General Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	HIPAA Privacy Officer	Chief Nursing & Compliance Officer	Mr.	Carlson	Timothy		8187743397				8187742424	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/11/2022	2026	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	HIPAA Security Officer	Director of Information Technology	Mr.	Lopez	Rey		8187743350				8187743020	rey.lopez@jha.org	7150 Tampa Avenue		Reseda	CA	91335	05/19/2025	2026	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	Interoperability Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	MA Appeals/Grievances Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	MA Claims Processing Contact for Public Website	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	Marketing Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Medical Director	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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		8187743397				8187742424	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	04/24/2017	2026	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 Coordinator	Health Plan Specialist	Ms	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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	Medication Therapy Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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	OffShore Subcontractor Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Online Enrollment Center Contact (Optional)	COO	Ms.	Stepanians	Larissa		8184300709					larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/04/2025	2026	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	Online Enrollment Center Contact (Primary)	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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 C Application Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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 Appeals	COO		Stepanians	Larissa							larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	8187743371				PACE - Nat		C	San Francisco
H7855	Part D Appeals Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie						8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	8187574458				PACE - Nat		C	San Francisco
H7855	Part D Application Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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 Benefits Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574588				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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 Claims Submission Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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.	Ilcken	Leslie						8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	8187574458				PACE - Nat		C	San Francisco
H7855	Part D Exceptions Contact (Secondary)	CNO		Carlson	Tim							Timothy.Carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	8187743397				PACE - Nat		C	San Francisco
H7855	Part D Price File Contact (Back-up)	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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 Price File Contact (Primary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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 Quality Assurance Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187748444				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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 Reporting Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	Patient Safety Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Payment Contact	CFO	Mrs.	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/04/2025	2026	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	Personal Health Record Contact	Director of Operations	Ms.	Graham	Amy		8187743328				8187745900	amy.graham@jha.org	7150 Tampa Avenue		Reseda	CA	91335	02/04/2025	2026	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 Director	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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 Network Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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 Network Management Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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						8187745900	ani.aramyan@jha.org	7150 Tampa Avenue		Reseda	CA	91335	01/07/2016	2026	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	8556543023				PACE - Nat		C	San Francisco
H7855	PHR Beneficiary Contact																	02/04/2025	2026	BRANDMAN CENTERS FOR SENIOR CARE, INC.	National PACE	Brandman Centers for Senior Care	National PACE	Los Angeles Jewish Health	Los Angeles Jewish Home for the Aging	506	Yes	Active	8187743274				PACE - Nat		C	San Francisco
H7855	Plan Directory Contact for Public Website	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Plan to Plan Reconciliation Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	janice.boothe@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	Processor Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	Quality Contact	Chief Nursing & Compliance	Ms.	Carlson	Timothy		8187743397				8187745907	timothy.carlson@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/11/2022	2026	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	Reconciliation Contact	CFO	Ms	Ruditsky	Crystal		8187743336				8187743020	crystal.ruditsky@jha.org	7150 Tampa Avenue		Reseda	CA	91335	10/04/2021	2026	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	Reconciliation Contact (Secondary)	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	Recovery Audit Contact	Health Plan Specialist	Ms.	Ilcken	Leslie		8187574458				8187745907	leslie.ilcken@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/06/2025	2026	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	Surveillance Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	System Contact	Director of Information Technology	Mr.	Lopez	Rey		8187743350				8187743020	rey.lopez@jha.org	7150 Tampa Avenue		Reseda	CA	91335	05/19/2025	2026	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	Third Party Administrator (TPA) Liaison	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	User Access Contact	Chief Operating Officer	Ms	Stepanians	Larissa		8187743371				8187742424	larissa.stepanians@jha.org	7150 Tampa Avenue		Reseda	CA	91335	08/21/2025	2026	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	Utilization Management Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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	Utilization Review Contact	Medical Director, Brandman Centers for Senior Care	Dr.	Ott	Casey		8187574418				8187745907	casey.ott@jha.org	7150 Tampa Avenue		Reseda	CA	91335	03/20/2019	2026	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	Agent/Broker Compensation Data Contact	Manager Broker Administration		Logan	Lynne		4235356550				4235353178	Lynne_Logan@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/01/2012	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Automated TrOOP Balance Transfer Contact	Advisor Business CVS		Davis	Brittany		4806064613					FIRSupport@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/21/2021	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Backup User Access Contact	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Best Available Evidence Contact	Manager Operations		Hardy	Sequita		4239911375					Sequita_Hardy@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/24/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Bid Audit Contact	Medicare Compliance Officer	Mrs	Womble	Charriet		6153479580					Charriet_Womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	374022011	07/08/2024	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Bid Primary Contact	Product Manager		Case	Taylor		4235354013					Taylor_Case@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	CAP Report Contact for Public Website	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	CEO - CMS Administrator Contact	President and Chief Executive Officer	Mr.	Hickey	JD		4235357767				4235351957	JD_Hickey@bcbst.com	One Cameron Hill Circle		Chattanooga	TN	37402	01/07/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	CEO - Senior Official for Contracting	President and Chief Executive Officer	Mr.	Hickey	JD		4235357767				4235351957	JD_Hickey@bcbst.com	One Cameron Hill Circle		Chattanooga	TN	37402	09/01/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Chief Financial Officer	Exec VP & Chief Financial Officer	Mr	Criswell	David		4235357016					David_Criswell@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/01/2024	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Chief Operating Officer	Chief Operating Officer	Mr	Pierce	Scott		4235357556				4235359109	Scott_Pierce@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/01/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Chief Information Officer	VP Infrastructure & Operations	Ms	Weaver	Jennifer		4235355173				4235359109	Jennifer_Weaver@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/16/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Chief Information Security Officer	VP/Chief Information Security Officer	Ms	Lee	Rosemarie		4235355853				4235359109	Rosemarie_Lee@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/24/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	CMS Casework Communication Contact	Manager Operations		Flagg	Kendra		4235357524				4235355498	Kendra_Flagg@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Complaints Tracking Contact	Business Analyst II		Morgan	Christi		4235358872				4235355270	Christi_Morgan@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/11/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Contact for Fraud Investigations	Director Special Investigations Unit	Mr.	Tidwell	Norman		6153483005				4235357024	Norman_Tidwell@bcbst.com	1 Cameron Hill Circle, Bldg 1.4		Chattanooga	TN	37402	05/02/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Coordination of Benefits Contact	Manger Revenue Reconciliation		Camp	Jan		4235353639					jan_camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/29/2017	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Corporate Mailing						4235355600					Todd_Ray@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Customer Service Operations Contact	Manager Operations		Walters	Karen		4235357696					Karen_Walters@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/31/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	DIR Contact	Pharmacy Analyst I		Bushey	Andrew		4235355402					Andrew_Bushey@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	DIR Contact (Secondary)	Pharmacy Operations Manager	Mrs	Moore	Mary-Marga		4235356116					Mary-Margaret_Moore@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Discount Program Payment Contact	Mgr Investments & Financial Mgt		Conway	Kendrick		4236819483					Kendrick_Conway@BCBST.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/10/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Emergency Part D Contact	VP of Pharmacy		Tate	Natalie		4234437868				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/20/2016	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Emergency Part D Contact (Secondary)	Advisor, Strategic Accounts		Edwards	Susan		4803821417					Susan.Edwards@CBSHealth.com	9501 E. Shea Blvd	Mail Code 121	Scottsdale	AZ	85260	12/04/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Encounter Data & Risk Adjustment Operations Contact	Director Medicare Advantage Risk Adjustment		Livingood	Eric		4235357352					Richard_Livingood@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/18/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Enrollment Contact	Manager Operations		Hardy	Sequita		4239911375					Sequita_Hardy@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/24/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	EOB Transfer Contact	Director Medicare Advantage Service Operations		Dobbs	Damon		4235355374				4235353558	Damon_Dobbs@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/16/2020	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Financial Audit Contact	External Audit Coordinator	Ms	Grafe	Kimberly		4232909053					Kimberly_Grafe@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/21/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Financial Reporting Contact	Financial Coordinator		Petty	Charles		4234753854					Charles_Petty@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/04/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Formulary Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Formulary Contact (Secondary)	Clinical Advisor Med D CVS		Tolbert	Myla		4698656265					Myla.Tolbert@CVSHealth.com	750 W John Carpenter Frwy		Irving	TX	75039	12/20/2021	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	General Contact	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Government Relations Contact	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	HIPAA Privacy Officer	Managing Director & Chief Privacy Officer		Yernberg	Heidi		7089302891					Heidi_Yernberg@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/03/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	HIPAA Security Officer	VP & Deputy General Counsel		Oliver	Alicia		4235352922					Alicia_Oliver@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	01/11/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Hospice Contact	Supervisor MA Reconciliation		Hicks	Brandon		4235353006	3006			4235355498	Brandon_Hicks@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/15/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Interoperability Contact	Application Manager		Foust	Adam		4235356672					Adam_Foust@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/28/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	MA Appeals/Grievances Contact	Director MA Member Experience & Engagment		Gordon	Destiny		4235358447				4235355270	Destiny_Gordon@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	MA Claims Processing Contact for Public Website	Director Medicare Advantage Service Operations		Dobbs	Damon		4235355374				4235353558	Damon_Dobbs@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	04/16/2020	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Marketing Contact	Ethics & Compliance Manager		Clements	Amy		4235358225					Amy_Clements@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Medical Director	Medical Director	Dr.	Pate	Linda		4233134326					Linda_Pate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	01/07/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Medicare Compliance Officer	Medicare Compliance Officer	Mrs	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Medicare Coordinator	Director Medicare Advantage Service Operations		Dobbs	Damon		4235355374					Damon_Dobbs@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	01/03/2020	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/19/2018	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Medication Therapy Management Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	OffShore Subcontractor Contact	Medicare Compliance Officer	Mrs	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Online Enrollment Center Contact (Back-up)	Business Analyst II		Sharp	Dana		4235354453					Dana_Sharp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/29/2017	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Online Enrollment Center Contact (Optional)	Manager Operations		Hardy	Sequita		4239911375					Sequita_Hardy@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/28/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Online Enrollment Center Contact (Primary)	Operations Supervisor II (QIP)		Bowling	Jameekah		4235356646					Jameekah_Bowling@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	09/15/2023	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part C Application Contact	Product Manager		Case	Taylor		4235354013					Taylor_Case@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/22/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part C Reporting Contact	Business Analytics Manager		Carson	Mindy		4235358476					Mindy_Carson@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/17/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Appeals	VP of Pharmacy		Tate	Natalie							Natalie_Tate@bcbst.com	1 Cameron Hill Circle	Suite 51	Chattanooga	TN	37402	12/09/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				PPO - BBA		C	Chicago
H7917	Part D Appeals Contact (Secondary)	Coverage Review Pharmacist		Holloway	Angela							Angela_Holloway@BCBST.com	1 Cameron Hill Circle	Suite 51	Chattanooga	TN	37402	12/31/2020	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				PPO - BBA		C	Chicago
H7917	Part D Application Contact	Product Manager		Case	Taylor		4235354013					Taylor_Case@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	03/22/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Benefits Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Claims Submission Contact	Sr Analyst, Account Manager CVS		Satre	Amanda		4807930968					Amanda.Satre@CVSHealth.com	9501 E. Shea Blvd	Mail Code 121	Scottsdale	AZ	85260	12/04/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Exceptions Contact	VP of Pharmacy		Tate	Natalie							Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				PPO - BBA		C	Chicago
H7917	Part D Exceptions Contact (Secondary)	Coverage Review Pharmacist		Dillon	Celia							Celia_Dillon@BCBST.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/12/2020	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				PPO - BBA		C	Chicago
H7917	Part D Price File Contact (Back-up)	Sr Analyst		Mitchell	Sarah		4804798023					sarah.mitchell3@CVSHealth.com	9501 E. Shea Blvd	MC034	Scottsdale	AZ	85260	06/03/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Price File Contact (Optional)	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Price File Contact (Primary)	Pharmacy Operations Manager		Moore	Mary	M	4235356116				4235357599	Mary-Margaret_Moore@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/12/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Quality Assurance Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Part D Reporting Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Patient Safety Contact	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Payment Contact	Manager Revenue Reconciliation		Camp	Jan		4235353639					Jan_Camp@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Pharmacy Director	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Pharmacy Network Management Contact	Advisor Network Products CVS		Lowe	David		4807449231				8773875800	David.Lowe2@CVSHealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/20/2021	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Pharmacy Network Management Contact (Secondary)	VP of Pharmacy		Tate	Natalie		4235353124				4235355100	Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	11/02/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Pharmacy Technical Help Desk Contact	Vendor Management		Rodriguez	Alex							Alex.rodriguez@CVSHealth.com	2401 Cherahala  Blvd		Knoxville	TN	37932	02/16/2024	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	8666934620				PPO - BBA		C	Chicago
H7917	Pharmacy Technical Help Desk Contact (Secondary)	VP of Pharmacy		Tate	Natalie							Natalie_Tate@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/31/2020	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active	8008312583				PPO - BBA		C	Chicago
H7917	Plan Directory Contact for Public Website	Director Operations		Service	Customer		8008312583					BlueAdvantageCS_GM@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	05/02/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Plan to Plan Reconciliation Contact	Business Analyst Associate		Stinnett	James		4235351624					P2PAdministration_GM@bcbst.com	Attn: P2P Coordinator	1 Cameron Hill Circle Suite 0050	Chattanooga	TN	374020050	02/07/2018	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Processor Contact	Mgr Ops & Claims		Dobbs	Damon		4235355374				4235353558	Damon_Dobbs@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/15/2015	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Quality Contact	Director MA Quality Improvement & Stars Program		Leun	Dianna		4235351654					Dianna_Leun@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	12/09/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Reconciliation Contact	Actuarial Assistant		Brown	Grace		4235444852					Grace_Brown@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Reconciliation Contact (Secondary)	Manager Actuarial Services Services		Fahr	Gregory		8137650612				4235353467	Gregory_Fahr@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/19/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Recovery Audit Contact	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	SNP Application Contact	Product Manager		Case	Taylor	D	4233643725					Taylor_Case@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/07/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Surveillance Contact	Medicare Compliance Officer	Mrs.	Womble	Charriet		6153479580					charriet_womble@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	System Contact	Director Applications Solutions		Jackson	Barbara		4235357380					Barbara_Jackson@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	02/04/2019	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Third Party Administrator (TPA) Liaison	Accounting Analyst		Toombs	Daniel		8658055741					Daniel_Toombs@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/17/2025	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	User Access Contact	Sr Ethics & Compliance Specialist		Underwood	Jackie		4233222094					Jackie_Underwood@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	07/10/2024	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Utilization Management Contact	Director MA Health Services		Swoope	LaShonda		4236676183					lashonda_swoope@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7917	Utilization Review Contact	Director MA Health Services		Swoope	LaShonda		4236676183					lashonda_swoope@bcbst.com	1 Cameron Hill Circle		Chattanooga	TN	37402	10/31/2022	2026	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	Local CCP	BlueCross BlueShield of Tennessee	Local PPO		BlueCross BlueShield of Tennessee	34	Yes	Active					PPO - BBA		C	Chicago
H7980	Agent/Broker Compensation Data Contact	Director, Sales Operations and Oversight		Hunt	Bae		2163751430					Bae.Hunt@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Automated TrOOP Balance Transfer Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					ashley.smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Backup User Access Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/31/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Best Available Evidence Contact	Sr Enrollment & Reconciliation Analyst		Cason	Joseph		6177486356					joseph.cason@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Bid Audit Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Bid Audit Site Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Bid Primary Contact	Director, Medicare Advantage Products		Gabrieli	Michael		3305186111					Michael.Gabrieli@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	CAP Report Contact for Public Website	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	CEO - CMS Administrator Contact	Interim President	Ms.	Cruz	Diana		4235030063					Diana.Cruz@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	08/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	CEO - Senior Official for Contracting	Interim President	Ms.	Cruz	Diana		4235030063					Diana.Cruz@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	08/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Chief Financial Officer	Chief Financial Officer	Mr.	Bennett	Darren		6177486160					Darren.Bennett@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	09/26/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Chief Operating Officer	Interim COO / SVP, Service & Ops	Ms.	Carbone	Jennifer		8578100850					Jennifer.Carbone@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	08/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Chief Information Officer	Chief Information Officer	Mr	Nair	Rajesh		6177486295					rajesh.nair@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Chief Information Security Officer	Sr. Director - Chief Information Security Officer	Mr	Cullivan	Lee		6179010454					lee.cullivan@bmc.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	CMS Casework Communication Contact	Director, Appeals & Grievances		Bigbee	Jacqueline		7746446922					jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Complaints Tracking Contact	Director, Appeals & Grievances		Bigbee	Jacqueline		7746446922					jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Contact for Fraud Investigations	Supervisor, Special Investigations Unit		Maurer	Randy		6174783977					Randy.Maurer@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Coordination of Benefits Contact	Manager, Coordination of Benefits		Castillo	Yvonne		6177486133					yvonne.castillo@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/23/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Corporate Mailing						6174783654					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Customer Service Operations Contact	Sr. Mgr, Regulatory Operations		Day	Jennifer		7815769126					jennifer.day@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	DIR Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Discount Program Payment Contact	Vice President of Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Emergency Part D Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Emergency Part D Contact (Secondary)	Sr. Director of Pharmacy Services		Pham	Phuong		6174783707					phuong.pham@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Encounter Data & Risk Adjustment Operations Contact	SVP & Chief Actuary		Li	Bo		6177486313					Bo.Li@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Enrollment Contact	Sr Enrollment & Reconciliation Analyst		Cason	Joseph		6177486356					joseph.cason@wellsense.org	100 City Square, Suite 20		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	EOB Transfer Contact	Director, Claims, Enrollment & Provider Appeals		Hinderman	Emily		6174783614				6178970884	emily.hinderman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Financial Audit Contact	Medicare Compliance Officer	Mr.	Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Financial Reporting Contact	Vice President of Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Formulary Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	General Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Government Relations Contact	Director of Government Affairs	Mr.	Krintzman	Josh		6177486490					Josh.Krintzman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	HIPAA Privacy Officer	Chief Privacy Officer		Wholley	Joseph		6177486226					Joseph.Wholley@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	HIPAA Security Officer	Information Security Officer		Tavares	Heather		6177486221					Heather.Tavares@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Hospice Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Interoperability Contact	VP, IT Enterprise Architecture		Ellis	Ezren		6177486381					ezren.ellis@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Bigbee	Jacqueline		7746446922					jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	MA Claims Processing Contact for Public Website	Director, Claims, Enrollment & Provider Appeals		Hinderman	Emily		6174783614					emily.hinderman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Marketing Contact	Director of Medicare Marketing		Chrzanowski	Kelly		2166950332					Kelly.Chrzanowski@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Medical Director	Senior Medical Director	Dr.	Rubinstein	Jessica		8573010164					Jessica.Rubinstein@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Medicare Coordinator	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/31/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Medicare Part D Opioid Overutilization Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					ashley.smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Medication Therapy Management Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	OffShore Subcontractor Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Online Enrollment Center Contact (Back-up)	Programmer Analyst II		Lapaix	Anord		7865415843					anord.lapaix@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Online Enrollment Center Contact (Primary)	EDI Analyst II		MacMillan	Sheba		6174783538					Sheba.MacMillan@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part C Application Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part C Reporting Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part D Appeals	Director, Appeals & Grievances		Bigbee	Jacqueline							jacqueline.bigbee@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active	8558338125				PPO - BBA		C	Boston
H7980	Part D Appeals Contact (Secondary)	Manager, Appeals & Grievances		DiSciscio	Felicia							Felicia.DiSciscio@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active	6174783556				PPO - BBA		C	Boston
H7980	Part D Application Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part D Benefits Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part D Claims Submission Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part D Exceptions Contact	Director of Clinical Pharmacy		Smith	Ashley							Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active	8558338125				PPO - BBA		C	Boston
H7980	Part D Exceptions Contact (Secondary)	Senior Director of Pharmacy Services		Pham	Phuong							Phuong.Pham@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active	8558338125				PPO - BBA		C	Boston
H7980	Part D Price File Contact (Back-up)	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part D Quality Assurance Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Part D Reporting Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@bmchp-wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Patient Safety Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Payment Contact	VP, Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Pharmacy Director	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Pharmacy Network Management Contact	Director of Clinical Pharmacy		Smith	Ashley		6174783738					Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Pharmacy Technical Help Desk Contact	Director of Clinical Pharmacy		Smith	Ashley							Ashley.Smith@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/28/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active	8009221557				PPO - BBA		C	Boston
H7980	Plan Directory Contact for Public Website	Director Provider Data Integrity		de Medeiros	Sherri-Ann		8885660008					providerinfo@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Plan to Plan Reconciliation Contact	Staff Accountant		Fraser	Amanda		8572215098					Amanda.Fraser@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	09/03/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Processor Contact	Director, Claims, Enrollment & Provider Appeals		Hinderman	Emily		6174783614					emily.hinderman@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Quality Contact	SVP, Chief Behavioral Health and Quality Officer		Borrelli	Jill		6177482457					jill.borrelli@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/21/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Reconciliation Contact	SVP & Chief Actuary		Li	Bo		6177486313					Bo.Li@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	11/06/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Reconciliation Contact (Secondary)	Senior Actuarial Analyst		Wagner	Rachel		7037407564					Rachel.Wagner@Wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	10/23/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Recovery Audit Contact	Medicare Compliance Officer	Mr.	Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	SNP Application Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Surveillance Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	System Contact	VP, IT Enterprise Architecture		Ellis	Ezren		6177486381					ezren.ellis@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Third Party Administrator (TPA) Liaison	Vice President of Finance & Corporate Controller		Goguen	Janice		6177486215					Janice.Goguen@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/06/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	User Access Contact	Medicare Compliance Officer		Comerford	Michael		7819620405					michael.comerford@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	03/27/2025	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Utilization Management Contact	Director of Utilization Management		Costello	Barbara		6174783648					Barbara.Costello@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7980	Utilization Review Contact	Director of Utilization Management		Costello	Barbara		6174783648					Barbara.Costello@wellsense.org	100 City Square, Suite 200		Charlestown	MA	02129	06/04/2024	2026	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	Local CCP	WellSense Health Plan	Local PPO		BMC Health System, Inc.	493	Yes	Active					PPO - BBA		C	Boston
H7993	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H7993	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H7993	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H7993	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H7993	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H7993	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H7993	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF TEXAS, INC.	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H7993	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	VP - Medicare Advantage & Strategic Initiatives		Edwards	Don		8032649482					Don.Edwards@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/23/2019	2026	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	Chicago
H8003	Automated TrOOP Balance Transfer Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Backup User Access Contact	Director - Medicare Advantage Operations		Morris	Charles		8032641799					charles.morris@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	04/12/2023	2026	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	Chicago
H8003	Best Available Evidence Contact	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	04/12/2023	2026	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	Chicago
H8003	Bid Audit Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
H8003	Bid Audit Site Contact	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
H8003	Bid Primary Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
H8003	CAP Report Contact for Public Website	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
H8003	CEO - CMS Administrator Contact	CEO	Mr.	Mizeur	Michael	J	8032646000					CEO@BCBSSC.com	I-20 at Alpine Road	AA-X01	Columbia	SC	29219	01/03/2025	2026	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	Chicago
H8003	CEO - Senior Official for Contracting	CEO	Mr.	Mizeur	Michael	J	8032646000					CEO@BCBSSC.com	I-20 at Alpine Road	AA-X01	Columbia	SC	29219	01/03/2023	2026	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	Chicago
H8003	Chief Financial Officer	VP & CFO, BCBS Div	Mrs.	Srulevich	Heather		8032649488					Heather.Srulevich@BCBSSC.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	10/26/2017	2026	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	Chicago
H8003	Chief Operating Officer	President, BlueCross BlueShield of SC	Mr	Graves	Scott		8033825114					SCOTT.GRAVES@bcbssc.com	I-20 Apline Road	AA-X18	Columbia	SC	29219	12/27/2016	2026	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	Chicago
H8003	Chief Information Officer	Executive VP, CIO	Mr.	Ackerson	Michael		8032646557					Michael.Ackerson@bcbssc.com	1-20 Alpine Road	AA-225	Columbia	SC	29219	02/26/2024	2026	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	Chicago
H8003	Chief Information Security Officer	Executive VP, CIO	Mr.	Ackerson	Michael		8032646557					Michael.Ackerson@bcbssc.com	1-20 Alpine Road	AA-225	Columbia	SC	29219	02/26/2024	2026	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	Chicago
H8003	CMS Casework Communication Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2026	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	Chicago
H8003	Complaints Tracking Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2026	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	Chicago
H8003	Contact for Fraud Investigations	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
H8003	Coordination of Benefits Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Corporate Mailing						8032642944					katrina.gesh-wilson@bcbssc.com	PO Box 100191		Columbia	SC	29202	11/15/2021	2026	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	Chicago
H8003	Customer Service Operations Contact	Senior Director		Surratt	Susan		8032641581					susan.surratt@BCBSSC.com	I-20 at Alpine Road	AX-F15	Columbia	SC	29219	03/01/2024	2026	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	Chicago
H8003	DIR Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		8032644347				8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2026	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	Chicago
H8003	DIR Contact (Secondary)	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
H8003	Discount Program Payment Contact	Director - Private Business Accounting		Campbell	Newt		8032640357					Newt.Campbell@bcbssc.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	12/11/2024	2026	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	Chicago
H8003	Electronic Health Record Contact	VP- Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Emergency Part D Contact	VP - Medicare Advantage Operations		Boggero	Laurin		8034224440				8032649581	laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Emergency Part D Contact (Secondary)	VP Medicare Advantage		Gesh-Wilson	Kat		2816841626					kat.gesh-wilson@bcbssc.com	I-20 at Alpine Road	AG-770	Columbia	SC	29219	12/13/2022	2026	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	Chicago
H8003	Employer Waiver Contact	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	04/12/2023	2026	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	Chicago
H8003	Encounter Data & Risk Adjustment Operations Contact	Director, Research and Statistics		Kosnosky	Brenda		8032642744					brenda.kosnosky@bcbssc.com	I-20 Alpine Rd	AX-555	Columbia	SC	29219	11/15/2021	2026	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	Chicago
H8003	Enrollment Contact	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	04/12/2023	2026	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	Chicago
H8003	EOB Transfer Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Financial Audit Contact	Compliance Officer	Mr.	Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
H8003	Financial Reporting Contact	Director - Financial Reporting		Haile	Karin		8032642089					Karin.Haile@bcbssc.com	1-20 at Alpine Road	AX-200	Columbia	SC	29219	08/09/2022	2026	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	Chicago
H8003	Formulary Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		8032644347				8038708162	Chris.Puffenbarger@bcbssc.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2026	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	Chicago
H8003	Formulary Contact (Secondary)	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	General Contact	VP - Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	Laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Government Relations Contact	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
H8003	HIPAA Privacy Officer	Privacy Compliance Officer		Weeks	Linda		8032643562					linda.weeks@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	02/21/2020	2026	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	Chicago
H8003	HIPAA Security Officer	AVP, I/S Goverance		Hubbard	Elizabeth		8032646146					Elizabeth.Hubbard@bcbssc.com	I-20 at Alpine Road	AA-225	Columbia	SC	29219	12/27/2016	2026	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	Chicago
H8003	Hospice Contact	Supervisor - Medicare Advantage Operations		DeWitt	Tanika		8032641103					tanika.dewitt@bcbssc.com	1-20 @ Alpine Rd.	AG-780	Columbia	SC	29223	10/25/2019	2026	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	Chicago
H8003	Interoperability Contact	VP Medicare Operations		Boggero	Laurin		8032646635					laurin.boggero@bcbssc.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/27/2021	2026	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	Chicago
H8003	MA Appeals/Grievances Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		8032641103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2026	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	Chicago
H8003	MA Claims Processing Contact for Public Website	Director Operations		Morris	Charles		8032641799					charles.morris@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	04/12/2023	2026	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	Chicago
H8003	Marketing Contact	VP -  Medicare Advantage Operations Marketing		Edwards	Don		8032649482					Don.Edwards@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Medical Director	Chief Medical Officer		Sungurov	Max		8032645729					max.sungurov@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	05/18/2023	2026	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	Chicago
H8003	Medicare Compliance Officer	Compliance Officer	Mr.	Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	01/05/2022	2026	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	Chicago
H8003	Medicare Coordinator	Manager Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	tanika.dewitt@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2026	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	Chicago
H8003	Medicare Part D Opioid Overutilization Contact	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	Medication Therapy Management Contact	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	OffShore Subcontractor Contact	VP-Medicare Advantage Operations	Ms.	Boggero	Laurin		8032646635				8032649581	laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Online Enrollment Center Contact (Back-up)	VP, Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	Laurin.Boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	03/11/2020	2026	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	Chicago
H8003	Online Enrollment Center Contact (Optional)	Manager Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	03/11/2020	2026	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	Chicago
H8003	Online Enrollment Center Contact (Primary)	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	04/12/2023	2026	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	Chicago
H8003	Part C Application Contact	VP Medicare Advantage		Gesh-Wilson	Katrina		8032642944					kat.gesh-wilson@bcbssc.com	I-20 @ Alpine Rd	AG-770	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	Part C Reporting Contact	VP - Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Part D Appeals	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris						8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/31/2020	2026	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	8032645355				PPO - BBA		C	Chicago
H8003	Part D Appeals Contact (Secondary)	Supervisor - Medicare Advantage Operations		Dewitt	Tanika						8032649581	tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	8032641103				PPO - BBA		C	Chicago
H8003	Part D Application Contact	VP Medicare Advantage		Gesh-Wilson	Katrina		8032642944					kat.gesh-wilson@bcbssc.com	I-20 @ Alpine Rd	AG-770	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	Part D Benefits Contact	Sr. Director -  Medicare Pharmacy		Coleman	Terrica		8032642728				8032649581	terrica.coleman@bcbssc.com	I-20 at Alpine Road	AG-770	Columbia	SC	29219	07/12/2023	2026	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	Chicago
H8003	Part D Claims Submission Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Part D Exceptions Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris						8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/31/2020	2026	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	8032645355				PPO - BBA		C	Chicago
H8003	Part D Exceptions Contact (Secondary)	Supervisor - Medicare Advantage Operations		Dewitt	Tanika							tankia.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	8032641103				PPO - BBA		C	Chicago
H8003	Part D Price File Contact (Back-up)	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	Part D Price File Contact (Primary)	Manager, MA Pharmacy Management		Puffenbarger	Chris		8032644347					Chris.Puffenbarger@bcbssc.com	1-20 Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2026	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	Chicago
H8003	Part D Quality Assurance Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Part D Reporting Contact	Corporate Compliance Director		Ortiz	Jason		8032643910					BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	03/01/2024	2026	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	Chicago
H8003	Patient Safety Contact	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	Payment Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
H8003	Personal Health Record Contact	VP, Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Pharmacy Director	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	Pharmacy Network Management Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		8032644347				8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2026	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	Chicago
H8003	Pharmacy Network Management Contact (Secondary)	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
H8003	Pharmacy Technical Help Desk Contact	Sr.		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	03/27/2024	2026	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	8555405951				PPO - BBA		C	Chicago
H8003	PHR Beneficiary Contact																	12/27/2016	2026	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	Local CCP	Blue Cross Blue Shield of South Carolina	Local PPO	BlueCross BlueShield of South Carolina, Medicare Advantage	BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	8886456025				PPO - BBA		C	Chicago
H8003	Plan Directory Contact for Public Website			Services	Provider		8003342583					Provider.Education@BCBSSC.com	I-20 at Alpine Road	AX-624	Columbia	SC	29219	12/27/2016	2026	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	Chicago
H8003	Plan to Plan Reconciliation Contact	Director, Accounting		Campbell	Newt		8032640357					Newt.Campbell@bcbssc.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	04/13/2023	2026	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	Chicago
H8003	Processor Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					tanika.dewitt@BCBSSC.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Quality Contact	Medicare Star Performance Officer		Sloan	Jason		8032647645					jason.sloan@bcbssc.com	1-20 at Alpine Road	AG-A10	Columbia	SC	29219	03/17/2020	2026	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	Chicago
H8003	Reconciliation Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
H8003	Reconciliation Contact (Secondary)	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
H8003	Recovery Audit Contact	VP-Medicare Advantage Operations	Ms.	Boggero	Laurin		8032646635				8032649581	laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Surveillance Contact	VP- MA Marketing		Edwards	Don		8032649482					Don.Edwards@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	08/29/2022	2026	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	Chicago
H8003	System Contact	Assistant Vice President - Information Systems		Aldinger	Eugenia		8032645410					Eugenia.Aldinger@bcbssc.com	I-20 at Alpine Road	AF-123	Columbia	SC	29219	04/12/2023	2026	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	Chicago
H8003	Third Party Administrator (TPA) Liaison	Accounting Manager		Shirey	Stephanie		8032641613					Stephanie.Shirey@bcbssc.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	12/11/2024	2026	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	Chicago
H8003	User Access Contact	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
H8003	Utilization Management Contact	VP - Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	laurin.boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8003	Utilization Review Contact	VP - Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/25/2019	2026	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	Chicago
H8010	Agent/Broker Compensation Data Contact	Telesales Director	Mr.	Gorman	Scott		7576399577					scott.gorman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O.Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Backup User Access Contact	Compliance Sr. Associate	Mrs.	Terrell	Linda		8324927622				2012554173	linda.terrell@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Bid Audit Contact	Chief Actuary	Mr.	Cap	Dale		8324927622				2012554173	dale.cap@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Bid Audit Site Contact	Chief Actuary	Mr.	Cap	Dale		8324927622				2012554173	dale.cap@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Bid Primary Contact	Chief Compliance Officer	Mrs.	Richey	Wendy		5512252014				2012554173	wendy.richey@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer	Mrs.	Richey	Wendy		5512252014				2012554173	Wendy.Richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs	Reynoso	Jamie		2014322133					jamie.reynoso@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs.	Reynoso	Jamie		2014322133					jamie.reynoso@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Operating Officer	COO	Mr.	Brand	Joseph		2014322133					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Information Officer	President	Mr.	Toy	Andrew		6463183182					andrew.toy@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Information Security Officer	Chief Security Officer	Mr.	Ross	Christophe		4257378141					christopher.ross@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	CMMI Model Point of Contact	CCO	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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		2013200506					robert.davis@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Complaints Tracking Contact	Sr Compliance Director	Mr.	Davis	Robert		2012554173					robert.davis@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Corporate Mailing						5512252014				2018587355	wendy.richey@cloverhealth.com	Clover Health	P.O. Box 21164	Eagan	MN	55121	03/12/2025	2026	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	COO	Mr.	Brand	Joseph		2014322133				2012554173	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	DIR Contact	Manager	Ms	Bhatt	Mital		5513584582					mital.bhatt@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	DIR Contact (Secondary)	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Discount Program Payment Contact	Sr. Accountant	Ms.	Bhatt	Mital		5513584582				2018587355	Mital.Bhatt@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Electronic Health Record Contact	COO	Mr.	Brand	Joseph		2015322133					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Emergency Part D Contact	VP of Pharmacy	Mr.	Pica	Michael		7188735606				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Ms.	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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	Employer Waiver Contact	CCO	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Actuary	Mr.	Cap	Dale		2014322133					dale.cap@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Enrollment Contact	Enrollment Director	Ms	Newman	Jennifer		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	EOB Transfer Contact	COO	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Financial Audit Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Financial Reporting Contact	CFO	Mr.	Thronton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Formulary Contact	VP of Pharmacy	Mr.	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Formulary Contact (Secondary)	Pharmacy Operations Manager	Ms.	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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	General Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	HIPAA Privacy Officer	Privacy Officer	Ms	Shah	Devi		7327131229					devi.shah@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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	HIPAA Security Officer	Security Officer	Mr.	Ross	Christophe		4257378141					christopher.ross@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Interoperability Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	MA Appeals/Grievances Contact	COO	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Information Officer	Ms.	Safe	Theresa		5513221075				2012554173	theresa.safe@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Marketing Contact	Sr. Compliance Director	Mr.	Davis	Robert		2012554173				2012554171	robert.davis@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Medical Director	Chief Medical Officer / Medical Director	Dr.	Gupta	Shelly		2014322133				2012554173	shelly.gupta@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Coordinator	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy Operations Manager	Ms	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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	Medication Therapy Management Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	OffShore Subcontractor Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Online Enrollment Center Contact (Back-up)	Telesales Director	Mr.	Gorman	Scott		7576399577					scott.gorman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Online Enrollment Center Contact (Primary)	Enrollment Director	Ms	Newman	Jennifer		7542456377					jennifer.newman@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 C Application Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 C Reporting Contact	Chief Compliance Officer	Ms	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Appeals	VP Pharmacy	Mr	Pica	Mike							mike.pica@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER HMO OF NEW JERSEY INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	2014322133				HMO - Health Maintenance Organization		C	New York
H8010	Part D Appeals Contact (Secondary)	Pharmacy Manager	Ms.	Zawadzki	Marta						5513490059	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER HMO OF NEW JERSEY INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	2014696805				HMO - Health Maintenance Organization		C	New York
H8010	Part D Application Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Benefits Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Claims Submission Contact	VP Pharmacy	Mr.	Pica	Mike		8887781478				2014322133	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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						2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER HMO OF NEW JERSEY INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	2014322133				HMO - Health Maintenance Organization		C	New York
H8010	Part D Exceptions Contact (Secondary)	Pharmacy Operations Manager	Ms	Zawadzki	Marta						8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER HMO OF NEW JERSEY INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	5513490059				HMO - Health Maintenance Organization		C	New York
H8010	Part D Price File Contact (Back-up)	Pharmacy operations manager	Ms	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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 Price File Contact (Optional)	Pharmacy Manager	Ms	Zawadzki	Marta		5513490059					pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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 Price File Contact (Primary)	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Quality Assurance Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Reporting Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Patient Safety Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Payment Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Personal Health Record Contact	President	Mr	Toy	Andrew		6463183182					andrew.toy@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Director	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Network Management Contact	SV Pharmacy	Mr	Pica	Michael		2014322133				4803146023	mike.pica@Cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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 Network Management Contact (Secondary)	Pharmacy operations manager	Ms	Zawadzki	Marta		5513490059				8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	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	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	CLOVER HMO OF NEW JERSEY INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H8010	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy operations manager	Ms	Zawadzki	Marta						8665090944	pharmacyteam@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	12/08/2025	2026	CLOVER HMO OF NEW JERSEY INC.	Local CCP	Clover Health	HMO/HMOPOS		Clover Health Holdings, Inc.	491	Yes	Active	5513490059				HMO - Health Maintenance Organization		C	New York
H8010	PHR Beneficiary Contact																	03/12/2025	2026	CLOVER HMO OF NEW JERSEY INC.	Local CCP	Clover Health	HMO/HMOPOS	Clover Health	Clover Health Holdings, Inc.	491	Yes	Active	8886571207				HMO - Health Maintenance Organization		C	New York
H8010	Physician Incentive Contact	Vice President Provider Experience	Ms.	Jones	Rachel		9144175963					rachel.jones@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting Manager		Bhatt	Mital		5513584582					mital.bhatt@cloverhealth.com	c/o PNC Bank	PO Box 825694	Philadelphia	PA	19182	03/20/2025	2026	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	Processor Contact	VP of Pharmacy	Mr	Pica	Michael		2014322133				2012554173	mike.pica@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Quality Contact	COO	Mr.	Brand	Joseph		2014322133				2018587355	joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Reconciliation Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Recovery Audit Contact	CFO	Mr.	Thornton	Clay		8592219670				2012554173	clay.thornton@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	SNP Application Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	SNP State Contact	SVP, Deputy, General Counsel	Ms.	Soares	Karen		2059087838					karen.soares@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Surveillance Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	System Contact	Chief Information Officer	Ms.	Safe	Theresa		5513221075					theresa.safe@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Third Party Administrator (TPA) Liaison	Sr. Accountant	Ms.	Bhatt	Mital		5513584582				2018587355	Mital.Bhatt@Cloverhealth.com	P.O. Box 21164	Suite 803	Eagan	MN	55121	03/12/2025	2026	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	User Access Contact	Chief Compliance Officer	Ms.	Richey	Wendy		5512252014				2012554173	wendy.richey@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Utilization Management Contact	COO	Mr.	Brand	Joseph		2010432213					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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	Utilization Review Contact	COO	Mr.	Brand	Joseph		2014322133					joe.brand@cloverhealth.com	P.O. Box 21164		Eagan	MN	55121	03/12/2025	2026	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
H8022	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd., Suite 140		Columbia	SC	29209	11/03/2025	2026	BAY AREA COMMUNITY HEALTH	National PACE	Bay Area Community Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8022	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd., Suite 140		Columbia	SC	29209	11/03/2025	2026	BAY AREA COMMUNITY HEALTH	National PACE	Bay Area Community Health PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8048	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Backup User Access Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Best Available Evidence Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	CAP Report Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active	5703717371				PACE - Nat		C	Chicago
H8048	CEO - CMS Administrator Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/11/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Chief Operating Officer	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Complaints Tracking Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	09/30/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Contact for Fraud Investigations	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Coordination of Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Customer Service Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	DIR Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Encounter Data & Risk Adjustment Operations Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Enrollment Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Financial Reporting Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	General Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Government Relations Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	HIPAA Privacy Officer	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	HIPAA Security Officer	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	MA Appeals/Grievances Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Marketing Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Medical Director	Compliance Officer		Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	09/30/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Medicare Compliance Officer	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Medicare Coordinator	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Medicare Part D Opioid Overutilization Contact	Compliance Officer	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part C Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part D Appeals	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active	5703717371				PACE - Nat		C	Chicago
H8048	Part D Application Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part D Benefits Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part D Claims Submission Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	08/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active	5703717371				PACE - Nat		C	Chicago
H8048	Part D Price File Contact (Back-up)	VP of Quality and Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/13/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part D Price File Contact (Primary)	VP of Quality and Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/13/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part D Quality Assurance Contact	VP of Quality and Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/13/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Part D Reporting Contact	VP of Quality and Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138TH CT		Vancouver	WA	98682	08/13/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active	5703717371				PACE - Nat		C	Chicago
H8048	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Quality Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	System Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8048	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF INDIANA, LLC	National PACE	Kinship PACE of Indiana, LLC	National PACE		CitiPACE Holding Company	841	Yes	Active					PACE - Nat		C	Chicago
H8051	Agent/Broker Compensation Data Contact	Director, Marketing & Communications		Bergensten	Gunilla		4156155914					gbergensten@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	06/12/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Automated TrOOP Balance Transfer Contact	Director, Claims		Vento-Gomez	Maria		4156154207					mvento-gomez01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Backup User Access Contact	Director, Regulatory Affairs		Bhambra	John		4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Best Available Evidence Contact	Senior Manager, Member Data		Huang	Leslie		4156154470					mhuang@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Bid Audit Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Bid Audit Site Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Bid Primary Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	CAP Report Contact for Public Website	Director, Regulatory Affairs		Bhambra	John		4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Richardson	Yolanda		4156155923					yrichardson@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/10/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Richardson	Yolanda		4156155923					yrichardson@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/10/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Chief Financial Officer	Chief Financial Officer	Mr.	Bishop	Skip		4156154230					sbishop@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	12/09/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Chief Operating Officer	Chief Operating Officer	Ms.	Moore	Jenn		4156155765					jmoore01@sfhp.org	50  Beale Street	13th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Chief Information Officer	Information Officer	Mr.	Vela	Tony		4156155679					tvela@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	06/12/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Chief Information Security Officer	Information Officer	Mr.	Vela	Tony		4156155679					tvela@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	CMMI Model Point of Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	CMS Casework Communication Contact	Director, Regulatory Affairs	Mr.	Bhambra	John	M	4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	05/20/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Complaints Tracking Contact	Senior Manager, Member Services		Tiani	Travis		4156154293					ttiani@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	06/12/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Contact for Fraud Investigations	Director, Compliance and Oversight		Garcia	Crystal		4156155619					cgarcia@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Coordination of Benefits Contact	Manager, Member Data		Huang	Leslie		4156154470					mhuang@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	06/12/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Corporate Mailing						4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Customer Service Operations Contact	Senior Manager, Member Services		Tiani	Travis		4156154293					ttiani@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	DIR Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	06/12/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	DIR Contact (Secondary)	Clinical Pharmacist		Vo	Katie		4156155446					kvo01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Discount Program Payment Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Electronic Health Record Contact	Information Officer		Vela	Tony		4156155679					tvela@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Emergency Part D Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Emergency Part D Contact (Secondary)	Clinical Pharmicist		Vo	Katie		4156155446					kvo01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	07/02/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare Risk Adjustment		Hugo	Melissa		4156155480					mhugo01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	06/12/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Enrollment Contact	Manager, Member Data		Huang	Leslie		4156154470					mhuang@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	EOB Transfer Contact	Director, Claims		Vento-Gomez	Maria		4156154207				4155477825	mvento-gomez01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Financial Audit Contact	Director, Compliance and Oversight	Ms.	Garcia	Crystal		4156155619					cgarcia@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Financial Reporting Contact	Controller		Takeuchi	Rand		4156155676					rtakeuchi@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Formulary Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Formulary Contact (Secondary)	Clinical Pharmacist		Vo	Katie		4156155446					kvo01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	07/02/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	General Contact	Director, Regulatory Affairs	Mr.	Bhambra	John	M	4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	05/20/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Government Relations Contact	Director, Regulatory Affairs		Bhambra	John		4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	HIPAA Privacy Officer	Chief Compliance and Regulatory Affairs Officer		Maruyama	Nina		4156154217					nmaruyama@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	HIPAA Security Officer	Information Officer		Vela	Tony		4156155679					tvela@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Hospice Contact	Manager, Clinical Operations		Kerrr	Morgan		4156155670					mkerr@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	06/17/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Interoperability Contact	Information Officer		Vela	Tony		4156155679					tvela@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	MA Appeals/Grievances Contact	Senior Manager, Member Services		Tiani	Travis		4156154293					ttiani@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	MA Claims Processing Contact for Public Website	Director, Claims		Vento-Gomez	Maria		4156154207					mvento-gomez01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Marketing Contact	Director, Marketing & Communications		Bergensten	Gunilla		4156155914					gbergensten@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Medical Director	Senior Medical Director		Shah	Rina		4155477818					rshah01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Medicare Compliance Officer	Chief Compliance and Regulatory Affairs Officer	Ms.	Maruyana	Nina		4156154217					nmaruyama@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Medicare Coordinator	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Medication Therapy Management Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Online Enrollment Center Contact (Back-up)	Sr Director, Health Plan Operations		Wong	Dave		4156154487					dwong@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Online Enrollment Center Contact (Optional)	Sr Manager, Member Data		Huang	Leslie		4156154470					mhuang@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part C Application Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part C Reporting Contact	Director, Regulatory Affairs	Mr.	Bhambra	John	M	4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	05/20/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Appeals	Senior Manager, Member Services		Tiani	Travis							ttiani@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active	8002885555				HMO - Health Maintenance Organization		C	New York
H8051	Part D Appeals Contact (Secondary)	Supervisor, Grievance and Appeals		Carino	Grace							gdadios@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active	8335307327				HMO - Health Maintenance Organization		C	New York
H8051	Part D Application Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Benefits Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Claims Submission Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Exceptions Contact	Director, Pharmacy		Ellsworth	Brian							bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active	8002885555				HMO - Health Maintenance Organization		C	New York
H8051	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Vo	Katie							kvo01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	07/02/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active	4156155446				HMO - Health Maintenance Organization		C	New York
H8051	Part D Price File Contact (Back-up)	Clinical Pharmacist		Vo	Katie		4156155446					kvo01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	07/02/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Price File Contact (Optional)		Ms.	Chan	Sue		4156154461					schan@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	12/09/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Price File Contact (Primary)	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Quality Assurance Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beal Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Part D Reporting Contact	Director, Regulatory Affairs	Mr.	Bhambra	John	M	4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	05/20/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Patient Safety Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Payment Contact	Controller		Takeuchi	Rand		4156155676					rtakeuchi@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Personal Health Record Contact	Information Officer		Vela	Tony		4156155679					tvela@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	06/12/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Pharmacy Director	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Pharmacy Network Management Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist		Vo	Katie		4156155446					kvo01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/17/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active	8335460101				HMO - Health Maintenance Organization		C	New York
H8051	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy		Ellsworth	Brian							bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	12/17/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active	8002885555				HMO - Health Maintenance Organization		C	New York
H8051	PHR Beneficiary Contact																	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS	San Francisco Health Plan	SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active	8335307327				HMO - Health Maintenance Organization		C	New York
H8051	Physician Incentive Contact	Chief Health Equity Officer		Poon	Edwin		4156155974					epoon1@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Plan Directory Contact for Public Website	Director, Marketing & Communications		Bergensten	Gunilla		4156155914					gbergensten@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Plan to Plan Reconciliation Contact	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	02/05/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Processor Contact	Director, Claims		Vento-Gomez	Maria		4156154207					mvento-gomez01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Quality Contact	Chief Health Equity Officer		Poon	Edwin		4156155974					epoon1@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Reconciliation Contact	Controller		Takeuchi	Rand		4156155676					rtakeuchi@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Reconciliation Contact (Secondary)	Director, Pharmacy		Ellsworth	Brian		4156155799					bellsworth01@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Recovery Audit Contact	Director, Compliance and Oversight	Ms.	Garcia	Crystal		4156155619					cgarcia@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	SNP Application Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	SNP State Contact	Director, Regulatory Affairs	Mr.	Bhambra	John	M	4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	05/20/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Surveillance Contact	Director, Marketing		Bergensten	Gunilla		4156155914					gbergensten@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	System Contact	Information Officer		Vela	Tony		4156155679					tvela@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	02/06/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Third Party Administrator (TPA) Liaison	Director, Regulatory Affairs	Mr.	Bhambra	John	M	4156155950					jbhambra@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	05/20/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	User Access Contact	Sr Director, Product and Growth		Le	Diem Chau		4156155619					cle01@sfhp.org	50 Beale Street	13th Floor	San Francisco	CA	94105	10/14/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Utilization Management Contact	Manager, Clinical Operations		Kerr	Morgan		4156155670					mkerr@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	06/17/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8051	Utilization Review Contact	Manager, Clinical Operations		Kerr	Morgan		4156155670					mkerr@sfhp.org	50 Beale Street	12th Floor	San Francisco	CA	94105	06/17/2025	2026	SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN	Local CCP	San Francisco Health Plan	HMO/HMOPOS		SAN FRANCISCO HEALTH AUTHORITY	869	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8067	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H8067	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Dallas
H8067	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Dallas
H8067	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Dallas
H8067	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H8067	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H8067	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8067	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H8082	Automated TrOOP Balance Transfer Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Backup User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Best Available Evidence Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/29/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	CAP Report Contact for Public Website		Ms.	Eidell	Rachel		7142927152					rachel.eidell@welbehealth.com	440 N BARRANCA AVE #4051		Covina	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	CEO - CMS Administrator Contact		Ms.	Thomas	Katherine		2096972632					katherine.thomas@welbehealth.com	582 East Harding Way		Stockton	CA	95204	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	CEO - Senior Official for Contracting		Ms.	Thomas	Katherine		2096972632					katherine.thomas@welbehealth.com	582 East Harding Way		Stockton	CA	95204	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Chief Financial Officer		Ms.	Thomas	Katherine		2096972632					katherine.thomas@welbehealth.com	582 East Harding Way		Stockton	CA	95204	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Chief Operating Officer		Ms.	Bosse	Colleen		2093009443					colleen.bosse@welbehealth.com	582 East Harding Way		Stockton	CA	95204	11/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Chief Information Security Officer		Mr.	Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	CMS Casework Communication Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Complaints Tracking Contact			Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Contact for Fraud Investigations			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Coordination of Benefits Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Customer Service Operations Contact			Thomas	Katherine		2096972632					katherine.thomas@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	DIR Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	DIR Contact (Secondary)			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Emergency Part D Contact (Secondary)			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Enrollment Contact			Holmes	Nicole		2699101107					nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	EOB Transfer Contact			Holmes	Nicole		2699101107				6263600082	nicole.holmes@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Financial Audit Contact	Director of Accounting	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	04/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Formulary Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	General Contact			Thomas	Katherine		2096972632					katherine.thomas@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Government Relations Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	HIPAA Privacy Officer			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	HIPAA Security Officer			Kazmi	Zeeshan		4153769704					zeeshan.kazmi@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Interoperability Contact			Shetty	Girish		2812353841					girish.shetty@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/19/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	MA Appeals/Grievances Contact		Ms.	Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/18/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	MA Claims Processing Contact for Public Website			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Medical Director			Lowe	Chad		6509354898					chad.lowe@welbehealth.com	582 East Harding Way		Stockton	CA	95204	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Medicare Compliance Officer		Ms.	Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Medicare Coordinator		Ms.	Thomas	Katherine		2096972632					katherine.thomas@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	05/29/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Medicare Part D Opioid Overutilization Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Medication Therapy Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Appeals		Ms.	Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/18/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	2192106392				PACE - Nat		C	San Francisco
H8082	Part D Appeals Contact (Secondary)			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H8082	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	02/27/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Benefits Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Claims Submission Contact			North	Tom		7148784552					tom.north@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	07/30/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Exceptions Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H8082	Part D Price File Contact (Back-up)			Nguyen	Rose		6505167911					rose.nguyen@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Price File Contact (Primary)			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Quality Assurance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Part D Reporting Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Patient Safety Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Pharmacy Director			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Pharmacy Network Management Contact			Lincoln-Giang	Pam		6502948027					pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Pharmacy Technical Help Desk Contact			Lincoln-Giang	Pam							pam.lincoln-giang@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	08/12/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active	6502948027				PACE - Nat		C	San Francisco
H8082	Plan Directory Contact for Public Website			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Plan to Plan Reconciliation Contact			Porras	Ashleigh		6504422660					ashleigh.porras@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Processor Contact			Cumpian	Terry		2098408404					terry.cumpian@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	09/17/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Reconciliation Contact			Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Surveillance Contact			Lee	Elizabeth		7144706077					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	03/05/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	System Contact			Delfausse	Aaron		6503360300					aaron.delfausse@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/08/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					Kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	10/23/2024	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	User Access Contact			Oomerjee	Feroze		5624129865					Feroze.Oomerjee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/24/2025	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8082	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	01/19/2023	2026	STOCKTON PACE	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Active					PACE - Nat		C	San Francisco
H8093	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Chief Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Chief Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Chief Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8449170645				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Formulary Contact	Clinical Formulary Pharmacist	Mr,	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Ms	Brimm	Angie		8449170645				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Ms.	Demick	Chris		8449170645				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Medicare Coordinator	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Medicare Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Part C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Part C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H8093	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/16/2022	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H8093	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H8093	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H8093	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Pharmacy Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Pharmacy Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	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	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8336655420				HMO - Health Maintenance Organization		C	Dallas
H8093	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Technician		Sanchez	Lynn						6157610920	lsanchez@amhealthplans.com	909 S Meridian Avenue	Ste 425	Oklahoma City	OK	73108	12/24/2019	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8336655420				HMO - Health Maintenance Organization		C	Dallas
H8093	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8449170645				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	SNP State Contact	VP, Operations	Mr	Haney	Jason		6159055420				8442805360	jhaney@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8093	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	GEORGIA ASSURANCE, INC.	Local CCP	Georgia Health Advantage	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8095	Agent/Broker Compensation Data Contact	Director, Finance Operations		Hoeg	Andrea		5153764509					commissioninquiry@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	02/16/2021	2026	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	Automated TrOOP Balance Transfer Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2026	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	Bid Primary Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director		Pickens	Veronica		2483955887					vpickens@bcsbm.com	600 East Lafayette	TC 1301	Detroit	MI	48826	03/05/2024	2026	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	CEO - CMS Administrator Contact	Plan President	Ms.	Winright	Krischa	K	2486654048					kwinright@bcbsm.com	1000 Town Center		Southfield	MI	48075	01/06/2025	2026	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	CEO - Senior Official for Contracting	Plan President	Ms.	Winright	Krischa	K	2486654048					kwinright@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/20/2023	2026	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		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/15/2021	2026	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 Operating Officer	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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 Information Officer	IT Director II	Mrs.	Krause	Amy		3132256638					akrause@bcbsm.com	600 East Lafayette Blvd. MC 0506		Detroit	MI	48826	06/17/2022	2026	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 Information Security Officer	VP Chief Information Security Officer	Mr.	Cieszynski	Brent		3132258766					bcieszynski@bcbsm.com	600 Lafayette East		Detroit	MI	48226	08/22/2022	2026	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	CMMI Model Point of Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Complaints Tracking Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Corporate Mailing						5152012513					briggs.hamor@wellmarkadvantagehealthplan.com	1331 Grand Avenue		Des Moines	IA	50309	04/27/2022	2026	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		3132250555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	11/15/2021	2026	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	DIR Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/07/2025	2026	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	DIR Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2025	2026	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	Discount Program Payment Contact	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	Electronic Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Emergency Part D Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	01/04/2023	2026	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	Emergency Part D Contact (Secondary)	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Employer Waiver Contact	Director		Nelson	Jessica		2483209946					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		King	Aleesha		9194303434					aking12@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	04/10/2025	2026	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	Enrollment Contact	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	EOB Transfer Contact	Director		Clark	Erica		6167580917				8556337633	eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	SVP, Controller	Mr.	Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/15/2021	2026	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	Formulary Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Formulary Contact (Secondary)	Manager		Jones	Marini		3135706777					Marini.Jones@emergient.com	1000 Town Center		Southfeld	MI	48075	03/05/2024	2026	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	General Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	HIPAA Privacy Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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	HIPAA Security Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Interoperability Contact	Manager, Functional Operations		Kingsley	Chris		2484444160					Christopher.kingsley@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	MA Appeals/Grievances Contact	Chief Operating Officer		Hower	Johanna		8048594034					Johanna.Hower@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	MA Claims Processing Contact for Public Website	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Marketing Contact	Marketing Manager		Madsen	Robin		2486654199					MadsenR@wellmark.com	1331 Grand Avenue		Des Moines	IA	50309	12/05/2024	2026	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	Medical Director	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette	TC 1301	Detroit	MI	48226	03/05/2024	2026	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 Part D Opioid Overutilization Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	Medication Therapy Management Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	09/11/2024	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	04/27/2022	2026	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	Online Enrollment Center Contact (Back-up)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Online Enrollment Center Contact (Optional)	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	Online Enrollment Center Contact (Primary)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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 C Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 C Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Appeals	Manager		Moran	Vickie							Vickie.Moran@CVSHealth.com	620 Epsilon Dr		Pittsburgh	PA	15238	04/26/2022	2026	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	4125263320				HMO - Health Maintenance Organization		C	Chicago
H8095	Part D Appeals Contact (Secondary)	Director		Christensen	Ann							Ann.Christensen@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	04/26/2022	2026	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	6023883829				HMO - Health Maintenance Organization		C	Chicago
H8095	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Claims Submission Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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		Clark	Erica							eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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	6167580917				HMO - Health Maintenance Organization		C	Chicago
H8095	Part D Exceptions Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	8553440930				HMO - Health Maintenance Organization		C	Chicago
H8095	Part D Price File Contact (Back-up)	Manager		Jones	Marini		3135706777					Marini.Jones@emergient.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Price File Contact (Optional)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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 Price File Contact (Primary)	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Quality Assurance Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Payment Contact	SVP, Controller	Mr.	Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/15/2021	2026	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	Personal Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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 Director	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Network Management Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	03/06/2024	2026	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 Network Management Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Manager, Pharmacy Operations		Zylstra	Jennifer							Jennifer.Zylstra@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/11/2023	2026	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	8006008065				HMO - Health Maintenance Organization		C	Chicago
H8095	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Operations		Jones	Marini							Marini.Jones@emergient.com	1000 Town Center		Southfield	MI	48075	12/11/2023	2026	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	8006008065				HMO - Health Maintenance Organization		C	Chicago
H8095	Physician Incentive Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Plan Directory Contact for Public Website	Director		Nelson	Jessica		8557162556					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Plan to Plan Reconciliation Contact	SVP, Controller	Mr.	Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/15/2021	2026	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	Processor Contact	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Quality Contact	Corporate Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Reconciliation Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Recovery Audit Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP State Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Surveillance Contact	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	User Access Contact	Administrative Assistant		Eddy	Chris		3132683879					CEddy@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/03/2024	2026	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	Utilization Management Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Utilization Review Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Director, PACE Health Plan Operations	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Backup User Access Contact	Director, PACE Health Plan Operations	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	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	Brooks	Chrissette		4342006516					Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Bid Primary Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	CAP Report Contact for Public Website	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	CEO - CMS Administrator Contact	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	CEO - Senior Official for Contracting	CEO	Mr.	Tugman	Richard		4342386720					Richard.Tugman@Centrahealth.com	1901 Atherholt Road		Lynchburg	VA	24501	01/15/2025	2026	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	Tonkinson	Rob		4342004708					rob.tonkinson@centrahealth.com	1901 Tate Springs Rd.		Lynchburg	VA	24501	08/16/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Chief Operating Officer	EVP, Chief Administrative & Transformation Officer	Mr.	Thompson	Chris		4342007740					chris.thompson@centrahealth.com	2310 Langhorne Road		Lynchburg	VA	24501	01/14/2025	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Chief Information Officer	CIO	Ms.	Hildwein	Robin		4342006081					cio.office@centrahealth.com	1920 Atherholt Road		Lynchburg	VA	24501	08/02/2022	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Chief Information Security Officer	Director IT Security/Privacy	Ms.	MEWBORN	BETSY	C	4342007996					betsy.mewborn@centrahealth.com	1901 Atherholt Road		Lynchburg	VA	24501	03/08/2016	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	CMS Casework Communication Contact	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Complaints Tracking Contact	Quality Manager	Ms	Brooks	Chrissette		4342006516					Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Contact for Fraud Investigations	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Coordination of Benefits Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Corporate Mailing						4342006516				4342006263	Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/31/2022	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Customer Service Operations Contact	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	DIR Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516				4342006263	megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	DIR Contact (Secondary)	Health Plan Supervisor		Richey	Chrissy		4342006516				4342006263	chrissy.richey@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/16/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Discount Program Payment Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516				4342006263	megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	12/03/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Emergency Part D Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Emergency Part D Contact (Secondary)	Health Plan Supervisor		Richey	Chrissy		4342006516					chrissy.richey@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/16/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Encounter Data & Risk Adjustment Operations Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516				4342006263	megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Enrollment Contact	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	EOB Transfer Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516				4342006263	megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Financial Audit Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516				4342006263	megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Financial Reporting Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan		4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Formulary Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Formulary Contact (Secondary)	Health Plan Supervisor		Richey	Chrissy		4342006516					chrissy.richey@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/16/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	General Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Government Relations Contact	Senior Director	Mrs	Boyd	Jennifer	H	4342006320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	HIPAA Privacy Officer	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	HIPAA Security Officer	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Interoperability Contact	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	MA Appeals/Grievances Contact	Quality Manager	Ms	Brooks	Chrissette		4342006516					Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	MA Claims Processing Contact for Public Website	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Marketing Contact	Senior Director	Mrs.	Boyd	Jennifer	H	4342006320					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Medical Director	Medical  Director	Dr.	Howard	Laura		4342004190					laura.howard@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/02/2022	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Medicare Compliance Officer	CORPORATE DIRECTOR COMPLIANCE & REGULATORY AFFAIRS	Mrs.	Sparks	Jenny		4342001539					jenny.sparks@centrahealth.com	2301 Langhorne Road		Lynchburg	VA	24501	11/13/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Medicare Coordinator	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Medicare Part D Opioid Overutilization Contact	Director, PACE Health Plan Operation		Beach	Megan		4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Medication Therapy Management Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	OffShore Subcontractor Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Online Enrollment Center Contact (Back-up)	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Online Enrollment Center Contact (Optional)	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Online Enrollment Center Contact (Primary)	Director, PACE Health Plan Operation	Mrs.	Beach	Meagn	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part C Application Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Appeals	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F						megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	8883169540				PACE - Nat		C	Philadelphia
H8096	Part D Appeals Contact (Secondary)	Quality Coordinator	Ms	Brooks	Chrissette							Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	8883169540				PACE - Nat		C	Philadelphia
H8096	Part D Application Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Benefits Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Claims Submission Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Exceptions Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F						megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	8883169540				PACE - Nat		C	Philadelphia
H8096	Part D Exceptions Contact (Secondary)	Senior Director	Mrs	Boyd	Jennifer	H						jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/31/2022	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	8883169540				PACE - Nat		C	Philadelphia
H8096	Part D Price File Contact (Back-up)	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Price File Contact (Optional)	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Price File Contact (Primary)	Director, PACE Health Plan Operation	Mr.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Quality Assurance Contact	Chrissette.brooks@centrahealth.com	Ms	Brooks	Chrissette		4342006516					Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Part D Reporting Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Patient Safety Contact	Senior Director	Mrs.	Boyd	Jennifer	H	4342006516					jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Payment Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Personal Health Record Contact	Senior Director	Mrs	Boyd	Jennifer	H	4342006516					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Pharmacy Director	Centra PACE Pharmacy Director	Mr	Puckett	Randall	K	4342003179					randall.puckett@centrahealth.com	3300 Rivermont Ave		Lynchburg	VA	24503	08/02/2022	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Pharmacy Network Management Contact	Business Manager	Mrs.	Beach	Megan	F	4342006303					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/31/2022	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Pharmacy Network Management Contact (Secondary)	Senior Director	Mrs	Boyd	Jennifer	H	4342006516					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	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	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	4342002148				PACE - Nat		C	Philadelphia
H8096	Pharmacy Technical Help Desk Contact (Secondary)	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F						megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active	4342006516				PACE - Nat		C	Philadelphia
H8096	Plan Directory Contact for Public Website	Senior Director	Mrs.	Boyd	Jennifer	H	4342006516					Jennifer.boyd@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Plan to Plan Reconciliation Contact	Business Manager	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	Centra PACE	407 Federal Street	Lynchburg	VA	24504	08/31/2022	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Processor Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Quality Contact	Quality Manager	Ms	Brooks	Chrissette		4342006516					Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Reconciliation Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516				4342006263	megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Reconciliation Contact (Secondary)	Health Plan Supervisor		Richey	Chrissy		4342006516				4342006263	chrissy.richey@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	08/16/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Recovery Audit Contact	Director, PACE Health Plan Operationsr	Mrs	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Surveillance Contact	Quality Manager	Ms	Brooks	Chrissette		4342006516				4342006263	Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	System Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Third Party Administrator (TPA) Liaison	Director, PACE Health Plan Operations		Beach	Megan		4342006516				4342006263	centrapacebusiness@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	12/04/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	User Access Contact	Centra PACE EPOC	Mrs	Sparks	Jennifer		4342001539					jenny.sparks@centrahealth.com	2301 Langhorne Road		Lynchburg	VA	24501	12/16/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Utilization Management Contact	Director, PACE Health Plan Operation	Mrs.	Beach	Megan	F	4342006516					megan.beach@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	CENTRA HEALTH, INC.	National PACE	Centra PACE	National PACE		Centra Health, Inc.	394	Yes	Active					PACE - Nat		C	Philadelphia
H8096	Utilization Review Contact	Quality Manager	Ms	Brooks	Chrissette		4342006516					Chrissette.brooks@centrahealth.com	407 Federal Street		Lynchburg	VA	24504	02/26/2024	2026	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	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Backup User Access Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Best Available Evidence Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Bid Primary Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	CAP Report Contact for Public Website	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd., Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	CEO - CMS Administrator Contact	Senior Vice President of Healthcare	Mr.	Soczynski	Paul	F	4144068843				5173190650	psoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	CEO - Senior Official for Contracting	Senior Vice President of Healthcare	Mr.	Soczynski	Paul	F	4144068843				5173190650	psoczynski@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Chief Financial Officer	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Chief Operating Officer	Executive DIrector	Mr.	McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd., Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Chief Information Officer	Chief Information Technologies Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Chief Information Security Officer	Chief Information Technologies Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	CMS Casework Communication Contact	Quality and Compliance Manager		Otto	Karen		5173190700				5179135991	kotto@voa.org	47 Cavalier Blvd., Suite 140		Florence	KY	41042	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Complaints Tracking Contact	Quality and Compliance Manager		Otto	Karen		5173190700				5179135991	kotto@voa.org	1921 East Miller Road		Lansing	MI	48911	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Contact for Fraud Investigations	Quality and Compliance Manager		Otto	Karen		5173190700				5179135991	kotto@voa.org	1921 East Miller Road		Lansing	MI	48911	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Coordination of Benefits Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Corporate Mailing						9529410305				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/23/2022	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Customer Service Operations Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	DIR Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	DIR Contact (Secondary)	AR Reimbursement Manager		Cox	Terra		9194253053					tecox@voa.org	5400 S. Miami Blvd. Suite 150		Durham	NC	27703	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Discount Program Payment Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Emergency Part D Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Emergency Part D Contact (Secondary)	Vice President of Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Encounter Data & Risk Adjustment Operations Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Enrollment Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	EOB Transfer Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Financial Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/23/2022	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Financial Reporting Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/23/2022	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Formulary Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	General Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Government Relations Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	HIPAA Privacy Officer	Chief Information Technologies Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	HIPAA Security Officer	Chief Information Technologies Officer	Mr	Osborne	David		9529410305				9529410428	dosborne@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Interoperability Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	MA Appeals/Grievances Contact	Quality & Compliance Manager		Otto	Karen		5173190700				5179135991	kotto@voa.org	1921 East Miller Road		Lansing	MI	48911	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	MA Claims Processing Contact for Public Website	Claims Administrator		Ford	Jill		9705087711				9707971984	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	09/21/2023	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Marketing Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Medical Director	Quality and Compliance Manager		Calico	Brittany		5173190700				5179135991	bcalico@voa.org	1921 East Miller Road		Lansing	MI	48911	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Medicare Compliance Officer	Director of Quality	Ms	Peterson	Nora		9709643500				9705250166	npeterson@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Medicare Coordinator	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Medicare Part D Opioid Overutilization Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Medication Therapy Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part C Application Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part D Appeals	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H8099	Part D Appeals Contact (Secondary)	Vice President of Quality and Compliance		Howell	Keith						9702520166	kehowell@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H8099	Part D Application Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part D Benefits Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part D Claims Submission Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part D Exceptions Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H8099	Part D Exceptions Contact (Secondary)	AR Reimbursement Specialist		Cox	Terra						9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9705087737				PACE - Nat		C	Atlanta
H8099	Part D Price File Contact (Back-up)	Vice President of Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part D Price File Contact (Primary)	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part D Quality Assurance Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Part D Reporting Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Patient Safety Contact	Quality & Compliance Manager		Otto	Karen		5173190700				5179135991	kotto@voa.org	1921 East Miller Road		Lansing	MI	48911	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Payment Contact	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Personal Health Record Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Pharmacy Director	Vice President of Quality and Compliance		Howell	Keith		9709643500				9702520166	kehowell@voa.org	2377Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Pharmacy Network Management Contact	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Pharmacy Technical Help Desk Contact	Regulatory Compliance Coordinator		Whitney	Courtney						9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active	9709643500				PACE - Nat		C	Atlanta
H8099	Plan Directory Contact for Public Website	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Plan to Plan Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Processor Contact	Claims Administrator		Ford	Jill		9705087711				9529410428	jford@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Quality Contact	Quality & Compliance Manager		Otto	Karen		5173190700				5179135991	kotto@voa.org	1921 East Miller Road		Lansing	MI	48911	05/30/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Reconciliation Contact	AR Reimbursement Specialist		Cox	Terra		9705087737				9702520166	tecox@voa.org	2377 Robins Way		Montrose	CO	81401	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Reconciliation Contact (Secondary)	Regional Vice President, PACE Operations	Mr	Nilsen	Eric		6124287858				9529410428	enilsen@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Recovery Audit Contact	Healthcare Controller	Ms	Nutz	Faith		6124287841				9529417097	fnutz@voa.org	7485 Office Ridge Circle		Eden Prairie	MN	55344	12/23/2022	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Surveillance Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	System Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Third Party Administrator (TPA) Liaison	Regulatory Compliance Coordinator		Whitney	Courtney		9709643500				9702520166	cwhitney@voa.org	2377 Robins Way		Montrose	CO	81401	12/31/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	User Access Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Utilization Management Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8099	Utilization Review Contact	Executive Director		McFalls	Robert		8599702450				8599702449	rmcfalls@voa.org	47 Cavalier Blvd. Suite 140		Florence	KY	41042	04/05/2024	2026	VOANS SENIOR COMMUNITY CARE OF NORTHERN KENTUCKY	National PACE	Senior CommUnity Care of Northern Kentucky	National PACE		Volunteers of America National Services	367	Yes	Active					PACE - Nat		C	Atlanta
H8106	Automated TrOOP Balance Transfer Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Backup User Access Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Best Available Evidence Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Bid Primary Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	CAP Report Contact for Public Website	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	CEO - CMS Administrator Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	CEO - Senior Official for Contracting	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Chief Financial Officer	CFO	Mr	Isaacs	William		8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Chief Operating Officer	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Chief Information Officer	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Chief Information Security Officer	CEO	Ms	Everitt	Nancy	C	8852095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	CMS Casework Communication Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Complaints Tracking Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Contact for Fraud Investigations	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Coordination of Benefits Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Corporate Mailing						8852095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Customer Service Operations Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	DIR Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	DIR Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Discount Program Payment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Emergency Part D Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Emergency Part D Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Encounter Data & Risk Adjustment Operations Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Enrollment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	EOB Transfer Contact	CEO	Ms	Everitt	Nancy	C	8552095451				8666113827		PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Financial Audit Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Financial Reporting Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Formulary Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Formulary Contact (Secondary)	SVP Program Operations, Quality and Compliance	Mr.	Kapolas	Peter		8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	General Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Government Relations Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	HIPAA Privacy Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	HIPAA Security Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Interoperability Contact	SVP Information Technology	Mr	Cantoria	Stephen	C	8852095451					scantoria@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	MA Appeals/Grievances Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	MA Claims Processing Contact for Public Website	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Marketing Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Medical Director	Medical Director	Mr	Wells	Wayne	O	8552095451					wwells@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Medicare Compliance Officer	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Medicare Coordinator	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Medicare Part D Opioid Overutilization Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Medication Therapy Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part C Application Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part D Appeals	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H8106	Part D Appeals Contact (Secondary)	SVP Program Operations, Quality, and Compliance	Mr.	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H8106	Part D Application Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part D Benefits Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part D Claims Submission Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part D Exceptions Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H8106	Part D Price File Contact (Back-up)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part D Price File Contact (Primary)	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part D Quality Assurance Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Part D Reporting Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Patient Safety Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Payment Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Pharmacy Director	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Pharmacy Network Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Pharmacy Technical Help Desk Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J						pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending	8552095451				PACE - Nat		C	Atlanta
H8106	Plan Directory Contact for Public Website	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Plan to Plan Reconciliation Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Processor Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Quality Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Reconciliation Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Recovery Audit Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Surveillance Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	System Contact	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Third Party Administrator (TPA) Liaison	CEO	Ms	Everitt	Nancy	C	8552095451					neveritt@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	User Access Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Utilization Management Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8106	Utilization Review Contact	SVP Program Operations, Quality, and Compliance	Mr	Kapolas	Peter	J	8552095451					pkapolas@heops.com	PO Box 2403		Brentwood	TN	37024	08/22/2024	2026	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE	LIFE COORDINATED COMMONWEALTH PACE III INC.	National PACE		LIFE COORDINATED  Commonwealth PACE III, Inc.	860	Yes	Pending					PACE - Nat		C	Atlanta
H8121	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Medical Director	Medical Director	Mr	Haake	Karl		9132951245					karl.haake@sunflowerhealthplan.com	77 West Wacker Drive, 14th Floor		Chicago	IL	60601	03/30/2021	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/18/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H8121	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H8121	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H8121	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H8121	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H8121	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H8121	PHR Beneficiary Contact																	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8665498289				PPO - BBA		C	Denver
H8121	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/03/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8121	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	CENTENE VENTURE COMPANY TENNESSEE	Local CCP	Ascension Complete	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8133	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8133	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H8133	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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	Dallas
H8133	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8133	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Dallas
H8133	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H8133	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Dallas
H8133	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8133	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H8133	CEO - Senior Official for Contracting	President, CEO and Chair of Board	Ms.	Grober	Stephania		9185513202				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1400 S Boston Ave	Tulsa	OK	74119	05/29/2025	2026	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	Dallas
H8133	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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	Dallas
H8133	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8133	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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	Dallas
H8133	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	Dallas
H8133	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8133	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Dallas
H8133	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H8133	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	Dallas
H8133	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	Dallas
H8133	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8133	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Dallas
H8133	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Dallas
H8133	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H8133	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8133	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H8133	EOB Transfer Contact	PBM OperatioMgr Project & Program Managementn	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H8133	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H8133	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Dallas
H8133	Formulary Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Dallas
H8133	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	Dallas
H8133	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8133	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	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	Dallas
H8133	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2026	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	Dallas
H8133	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	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	Dallas
H8133	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	Dallas
H8133	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8133	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Dallas
H8133	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8133	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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	Dallas
H8133	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8133	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Dallas
H8133	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	Dallas
H8133	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8133	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H8133	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8133	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8133	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	Part D Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8133	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8133	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8133	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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	Dallas
H8133	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	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	Dallas
H8133	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8133	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8133	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H8133	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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	Dallas
H8133	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8133	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8133	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Dallas
H8133	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H8133	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	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	Dallas
H8133	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8133	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H8133	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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	Dallas
H8133	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8772777898				HMO - Health Maintenance Organization		C	Dallas
H8133	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/23/2022	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	0000000000				HMO - Health Maintenance Organization		C	Dallas
H8133	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	09/21/2018	2026	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	Dallas
H8133	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8133	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Dallas
H8133	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8133	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8133	Reconciliation Contact (Secondary)	Accountant II	Ms.	Bowen	Niaya		9727661324				0000000000	P2P@HCSC.NET	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	10/31/2024	2026	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	Dallas
H8133	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8133	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8133	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8133	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8133	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8133	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Dallas
H8133	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Dallas
H8133	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Dallas
H8133	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	04/26/2016	2026	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	Dallas
H8142	Agent/Broker Compensation Data Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Backup User Access Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Best Available Evidence Contact	Director, HP Enrollment		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Bid Audit Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Bid Audit Site Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Bid Primary Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	CAP Report Contact for Public Website	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	CEO - CMS Administrator Contact	CFO	Mr.	Bush	Stephen		2542986090					stephen.bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	06/17/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	CEO - Senior Official for Contracting	CFO	Mr.	Bush	Stephen		2542986090					stephen.bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	06/17/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Chief Financial Officer	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Chief Operating Officer	Chief Operating Officer	Mr.	Richey	Victor		2148204200					Vic.Richey@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Chief Information Officer	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Chief Information Security Officer	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	CMMI Model Point of Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	CMS Casework Communication Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Complaints Tracking Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Contact for Fraud Investigations	Manager, Corporate Compliance		Serrano	Gabriela		2148206970					Gabriela.Serrano@BSWHealth.org	301 N. Washington Avenue		Dallas	TX	75246	09/29/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Coordination of Benefits Contact	Director, Enrollment Operations		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Corporate Mailing						2542986088					Jeffrey.Ingrum@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Customer Service Operations Contact	Director, Customer Advocacy		Perkins	Michelle		2542983393					Michelle.Perkins@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	DIR Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	DIR Contact (Secondary)	VP, Finance		Cutroni	Michael		2542983085					Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Discount Program Payment Contact	VP, Finance		Cutroni	Michael		2542983085				2542983005	Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Electronic Health Record Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Emergency Part D Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2546243358					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations	Ms	Symm	Sheila		2542929095					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Employer Waiver Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment		Coakley	Deborah		5059342320					Deborah.Coakley@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Enrollment Contact	Director, HP Enrollment		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	EOB Transfer Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Financial Audit Contact	VP, Finance	Mr.	Cutroni	Michael		2542983085					Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Financial Reporting Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Formulary Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Formulary Contact (Secondary)	Manager, RX Operations		Symm	Sheila		2542986173					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	General Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Government Relations Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Von Sehrwald	Margaret		2542986062					Margaret.VonSehrwald@BSWHealth.org	301 N. Washington Avenue		Dallas	TX	75201	09/29/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	HIPAA Security Officer	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Hospice Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Interoperability Contact	Director, Information Systems	Mr.	Fort	Rob		2542983233					Rob.Fort@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	MA Appeals/Grievances Contact	Director, Appeals and Grievances		Saravia	Sharon		2542986156					Sharon.Saravia@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	MA Claims Processing Contact for Public Website	Director - Claims		Barnes Hervey	Patricia		7374019216					Patricia.BarnesHervey@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	08/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Marketing Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Medical Director	Chief Medical Officer	Dr.	Waterhouse	Robert		2148652763					robert.waterhouse@BSWHealth.org	301 N Washington Ave		Dallas	TX	75246	03/19/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Medicare Compliance Officer	SVP, Ethics & Compliance	Ms	Von Sehrwald	Margaret		2148202851					Margaret.VonSehrwald@BSWHealth.org	301 N Washington Avenue		Dallas	TX	75201	07/09/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Medicare Coordinator	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	12/19/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Medication Therapy Management Contact	Manager, Managed Care Pharmacy		Thomas	Megan		2542986154					Megan.Cunningham@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	OffShore Subcontractor Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Online Enrollment Center Contact (Primary)	Director, HP Enrollment		Ulrich	Deanna		2542983340					Deanna.Ulrich@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part C Application Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part C Reporting Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Appeals	Director, Appeals and Grievances		Saravia	Sharon							Sharon.Saravia@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active	2542986156				HMO - Health Maintenance Organization		C	Denver
H8142	Part D Appeals Contact (Secondary)	Manager, Appeals and Grievances		Banks	Rametria						2542983086	Rametria.Banks@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active	2542983490				HMO - Health Maintenance Organization		C	Denver
H8142	Part D Application Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Benefits Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Claims Submission Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Exceptions Contact	Manager, Managed Care Pharmacy		Thomas	Megan							Megan.Cunningham@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active	2542986108				HMO - Health Maintenance Organization		C	Denver
H8142	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations		Luebbert	Charlotte							Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active	2542986151				HMO - Health Maintenance Organization		C	Denver
H8142	Part D Price File Contact (Back-up)	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Price File Contact (Optional)	Manager, Rx Operations		Symm	Sheila		2542986173					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Price File Contact (Primary)			Rx	Capital		6154231269					governmentprograms@cap-rx.com	228 Park Avenue South	Suite 87234	New York	NY	10003	12/24/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Quality Assurance Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Part D Reporting Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Patient Safety Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Payment Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Pharmacy Director	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Pharmacy Network Management Contact	Director, Pharmacy Operations		Luebbert	Charlotte		2542986151					Charlotte.Luebbert@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Pharmacy Network Management Contact (Secondary)	Manager, RX Operations		Symm	Sheila		2542986173					Sheila.Symm@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Pharmacy Technical Help Desk Contact			Rx	Capital							giajernigan@cap-rx.com	228 Park Avenue South	Suite 87234	New York	NY	10003	12/11/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active	8442309357				HMO - Health Maintenance Organization		C	Denver
H8142	Physician Incentive Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Plan Directory Contact for Public Website	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Plan to Plan Reconciliation Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Processor Contact	Chief Financial Officer		Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Quality Contact	Director, QI & Clinical Analytics		Lanns	Brandy		2256102502				2542983005	Brandy.Lanns@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	04/30/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Reconciliation Contact	Chief Financial Officer		Bush	Stephen	P	2542983568				2542983005	Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Reconciliation Contact (Secondary)	Manager, Finance		Albright	Irina		7374019254					Irina.Albright@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Recovery Audit Contact	Chief Financial Officer	Mr.	Bush	Stephen	P	2542983568					Stephen.Bush@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	SNP Application Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	SNP State Contact	Director, Government Programs		Jaber	Danielle		5122576136					Danielle.Jaber@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Surveillance Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	System Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	09/29/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Third Party Administrator (TPA) Liaison	VP, Finance		Cutroni	Michael		2542983085				2542983005	Michael.Cutroni@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/26/2024	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	User Access Contact	Manager, Health Plan Compliance		Ponce	Vilaida		2542983238					Vilaida.Ponce@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	07/01/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Utilization Management Contact	Director, Health Services		Adda	Kimberley		2542983674				2542983005	kimberley.adda@bswhealth.org	1206 West Campus Drive		Temple	TX	76502	08/27/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8142	Utilization Review Contact	Director, Health Services		Adda	Kimberley		2542983674				2542983005	Kimberley.Adda@BSWHealth.org	1206 West Campus Drive		Temple	TX	76502	08/27/2025	2026	SCOTT AND WHITE HEALTH PLAN	Local CCP	Baylor Scott & White Health Plan	HMO/HMOPOS		Baylor Scott & White Health	588	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8145	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	8593219075				PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	5024989871				PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	8593219075				PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	5024682494				PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	PFFS Terms and Conditions of Payment Contact for Public Website			Hunt	Stephanie		8004574708					InquiriesForPFFS@humana.com	PO Box 14601		Lexington	KY	40512	07/14/2023	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	8008658715				PFFS - Private Fee for Service		C	Kansas City
H8145	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active	5025800475				PFFS - Private Fee for Service		C	Kansas City
H8145	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8145	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	PFFS	Humana	PFFS		Humana Inc.	128	Yes	Active					PFFS - Private Fee for Service		C	Kansas City
H8166	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/13/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/10/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	09/25/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Corporate Mailing						4125447031					Thomas.Boettler@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Customer Service Operations Contact	Director, Customer Experience		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/04/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5182205661				5184232294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	06/23/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	06/23/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Encounter Data & Risk Adjustment Operations Contact	Director, Actuarial Services	Mr.	DelPrince	Vincent	M	4125443939					Vincent.Delprince@highmark.com	501 Penn Avenue		Pittsburgh	PA	15222	01/28/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Enrollment Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	EOB Transfer Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	bob.opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					Justine.Patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Interoperability Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	MA Appeals/Grievances Contact	Manager, Appeals & Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	MA Claims Processing Contact for Public Website	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/22/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	10/14/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Medical Director	VP, Executive Medical Director	Dr,	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing	Mr.	Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part C Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part C Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125444579				PPO - BBA		C	Boston
H8166	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	4125441596				PPO - BBA		C	Boston
H8166	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	11/08/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite P4207	Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8006002227				PPO - BBA		C	Boston
H8166	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	9013817109				PPO - BBA		C	Boston
H8166	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Payment Contact	Vice President, Accounting and Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		Buffalo	NY	14203	02/14/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
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	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	8009221557				PPO - BBA		C	Boston
H8166	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active	5705783579				PPO - BBA		C	Boston
H8166	PHR Beneficiary Contact																	03/23/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO	Highmark BCBSD Inc	Highmark Health	123	Yes	Active	8665886967				PPO - BBA		C	Boston
H8166	Physician Incentive Contact	VP Prov Reimbursement & Network	Mr.	McDonald	Brendan		4125446611					brendan.mcdonald@highmarkhealth.org	120 5th Avenue Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Plan Directory Contact for Public Website			Service	Provider		8665886967					resourcecenter@highmark.com	120 Fifth Ave		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	7173022748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 898820	Camp Hill	PA	170890407	06/28/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Quality Contact	Director, Clinical Quality		Christian	Shari		7168878811					shari.christina@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/29/2025	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Utilization Management Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8166	Utilization Review Contact	VP, UM Transformation & Operations	Mr.	Erickson	Justin		6126690506					justin.erickson@highmark.com	150 5th Ave Place		Pittsburgh	PA	152223099	08/16/2023	2026	HIGHMARK BCBSD INC.	Local CCP	Highmark Blue Cross Blue Shield	Local PPO		Highmark Health	123	Yes	Active					PPO - BBA		C	Boston
H8167	Automated TrOOP Balance Transfer Contact			Davila	Mirla		9166280448					mirlad@sacpace.com	8795 Folsum Boulevard		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Backup User Access Contact	CEO	Ph.D	Martinez	Stephem		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacra	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Best Available Evidence Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Bid Primary Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	CAP Report Contact for Public Website	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending	6268249951				PACE - Nat		C	San Francisco
H8167	CEO - CMS Administrator Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	CEO - Senior Official for Contracting	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Chief Financial Officer	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Chief Operating Officer	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Chief Information Officer	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Chief Information Security Officer	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	CMS Casework Communication Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Complaints Tracking Contact	Participant Representative		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Contact for Fraud Investigations	Participant Representative		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Coordination of Benefits Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Corporate Mailing						8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Customer Service Operations Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	DIR Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	DIR Contact (Secondary)	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Discount Program Payment Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Emergency Part D Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Emergency Part D Contact (Secondary)	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Encounter Data & Risk Adjustment Operations Contact	CEO	Ph.D	Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Enrollment Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	EOB Transfer Contact	Development Officer		Davila	Mirla		8445722722				8445722722	mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Financial Audit Contact	Development Officer	Ms	Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Financial Reporting Contact			Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Formulary Contact	CEO		Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Formulary Contact (Secondary)	CEO		Martinez	Stephen		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	General Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Government Relations Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	HIPAA Privacy Officer	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	HIPAA Security Officer	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Interoperability Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	MA Appeals/Grievances Contact			Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	MA Claims Processing Contact for Public Website	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Marketing Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Medical Director	Ms.	MD	Eswar	Kali Eswar		6268249951					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Medicare Compliance Officer	Chief Medical Officer	MD	Eswar	Kali Eswar		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Medicare Coordinator	Chief Medical Officer	MD	Eswar	Kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	MD	Eswar	Kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Medication Therapy Management Contact	Chief Medical Officer	MD	Eswar	Kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part C Application Contact			Davila	Mirla		9166280448					mirlad@sacpace.com	8795 Folsum Boulevard		Sacramento	CA	95826	07/19/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part D Appeals	Chief Medical Officer	MD	Eswar	Kali						8445722722	stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending	8445722722				PACE - Nat		C	San Francisco
H8167	Part D Application Contact			Davila	Mirla		9166280448					mirlad@sacpace.com	8795 Folsum Boulevard		Sacramento	CA	95826	07/19/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part D Benefits Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part D Claims Submission Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part D Exceptions Contact	Development Officer		Davila	Mirla						8445722722	mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending	8445722722				PACE - Nat		C	San Francisco
H8167	Part D Price File Contact (Back-up)	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part D Price File Contact (Primary)	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part D Quality Assurance Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Part D Reporting Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Patient Safety Contact	Chief Medical Officer	MD	Eswar	kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Payment Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Pharmacy Director	Chief Medical Officer	MD	Eswar	kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Pharmacy Network Management Contact	Chief Medical Officer	MD	Eswar	kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Pharmacy Technical Help Desk Contact	Chief Medical Officer	MD	Eswar	kali							stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending	8445722722				PACE - Nat		C	San Francisco
H8167	Plan Directory Contact for Public Website	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Plan to Plan Reconciliation Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Processor Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Quality Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Reconciliation Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Recovery Audit Contact	Development Officer	CPA	Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Surveillance Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	System Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Third Party Administrator (TPA) Liaison	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	User Access Contact	Development Officer		Davila	Mirla		8445722722					mirlad@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Utilization Management Contact	Chief Medical Officer	MD	Eswar	kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8167	Utilization Review Contact	Chief Medical Officer	MD	Eswar	kali		8445722722					stephenm@sacpace.com	8795 Folom Blvd		Sacramento	CA	95826	09/28/2023	2026	PACE OF SACRAMENTO, INC.	National PACE	PACE of Sacramento, Inc	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H8171	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Best Available Evidence Contact	Regional Director of Operations	Ms	Cooper	Wanda		8483323443					wcooper@boldagepace.com	5419 135th St		Crestwood	IL	60445	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	CAP Report Contact for Public Website	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923501	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	CMS Casework Communication Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Contact for Fraud Investigations	Director of Compliance	Ms	Copper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Customer Service Operations Contact	Regional Director of Operations	Ms	Cooper	Wanda		8483323443					wcooper@boldagepace.com	5419 135th St		Crestwood	IL	60445	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Formulary Contact	Medical DirectorChief Medical Officer	Dr	Everette	Kenya		6406501565					Keverette@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	General Contact	Regional Director of Operations	Ms	Cooper	Wanda		8483323443					wcooper@boldagepace.com	5419 135th St		Crestwood	IL	60445	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation		Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Medical Director	Medical Director	Dr.	Everette	Kenya		7325923400					Keverette@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Medicare Coordinator	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	5419 135th St		Crestwood	IL	60445	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Medication Therapy Management Contact	Medical Director	Ms	Everette	Kenya		9548395000				7325923500	Keverette@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	OffShore Subcontractor Contact	Chief Administrative Officer		Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Online Enrollment Center Contact (Back-up)			Cooper	Wanda		2675751196					WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Online Enrollment Center Contact (Primary)			Hull	Leigh		7325923400					lhull@boldagepace.com	1075 Stephenson Avenue Suite B	Suite B	Oceanport	NJ	07757	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part D Appeals	Director of Compliance	Ms	Cooper	Wanda						2675751196	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H8171	Part D Appeals Contact (Secondary)	Chief Health Plan Operations		Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7328063224				PACE - Nat		C	New York
H8171	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part D Exceptions Contact	Medical Director	Ms	Everette	Kenya							Keverette@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H8171	Part D Exceptions Contact (Secondary)	Medical Director	Dr.	Everette	Kenya							Keverette@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	11/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H8171	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part D Quality Assurance Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Patient Safety Contact	Medical Director	Dr	Everette	Kenya		9548395000					Keverette@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Pharmacy Director	Chief Medical Officer	Ms	Everette	Kenya		9548395000					Keverette@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H8171	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H8171	PHR Beneficiary Contact																	08/19/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE	BoldAge PACE Illinois	Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7218063224				PACE - Nat		C	New York
H8171	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Plan to Plan Reconciliation Contact	Financial Specialist	Mr	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Surveillance Contact	Regional Director of Operations	Ms	Cooper	Wanda		8483323443					wcooper@boldagepace.com	5419 135th St		Crestwood	IL	60445	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	User Access Contact	Business Administrator		Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8171	Utilization Review Contact	Regional Director of Operations	Ms	Cooper	Wanda		8483323443					wcooper@boldagepace.com	5419 135th St		Crestwood	IL	60445	01/06/2025	2026	BEACON PACE ILLINOIS, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8173	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H8173	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	New York
H8173	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	New York
H8173	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H8173	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H8173	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	New York
H8173	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF ARIZONA, INC.	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	New York
H8173	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H8176	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H8176	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H8176	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H8176	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H8176	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF SOUTH CAROLINA,INC	Local CCP	Molina Healthcare of South Carolina	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H8176	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Agent/Broker Compensation Data Contact	Commission Analyst	Ms.	Westley	Tracey		4029828256					tracey.westley@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/11/2025	2026	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	Chicago
H8181	Backup User Access Contact			Nysson	Jacob		4023901820					Jacob.Nysson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	06/25/2025	2026	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	Chicago
H8181	Best Available Evidence Contact	Manager Medicare Advantage Accounts Rec & Enrollme	Ms.	Vlietstra	Josh		4029826064					Josh.Vlietstra@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68108	08/07/2025	2026	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	Chicago
H8181	Bid Audit Contact	Sr Product Portfolio Manager		Wilkinson	Celia		4023901820					celia.wilkinson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Bid Audit Site Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Bid Primary Contact	Sr. Product Portfolio Manager	Ms.	Wilkinson	Celia		4029827000					celia.wilkinson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	CEO - CMS Administrator Contact	Chief Revenue Officer	Mr	Rowe	Ron		4029826013					ron.rowe@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	CEO - Senior Official for Contracting	Chief Revenue Officer	Mr	Rowe	Ron		4029826013					ron.rowe@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Chief Financial Officer	EVP Chief Financial Officer	Mr	Werner	Chad		4026162860					chad.werner@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Chief Operating Officer	VP, Senior Market Segment Leader	Mr	Peifer	M. Keith		4029827000					Mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Chief Information Officer	VP Information Services, CIO	Mr.	Kolli	Rama		4029827556					Rama.Kolli@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Chief Information Security Officer	Director of Information Assurance and CSO	Mr.	Kremke	Kerry		4029827583					Kerry.Kremke@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	CMS Casework Communication Contact	MCO	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Drive		nebraska	NE	68106	09/09/2024	2026	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	Chicago
H8181	Complaints Tracking Contact	MCO	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Drive		nebraska	NE	68106	12/19/2024	2026	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	Chicago
H8181	Contact for Fraud Investigations	Director Payment Integrity		Hirschbrunner	Scott		4029827000					si@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	11/17/2025	2026	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	Chicago
H8181	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/11/2025	2026	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	Chicago
H8181	Corporate Mailing						4023901820					MedicareCompliance@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Customer Service Operations Contact	Manager Customer Service		Graeve	Sheryl		4029827036					Sheryl.Graeve@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	11/17/2025	2026	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	Chicago
H8181	DIR Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	DIR Contact (Secondary)	Part D Program Manager		Westrum	Josh		4023901820					josh.westrum@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Discount Program Payment Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Electronic Health Record Contact	Director Clnical Quality Improvement	Ms.	Collins	Shelley		4029828564					Shelley.Collins@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Emergency Part D Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Emergency Part D Contact (Secondary)	MCO		Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/19/2024	2026	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	Chicago
H8181	Employer Waiver Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Encounter Data & Risk Adjustment Operations Contact	Manager Risk Adjustment	Ms.	Boardman	Laura		4029827636					laura.boardman@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Enrollment Contact	Manager Medicare Advantage Accounts Rec & Enrollme	Ms.	Vlietstra	Josh		4029826064					Josh.Vlietstra@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68108	08/07/2025	2026	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	Chicago
H8181	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/11/2025	2026	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	Chicago
H8181	Financial Audit Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Financial Reporting Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Formulary Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384					cindy.godfrey@primetherapeutics.com	29090 Ames Crossing Road		Eagan	MN	55121	12/16/2025	2026	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	Chicago
H8181	General Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Government Relations Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	HIPAA Privacy Officer	Director of Information Assurance and CSO	Mr.	Kremke	Kerry		4029827583					Kerry.Kremke@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	HIPAA Security Officer	Director of Information Assurance and CSO	Mr.	Kremke	Kerry		4029827583					Kerry.Kremke@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Hospice Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Interoperability Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	MA Appeals/Grievances Contact	Medicare Advantage Specialist		Norman	Courtney		4029828931					Courtney.Norman@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H8181	MA Claims Processing Contact for Public Website		Ms.	Vytlas	Shannon		4029827000					Shannon.Vytlas@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H8181	Marketing Contact	Marketing Specialist, Direct to Consumer	Ms.	Young	Morgan		4029827000					morgan.young@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Medical Director	CMO, VP Healthcare Svcs	Dr.	Gordon-Simet	Josette		4029828925					josette.gordonsimet@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Medicare Compliance Officer	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	05/19/2025	2026	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	Chicago
H8181	Medicare Coordinator		Mr	Nysson	Jacob		4023901820					jacob.nysson@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Medicare Part D Opioid Overutilization Contact	Supv Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/19/2024	2026	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	Chicago
H8181	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations		Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	2900 Ames Crossing Road		EAgan	MN	55120	03/11/2025	2026	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	Chicago
H8181	Online Enrollment Center Contact (Primary)	Manager Medicare Advantage Accounts Rec & Enroll	Ms.	Vlietstra	Josh		4029826064					Josh.Vlietstra@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68108	08/07/2025	2026	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	Chicago
H8181	Part C Application Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Part C Reporting Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/19/2024	2026	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	Chicago
H8181	Part D Appeals	Regulatory Pharmacist		Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/22/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8181	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetheraputics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/18/2024	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8181	Part D Application Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Part D Benefits Contact	Manager, PBM Operations		Sager	Shelby		9529133984					Shelby.Sager@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/16/2025	2026	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	Chicago
H8181	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	09/18/2024	2026	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	Chicago
H8181	Part D Exceptions Contact	Regulatory Pharmacist		Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/22/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8181	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/18/2024	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8181	Part D Price File Contact (Back-up)	Price File Analyst Sr		Trudeau	Ashley		6127771338					ashley.trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/09/2024	2026	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	Chicago
H8181	Part D Price File Contact (Optional)	QA Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/09/2024	2026	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	Chicago
H8181	Part D Price File Contact (Primary)	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Part D Quality Assurance Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Part D Reporting Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/19/2024	2026	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	Chicago
H8181	Patient Safety Contact	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Payment Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Pharmacy Director	Director of Pharmacy	Mr.	Huether	Jeff		4029826655					jeff.huether@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Pharmacy Network Management Contact	AVP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	MConlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/09/2024	2026	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	Chicago
H8181	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	09/09/2024	2026	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	Chicago
H8181	Pharmacy Technical Help Desk Contact	Sr Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/16/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8554571351				PPO - BBA		C	Chicago
H8181	Pharmacy Technical Help Desk Contact (Secondary)	AVP , Customer Experience & Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/16/2025	2026	SAPPHIRE EDGE, INC.	Local CCP	Blue Cross and Blue Shield of Nebraska	Local PPO		Blue Cross Blue Shield of Nebraska	647	Yes	Active	8554571209				PPO - BBA		C	Chicago
H8181	Physician Incentive Contact	CMO, VP Healthcare Svcs	Dr.	Gordon-Simet	Josette		4029828925					josette.gordonsimet@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Plan Directory Contact for Public Website	Manager, Provider Services		Trice	Ashley		4029827000					Ashley.Trice@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Plan to Plan Reconciliation Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Processor Contact	Director PBM Operations	Ms.	Allie	Cindy		6127776755				6127776706	MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing		Eagan	MN	55121	09/09/2024	2026	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	Chicago
H8181	Quality Contact	Manager Clinical Quality Improvement	Ms.	Frey	Sherri		4029828539					sherri.frey@nebraskablue.com	1919 Aksarben Drive		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H8181	Reconciliation Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	12/19/2024	2026	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	Chicago
H8181	Recovery Audit Contact	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Surveillance Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	System Contact	VP Senior Market Segment Leader	Mr	Pfeifer	Keith		4029827000					mkeith.peifer@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H8181	Third Party Administrator (TPA) Liaison	Sr Accountant Medicare Advantage	Ms.	Richter	Sarah		4029828790					Sarah.Richter@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	User Access Contact	MA Compliance Officer	Ms.	Vaughn	Shannon		4029827846					shannon.vaughn@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	09/09/2024	2026	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	Chicago
H8181	Utilization Management Contact	Manager Government Medical Services	Ms.	Garmong	Cortny		4029826002					cortny.garmong@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H8181	Utilization Review Contact	Manager Government Medical Services	Mr.	Garmong	Cortny		4029826002					cortny.garmong@nebraskablue.com	1919 Aksarben Dr		Omaha	NE	68180	10/29/2024	2026	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	Chicago
H8189	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/18/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H8189	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H8189	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H8189	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H8189	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H8189	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H8189	PHR Beneficiary Contact																	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H8189	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8189	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	MANAGED HEALTH SERVICES INSURANCE CORP.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H8205	Part C Application Contact			Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th CT		Vancouver	WA	98682	12/04/2025	2026	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H8205	Part D Application Contact			Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th CT		Vancouver	WA	98682	12/04/2025	2026	KINSHIP PACE OF CENTRAL FLORIDA, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H8211	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H8211	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H8211	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H8211	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H8211	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8211	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8212	Agent/Broker Compensation Data Contact	National Director Retail Sales	Mr.	Javor	Chris		2159378396					cjavor@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Automated TrOOP Balance Transfer Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Backup User Access Contact	Medicare Compliance Sr Operations Analyst	Ms	Morris	Gail		2158635141					gpmorris@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Best Available Evidence Contact	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Bid Audit Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Bid Audit Site Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Bid Primary Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	05/07/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	CEO - CMS Administrator Contact	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	CEO - Senior Official for Contracting	Executive VP, Public Affairs & Government Markets	Mr.	Fera	Stephen		2152413207					Stephen.Fera@ibx.com	1901 Market Street, 45th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Chief Financial Officer	EVP, CFO & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street, 39th floor		Philadelphia	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Chief Operating Officer	President, Medicare Markets	Mr.	McDade	Chris		5704179770					cmcdad@amerihealthcaritas.com	AmeriHealth Caritas Families of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Chief Information Officer	Exec. Vice President, Chief Information Officer	Mr.	Dickson	Fred		2158636570					fdickson@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	CMS Casework Communication Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Complaints Tracking Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Contact for Fraud Investigations	Director, SIU	Mr.	McCall	Trevor		4844971241					tmccall2@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Coordination of Benefits Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Corporate Mailing						2159378725					KGrimmett@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive, 1st Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Customer Service Operations Contact	Director, Medicare Customer Service	Ms.	Veras	Helen		2672981794					hveras@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	DIR Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/07/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	DIR Contact (Secondary)	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2824045991					AKindred@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Discount Program Payment Contact	Director, Finance	Ms.	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Electronic Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Emergency Part D Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Emergency Part D Contact (Secondary)	VP, Corporate Pharmacy		Cherian	Sheena		2158635768					scherian@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	2002 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Encounter Data & Risk Adjustment Operations Contact	Director, Medicare ACA and Risk Adjustment	Mr.	Greer	Kevin		2159378761					kgreer@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Enrollment Contact	Manager, Enrollment Operations	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	EOB Transfer Contact	VP, Medicare Claims	Mr.	Boyer	Joseph		2158636668				2159375321	jboyer@Amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Financial Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					ak16850@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Financial Reporting Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Formulary Contact	Director of Clinical Services, Formulary/DUR	Ms.	Megargell	Lauren		2159374135					Lauren.megargell@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	General Contact	VP, Medicare Strategy & Execution	Mr.	Sukhu	Chistopher		4844233175					csukhu@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	06/27/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Government Relations Contact	VP,  Government Relations, External Affairs	Mr.	Cozzo	Steven		2159378236					scozzo@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	HIPAA Privacy Officer	Director Privacy	Ms.	Desipio	Nicole		4844971132					ndesipio@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	HIPAA Security Officer	VP, Chief Information Security Officer	Mr.	Wehrle	Thomas		2158635549					twehrle@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Hospice Contact	Dir.  Medicare Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Interoperability Contact	Director, Medicare Performance Management		Kindred	Amanda		2484045991					akindred@amerihealthcaritas.com	4000 Town Center	Suite 1300	Southfield	MI	48075	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	MA Appeals/Grievances Contact	Director Medicare Appeals and Grievances	Ms.	Lopez	Yismell		2158635677					yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	MA Claims Processing Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Marketing Contact	Medicare Compliance Sr Operations Analyst	Ms.	Morris	Gail	P	2158635141					gpmorris@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newton Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Medical Director	Chief Medical Officer, Population Health	Dr.	Wright	Julia		2159378000					jwright6@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Medicare Coordinator	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Medication Therapy Management Contact	Director, Clinical Outcomes & Therapeutic Optimiz	Ms.	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	OffShore Subcontractor Contact	Esquire	Ms.	Sitner	Roni		8602149125					rsitner@ameriheathcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Online Enrollment Center Contact (Primary)	Medicare Enrollment Manager	Ms.	Mullins	Naketa		4844971171					nmullins@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part C Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part C Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Appeals	Director,  Medicare Appeals and Grievances	Ms.	Lopez	Yismell							yelopez@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158635677				HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Appeals Contact (Secondary)	Manager, Medicare Appeals & Grievance	Ms.	Smith-Cooks	Tiarra							tsmithcooks@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2151112917				HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Benefits Contact	Director of Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Claims Submission Contact	Director, Clinical Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Exceptions Contact	Director, Pharmacy Utilization Management	Mr.	Bonko	Gerald						2158635100	gbonko@performrx.com	PerformRx	200 Stevens Dr	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Prior Authorization	Mr.	McHale	Shawn						2158635100	smchale@performrx.com	PerformRx	200 Stevens drive	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636483				HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Price File Contact (Back-up)	Medicare Part D program Analyst	Ms.	Benedicto	Abigail		5107895555					Abigail.Benedicto@abarcahealth.com	1606 Ave Ponce de Leon		San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Price File Contact (Optional)	Medicare Part D Program Analyst	Ms	Wiehe	Heather		4127156363					heather.weihe@abarcahealth.com	Abarca Health	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Price File Contact (Primary)	Medicare Part D Program Anaylst	Ms.	West	Ariel		3133781225					Ariel.West@abarcahealth.com	PerformRx	1606 Ave Ponce de Leon	San Juan	PR	00909	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Part D Reporting Contact	Manager, Medicare Regulatory Data & Analytics	Ms.	Nelson	Jinelle		8439297258					Jnelson@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	4390 Belle Oak drive , Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Patient Safety Contact	Director,Clinical Outcomes &Therap Optimization	Ms	McMahon	Courtney		2159378563					cmcmahon@performrx.com	PerformRx	200 Stevens Drive, 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Payment Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Personal Health Record Contact	Manager Information Services	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Pharmacy Director	Director, Pharmacy	Ms.	Shepard	Jen		6107428664					jshepard1@amerihealthcaritas.com	AmeriHealth Caritas	200 Stevens Drive	Philadephia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Pharmacy Network Management Contact	President, Network Strategy	Mr	Sullivan	Tim		6303303638					tssullivan@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Pharmacy Network Management Contact (Secondary)	Network Operations Analyst	Mr.	Kramerov	Allen		2159374120					akramerov@performrx.com	PerformRx	200 Stevens Dr. 4th Floor	Philadelphia	PA	19113	07/08/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Pharmacy Technical Help Desk Contact	Manager, Call Center		Vargas	Crystal							cvargas@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	7325168499				HMO - Health Maintenance Organization		C	Chicago
H8212	Pharmacy Technical Help Desk Contact (Secondary)	Director of Service Operations		Leal	Avelina							aleal@performrx.com	PerformRx	200 Stevens Drive	Philadelphia	PA	19113	12/15/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active	2158636540				HMO - Health Maintenance Organization		C	Chicago
H8212	PHR Beneficiary Contact																	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS	AmeriHealth Caritas	Independence Health Group, Inc.	609	Yes	Active	2672985710				HMO - Health Maintenance Organization		C	Chicago
H8212	Physician Incentive Contact	Manager,  Medicare Regulatory Performance	Ms.	Williams	Kathy		8438300812					kwilliams@firstchoicevipcareplus.com	Amerihealth Caritas Family of Companies	4390 Belle Oak Dr, Suite 400	Charleston	SC	29405	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Plan Directory Contact for Public Website			Services	Provider		8005216007					VIPProviderComm@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Plan to Plan Reconciliation Contact	Director, Finance	Ms	Sow	Oumou		4102584587					osow@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	P.O. 7137	London	KY	40742	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Processor Contact	Director of Clincal Operations	Mr.	Ortiz	Noel		2159375325					nortiz@performrx.com	PerFormrx	200 Stevens drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Quality Contact	Director, Quality Management	Ms.	Popiolek	Rose		6107234450					rpopiolek@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Reconciliation Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Reconciliation Contact (Secondary)	Manager, Medicare Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Dr	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Recovery Audit Contact	Director, Medicare Performance Management	Ms.	Kindred	Amanda		2484045991					AKindred@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	SNP Application Contact	Med Product Development Manager	Ms	Marcozzi	Samantha		7327571884					smarcozzi@amerihealthcaritas.com	Amerihealth Caritas	3875 West Chester Pike	Newtown Square	PA	19103	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	SNP State Contact	Vice President, Medicare Administration	Ms.	Moody	Tonya	R	2158635700					tmoody@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	200 Stevens Dr.	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Surveillance Contact	Director, Retail Sales Operations	Ms.	Bech	Mary		4146875533					mbech@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	System Contact	Manager, Medicare IS	Ms.	Drumming	Terri		2159378578					tdrumming@amerihealthcaritas.com	Amerihealth Caritas	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Third Party Administrator (TPA) Liaison	Manager, MCR Performance Program Oversight	Ms.	Aning	Akua		6105376208					aaning1@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	03/06/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	User Access Contact	Medicare Compliance Officer	Ms	Dupre	Colleen		3863364322					cdupre@amerihealthcaritas.com	AmeriHealth Caritas Family of Companies	3875 West Chester Pike	Newtown Square	PA	19073	05/07/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Utilization Management Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8212	Utilization Review Contact	Vice President Utilization Management, Operations	Ms.	Johnson	Vanessa		2159378766					vmjohnson@amerihealthcaritas.com	Amerihealth Caritas Family of Companies	200 Stevens Drive	Philadelphia	PA	19113	02/12/2025	2026	AMERIHEALTH CARITAS NORTH CAROLINA, INC.	Local CCP	AmeriHealth Caritas VIP Care	HMO/HMOPOS		Independence Health Group, Inc.	609	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8220	Automated TrOOP Balance Transfer Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Backup User Access Contact			Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Bid Primary Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	CAP Report Contact for Public Website			Rolfe	Tammy		3212694240					trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	CEO - CMS Administrator Contact		Mr.	Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	CEO - Senior Official for Contracting		Mr.	Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Chief Operating Officer		Ms.	Rolfe	Tammy		3212694240					trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Chief Information Officer		Ms.	Rolfe	Tammy		3212694240					trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Chief Information Security Officer		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Complaints Tracking Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Contact for Fraud Investigations		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Corporate Mailing						5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	DIR Contact		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Discount Program Payment Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Emergency Part D Contact		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Encounter Data & Risk Adjustment Operations Contact		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Enrollment Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	EOB Transfer Contact			Rolfe	Tammy		2072425386				3212695428	trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Financial Audit Contact	Chief Compliance Officer	Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Financial Reporting Contact		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Formulary Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	General Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	HIPAA Privacy Officer		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	HIPAA Security Officer		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Interoperability Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	MA Appeals/Grievances Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	MA Claims Processing Contact for Public Website			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Marketing Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Medical Director			Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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		3212694240					trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Medicare Coordinator			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Medicare Part D Opioid Overutilization Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Medication Therapy Management Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part C Application Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	07/07/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part D Appeals			Rolfe	Tammy							trolfe@reflectionslc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending	2072425386				PACE - Nat		C	Atlanta
H8220	Part D Application Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	07/07/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part D Benefits Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part D Claims Submission Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	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	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending	2072425386				PACE - Nat		C	Atlanta
H8220	Part D Price File Contact (Back-up)			Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part D Price File Contact (Primary)			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part D Quality Assurance Contact		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/28/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Part D Reporting Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Patient Safety Contact		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Payment Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Pharmacy Director			Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Pharmacy Network Management Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	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	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending	2072425386				PACE - Nat		C	Atlanta
H8220	Plan Directory Contact for Public Website			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Plan to Plan Reconciliation Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Processor Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Quality Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Reconciliation Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Recovery Audit Contact	Chief Compliance Officer	Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Surveillance Contact		Ms.	Forbes	Angela		3216158762					aforbes@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	System Contact			Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Third Party Administrator (TPA) Liaison			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	User Access Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Utilization Management Contact			Killian	Joseph		5133826688					jkillian@reflectionslsc.org	1250 B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8220	Utilization Review Contact			Rolfe	Tammy		3212694240					trolfe@reflectionslsc.org	1250-B Grumman Place		Titusville	FL	32780	09/29/2022	2026	HOSPICE OF ST. FRANCIS, INC.	National PACE	St. Francis Reflections PACE	National PACE				Yes	Pending					PACE - Nat		C	Atlanta
H8261	Automated TrOOP Balance Transfer Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard		Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Backup User Access Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327				5413853008	Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	11/03/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Best Available Evidence Contact	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/12/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Bid Primary Contact	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/12/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	CAP Report Contact for Public Website	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/12/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	CEO - CMS Administrator Contact	President and Chief Executive Officer (CEO)	Mr	Espinola	John		5416845286					John.Espinola@pacificsource.com	555 International Way		Springfield	OR	97477	01/16/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	CEO - Senior Official for Contracting	President and Chief Executive Officer (CEO)	Mr	Espinola	John		5416845286					John.Espinola@pacificsource.com	555 International Way		Springfield	OR	97477	01/16/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Chief Financial Officer	Senior Vice President and Chief Financial Officer	Mr	Fellner	Brian		2085632342					Brian.Fellner@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	10/28/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Chief Operating Officer	Senior Vice President, Health Plan Operations	Mr.	Ghaly	Khaled		2085632338					Khaled.Ghaly@pacificsource.com	555 International Way		Springfield	OR	97477	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Chief Information Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Chief Information Security Officer	VP of IT, Infrastructure and Analytics	Mr.	Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	CMS Casework Communication Contact	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Complaints Tracking Contact	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Contact for Fraud Investigations	Corporate Compliance Officer		Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/12/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Coordination of Benefits Contact	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/12/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Corporate Mailing						9712221036					Ellen.Garcia@pacificsource.com	PO Box 7068		Springfield	OR	97475	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Customer Service Operations Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	DIR Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	DIR Contact (Secondary)	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Discount Program Payment Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Emergency Part D Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Emergency Part D Contact (Secondary)	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Analytic Manager		Kellogg	Ariel		5412253719					Ariel.Kellogg@pacificsource.com	555 International Way		Springfield	OR	97477	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Enrollment Contact	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	EOB Transfer Contact	Senior Vice President, Health Plan Operations	Mr	Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Financial Audit Contact	PACE Quality and Compliance Program Manager	Ms.	Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Financial Reporting Contact	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Formulary Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Formulary Contact (Secondary)	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	08/20/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	General Contact	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Government Relations Contact	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	HIPAA Privacy Officer	HIPAA Privacy Specialist		Olson	Terrie		5416408765					Terrie.Olson@pacificsource.com	555 International Way		Springfield	OR	97477	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	HIPAA Security Officer	Information Security Manager		Mohr	David		5416845252					David.Mohr@pacificsource.com	555 International Way		Springfield	OR	97477	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Interoperability Contact	VP of IT Infrastructure and Analytics		Wetter	Brian		5412253666					Brian.Wetter@pacificsource.com	PO Box 7469		Bend	OR	97708	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	MA Appeals/Grievances Contact	Health Services Regulatory Manager		Downey	Reanna		5417065031					Reanna.Downey@pacificsource.com	PO Box 7469		Bend	OR	97708	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	MA Claims Processing Contact for Public Website	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Marketing Contact	Marketing and Communications Business Partner		Wright	Alice		9712221057					Alice.Wright@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Medical Director	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Medicare Compliance Officer	Interim Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	11/20/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Medicare Coordinator	Compliance Project Specialist		Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Medicare Part D Opioid Overutilization Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Medication Therapy Management Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	OffShore Subcontractor Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327					Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	11/03/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Online Enrollment Center Contact (Back-up)	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Online Enrollment Center Contact (Primary)	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part C Application Contact	Compliance Project Specialist		Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Appeals	PACE Chief Medical Officer		Van Fleet - Green	Jessica							Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending	2532384018				PACE - Nat		C	Seattle
H8261	Part D Appeals Contact (Secondary)	PACE Executive Director		Garcia	Ellen							Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending	9712221036				PACE - Nat		C	Seattle
H8261	Part D Application Contact	Compliance Project Specialist		Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Benefits Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Claims Submission Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Exceptions Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica							Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending	2532384018				PACE - Nat		C	Seattle
H8261	Part D Exceptions Contact (Secondary)	PACE Executive Director		Garcia	Ellen							Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending	9712221036				PACE - Nat		C	Seattle
H8261	Part D Price File Contact (Back-up)	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Price File Contact (Optional)	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Price File Contact (Primary)	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Quality Assurance Contact	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Part D Reporting Contact	Corporate Compliance Officer	Mr	Cass	Dave		5038025327				5413853008	Dave.Cass@pacificsource.com	1500 SW 1st Ave	Suite 200	Portland	OR	97201	11/03/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Patient Safety Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Payment Contact	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Personal Health Record Contact	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Pharmacy Director	VP of Pharmacy Services		Joffer	John		9712221070					John.Joffer@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Pharmacy Network Management Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Pharmacy Network Management Contact (Secondary)	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Pharmacy Technical Help Desk Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica							Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending	2532384018				PACE - Nat		C	Seattle
H8261	Pharmacy Technical Help Desk Contact (Secondary)	PACE Executive Director		Garcia	Ellen							Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/17/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending	9712221036				PACE - Nat		C	Seattle
H8261	PHR Beneficiary Contact																	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE	PacificSource PACE LLC	PacificSource	429	Yes	Pending	8882197028				PACE - Nat		C	Seattle
H8261	Plan Directory Contact for Public Website	Director of Provider Network		Ohrtman	Sara		5416845270					Sara.Ohrtman@pacificsource.com	555 International Way		Springfield	OR	97477	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Plan to Plan Reconciliation Contact	PACE Executive Director		Garcia	Ellen		9712221036					Ellen.Garcia@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Processor Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Quality Contact	PACE Quality and Compliance Program Manager		Crabtree	Melanie		5033883232					Melanie.Crabtree@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/14/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Reconciliation Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Reconciliation Contact (Secondary)	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Recovery Audit Contact	Director, Government Compliance	Ms.	Brown	Jennifer		5413308115				5413853008	Jennifer.Brown@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Surveillance Contact	Director, Government Compliance	Ms.	Brown	Jennifer		5413308115				5413853008	Jennifer.Brown@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	System Contact	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Third Party Administrator (TPA) Liaison	Senior Vice President, Health Plan Operations		Ghaly	Khaled		2085632338				5413853008	Khaled.Ghaly@pacificsource.com	408 E Parkcenter Boulevard	Suite 100	Boise	ID	83706	07/02/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	User Access Contact	Compliance Project Specialist		Ely	Shelley		5413304914					Shelley.Ely@pacificsource.com	PO Box 7469		Bend	OR	97708	01/21/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Utilization Management Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8261	Utilization Review Contact	PACE Chief Medical Officer		Van Fleet - Green	Jessica		2532384018					Jessica.VanFleet-Green@pacificsource.com	1500 SW First Ave	Suite 200	Portland	OR	97201	03/13/2025	2026	PACIFICSOURCE PACE, LLC	National PACE	PacificSource PACE	National PACE		PacificSource	429	Yes	Pending					PACE - Nat		C	Seattle
H8263	Automated TrOOP Balance Transfer Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Backup User Access Contact			Durbin	Patrick		8446642248					pdurbin@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Best Available Evidence Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Bid Primary Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	CAP Report Contact for Public Website			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	CEO - CMS Administrator Contact		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	CEO - Senior Official for Contracting		Mr.	Bennett	Matthew		8446642248					mbennett@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Chief Financial Officer		Mr.	Fuentes	Robert		8446642248					rfuentes@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Chief Operating Officer		Ms.	Funk	Jennie		8446642248					jfunk@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Chief Information Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Chief Information Security Officer		Mrs.	Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	CMS Casework Communication Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Complaints Tracking Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Contact for Fraud Investigations			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Coordination of Benefits Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Corporate Mailing						8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Customer Service Operations Contact			Waschevski	Susan		8446642248					swaschevski@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	DIR Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Discount Program Payment Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Emergency Part D Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Encounter Data & Risk Adjustment Operations Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Enrollment Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	EOB Transfer Contact			Siler	Sarah		8446642248				9167372990	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Financial Audit Contact	Sr. Dir, Health Plan	Mrs.	Siler	Sarah		8446642248				9167372990	ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Financial Reporting Contact			Ryan	Chandler		8446642248					cryan@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Formulary Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	General Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Government Relations Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	HIPAA Privacy Officer			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	HIPAA Security Officer			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Interoperability Contact			Karyeva	Inna		8446642248					ikaryeva@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	MA Appeals/Grievances Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	MA Claims Processing Contact for Public Website			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Marketing Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Medical Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Medicare Compliance Officer		Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Medicare Coordinator	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Medicare Part D Opioid Overutilization Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Medication Therapy Management Contact	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part C Application Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part D Appeals		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8446642248				PACE - Nat		C	San Francisco
H8263	Part D Application Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part D Benefits Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part D Claims Submission Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part D Exceptions Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8446642248				PACE - Nat		C	San Francisco
H8263	Part D Price File Contact (Back-up)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part D Price File Contact (Primary)			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part D Quality Assurance Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Part D Reporting Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Patient Safety Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Payment Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Pharmacy Director	MD		Peralta	Carmen		8446642248					cperalta@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Pharmacy Network Management Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Pharmacy Technical Help Desk Contact		Mrs.	Siler	Sarah							ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending	8446642248				PACE - Nat		C	San Francisco
H8263	Plan Directory Contact for Public Website			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Plan to Plan Reconciliation Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Processor Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Quality Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Reconciliation Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Recovery Audit Contact	VP, Compliance	Mrs.	Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Surveillance Contact			Min-Morrison	Yoonjin		8446642248					yminmorrison@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	System Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Third Party Administrator (TPA) Liaison			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	User Access Contact			Dey	Anna		8446642248					adey@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Utilization Management Contact			Siler	Sarah		8446642248					ssiler@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8263	Utilization Review Contact			Mendez	Kyle		8446642248					kmendez@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	01/24/2025	2026	HABITAT HEALTH WEST COVINA, LLC	National PACE	Habitat Health West Covina	National PACE		Tungsten Health Holdings, LLC	826	Yes	Pending					PACE - Nat		C	San Francisco
H8298	Agent/Broker Compensation Data Contact	Regulatory Compliance Assoc.	Ms.	Jenkins	Nicole		9734668149					nicole_jenkins@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	06/05/2024	2026	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	Dallas
H8298	Automated TrOOP Balance Transfer Contact	Director, PBM Ops.	Ms.	Cain	Christina		6127776722				6127771330	EOBP2P@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	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	Dallas
H8298	Backup User Access Contact	Medicare Program Analyst		Vargas	Mario		9734666379					mario_vargas@horizonblue.com	3 Penn Plaza East	16-C	Newark	NJ	07105	07/23/2019	2026	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	Dallas
H8298	Best Available Evidence Contact	Supervisor, Govt. Programs		Achoe	Kisha		9734667328					Kisha_Achoe@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	07/27/2023	2026	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	Dallas
H8298	Bid Audit Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319					jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	12/30/2015	2026	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	Dallas
H8298	Bid Audit Site Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319					jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	12/30/2015	2026	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	Dallas
H8298	Bid Primary Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319					jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	12/30/2015	2026	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	Dallas
H8298	CAP Report Contact for Public Website	VP, Reg. Compliance/MCO	Mr	McGrady	Daniel		6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	04/06/2023	2026	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	Dallas
H8298	CEO - CMS Administrator Contact	SVP, Government Programs	Ms.	Rittenour	Debbie		4124451886					debbie_rittenour@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	03/27/2025	2026	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	Dallas
H8298	CEO - Senior Official for Contracting	SVP, Government Programs	Ms.	Rittenour	Debbie		4124451886					debbie_rittenour@horizonblue.com	3  Penn Plaza	PP-16	Newark	NJ	07105	03/27/2025	2026	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	Dallas
H8298	Chief Financial Officer	SVP & Chief Financial Offcr.	Mr.	Rosenberg	David		9734664600					david_rosenberg@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/02/2022	2026	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	Dallas
H8298	Chief Operating Officer	SVP, Government Programs	Ms.	Rittenour	Debbie		4124451886					debbie_rittenour@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	03/27/2025	2026	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	Dallas
H8298	Chief Information Officer	Chief Information Officer	Ms.	Lavoie	Heather		9734664650					heather_lavoie@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	07/02/2025	2026	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	Dallas
H8298	Chief Information Security Officer	Chief Information Security Officer	Mr.	Patel	Niraj		9734664409					niraj_patel@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	CMS Casework Communication Contact	Director, GP Operations		Maramraju	Venkata		6095372113					venkata.maramraju@horizonblue.com	1700 American Boulevard		Pennington	NJ	08534	01/03/2022	2026	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	Dallas
H8298	Complaints Tracking Contact	Mgr, Exec DOBI Compl & Appls		Mestres	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	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	Dallas
H8298	Contact for Fraud Investigations	Sr. Director, Special Investigations		Dineen	Timothy		9734668723					timothy_dineen@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Coordination of Benefits Contact	Director, PBM Ops	Ms.	Cain	Christina		6127776722				6127771330	COBMedD@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	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	Dallas
H8298	Corporate Mailing						6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	04/06/2023	2026	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	Dallas
H8298	Customer Service Operations Contact	Director, Service Operations	Mr.	Yanek	John		5182208000					john_yanek@horizonblue.com	3 Penn Plaza		Newark	NJ	07105	06/13/2022	2026	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	Dallas
H8298	DIR Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542				9734664665	athena_patrikios@horizonblue.com	3 Penn Plaza East,  PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	DIR Contact (Secondary)	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	3 Penn Plaza East	PP-12	Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Discount Program Payment Contact	Supervisor-Accounting		Fuentes	Yuneti		2018895531					yunetsi_fuentes@horizonblue.com	3 Penn Plaza E		Newark	NJ	07101	09/17/2025	2026	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	Dallas
H8298	Emergency Part D Contact	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	01/06/2025	2026	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	Dallas
H8298	Emergency Part D Contact (Secondary)	Manager, Clinical Pharmacy		Sun	Jane		9734665044					jane_sun@horizonblue.com	3 Penn Plaza	PP 12-Q	Newark	NJ	07105	12/11/2018	2026	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	Dallas
H8298	Encounter Data & Risk Adjustment Operations Contact	Mgr, Medicare & Medicaid Risk Assessment		Goryachkovsky	Jenny		9734665956					jenny_goryachkovsky@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	12/02/2020	2026	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	Dallas
H8298	Enrollment Contact	Director, G. P. Operations		Maramraju	Venkata		6095372113					venkata_maramraju@horizonblue.com	1700 American Blvd. HL-03		Pennington	NJ	08534	10/31/2017	2026	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	Dallas
H8298	EOB Transfer Contact	Director, PBM Ops.	Ms.	Cain	Christina		6127776722				6127771330	EOBP2P@primetherapeutics.com	2990 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	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	Dallas
H8298	Financial Audit Contact	Director, Regulatory Compliance	Ms.	Ventura	Jill		6095372611					Jill_Ventura@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/22/2023	2026	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	Dallas
H8298	Financial Reporting Contact	Corporate Controller		Concepcion	Ivan		9734664188					Ivan_Concepcion@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	05/01/2023	2026	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	Dallas
H8298	Formulary Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					athena_patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	06/09/2025	2026	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	Dallas
H8298	General Contact	Director, Regulatory Compliance	Ms.	Ventura	Jill		6095372611					Jill_Ventura@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/22/2023	2026	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	Dallas
H8298	Government Relations Contact	Director, Regulatory Compliance	Ms.	Ventura	Jill		6095372611					Jill_Ventura@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/22/2023	2026	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	Dallas
H8298	HIPAA Privacy Officer	Privacy Official		Dates	Chris	A	9734667669					chris_dates@horizonblue.com	3 Penn Plaza East, PP-16C		Newark	NJ	07105	12/30/2015	2026	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	Dallas
H8298	HIPAA Security Officer	Chief Information Security Officer	Mr.	Patel	Niraj		9734664409					niraj_patel@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Hospice Contact	Director, Clinical Special Needs Plan		Smolij	Carol		8566383595					Carol_Smolij@horizonblue.com	250 Century Pkwy		Mt. Laurel	NJ	08054	04/04/2018	2026	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	Dallas
H8298	Interoperability Contact	Director, Mandate Implementation		Gregory	Stacey		9734668278					Stacey_Gregory@horizonblue.com	3 Penn Plaza	PP-09	Newark	NJ	07105	01/04/2023	2026	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	Dallas
H8298	MA Appeals/Grievances Contact	Manager, Service Ops. II	Ms.	Mestres	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/13/2022	2026	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	Dallas
H8298	MA Claims Processing Contact for Public Website	Mgr, Exec DOBI Compl & Appls		Mestress	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	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	Dallas
H8298	Marketing Contact	Sales Manager II		Cennamo	Steven	P	9084160480					steven_cennamo@horizonblue.com	3 Penn Plaza East	PP-12F	Newark	NJ	07105	02/09/2022	2026	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	Dallas
H8298	Medical Director	Senior Medical Director	Dr.	Abidi	Fatema		8566383042					fatema_abidi@horizonblue.com	1700 American Blvd	HL-01	Pennington	NJ	08534	12/13/2024	2026	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	Dallas
H8298	Medicare Compliance Officer	Director, Reg. Requirements/ MCO	Mr	McGrady	Daniel		7325393680					daniel_mcgrady@horizonblue.com	1700 American Blvd.	HL-03	Pennington	NJ	08534	07/12/2021	2026	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	Dallas
H8298	Medicare Coordinator	VP, Reg. Compliance/MCO	Mr.	McGrady	Daniel		6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	04/06/2023	2026	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	Dallas
H8298	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacists		Anderson	Ally		8554570763				8557297221	PartDoverutil@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	03/21/2022	2026	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	Dallas
H8298	Medication Therapy Management Contact	Manager, MTM and Case/Care Management		Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	PRIME Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/21/2022	2026	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	Dallas
H8298	OffShore Subcontractor Contact	Manager, Medicaid Regulatory Requirements		McGrady	Daniel		6095372617					daniel_mcgrady@horizonblue.com	1700 American Blvd	HL-03P	Pennington	NJ	08534	12/11/2018	2026	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	Dallas
H8298	Online Enrollment Center Contact (Back-up)	Supervisor		Johnson	Cheryl		9734666931					cheryl_johnson@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	10/21/2016	2026	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	Dallas
H8298	Online Enrollment Center Contact (Optional)	Team Leader		Johnson	Cheryl		9734666931					Cheryl_Johnson@horizonblue.com	3 Penn Plaza - PP12L		Newark	NJ	07105	04/18/2016	2026	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	Dallas
H8298	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Santiago-Mercado	Nitza		9734667346					Nitza_Santiago-mercado@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	09/13/2018	2026	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	Dallas
H8298	Part C Application Contact	Director, Medicare Products, Community & Sales		Kudgis	Len		6095372085					len_kudgis@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	01/08/2025	2026	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	Dallas
H8298	Part C Reporting Contact	Manager, Audit Readiness	Mrs.	Santoro	Cynthia		9734668395					cynthia_santoro@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Part D Appeals	Regulatory Director	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	03/21/2022	2026	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	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8298	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd	Clinical Review	Eagan	MN	55121	03/21/2022	2026	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	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8298	Part D Application Contact	Director, Medicare Products, Community & Sales		Kudgis	Len		6095372085					len_kudgis@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	01/08/2025	2026	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	Dallas
H8298	Part D Benefits Contact	Director, Benefits Ops.	Ms.	Gergen	Ashley		6127772506					agergen@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	10/06/2020	2026	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	Dallas
H8298	Part D Claims Submission Contact	Functional Business Consultant - Govt. Programs	Mr.	Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	PRIME Therapeutics, LLC	2655 Eagan Woods Drive	Eagan	MN	55122	04/09/2019	2026	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	Dallas
H8298	Part D Exceptions Contact	Director, Reg/Audit Response	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd		Eagan,	MN	55121	04/15/2021	2026	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	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8298	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/21/2022	2026	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	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8298	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699					Emily.Tastad@PrimeTherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	11/28/2023	2026	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	Dallas
H8298	Part D Price File Contact (Optional)	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	Horizon Blue Cross Blue Shield of NJ	3 Penn Plaza, PP-12	Newark	NJ	07105	01/06/2025	2026	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	Dallas
H8298	Part D Price File Contact (Primary)	Sr. Business Solutions Analyst	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	PRIME Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/28/2023	2026	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	Dallas
H8298	Part D Quality Assurance Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					Athena_Patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Part D Reporting Contact	Manager, Audit Readiness	Mrs.	Santoro	Cynthia		9734668395					cynthia_santoro@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Patient Safety Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					Athena_Patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Payment Contact	Supervisor-Accoutning		Fuentes	Yunetsi		2018895531					yunetsi_fuentes@horizonblue.com	3 Penn Plaza E		Newark	NJ	07101	09/17/2025	2026	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	Dallas
H8298	Pharmacy Director	Director, Pharmacy - Medicare		Patrikios	Athena		9734664654					athena_patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	Pharmacy Network Management Contact	AVP, Network Mgmt	Ms	Conlin	Marci		6127772842					Marci.Conlin@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	04/15/2021	2026	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	Dallas
H8298	Pharmacy Network Management Contact (Secondary)	Sr. Director Network Client Svcs.	Ms	Hanley	Megan		6127773969				8778236373	Megan.Hanley@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55122	01/05/2021	2026	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	Dallas
H8298	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/12/2024	2026	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	8554571347				HMO - Health Maintenance Organization		C	Dallas
H8298	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Exp. & Member Ops.		Bunch	Jonathan							jonathan.bunch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/12/2024	2026	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	8554571347				HMO - Health Maintenance Organization		C	Dallas
H8298	Plan Directory Contact for Public Website	Mgr, Exec DOBI Compl & Appls		Mestres	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	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	Dallas
H8298	Plan to Plan Reconciliation Contact	Pharmacy Business Admin		Cunningham	Theresa		9734667886				9734664665	theresa_cunningham@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/22/2016	2026	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	Dallas
H8298	Processor Contact	Director, PBM Ops.	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	09/28/2022	2026	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	Dallas
H8298	Quality Contact	Director, Quality Improvement Operations		Harris	Andrea		6095373027					andrea_harris@horizonblue.com	1700 American Blvd	HL-02	Pennington	NJ	08534	10/10/2019	2026	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	Dallas
H8298	Reconciliation Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319				7322565428	jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	12/30/2015	2026	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	Dallas
H8298	Reconciliation Contact (Secondary)	Manager, Actuarial		Muellers	Barbara		7322565313				7322565428	barbara_muellers@horizonblue.com	1427 Wyckoff Road	WL-03R	Wall	NJ	07727	12/30/2015	2026	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	Dallas
H8298	Recovery Audit Contact	Sr. Director, Special Investigations	Mr.	Dineen	Timothy		9734668723					timothy_dineen@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	SNP Application Contact	Director, Clinical SNP	Ms.	Smolij	Carol		9735584774					Carol_Smolij@horizonblue.com	1700 American Blvd		Pennington	NJ	08534	04/18/2022	2026	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	Dallas
H8298	Surveillance Contact	VP, Reg. Compliance/MCO	Mr.	McGrady	Daniel		6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	04/06/2023	2026	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	Dallas
H8298	System Contact	Director, Information Security		Andreano	Matthew		9734667330					Matthew_Andreano@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	05/19/2022	2026	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	Dallas
H8298	Third Party Administrator (TPA) Liaison	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					athena_patrikios@horizonblue.com	3 Penn Plaza East	PP-12	Newark	NJ	07105	12/13/2024	2026	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	Dallas
H8298	User Access Contact	Regulatory Compliance Assoc.	Mr.	Vargas	Mario		9734666379					Mario_Vargas@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	06/05/2024	2026	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	Dallas
H8298	Utilization Management Contact	VP, Clinical Operations		Rush	Lisa		7322565016					Lisa_Rush@horizonblue.com	250 Century Parkway	3-D	Mount Laurel	NJ	08054	12/13/2024	2026	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	Dallas
H8298	Utilization Review Contact	VP, Clinical Operations		Rush	Lisa		7322565016					Lisa_Rush@horizonblue.com	250 Century Parkway	3-D	Mount Laurel	NJ	08054	12/13/2024	2026	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	Dallas
H8320	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H8320	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H8320	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H8320	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H8320	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H8320	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H8320	PHR Beneficiary Contact																	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H8320	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8320	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	Devoted of Illinois, Inc.	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8330	Agent/Broker Compensation Data Contact	Manager, Sales Operations		Chowdhury	Nahar		6179729400	60926				Nahar.Chowdury@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Automated TrOOP Balance Transfer Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Backup User Access Contact	Lead Govt Prgms Compliance Manager		Foster	Amber		7816128333					Amber.Foster@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	3152780				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Bid Audit Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Bid Audit Site Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Bid Primary Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	CAP Report Contact for Public Website	Director, Government Programs Compliance Officer		Geroski	Tami		7816121000	86892				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	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	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	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 Operating Officer	Chief Operating Officer	Ms.	Catlender	Kathryn		7816126840	84588				Katie.Catlender@point32health.org	1 Wellness Way		Canton	MA	02021	07/14/2025	2026	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 Information Officer	SVP and Chief Information Officer	Ms.	Ferhatbegovic	Selma		7816121000	84633				Selma.Ferhatbegovic@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Information Security Officer	VP Chief Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Complaints Tracking Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				Sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Contact for Fraud Investigations	VP,  Privacy, Fraud Prevention & Recovery		Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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			COB Inquiries	Medicare		7816121000					Medicare_COB_Inquiries@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Corporate Mailing						7816121000					R.Scott.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Villatoro	Yesly		7816121000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	DIR Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	DIR Contact (Secondary)	Pharmacy Analyst Senior		Santino	Cristina		7816121000	82560				cristina.santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Discount Program Payment Contact	Sr. Manager, Accounting		Parikh	Roshni		7816121000	84512				roshni.parikh@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Electronic Health Record Contact	Director, Core Administration System Application		Pavao	Joseph		7816121000	83289				Joseph.Pavao@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Emergency Part D Contact	Director, Pharmacy Operations		Bonica	Joseph		7816123342					joseph.bonica@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Emergency Part D Contact (Secondary)	Senior Manager, Pharmacy Operations		MacAuley	Jacqueline		6176123059					jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/04/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Employer Waiver Contact	Manager, Client Services		Bartkiewicz	Mary		7816121000	83937				Mary.Bartkiewicz@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment Data & Reporting		Quinlan	Judith		7816121000	83377				judith.quinlan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Enrollment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	EOB Transfer Contact	Manager, Business Implementation		Nesmith	Tanisha		7816124861				6176730286	tanisha.nesmith@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Financial Audit Contact	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	07/15/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Financial Reporting Contact	Assistant Corporate Controller		Jaiswal	Ruchi		6179729400	84518				Ruchi.Jaiswal@point32health.org	1 Wellness Way		Canton	MA	02021	08/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Formulary Contact	Clinical Pharmacist Senior		Kowalski	Alec		7816121000	82045				alec.kowalski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	General Contact	Medicare Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Lewis	Kristin		7816121000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	HIPAA Privacy Officer	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	10/06/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	HIPAA Security Officer	VP Chief  Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		MacAuley	Jacqueline		7816121000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Interoperability Contact	VP, Information Security Officer		Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Gonzalez	Michelle		6179729400	83114				michelle.gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	MA Claims Processing Contact for Public Website	Director, Claims		Patel	Monal		7816121000	88187				Monal.Patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Marketing Contact	Director, Marketing		Walsh	Tim		7816121000	87541				Tim.Walsh@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Medical Director	Medical Director	Dr.	Courtemanche	Abbie		7816121000	67024				Abbie.Courtemanche@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Medicare Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Coordinator	Vice President, Medicare		Walker	Eddie		7816121000	84471				Edward.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr.	Dohan	David		7816121000	82615				David.Dohan@point32health.org	1 Wellness Way		Canton	MA	02021	07/07/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Medication Therapy Management Contact	Sr Pharmacy Program Manager		Burns	Ashlyn		7816122239					ashlyn.burns@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Ben-Ezra	Daniel		7816121000	54054				Daniel.Ben-Ezra@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Online Enrollment Center Contact (Optional)	Supervisor, Enrollment		Maloney	Kimberly		7816121000	83576				Kimberly.Maloney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Online Enrollment Center Contact (Primary)	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 C Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 C Reporting Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Appeals	Director, Appeals & Grievances		Gonzalez	Michelle							Michelle.Gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	83114			HMO - Health Maintenance Organization		C	Boston
H8330	Part D Appeals Contact (Secondary)	Sr. Program Manager, Appeals & Grievances		Mello	Sheri							sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	84862			HMO - Health Maintenance Organization		C	Boston
H8330	Part D Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Benefits Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Claims Submission Contact	Senior Manager, Pharmacy Operations		Alves	Heather		7816121000	82988				heather.alves@point32health.org	1 Wellness Way		Canton	MA	02021	10/09/2025	2026	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		Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	82370			HMO - Health Maintenance Organization		C	Boston
H8330	Part D Exceptions Contact (Secondary)	Supervisor, Pharmacy Utilization Management		Bannan	Philip							Philip.Bannan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	7816121000	60178			HMO - Health Maintenance Organization		C	Boston
H8330	Part D Price File Contact (Back-up)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					Tim.Sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Price File Contact (Optional)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					tim.sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Price File Contact (Primary)	Sr Business Analyst		Moore-Elliott	Shalandria		7637974305					shalandria.moore-elliott@optum.com	1600 McConnor Pwy.		Schaumburg	IL	60173	04/03/2025	2026	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 Quality Assurance Contact	Vice President, Pharmacy		Fenton	Karen		7186121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Reporting Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Patient Safety Contact	Sr Pharmacy Implementation Specialist		von Fritzinger	Lisa		7816123778					lisa.vonfritzinger@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Payment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Director	Vice President, Pharmacy		Fenton	Karen		7816121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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 Network Management Contact	Manager, Retail Network Operations		Hagan	Kyle		3039895828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	04/03/2025	2026	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 Network Management Contact (Secondary)	Manager, Retail Network Operations		Ashby	JoLynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	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	Sr. Manager		Villaneuva	Juan							Juan.Villanueva@optum.com	3515 S Harbor Blvd.		Costa Mesa	CA	92626	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H8330	Pharmacy Technical Help Desk Contact (Secondary)	Associate Director, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active	8556792639				HMO - Health Maintenance Organization		C	Boston
H8330	Plan Directory Contact for Public Website	Marketing Materials Production Manager		Kayser	Kenneth		7816121000	83518				kenneth.kayser@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Plan to Plan Reconciliation Contact	Manager, Finance Operations Compliance		Schumaker	Tyler		6179729400	87394				Tyler.Schumaker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Processor Contact	Director, Claims		Patel	Monal		7816121000	88187				monal.patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Quality Contact	Director, HEDIS Quality Informatics		McCoy	Kelly		7816121000	83515				kelly.mccoy@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Reconciliation Contact	Senior Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Reconciliation Contact (Secondary)	Pharmacy Analyst Sr.		Santino	Cristina		7816121000	82560				Cristino.Santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Recovery Audit Contact	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	SNP Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	03/07/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	SNP State Contact	Director Business Implementation		Chukwu	Matthew		7816123967					matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	10/07/2024	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Surveillance Contact	Director, Sales Operations		Tollefsen	John		7816122266					John.Tollefsen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	System Contact	Senior Manager, Business Account Management		Allen	Jeffrey		7816121000	83167			6179729008	Jeffrey.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Third Party Administrator (TPA) Liaison	Manager, Accounting		Gatzen	Kelly	A	8609896689					kelly.gatzen@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	User Access Contact	Director Medicare Compliance Officer		Geroski	Tami	A	5708142999	0				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	10/21/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Utilization Management Contact	Director, Utilization Management		Walker	Karen		7816121000					Karen.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8330	Utilization Review Contact	Lead Medical Director, Clinical Reviews	Dr.	Slota	Janet		6179729400	87527				Janet.Slota@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	HMO/HMOPOS		Point32Health, Inc.	398	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8332	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/30/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	01/13/2020	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/13/2020	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/13/2020	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/13/2020	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H8332	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/13/2020	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8332	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF KANSAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8371	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Backup User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Best Available Evidence Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	CAP Report Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Denver
H8371	CEO - CMS Administrator Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Chief Operating Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Complaints Tracking Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Contact for Fraud Investigations	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Coordination of Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Customer Service Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	DIR Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Encounter Data & Risk Adjustment Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Enrollment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Financial Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	General Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Government Relations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	HIPAA Privacy Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	HIPAA Security Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	MA Appeals/Grievances Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Marketing Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Medical Director	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Medicare Compliance Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Medicare Coordinator	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Medicare Part D Opioid Overutilization Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part C Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part D Appeals	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Denver
H8371	Part D Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part D Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part D Claims Submission Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Denver
H8371	Part D Price File Contact (Back-up)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part D Price File Contact (Primary)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part D Quality Assurance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Part D Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending	5703717371				PACE - Nat		C	Denver
H8371	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Quality Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Reconciliation Contact (Secondary)	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	10/10/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	System Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8371	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	05/20/2025	2026	KINSHIP PACE OF WESTERN ARKANSAS, LLC	National PACE	Kinship PACE of Western Arkansas, LLC	National PACE				Yes	Pending					PACE - Nat		C	Denver
H8379	Agent/Broker Compensation Data Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		6164648667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Backup User Access Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Bid Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Bid Audit Site Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Bid Primary Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	CAP Report Contact for Public Website	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	CEO - CMS Administrator Contact	President and Chief Health Plan Officer	Mr	Gates	Nick		6164648144					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	CEO - Senior Official for Contracting	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Chief Financial Officer	Senior Vice President, Finance	Mrs.	McIntyre	Celeste		6167745142					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Chief Operating Officer	SVP, Government/Consumer Markets	Mrs.	Kincaid	Carrie		6164648969					phcompliance@priorityhealth.com	1231 East Beltine NE		Grand Rapids	MI	49525	02/10/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Chief Information Officer	Chief Information Officer	Mr	Crook	Chris		6164649939					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Chief Information Security Officer	SVP, IS Technology Services	Mr	Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE	MC 843	Grand Rapids	MI	49503	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	CMMI Model Point of Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Complaints Tracking Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE	MS 1115	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Contact for Fraud Investigations	Manager, Special Investigations Unit		Gross	Brenda		6164648152					Brenda.Gross@PriorityHealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Coordination of Benefits Contact	Claims Manager		Ball	Jill		8883896648					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Corporate Mailing						6169420954				6164640145	PH-DistributionSE@PriorityHealth.com	1231 East Beltline Ave, NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		5033309550					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	DIR Contact	Senior Accountant		Savic	Stephanie	M	6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	DIR Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel	K	6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	01/27/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Discount Program Payment Contact	Senior Accountant		Savic	Stephanie	M	6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Electronic Health Record Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Emergency Part D Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Emergency Part D Contact (Secondary)	Manager, Medicare Pharmacy Operations		VanLoenen	Amanda		6164648750					Amanda.VanLoenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Employer Waiver Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Encounter Data & Risk Adjustment Operations Contact			Florn	Cathy		7348902858					cathy.florn@priorityhealth.com	1239 E Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Enrollment Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	EOB Transfer Contact	Claims Manager		Ball	Jill		6164648044				6169750247	phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Financial Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Financial Reporting Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Formulary Contact	Medicare Part D Operations Manager		Van Loenen	Amanda		6164648750					PH-MedicareFormularyContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	General Contact	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Government Relations Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	HIPAA Privacy Officer	VP, Compliance & Privacy Officer		Rollenhagen	Cindy		6164648424					phcompliance@priorityhealth.com	1231 East Beltline Ave NE	MS3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	HIPAA Security Officer			Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE		Grand Rapids	MI	49503	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Hospice Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Interoperability Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	MA Appeals/Grievances Contact	Manager Grievance & Appeal		Macdonald	Amanda		6164648264					phcompliance@priorityhealth.com	1231 East Beltline Ave NE	MS 1115	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	MA Claims Processing Contact for Public Website	Claims Manager		Ball	Jill		6164648044					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Marketing Contact	Sr. Markets & Product Development Director		Brown	Samia		6164648002					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Medical Director	SVP, Chief Medical Officer		Oker	Elif		6164643510					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Medicare Compliance Officer	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Medicare Coordinator	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Medicare Part D Opioid Overutilization Contact	Medicare Quality Manager		Gutierrez	Salvador		6165757622					salvador.gutierrez@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	06/29/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Medication Therapy Management Contact	Director of Pharmacy Operations		Chaffee	Jacob		6168261329					jacob.chaffee@priorityhealth.com	1231 East Beltline Dr Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	OffShore Subcontractor Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Online Enrollment Center Contact (Optional)	Government Programs Enrollment Coordinator		Rice	Lori		6164648667					lori.rice@priorityhealth.com	1231 East Beltline Ave NE	MS 1180	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part C Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part C Reporting Contact	Sr. Compliance Analyst		Eizinger	Eric		2178400871					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Appeals	Supervisor, Medicare Part D Appeals		Anderson	Melissa							PHMedicarePartDAPPLS@spectrumhealth.org	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164648547				HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Appeals Contact (Secondary)	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather							phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164643510				HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Benefits Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Claims Submission Contact	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Exceptions Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	8004666642				HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Exceptions Contact (Secondary)	Mgr, Medicare Part D Operations	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164648750				HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					Medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Price File Contact (Optional)	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Quality Assurance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Part D Reporting Contact	Sr. Compliance Analyst		Eizinger	Eric		2178400871					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Patient Safety Contact	Clinical Pharmacy Program Manager	Mr	Chaffee	Jacob		6165756149					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Payment Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Personal Health Record Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Pharmacy Director	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Pharmacy Network Management Contact (Secondary)	Manager, Medicare Pharmacy Operations		Van Loenen	Amanda		6164648750					amanda.vanloenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	8004666642				HMO - Health Maintenance Organization		C	Seattle
H8379	Pharmacy Technical Help Desk Contact (Secondary)	Mgr, Medicare Part D Ops	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active	6164648750				HMO - Health Maintenance Organization		C	Seattle
H8379	Physician Incentive Contact	Director, Provider Strategy & Solutions		Ryan	Susan		3137010444					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Plan Directory Contact for Public Website			Service	Customer		8883896648					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Plan to Plan Reconciliation Contact	Business Systems Analyst		Robinson	Aminah		6168629827					aminah.robinson@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	07/01/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Processor Contact	ESI Sr Dir - Product Management Medicare		Mahon	Snezana		3146846361					SMahon@express-scripts.com	ESI	One Express Way	St. Louis	MO	63121	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Quality Contact	Manager, Quality	Mr	Straayer	Ian		6165752782					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Reconciliation Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Reconciliation Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel		6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Recovery Audit Contact	Manager Cost Recovery	Ms	Gross	Brenda		6164648152					brenda.gross@priorityhealth.com	1231 East Beltline NE	Mail Stop 2305	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	SNP Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					janine.bishop@priorityhealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	SNP State Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					janine.bishop@priorityhealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	06/02/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Surveillance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	System Contact	Data Analytics Analyst-Senior, Sr Markets		Johnson	Joshua		6165755760					PH-MedicareSystemsContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Third Party Administrator (TPA) Liaison	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	User Access Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Utilization Management Contact	Director, Utilization Mgmt PH Pre-Service		Mahoney	Diana		8439068561					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8379	Utilization Review Contact	Director, Medicare Care Management		Scovel	Janet		6164648656					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH CHOICE, INC.	Local CCP	Priority Health Medicare	HMO/HMOPOS		Corewell Health	190	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H8385	Agent/Broker Compensation Data Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Backup User Access Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Best Available Evidence Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Bid Audit Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Bid Audit Site Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Bid Primary Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	CAP Report Contact for Public Website	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8007525863				PPO - BBA		C	Dallas
H8385	CEO - CMS Administrator Contact	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	CEO - Senior Official for Contracting	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Chief Financial Officer	Chief Financial Officer	Mr.	Custis	Stephen		6129649158					Stephen.Custis@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Chief Operating Officer	Vice President of Operations	Ms.	Foemmel	Sara		7153836634					foemmel.sara@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Chief Information Officer	Cheif Information Officer	Mr.	Reimer	Brad		6053287937					Brad.Reimer@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Chief Information Security Officer	Vice President - Information Security Officer	Ms.	Hogstad	Kimberly		6053287410					Kimberly.Hogstad@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	CMS Casework Communication Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Complaints Tracking Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Contact for Fraud Investigations	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Coordination of Benefits Contact	Director of Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Corporate Mailing						8007525863					memberservices@sanfordhealth.org	PO BOX 91110		Sioux Falls	SD	57109	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by 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		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	DIR Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	DIR Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Discount Program Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Emergency Part D Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Emergency Part D Contact (Secondary)	Senior Pharmacist	Mr.	Reuman	Reed		6053122761					Reed.Reuman@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Employer Waiver Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Encounter Data & Risk Adjustment Operations Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Enrollment Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	EOB Transfer Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		6053287182				6053286811	Aleesa.Jansick@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Financial Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Financial Reporting Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Formulary Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Formulary Contact (Secondary)	Principal Pharmacy Benefits Specialist		Chen	Honghua		2242312740					Christine.Chen2@optum.com	1600  McConnor Parkway	Suite 201	Schaumburg	IL	601736801	01/04/2023	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	General Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Government Relations Contact	Head of Government Affairs	Mr.	Wheeler	Dylan		6053287186					Dylan.Wheeler@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	HIPAA Privacy Officer	Lead Privacy Officer	Ms.	Sundby	Jennifer		6053625407					Jennifer.Sundby@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	HIPAA Security Officer	Information Security Compliance Officer	Mr.	Otte	Brody		6053126563					Brody.Otte@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Hospice Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Interoperability Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	MA Appeals/Grievances Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	MA Claims Processing Contact for Public Website	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Marketing Contact	Director of Marketing	Ms.	McCloskey	Diana		6053122762					Diana.Mccloskey@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Medical Director	Chief Medical Officer	Dr.	Faber	Kevin		6053287192					Kevin.Faber@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Medicare Compliance Officer	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Medicare Coordinator	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Medication Therapy Management Contact	Clinical Program Manager	Ms.	Liaqat	Tazeen		6305440541					Tazeen.liaqat@optum.com	1240 South Pine Island Rd.		Plantation	FL	33324	01/13/2023	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	OffShore Subcontractor Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Online Enrollment Center Contact (Back-up)	Manager of Inside Sales	Mr.	Arnett	Jack		6053286886					Jack.Arnett@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Online Enrollment Center Contact (Optional)	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Online Enrollment Center Contact (Primary)	Director of Medicare Programs	Mr.	Ovenden	Nathan		6053122606					Nathan.Ovenden@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part C Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part C Reporting Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Appeals	Manager, Prior Authorization Appeals	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H8385	Part D Appeals Contact (Secondary)	Pharmacy Technician, PA Appeals	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H8385	Part D Application Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Benefits Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Claims Submission Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by 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						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H8385	Part D Exceptions Contact (Secondary)	Pharmacy Technician, PA	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8884033398				PPO - BBA		C	Dallas
H8385	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms.	Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Price File Contact (Optional)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Price File Contact (Primary)	Senior Business Analyst	Ms.	Lam	Annie		6124286588					Annie.Lam@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Quality Assurance Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Part D Reporting Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Patient Safety Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Personal Health Record Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Pharmacy Director	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Perez	Felix		7632833503					Felix.Perez@optum.com	1600 McConnor Parkway , IL 601736801		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations	Ms.	Ashby	Jolynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	01/04/2023	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Pharmacy Technical Help Desk Contact	Pharmacy Technical Help Desk	Sr.	Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/15/2023	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active	8446429090				PPO - BBA		C	Dallas
H8385	PHR Beneficiary Contact																	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO	Sanford Health Plan	Sanford Health	740	Yes	Active	8882786485				PPO - BBA		C	Dallas
H8385	Physician Incentive Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Plan Directory Contact for Public Website	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Processor Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Quality Contact	Director of Quality and STARS Strategy	Ms.	Kanta	Misty		6053122788					Misty.Kanta@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Reconciliation Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Recovery Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	SNP Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	SNP State Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Surveillance Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	System Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Third Party Administrator (TPA) Liaison	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	User Access Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Utilization Management Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8385	Utilization Review Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/20/2024	2026	SANFORD HEALTH PLAN	Local CCP	Align powered by Sanford Health Plan	Local PPO		Sanford Health	740	Yes	Active					PPO - BBA		C	Dallas
H8390	Agent/Broker Compensation Data Contact	AVP, Sales Operations	Mr.	Handerhan	Bill		7328291160					bill.handerhan@caresource.com	230 N Main St		Dayton	OH	45402	07/15/2022	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Backup User Access Contact	Compliance Analyst	Mr.	Merrick	Nick		3306910252					macompliance@CareSource.com	230 North Main St		Dayton	OH	45402	01/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Best Available Evidence Contact	Enrollment Team Lead	Mr.	Richardson	Kal		9372243300	3437			9374250909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Bid Audit Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wes.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Bid Audit Site Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wes.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Bid Primary Contact	Senior Director, Actuarial Science	Mr.	Royse	Wes		5029746324					wes.royse@caresource.com	230 N. Main Street		Dayton	OH	45402	02/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	CAP Report Contact for Public Website	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 N Main St		Dayton	OH	45402	07/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Preitauer	Erhardt		9374742424					Erhardt.Preitauer@caresource.com	P. O. Box 8738		Dayton	OH	45401	12/18/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Preitauer	Erhardt		9375312455					Erhardt.Preitauer@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/03/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Chief Financial Officer	Chief Financial Officer	Mr.	Smart	Lawrence		8139978807					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	12/18/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Chief Operating Officer	Chief Operating Officer	Mr.	Schultz	Fred		9379016371					fred.schulz@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Chief Information Officer	Chief Information Officer	Ms.	Valencia	Devon		9375312552					devon.valencia@caresource.com	P.O. Box 8738		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Chief Information Security Officer	VP , Information Security and Privacy	Mrs.	Heckler	Lisa		9375313895					lisa.heckler@caresource.com	P.O. Box 8738		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	CMMI Model Point of Contact	Product Management Specialist	Mr.	Blankenship	Aaron		9374876526					aaron.blankenship@caresource.com	230 N. Main Street		Dayton	OH	45402	01/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	CMS Casework Communication Contact	AVP, Grievance and Appeals	Mr.	Mayo	Faustino		9377013522					faustino.mayo@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Complaints Tracking Contact	AVP, Grievance and Appeals	Mr.	Mayo	Faustino		9377013522					faustino.mayo@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Contact for Fraud Investigations	Program Integrity Analyst	Ms.	Johnson	Alexis	N	9372243300	2870			9373963876	SIUprogramintegrity@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Coordination of Benefits Contact	Manager, Enrollment Operations	Mr.	Spivey	Michael		9375313682				9374870643	COBInquiry@caresource.com	230 N. Main St.		Dayton	OH	45402	04/15/2022	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Corporate Mailing						9372243300					macompliance@caresource.com	P. O. Box 8738		Dayton	OH	45401	08/31/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Customer Service Operations Contact	Director, Customer Care		Cary	Lisa		9372326458					lisa.cary@caresource.com	40 W 2nd St		Dayton	OH	45402	10/04/2021	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	DIR Contact	AVP, Actuarial Science		Chen	Frank		5625532115					Frank.Chen@caresource.com	230 N. Main Street		Dayton	OH	45402	01/15/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Discount Program Payment Contact	Senior Manager, Accounting		Schoen	Dawn		4845230738					dawn.schoen@caresource.com	230 N. Main Street		Dayton	OH	45402	08/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Emergency Part D Contact	AVP, Pharmacy	Ms.	Robertson-Jones	Turkesia		4042720963					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/09/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Emergency Part D Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Encounter Data & Risk Adjustment Operations Contact	Director, Claims Encounter Data	Mr.	Shareef	Akbar		9374876640					MyCare-MA_EncounterRequests@caresource.com	220 E. Monument Ave.		Dayton	OH	45402	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Enrollment Contact	Enrollment Team Lead	Mr.	Richardson	Kal		9372243300	3437			9374250909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	EOB Transfer Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479				9374870359	rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Financial Audit Contact	Director Compliance (External Audit)	Ms.	Hoben	Erin		8315885093					erin.hoben@caresource.com	230 N. Main Street		Dayton	OH	45402	12/21/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Financial Reporting Contact	Chief Financial Officer	Mr.	Smart	Lawrence		9375313335					Lawrence.Smart@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/15/2021	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Formulary Contact	Director, Clinical Strategy	Ms.	Condon	Kelani		7373142944					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	General Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Government Relations Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	HIPAA Privacy Officer	AVP, Privacy and Compliance	Ms.	Fogler	Anne		9378231436					anne.fogler@caresource.com	P.O. Box 8738		Dayton	OH	45401	02/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	HIPAA Security Officer	VP, Cybersecurity, Privacy and Technology Services	Ms.	Heckler	Lisa		9375460770					lisa.heckler@caresource.com	P. O. Box 8738		Dayton	OH	45401	02/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Hospice Contact	Director, Enrollment	Mr.	Castro	Armando		9375312291					armando.castro@caresource.com	230 N Main St		Dayton	OH	45402	05/29/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Interoperability Contact	AVP, Enterprise Architecture		Hanley	Michael		8033721957					michael.hanley@caresource.com	230 N Main St		Dayton	OH	45402	06/01/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	MA Appeals/Grievances Contact	AVP, Grievance and Appeals	Mr.	Mayo	Faustino		9377013522					faustino.mayo@caresource.com	P.O. Box 1947		Dayton	OH	45401	02/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	MA Claims Processing Contact for Public Website	VP of Claims and Configuration	Ms.	Hans	Holly		9375312750					Holly.Hans@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Marketing Contact	Compliance Analyst	Mr.	Merrick	Nick		3306910252					macompliance@CARESOURCE.COM	230 N Main St		Dayton	OH	45402	01/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Medical Director	Medical Director	Dr.	Mukunda	Beejadi		2166459092					beejadi.mukunda@caresource.com	5900 Landerbrook Drive	Ste 300	Mayfield Heights	OH	44124	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Medicare Compliance Officer	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 N. Main St.		Dayton	OH	45402	07/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Medicare Coordinator	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Clinical Strategy	Ms.	Condon	Kelani		7373142944					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/11/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Medication Therapy Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Online Enrollment Center Contact (Optional)	Director, Enrollment	Mr.	Castro	Armando		9375312291					armando.castro@caresource.com	230 N Main Street		Dayton	OH	45402	05/29/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Online Enrollment Center Contact (Primary)	Enrollment Team Lead	Mr.	Richardson	Kal		9372243300	3437			9374250909	kal.richardson@caresource.com	P. O. Box 45401		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part C Application Contact	Director, Medicare & Marketplace Filing		Gray	Melissa		9375312328					melissa.gray@caresource.com	230 N Main St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part C Reporting Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part D Appeals	Express Scripts, Sr. Pharmacy Manager		Schumm	Brian						8555858246	Brian_Schumm@express-scripts.com	5151 B		Dublin	OH	43017	06/08/2022	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Boston
H8390	Part D Appeals Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	02/08/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	9378187479				HMO - Health Maintenance Organization		C	Boston
H8390	Part D Application Contact	Director, Medicare & Marketplace Filing		Gray	Melissa		9375312328					melissa.gray@caresource.com	230 N Main St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part D Benefits Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part D Claims Submission Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Boston
H8390	Part D Exceptions Contact (Secondary)	Director. Pharmacy Operations	Ms.	Rattan	Sangeet							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	03/25/2022	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	9375911634				HMO - Health Maintenance Organization		C	Boston
H8390	Part D Price File Contact (Back-up)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part D Price File Contact (Optional)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	11/22/2021	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part D Price File Contact (Primary)	Sr Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/22/2021	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part D Quality Assurance Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Part D Reporting Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Patient Safety Contact	Pharmacist, Formulary Strategy & Management	Mr.	Bogner	Craig		9374874026					rxcompliancerequest@caresource.com	140 N Jefferson St.		Dayton	OH	45402	02/08/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Payment Contact	Senior Manager, Accounting		Schoen	Dawn		4845230738					dawn.schoen@caresource.com	P. O. Box 8738		Dayton	OH	45401	08/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Pharmacy Director	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Pharmacy Network Management Contact	Director, Pharmacy Innovation	Ms.	Loricco	Nichol		9378187479					rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
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	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Boston
H8390	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Innovation	Ms.	Loricco	Nichol							rxcompliancerequest@caresource.com	140 N Jefferson St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active	9378187479				HMO - Health Maintenance Organization		C	Boston
H8390	Plan Directory Contact for Public Website	VP Ente	Mr.	Gengo	Chris		9376600192					chris.gengo@caresource.com	P. O. Box 8378		Dayton	OH	45401	07/11/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Plan to Plan Reconciliation Contact	Senior Manager, Accounting	Ms.	Schoen	Dawn		9374876597					CareSourceP2P@caresource.com	CareSource Accounting	PO Box 2208	Dayton	OH	45401	08/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Processor Contact	VP Claims and Configuration		Hans	Holly		9372243300	12750				Holly.Hans@caresource.com	PO Box 8738		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Quality Contact	Director, Enterprise Quality Improvement Programs	Mr.	Fox	Logan		9379742145					logan.fox@caresource.com	230 N Main St.		Dayton	OH	45502	02/06/2025	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Reconciliation Contact	Senior Manager, Accounting	Ms.	Schoen	Dawn		4845230738					dawn.schoen@caresource.com	P. O. Box 8738		Dayton	OH	45401	08/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Recovery Audit Contact	VP, Claims	Ms.	Hans	Holly		9375312750					holly.hans@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	SNP Application Contact	Director, Medicare & Marketplace Filing		Gray	Melissa		9375312328					melissa.gray@caresource.com	230 N Main St		Dayton	OH	45402	04/18/2023	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Surveillance Contact	Manager Program Integrity	Ms.	Johnson	Alexis		9375312870					Alexis.Johnson@CareSource.com	230 North Main Street		Dayton	OH	45402	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	System Contact	Chief Information Officer	Ms.	Valencia	Devon		9375312552					devon.valencia@caresource.com	P. O. Box 8738		Dayton	OH	45401	01/16/2020	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Third Party Administrator (TPA) Liaison	Senior Manager, Accounting		Schoen	Dawn		4845230738					dawn.schoen@caresource.com	230 N. Main Street		Dayton	OH	45402	08/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	User Access Contact	Sr. Manager, Medicare Compliance Officer	Ms.	Nettles	Kylie		9374876159					kylie.nettles@caresource.com	230 North Main Street		Dayton	OH	45402	07/12/2024	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Utilization Management Contact	Director, Clinical Operations		Honig	Deronda		2162180296					Deronda.Honig@CareSource.com	P. O. Box 8738		Dayton	OH	45401	03/01/2021	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8390	Utilization Review Contact	Director, Clinical Operations		Honig	Deronda		2162180296					Deronda.Honig@CareSource.com	P. O. Box 8738		Dayton	OH	45401	03/01/2021	2026	CARESOURCE GEORGIA CO.	Local CCP	CareSource	HMO/HMOPOS		CareSource	321	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8421	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Best Available Evidence Contact	VP Clinical Operations	Ms	Runyon	Bobbi		7128270227					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/08/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	CAP Report Contact for Public Website	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooperi@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	CMS Casework Communication Contact	Director of Compliance	Mr.	Cooper	Wanda		2675751196				7325923500	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Customer Service Operations Contact	VP of Clinical Operations	Ms	Runyon	Bobbi		7128270227					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/08/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Formulary Contact	Finance Specialist	Mr	Partlow	Jennie		6406501565					jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923500	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	General Contact	VP of Clinical Operations	Ms	Runyon	Bobbi		7128270227					BRunyon@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/08/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation	Mr	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Medical Director	Medical Director	Dr.	Fornadel	Brian		7325923400					bfornadol@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Medicare Coordinator	Compliance Director	Ms	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/08/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Medicare Part D Opioid Overutilization Contact	Director of Compliance		Cooper	Wanda		2675751196					Wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Medication Therapy Management Contact	Medical Director	Mr	Fornadel	Brian		9548395000				7325923500	bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part D Appeals	Director of Compliance		Cooper	Wanda						2675751196	wcoooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7325923407				PACE - Nat		C	New York
H8421	Part D Appeals Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	06/13/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7328063224				PACE - Nat		C	New York
H8421	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part D Exceptions Contact	Medical Director	Mr	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H8421	Part D Exceptions Contact (Secondary)	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	09/11/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H8421	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part D Quality Assurance Contact	Director of Compliance	Ms	Coooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Patient Safety Contact	Finance Specialist		Partlow	Jennie		9548395000					jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/05/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Pharmacy Director	Medical Director	Mr	Fornadel	Brian		9548395000					bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H8421	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H8421	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Plan to Plan Reconciliation Contact	Financial Specialist	Mr	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Surveillance Contact	Compliance Director	Mr	Cooper	Wanda		2675751196					WCooper@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/08/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/03/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	User Access Contact	Business Administrator		Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	10/08/2024	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8421	Utilization Review Contact	Health Plan Management Director	Ms	Ternay	Jennifer		7328063224					Jternay@boldagepace.com	1700 E Dublin Granville Road		Columbus	OH	43229	07/08/2025	2026	ACUTECARE PACE FRANKLIN, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H8424	Automated TrOOP Balance Transfer Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Backup User Access Contact	CEO		Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Best Available Evidence Contact	CEO		Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Bid Primary Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	CAP Report Contact for Public Website	COO		Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 TriView Ave		Sioux City	IA	51103	11/03/2022	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active	7122247316				PACE - Nat		C	San Francisco
H8424	CEO - CMS Administrator Contact	CEO	Mr	Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	CEO - Senior Official for Contracting	CEO	Mr	Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Chief Financial Officer	Chief Financial Officer	Mr	Seashore	Keith		7122247223					keith.seashore@unitypoint.org	1776 West Lakes Pkwy	Suite 400	West Des moines	IA	50266	04/16/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Chief Operating Officer	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Chief Information Officer	Compliance Officer	Ms	Ricklefs	Jodi	M	5155748437					jodi.ricklefs2@unitypoint.org	1776 West Lakes PKWY	Suite 400	West Des Moines	IA	50266	09/19/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Chief Information Security Officer	Information Security Officer	Ms	Wilson	Dorrie	J	7122793649					dorrie.wilson@unitypoint.org	1776 West Lakes PKWY		West Des Moines	IA	50266	04/21/2025	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	CMS Casework Communication Contact	CEO	Mr	Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Complaints Tracking Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Contact for Fraud Investigations	Compliance Officer	Ms	Ricklefs	Jodi	M	5155748437					jodi.ricklefs2@unitypoint.org	1776 West Lakes PKWY	Suite 400	West Des Moines	IA	50266	09/19/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Coordination of Benefits Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Corporate Mailing						5154719702				5152414238	matt.swanstrom@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Customer Service Operations Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	DIR Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	DIR Contact (Secondary)			Hanson	Roberta	S	7122247223					roberta.hanson@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	03/06/2023	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Discount Program Payment Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Emergency Part D Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Encounter Data & Risk Adjustment Operations Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Enrollment Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	EOB Transfer Contact	COO		Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	Siouxland PACE		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Financial Audit Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Financial Reporting Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Formulary Contact	Pharmacist	Ms	Huber	Michelle		7122247223				7122247251	michelle.huber@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	02/11/2022	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	General Contact	CEO		Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Government Relations Contact	CEO		Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	HIPAA Privacy Officer	Privacy Officer	Ms	Fleming	Laurel		5152415999					laurel.fleming@unitypoint.org	1776 Westlakes PKWY	Suite 400	West Des Moines	IA	50266	08/20/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	HIPAA Security Officer	Compliance Officer	Ms	Ricklefs	Jodi	M	5155748437					jodi.ricklefs2@unitypoint.org	1776 West Lakes Parkway	Suite 400	West Des Moines	IA	50266	09/19/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Interoperability Contact			Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	MA Appeals/Grievances Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	MA Claims Processing Contact for Public Website	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Marketing Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Medical Director	Medical Director	Dr.	Knoblauch	Angela		7122247223				7122247251	angela.knoblauch@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	12/01/2023	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Medicare Compliance Officer	Compliance Officer	Ms	Ricklefs	Jodi	M	5155748437					jodi.ricklefs2@unitypoint.org	1776 West Lakes Parkway	Suite 400	West Des Moines	IA	50266	09/19/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Medicare Coordinator	CEO	Mr	Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Medicare Part D Opioid Overutilization Contact	Pharmacist		Huber	Michelle		7122247223				7122247251	michelle.huber@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	02/11/2022	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Medication Therapy Management Contact	Pharmacist		Huber	Michelle		7128981996				7122247250	Michelle.Huber@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	10/17/2019	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part C Application Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part D Appeals	COO		Smith	Wendy						7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	11/03/2022	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active	8887223713				PACE - Nat		C	San Francisco
H8424	Part D Application Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part D Benefits Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part D Claims Submission Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part D Exceptions Contact	COO		Smith	Wendy						7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	11/03/2022	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active	8887223713				PACE - Nat		C	San Francisco
H8424	Part D Price File Contact (Back-up)	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part D Price File Contact (Primary)	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part D Quality Assurance Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Part D Reporting Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Patient Safety Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Payment Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Pharmacy Director	Pharmacist		Huber	Michelle		7128981996				7122247254	Michelle.Huber@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	09/07/2017	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Pharmacy Network Management Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Pharmacy Technical Help Desk Contact	COO		Smith	Wendy						7122247253	Wendy.smith@unitypoint.org	Siouxland PACE		Sioux City	IA	51103	11/03/2022	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active	7122247256				PACE - Nat		C	San Francisco
H8424	Plan Directory Contact for Public Website	CEO		Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Plan to Plan Reconciliation Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Processor Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Quality Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Reconciliation Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Recovery Audit Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Surveillance Contact	COO	Ms	Smith	Wendy		7122247316				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	11/03/2022	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	System Contact	CEO		Swanstrom	Matt		5154719702				5152414238	matt.swanstrom@unitypoint.org	1776 Westlakes Pkwy	Suite 400	West Des Moines	IA	50266	05/08/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Third Party Administrator (TPA) Liaison	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	User Access Contact	Information Security Officer	Ms	Wilson	Dorrie	J	7122793649					dorrie.wilson@unitypoint.org	1776 West Lakes Parkway		West Des Moines	IA	50266	04/21/2025	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Utilization Management Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8424	Utilization Review Contact	COO	Ms	Smith	Wendy		7122247223				7122247253	Wendy.smith@unitypoint.org	1200 Tri View Ave.		Sioux City	IA	51103	08/14/2024	2026	SIOUXLAND PACE, INC.	National PACE	UnityPoint Health PACE Senior Care	National PACE		Iowa Health System	657	Yes	Active					PACE - Nat		C	San Francisco
H8432	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H8432	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H8432	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H8432	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8432	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM HP, LLC.	Local CCP	Anthem Blue Cross and Blue Shield HP	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8457	Agent/Broker Compensation Data Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Automated TrOOP Balance Transfer Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Backup User Access Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Best Available Evidence Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Bid Audit Contact			Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Bid Audit Site Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Bid Primary Contact		Mr.	Granow	Les		5614440709					Les.Granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	CAP Report Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	CEO - CMS Administrator Contact		Mr.	Lerer	Ben		5614440780					Ben.lerer@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H8457	CEO - Senior Official for Contracting		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Chief Financial Officer		Mr.	Granow	Les		5614440709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Chief Operating Officer		Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Chief Information Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Chief Information Security Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	CMS Casework Communication Contact			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Complaints Tracking Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Contact for Fraud Investigations			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Coordination of Benefits Contact		Ms.	Crowl	Lacey		7657921412					Lacey.crowl@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Corporate Mailing						5616901134					compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Customer Service Operations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	DIR Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H8457	DIR Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Discount Program Payment Contact		Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	Longevity Health Plan	485 Madison Avenue Suite 202	New York	NY	10022	05/30/2025	2026	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	Seattle
H8457	Electronic Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Emergency Part D Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Emergency Part D Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Encounter Data & Risk Adjustment Operations Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Enrollment Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	EOB Transfer Contact		Ms.	Socoski	Beth		5616901134				5616901134	Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Financial Audit Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Financial Reporting Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Formulary Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Formulary Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	General Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Government Relations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	HIPAA Privacy Officer	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	HIPAA Security Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Hospice Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Interoperability Contact	CIO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	MA Appeals/Grievances Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	MA Claims Processing Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Marketing Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Medical Director		Mr.	Orgain	Javette		3127206656					javette.orgain@longevityhealthplan.com	Longevity Health Plan	1611 Church Street	Evanston	IL	60201	05/30/2025	2026	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	Seattle
H8457	Medicare Compliance Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Medicare Coordinator	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Medicare Part D Opioid Overutilization Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Medication Therapy Management Contact		Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	OffShore Subcontractor Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part C Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part C Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H8457	Part D Appeals Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H8457	Part D Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part D Benefits Contact		Mr.	Latko	Jeff		6363352997					JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H8457	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		8002040016					Rosario_dovico@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H8457	Part D Exceptions Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H8457	Part D Price File Contact (Back-up)	Product Manager Advisor	Ms.	Williams	Stephanie		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part D Price File Contact (Optional)	Medicare Compliance Director	Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part D Price File Contact (Primary)	sr mgr, Government Programs		Dolfi	Amanda		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part D Quality Assurance Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Part D Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Patient Safety Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Payment Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Personal Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Pharmacy Director	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		8002040016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Pharmacy Network Management Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						8882358551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H8457	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Account Manager	Ms.	Lennox	Melyssa							Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	Local CCP	Longevity Health Plan	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H8457	Physician Incentive Contact		Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Plan Directory Contact for Public Website	Medicare Compliance Director	Ms.	Socoski	Beth		8883133609					Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Plan to Plan Reconciliation Contact		Ms.	Ajayi	Bisi		5616328915					bisi.ajayi@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Processor Contact		Mr.	Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Quality Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Reconciliation Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Reconciliation Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Recovery Audit Contact	VP Compliance	Ms.	Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	SNP Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	SNP State Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Surveillance Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	System Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Third Party Administrator (TPA) Liaison	COO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	User Access Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Utilization Management Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8457	Utilization Review Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H8459	Part C Application Contact			Waschevski	Susan		3175093202					swaschevski@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	11/02/2025	2026	CPV EAST ST. LOUIS, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H8459	Part D Application Contact			Waschevski	Susan		3175093202					swaschevski@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	11/02/2025	2026	CPV EAST ST. LOUIS, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H8481	Agent/Broker Compensation Data Contact	Supervisor, Medicare Sales		Guzman	Tati		8089485463				8089486585	tati_guzman@hmsa.com	P.O. Box 860	8 AMS	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Automated TrOOP Balance Transfer Contact	Senior Business Analyst		Kalino	Karen		8089486262				8089486585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Backup User Access Contact	VP, Chief Compliance Officer		Nakamura	Carrie		8089485369					carrie_nakamura@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Best Available Evidence Contact	Manager, IO Liaison Enrollment		Makio	Lani		8089486215				8089486285	lani_makio@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Bid Audit Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Bid Audit Site Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Bid Primary Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Rivad	Maila		8089485767				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	CEO - CMS Administrator Contact	CEO	Mr.	Mugiishi	Mark		8089485021				8089485999	mark_mugiishi@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	CEO - Senior Official for Contracting	CEO	Mr.	Mugiishi	Mark		8089485021				8089485999	mark_mugiishi@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Chief Financial Officer	EVP, Chief Financial Officer	Ms.	Smith	Xuejun		8089486621					jenny_smith@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Chief Operating Officer	President and  COO	Ms.	Smith	Jenny		8089486621				8089485999	Jenny_smith@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Chief Information Officer	EVP and Chief Information Officer	Mr.	Hopfer	Rick		8089486025				8089485999	rick_hopfer@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Chief Information Security Officer	CISO	Mr.	Gummadi	Sudhakar		8087434389				8089527580	sudhakar_gummadi@hmsa.com	P.O. Box 860	10 - IPP	Honolulu	HI	96808	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	CMMI Model Point of Contact	Manager, Medicare Programs		Lyons	Malia		8089485191				8089486887	malia_lyons@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	CMS Casework Communication Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		8089485347				8089527546	Renee_Hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Complaints Tracking Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		8089485347				8089527546	renee_hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Contact for Fraud Investigations	Director, Special Investigations Unit		Aronson	Virginya		8089528548					virginya_aronson@hmsa.com	P.O. Box 860	10 SIU	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Coordination of Benefits Contact	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Corporate Mailing						8089486000					!MedicarePrograms@hmsa.com	P.O. Box 860	9 - MP	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Customer Service Operations Contact	Senior Manager, Customer Relations		Forsyth	Clarice		8089485224				8089485567	Customer-service@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	DIR Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	DIR Contact (Secondary)	Sr Business Analyst		Smith	Nicolette		8089485631					nicolette_smith@hmsa.com	P.O. Box 860	6 - FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Discount Program Payment Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Emergency Part D Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Emergency Part D Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus		8089527772				8089485618	medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Encounter Data & Risk Adjustment Operations Contact	Manager, Financial Services - HMO & Govt Reporting		Nakashima	Mark		8089486594				8089485063	mark_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Enrollment Contact	Manager, IO Liaison Enrollment		Makio	Lani		8089486215				8089486285	lani_makio@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	EOB Transfer Contact	Senior Business Analyst, Medicare Programs		Refuerzo	Marilou		8084970295				8089486585	marilou_refuerzo@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Financial Audit Contact	Director, Government Accounting and Reporting	Ms.	Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Financial Reporting Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Formulary Contact	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Formulary Contact (Secondary)	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	General Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Government Relations Contact	SVP, Government		Diesman	Jennifer		8085616397				8089486860	jennifer_diesman@hmsa.com	P.O. Box 860	11 EXEC	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	HIPAA Privacy Officer	AVP, Compliance & Prv Officer		Borje-Bonkowski	Maria		8089486205					maria_borje-bonkowski@hmsa.com	P.O. Box 860	10 - C&E	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	HIPAA Security Officer	CISO	Mr.	Gummadi	Sudhakar		8087434389				8089527580	sudhakar_gummadi@hmsa.com	P.O. Box 860	10 - IPP	Honolulu	HI	96808	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Hospice Contact	Business Analyst - Medicare Part D		Kanda	Jordan		8089527749				8089485611	jordan_kanda@hmsa.com	P.O. Box 860	10 - KB-PM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Interoperability Contact	VP, Health Data Integ & Analytic		Dobbs	David	C	8089486030					david_dobbs@hmsa.com	P.O. Box 860	6 CORP	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	MA Appeals/Grievances Contact	Senior Manager, Member Advocacy and Appeals		Inouye	Marissa		8089527792				8089527546	marissa_inouye@hmsa.com	P.O. Box 860		Honolulu	HI	96808	10/17/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	MA Claims Processing Contact for Public Website	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Marketing Contact	Sr. Business Analyst		Peters	Kristen	A	8089481180					Kristen_Peters@HMSA.com	PO Box 860	8 - MP	Honolulu	HI	96814	07/01/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Medical Director	Medicare Medical Director		Percy	David		8089486252				8089486340	david_percy@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Medicare Compliance Officer	AVP, Regulatory Compliance and SIU	Ms.	Aronson	Virginya		8089528548				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Medicare Coordinator	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	02/10/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Medication Therapy Management Contact	BH Business Analyst		Francis	Teesha		8089527564					teesha_francis@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	OffShore Subcontractor Contact	Manager, Medicare Programs		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Online Enrollment Center Contact (Optional)	Sr. Business Analyst		Peters	Kristen	A	8089481180					Kristen_Peters@HMSA.com	PO Box 860	8 - MP	Honolulu	HI	96814	07/01/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Online Enrollment Center Contact (Primary)	Manager, IO Liaison Enrollment		Makio	Lani		8089486215				8089486285	lani_makio@hmsa.com	P.O. Box 860	7 MS	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part C Application Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part C Reporting Contact	Manager, Medicare Program		Hishinuma	Nathan		8089527823				8089486687	nathan_hishinuma@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Appeals	Senior Manager, Member Advocacy and Appeals		Inouye	Marissa						8089527546	marissa_inouye@hmsa.com	P.O. Box 860		Honolulu	HI	96808	10/17/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8089527792				PPO - BBA		C	San Francisco
H8481	Part D Appeals Contact (Secondary)	Senior Business Analyst		Kalino	Karen						8089486585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8089486262				PPO - BBA		C	San Francisco
H8481	Part D Application Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Benefits Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Claims Submission Contact	Manager, Financial Services - HMO & Govt Reporting		Nakashima	Mark		8089486594				8089485063	mark_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Exceptions Contact	Clinical Pharmacist, Government Programs		Iwaishi	Brandon							Brandon_Iwaishi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8089485618				PPO - BBA		C	San Francisco
H8481	Part D Exceptions Contact (Secondary)	Manager, Clinical Pharmacy		Kuniyoshi	Derek							derek_kuniyoshi@hmsa.com	P.O. Box 860	10-KB-PM	Honolulu	HI	96808	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8004622085				PPO - BBA		C	San Francisco
H8481	Part D Price File Contact (Back-up)	Manager of Financial Operations		Albert	Sebastian		4802519123					Sebastian.Albert2@cvshealth.com	9501 E Shea Blvd	CVS Caremark	Scottsdale	AZ	85260	10/10/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Price File Contact (Optional)	Program Manager   PBM Finance Operations		Pertgen	Richard		8045258502					Richard.Pertgen@cvshealth.com	9501 E. Shea Blvd. MC080	CVS Caremark	Scottsdale	AZ	85260	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Price File Contact (Primary)	Sr. Analyst		Scott	Sara		4803109219					sarah.scott@cvshealth.com	9501 E. Shea Blvd.	CVS Caremark	Scottsdale	AZ	85260	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Quality Assurance Contact	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Part D Reporting Contact	Medicare Compliance Officer	Ms.	Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	11/06/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Patient Safety Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Payment Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Pharmacy Director	Director, Pharmacy Operations		Goo	Roy		8082225910					roy_goo@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Pharmacy Network Management Contact	Director		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd., MC080	CVS Caremark	Scottsdale	AZ	85260	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Pharmacy Network Management Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Pharmacy Technical Help Desk Contact	Sr. Manager		Stauffer	Grace							grace.stauffer@cvshealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8666934620				PPO - BBA		C	San Francisco
H8481	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus							medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active	8089527772				PPO - BBA		C	San Francisco
H8481	Plan Directory Contact for Public Website	Manager, Medicare Program		Hishinuma	Nathan		8089527823				8089527823	nathan_hishinuma@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Plan to Plan Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Processor Contact	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Quality Contact	Director, Medicare Stars		Loo	Trisha		8089486103					Trisha_Loo@hmsa.com	P.O. Box 860	6-QM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Reconciliation Contact (Secondary)	Sr Business Analyst		Smith	Nicolette		8089485631					nicolette_smith@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Recovery Audit Contact	Director, Government Accounting and Reporting	Ms.	Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	SNP Application Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	SNP State Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Surveillance Contact	Supervisor, Medicare Sales		Guzman	Tati		8089485463				8089486585	tati_guzman@hmsa.com	P.O. Box 860	8 AMS	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	System Contact	Solution Delivery Advisor		Ng	Philip		8089486688				8089486799	philip_ng@hmsa.com	P.O. Box 860	5 - IS	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Third Party Administrator (TPA) Liaison	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	User Access Contact	Medicare Compliance Officer	Ms.	Rivad	Maila		8089485767				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Utilization Management Contact	Director, Utilization Management		Hoppe	Miki		8089486739				8089445611	miki_hoppe@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8481	Utilization Review Contact	Director, Utilization Management		Hoppe	Miki		8089486739				8089445611	miki_hoppe@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	01/23/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	Local CCP	HMSA Akamai Advantage Dual Care	Local PPO		Hawaii Medical Service Association	107	Yes	Active					PPO - BBA		C	San Francisco
H8492	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms	Mohning	Kathleen		6154302306					kmohning@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Automated TrOOP Balance Transfer Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Backup User Access Contact	Compliance Officer	Ms	Ward	Debbie		4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Best Available Evidence Contact	Manager, Enrollment		Mohning	Kathleen		6154302306					kmohning@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	CAP Report Contact for Public Website	Compliance Officer	Ms	Ward	Debbie		4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	4054046691				HMO - Health Maintenance Organization		C	Dallas
H8492	CEO - CMS Administrator Contact	Chief Operating Officer	Mrs.	Bradley	Robin		6154815109					rbradley@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	CEO - Senior Official for Contracting	Chief Executive Officer	Mr	Bailey	Michael		4054046691					mbailey@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Chief Financial Officer	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Chief Operating Officer	Chief Operating Officer	Mrs.	Bradley	Robin		6154815109					rbradley@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Chief Information Officer	Chief Information Officer	Mr	Shermer	Barry		6156967173					bshermer@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Chief Information Security Officer	Chief Information Officer	Mr	Shermer	Barry		6156967173					bshermer@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	CMS Casework Communication Contact	Manager, Enrollment	Mrs.	Mohning	Kathleen		6154302306					kmohning@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Complaints Tracking Contact	Compliance Officer		Ward	Debbie		4054046691					dward@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	07/03/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Contact for Fraud Investigations	Compliance Officer		Ward	Debbie		4054046691					dward@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	07/03/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Coordination of Benefits Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Corporate Mailing						2259648581					dharvey@digntyhmo.com	950 Causeway Approach		Mandeville	LA	70471	08/25/2020	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Customer Service Operations Contact	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8662666010					abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	DIR Contact	Senior Director Government Programs		Farmer	Jim		3308886098					jfarmer@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	DIR Contact (Secondary)	Analyst III Government Programs		Houchens	Logan		3308886095					lhouchens@elixirsolutions.com	835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms	Tilley	Stephanie		9312420499					stilley@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Emergency Part D Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Emergency Part D Contact (Secondary)	PHarmacy Operations		Sanchez	Lynn		4057066535					lsanchez@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Encounter Data & Risk Adjustment Operations Contact	SVP, Operations	Mr	Haney	Jason		3149607231					jhaney@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Enrollment Contact	Manager, Enrollment	Mrs.	Mohning	Kathleen		6154302306					kmohning@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154302306				8662805656	kmohning@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Financial Audit Contact	Health Plan Compliance Officer	Mrs	Ward	Debbie		4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Formulary Contact (Secondary)	Director Formulary Operation		Singh	Roop		3304866482					rsingh@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	General Contact	Chief Operating Officer	Mrs.	Bradley	Robin		6154815109					rbradley@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Government Relations Contact	Compliance Officer	Ms.	Ward	Debbie		4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	HIPAA Privacy Officer	Compliance Officer		Ward	Debbie		4054046691					dward@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	07/03/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	HIPAA Security Officer	Compliance Officer		Ward	Debbie		4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Hospice Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Interoperability Contact	Sr Director, Health Plan Administration		Brimm	Angie		6153900555					abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration		Brimm	Angie		8662666010					abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8662666010					CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Marketing Contact	Compliance Manager		Burguieres	Fredrick		4054046691					rburguieres@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	07/03/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Medical Director	Medical Director		Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	04/10/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Medicare Compliance Officer	Compliance Officer	Ms.	Ward	Debbie		4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Medicare Coordinator	SVP, Operations	Mr	Haney	Jason		3149607231					jhaney@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Medicare Part D Opioid Overutilization Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Medication Therapy Management Contact	VP, Pharmacy Solutions		Miller	Holly		3302931916					hmiller@healthdialog.com	7835 Freedom Avenue NW	Suite #100	North Canton	OH	44720	12/05/2022	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part C Application Contact	VP, Government Programs	Ms	Foote	Denise		6156568049					dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part C Reporting Contact	COO	Mrs	Ward	Debbie	R	4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Appeals	Pharmacy Director		Roper	Lisa						3304058081	Appeals@elixirsolutions.com	Elixir c/o Dignity Health Plan ATTN: Clinical Services	7835 Freedom Avenue NW	North Canton	OH	44720	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3303449571	0409			HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Appeals Contact (Secondary)	Supervisor, Clinical Operations		Binegar	Sam						3304058081	Appeals@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3303449571	0409			HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Application Contact	VP, Government Programs	Ms.	Foote	Denise		6156568049					dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Benefits Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Claims Submission Contact			Voss	Laurie		2342123780					lvoss@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Exceptions Contact	Pharmacy Director		Roper	Lisa						3304058081	lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3303449571	0409			HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr.	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/17/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Price File Contact (Optional)	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Quality Assurance Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Part D Reporting Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Patient Safety Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Pharmacy Director	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Pharmacy Network Management Contact	Director Pharmacy Network Development and Operatio		Profio	Lauren		3304864864				3304058094	lprofio@elixirsolutions.com	7835 Freedom Avenue NW		North Canton	OH	44720	12/05/2022	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	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	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8336611989				HMO - Health Maintenance Organization		C	Dallas
H8492	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8662666010					abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Processor Contact	Pharmacy Director		Roper	Lisa		4058262110					lroper@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/21/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Quality Contact	Director, Quality and Care Coordination		Anderson	Rebecca		4054712919					banderson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Recovery Audit Contact	Compliance Officer	Ms.	Ward	Debbie		4054046691					dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	SNP Application Contact	SVP, Operations	Mr	Haney	Jason		3149607231					jhaney@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Surveillance Contact	Compliance Officer	Ms.	Ward	Debbie		4054046691					dward@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	07/03/2023	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	System Contact	Chief Information Officer	Mr	Shermer	Barry		6156967173					bshermer@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms	Tilley	Stephanie		9312420499					stilley@amhealthplans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	User Access Contact	Chief Information Officer	Mr	Shermer	Barry		6156967173					bshermer@amhealthpartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	03/06/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Utilization Management Contact	Director, Utilization Management	Ms	Nelson	Susie		6156365478					snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8492	Utilization Review Contact	Director, Utilization Management	Ms	Nelson	Susie		6156365478					snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	DIGNITY CARE CORPORATION	Local CCP	American Health Advantage of Louisiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8547	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Chicago
H8547	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H8547	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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	Chicago
H8547	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H8547	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Chicago
H8547	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/09/2020	2026	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	Chicago
H8547	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	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	Chicago
H8547	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H8547	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H8547	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H8547	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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	Chicago
H8547	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H8547	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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	Chicago
H8547	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	Chicago
H8547	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H8547	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	01/13/2020	2026	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	Chicago
H8547	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127771670	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H8547	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Chicago
H8547	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	Chicago
H8547	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H8547	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/13/2020	2026	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	Chicago
H8547	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Chicago
H8547	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H8547	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Chicago
H8547	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Chicago
H8547	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Chicago
H8547	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/09/2020	2026	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	Chicago
H8547	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Chicago
H8547	Formulary Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Chicago
H8547	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	Chicago
H8547	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H8547	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	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	Chicago
H8547	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	01/13/2020	2026	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	Chicago
H8547	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	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	Chicago
H8547	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	Chicago
H8547	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H8547	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Chicago
H8547	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Chicago
H8547	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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	Chicago
H8547	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Chicago
H8547	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Chicago
H8547	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	Chicago
H8547	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H8547	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Chicago
H8547	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Chicago
H8547	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H8547	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	Part D Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	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	8006936651				HMO - Health Maintenance Organization		C	Chicago
H8547	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	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	8006936651				HMO - Health Maintenance Organization		C	Chicago
H8547	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H8547	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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	Chicago
H8547	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	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	Chicago
H8547	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	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	8006936651				HMO - Health Maintenance Organization		C	Chicago
H8547	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/22/2025	2026	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	8006936651				HMO - Health Maintenance Organization		C	Chicago
H8547	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Chicago
H8547	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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	Chicago
H8547	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H8547	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H8547	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/13/2020	2026	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	Chicago
H8547	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Chicago
H8547	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	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	Chicago
H8547	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Chicago
H8547	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Chicago
H8547	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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	Chicago
H8547	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	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	8772777898				HMO - Health Maintenance Organization		C	Chicago
H8547	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/23/2022	2026	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	0000000000				HMO - Health Maintenance Organization		C	Chicago
H8547	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	01/13/2020	2026	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	Chicago
H8547	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	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	Chicago
H8547	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Chicago
H8547	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Chicago
H8547	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Chicago
H8547	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Chicago
H8547	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Chicago
H8547	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H8547	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Chicago
H8547	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Chicago
H8547	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Chicago
H8547	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/13/2020	2026	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	Chicago
H8547	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Chicago
H8547	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	01/13/2020	2026	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	Chicago
H8547	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	01/13/2020	2026	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	Chicago
H8552	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H8552	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H8552	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				PPO - BBA		C	Chicago
H8552	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				PPO - BBA		C	Chicago
H8552	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H8552	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				PPO - BBA		C	Chicago
H8552	PHR Beneficiary Contact																	03/15/2022	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				PPO - BBA		C	Chicago
H8552	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8552	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	Local CCP	Anthem Blue Cross Life and Health Insurance Company	Local PPO		Elevance Health, Inc.	1	Yes	Active					PPO - BBA		C	Chicago
H8554	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8554	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127771330	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H8554	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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	Dallas
H8554	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8554	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/03/2022	2026	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	Dallas
H8554	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H8554	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482					Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/03/2022	2026	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	Dallas
H8554	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8554	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H8554	CEO - Senior Official for Contracting	President, CEO and Chair of Board	Ms.	Grober	Stephania		9185513202				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1400 S Boston Ave	Tulsa	OK	74119	05/29/2025	2026	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	Dallas
H8554	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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	Dallas
H8554	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8554	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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	Dallas
H8554	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	Dallas
H8554	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8554	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Dallas
H8554	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127771330	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H8554	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	Dallas
H8554	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	Dallas
H8554	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8554	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Dallas
H8554	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Dallas
H8554	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H8554	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8554	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H8554	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127771330	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H8554	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H8554	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Dallas
H8554	Formulary Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Dallas
H8554	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	Dallas
H8554	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8554	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	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	Dallas
H8554	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	03/25/2019	2026	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	Dallas
H8554	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	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	Dallas
H8554	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	Dallas
H8554	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8554	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Dallas
H8554	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8554	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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	Dallas
H8554	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H8554	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Dallas
H8554	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	Dallas
H8554	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8554	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H8554	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H8554	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8554	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	Part D Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8554	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/22/2025	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8554	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8554	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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	Dallas
H8554	Part D Claims Submission Contact	Functional Business Consultant	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	08/09/2019	2026	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	Dallas
H8554	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8554	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/22/2025	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H8554	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H8554	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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	Dallas
H8554	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8554	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8554	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Dallas
H8554	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H8554	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	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	Dallas
H8554	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H8554	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H8554	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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	Dallas
H8554	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8772777898				HMO - Health Maintenance Organization		C	Dallas
H8554	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/23/2022	2026	GHS INSURANCE COMPANY	Local CCP	Blue Cross and Blue Shield of OK, TX	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	0000000000				HMO - Health Maintenance Organization		C	Dallas
H8554	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	09/21/2018	2026	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	Dallas
H8554	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8554	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Dallas
H8554	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8554	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H8554	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Dallas
H8554	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8554	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8554	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H8554	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H8554	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H8554	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	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	Dallas
H8554	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Dallas
H8554	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	06/09/2017	2026	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	Dallas
H8554	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	06/09/2017	2026	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	Dallas
H8561	Automated TrOOP Balance Transfer Contact	CFO	Mrs	Medina	Margarita		5596644406					mmedina@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Backup User Access Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Best Available Evidence Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Bid Primary Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	CAP Report Contact for Public Website	COO	Mrs	Howland	Christine		5596644062					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending	5596644406				PACE - Nat		C	San Francisco
H8561	CEO - CMS Administrator Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	CEO - Senior Official for Contracting	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Chief Financial Officer	CFO	Mrs	Medina	Margarita		5596644406					mmedina@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Chief Operating Officer	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Chief Information Officer	CIO	Mr	Gaskin	Michael		5596644010					mgaskin@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Chief Information Security Officer	CIO	Mr	Gaskin	Michael		5596644010					mgaskin@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	CMS Casework Communication Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Complaints Tracking Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Contact for Fraud Investigations	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Coordination of Benefits Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Corporate Mailing						5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Customer Service Operations Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	DIR Contact	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	DIR Contact (Secondary)	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Discount Program Payment Contact	CFO	Mrs	Medina	Margarita		5596644406					mmedina@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Emergency Part D Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Emergency Part D Contact (Secondary)	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Encounter Data & Risk Adjustment Operations Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Enrollment Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	EOB Transfer Contact	COO	Mrs	Howland	Christine		5596644142				5596644406	chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Financial Audit Contact	CFO	Mrs	Medina	Margarita		5596644406					mmedina@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Financial Reporting Contact	CFO	Mrs	Medina	Margarita		5596644406					mmedina@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Formulary Contact	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Formulary Contact (Secondary)	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	General Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Government Relations Contact	Chief Strategy Officer	Mrs	Mosqueda	Nichole		5596644339					nmosqueda@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	HIPAA Privacy Officer	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	HIPAA Security Officer	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Interoperability Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	MA Appeals/Grievances Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	MA Claims Processing Contact for Public Website	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Marketing Contact	Chief Strategy Officer	Mrs	Mosqueda	Nichole		5596644339					nmosqueda@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Medical Director	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Medicare Compliance Officer		Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Medicare Coordinator	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Medicare Part D Opioid Overutilization Contact	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Medication Therapy Management Contact	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	OffShore Subcontractor Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Online Enrollment Center Contact (Back-up)	Chief of Health Center Operations	Mrs	Serrano-Monson	Lilia		5596644383					lsmonson@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Online Enrollment Center Contact (Primary)	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part C Application Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street, Suite 202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part D Appeals	CMO	Dr	Ramirez	Joel							jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending	5596644360				PACE - Nat		C	San Francisco
H8561	Part D Appeals Contact (Secondary)	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor							lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending	5596644086				PACE - Nat		C	San Francisco
H8561	Part D Application Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street, Suite 202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part D Benefits Contact	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part D Claims Submission Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part D Exceptions Contact	COO	Mrs	Howland	Christine							chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending	5596644142				PACE - Nat		C	San Francisco
H8561	Part D Exceptions Contact (Secondary)	CMO	Dr	Ramirez	Joel							jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending	5596644360				PACE - Nat		C	San Francisco
H8561	Part D Price File Contact (Back-up)	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part D Price File Contact (Primary)	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part D Quality Assurance Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Part D Reporting Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Patient Safety Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Payment Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Personal Health Record Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Pharmacy Director	Clinical Pharmacist	Mr	Snowden	Stanley		5596644304					ssnowden@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Pharmacy Network Management Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Pharmacy Network Management Contact (Secondary)	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Pharmacy Technical Help Desk Contact	Clinical Pharmacist	Mr	Snowden	Stanley							ssnowden@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending	5596644304				PACE - Nat		C	San Francisco
H8561	Pharmacy Technical Help Desk Contact (Secondary)	CMO	Dr	Ramirez	Joel							jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending	5596644360				PACE - Nat		C	San Francisco
H8561	PHR Beneficiary Contact																	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE	Camarena Health	Camarena Health, Inc.	846	Yes	Pending	5596644062				PACE - Nat		C	San Francisco
H8561	Plan Directory Contact for Public Website	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Plan to Plan Reconciliation Contact	CMO	Dr	Ramirez	Joel		5596644360					jramirez@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Processor Contact	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Quality Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Reconciliation Contact	CFO	Mrs	Medina	Margarita		5596644406					mmedina@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Reconciliation Contact (Secondary)	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Recovery Audit Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Surveillance Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	System Contact	CEO	Mr	Soares	Paulo		5596644089					psoares@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Third Party Administrator (TPA) Liaison	COO	Mrs	Howland	Christine		5596644142					chowland@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	User Access Contact	Chief of Health Center Operations	Mrs	Serrano-Monson	Lilia		5596644383					lsmonson@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Utilization Management Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8561	Utilization Review Contact	Chief Quality & Compliance Officer	Mrs	Seiler	Leonor		5596644086					lseiler@camarenahealth.org	730 N. I Street #202		Madera	CA	93637	03/08/2024	2026	CAMARENA HEALTH, INC.	National PACE	Camarena Health, Inc.	National PACE		Camarena Health, Inc.	846	Yes	Pending					PACE - Nat		C	San Francisco
H8573	Automated TrOOP Balance Transfer Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Backup User Access Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Best Available Evidence Contact	Executive Director		Gagliano	Melissa		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Bid Primary Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	CAP Report Contact for Public Website	Network Marketing Director		Hull	Leigh		7327164600				7325923501	lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	CEO - CMS Administrator Contact	CEO	Mrs	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	CEO - Senior Official for Contracting	Executive Director	Mr.	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		4437610607					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Chief Operating Officer	Executive Director	Mr.	Tango	Jay		7327164600				7325923500	jtango@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Chief Information Officer	Chief Financial Officer	Mr	Schlesinger	David		4437610607					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Chief Information Security Officer	Chief Financial Officer	Mr	Schlesinger	David		4437610607					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	CMS Casework Communication Contact	Executive Director		Gagliano	Melissa		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Complaints Tracking Contact	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Contact for Fraud Investigations	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Coordination of Benefits Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Corporate Mailing						7327164600					mgagliano@boldagepace.com	1075 Stephenson Avenue, B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Customer Service Operations Contact	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	DIR Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	DIR Contact (Secondary)	Executive Director	Ms.	Gagliano	Melissa		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Discount Program Payment Contact	Chief Financial Officer	Ms.	Prentiss	Kristin	C	7328063224				7328063324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Emergency Part D Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Emergency Part D Contact (Secondary)	Compliance Director		Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Enrollment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	EOB Transfer Contact	Chief Financial Officer		Schlesinger	David	C	7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David	C	7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Formulary Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Formulary Contact (Secondary)	Executive Director	Ms.	Gagliano	Melissa		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	General Contact	Executive Director	Ms.	Gagliano	Melissa		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Government Relations Contact	Executive Director	Ms.	Cooper	Wanda		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	HIPAA Privacy Officer	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	HIPAA Security Officer	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Interoperability Contact	Compliance Director		Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	MA Appeals/Grievances Contact	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	MA Claims Processing Contact for Public Website	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Marketing Contact	Network Marketing Director	Ms.	Hull	Leigh		7327164600				7325923500	lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Medical Director	Medical Director	Dr.	TBD	TBD		7325923400					WCooper@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Medicare Compliance Officer	Chief Financial Officer	Mr	Schlesinger	David		4437610607					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Medicare Coordinator	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Medicare Part D Opioid Overutilization Contact	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Medication Therapy Management Contact	Compliance Director	Ms.	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	OffShore Subcontractor Contact	CFO	Mrs	Prentis	Kristin		7328063224					kprentiss@acutecarehs.com	106 West Moore Ave, Suite A		Mooresville	NC	28115	12/08/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Online Enrollment Center Contact (Back-up)	CEO	Mrs	Austin	Mary		2156098714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	12/08/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Online Enrollment Center Contact (Primary)	CEO	Mrs	Austin	Mary		2156098714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	12/08/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part C Application Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part D Appeals	Compliance Director	Ms.	Cooper	Wanda						7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	2675751196				PACE - Nat		C	New York
H8573	Part D Appeals Contact (Secondary)	Chief Financial Officer	Ms.	Schlesinger	David						7328063324	dschlesinger@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7328063224				PACE - Nat		C	New York
H8573	Part D Application Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part D Benefits Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part D Claims Submission Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part D Exceptions Contact	Chief Financial Officer	Ms.	Prentiss	Kristin	C					7328063324	kprentiss@acutecarehs.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	1800000000				PACE - Nat		C	New York
H8573	Part D Exceptions Contact (Secondary)	Compliance Director		Cooper	Wanda							WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	2675751196				PACE - Nat		C	New York
H8573	Part D Price File Contact (Back-up)	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part D Price File Contact (Primary)	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part D Quality Assurance Contact	Director of Health Plan Management	Ms.	Ternay	Jennifer		7325923407				7325923507	Jternay@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Part D Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Patient Safety Contact	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Personal Health Record Contact	CEO	Mrs	Austin	Mary		2156098714					maustin@boldagepace.com	134 Mary Hill Road		Phoenixville	PA	19460	12/08/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Pharmacy Director	Compliance Director	Mr.	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Pharmacy Network Management Contact	Compliance Director	Ms.	Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Pharmacy Network Management Contact (Secondary)	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Pharmacy Technical Help Desk Contact			Schlesinger	David							dschlesinger@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7328063224				PACE - Nat		C	New York
H8573	Pharmacy Technical Help Desk Contact (Secondary)			Schlesinger	David							dschlesinger@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7328063224				PACE - Nat		C	New York
H8573	PHR Beneficiary Contact																	12/08/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE	Beacon of Life SC	Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending	7325923400				PACE - Nat		C	New York
H8573	Plan Directory Contact for Public Website	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Processor Contact	Compliance Director	Ms.	Cooper	Wanda		7325923400				7325923500	jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Quality Contact	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Reconciliation Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Reconciliation Contact (Secondary)	CFO	Mrs	Prentis	Kristin		7328063224					kprentiss@acutecarehs.com	106 West Moore Avenue		Mooresville	NC	28115	12/08/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Recovery Audit Contact	Chief Financial Officer	Mr	Schlesinger	David	C	7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Surveillance Contact	Compliance Director		Cooper	Wanda		2675751196				7325923507	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	System Contact	Compliance Director		Cooper	Wanda		2675751196				7325923500	WCooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	User Access Contact	Business Administrator		Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Utilization Management Contact	Executive Director	Ms.	Gagliano	Melissa		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8573	Utilization Review Contact	Executive Director	Ms	Gagliano	Melissa		7325923400				7325923500	mgagliano@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	08/12/2025	2026	BEACON OF LIFE NORTH NJ, LLC	National PACE	Beacon of Life North NJ, LLC	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Pending					PACE - Nat		C	New York
H8578	Agent/Broker Compensation Data Contact	Medicare Sales Manager	Ms.	Fernandes	Sarah		4132332222				4132332222	sfernandes@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/16/2014	2026	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	Boston
H8578	Automated TrOOP Balance Transfer Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2026	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	Boston
H8578	Backup User Access Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Best Available Evidence Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Bid Audit Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Bid Audit Site Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Bid Primary Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	CAP Report Contact for Public Website	Medicare Compliance Program Supervisor	Ms	Powers	Shannon	A	4132333424				4132333424	spowers@hne.com	1414 Main Street	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	4132333055				HMO - Health Maintenance Organization		C	Boston
H8578	CEO - CMS Administrator Contact	President	Mr.	Treash	Kenneth		4137874000					ktreash@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/13/2025	2026	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	Boston
H8578	CEO - Senior Official for Contracting	President	Mr.	Treash	Kenneth		4137874000					ktreash@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/13/2025	2026	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	Boston
H8578	Chief Financial Officer	Chief Financial Officer	Ms.	Cohen	Lisa		4132333024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/26/2022	2026	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	Boston
H8578	Chief Operating Officer	Chief Financial Officer / VP of Operations	Ms.	Cohen	Lisa		4132333024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/30/2023	2026	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	Boston
H8578	Chief Information Officer	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/07/2021	2026	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	Boston
H8578	Chief Information Security Officer	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/07/2021	2026	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	Boston
H8578	CMS Casework Communication Contact	Complaints & Appeals Manager	Mr.	Farrell	James		4132333231				4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	03/01/2018	2026	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	Boston
H8578	Complaints Tracking Contact	Complaints & Appeals Manager	Mr.	Farrell	James		4132333231				4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	03/01/2018	2026	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	Boston
H8578	Contact for Fraud Investigations	Director of Compliance	Ms.	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2026	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	Boston
H8578	Coordination of Benefits Contact	Recovery and Reinsurance Manager	Ms.	Carter	Ronda		4132333353				4132333353	rcarter@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/26/2023	2026	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	Boston
H8578	Corporate Mailing						4137874000				4137343356	soconnor@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/16/2014	2026	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	Boston
H8578	Customer Service Operations Contact	Member Services Supervisor	Ms.	Rivera	Aracelis		4132333209				4132333301	arivera@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	11/14/2023	2026	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	Boston
H8578	DIR Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2026	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	Boston
H8578	DIR Contact (Secondary)	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Discount Program Payment Contact	Director Medicare Program Development		Powers	Shannon		4132333055					spowers@hne.com	One Monarch Place	Springfield, MA 01144	Springfield	MA	01144	04/17/2025	2026	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	Boston
H8578	Emergency Part D Contact	Director of Pharmacy	Mr.	Tereso	Gary		4135311752				4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/28/2022	2026	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	Boston
H8578	Emergency Part D Contact (Secondary)	Director of Compliance	Ms	Tulloch	Charmalee		8607090397					ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	01/04/2024	2026	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	Boston
H8578	Employer Waiver Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Program Manager		Morgan	Stephne		4132333431				4132333431	smorgan@hne.com	One Monarch Place	Suite 1500	Springfield	MA	01144	04/26/2023	2026	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	Boston
H8578	Enrollment Contact	Medicare Enrollment Supervisor	Ms.	Henriques	Christina		4137874000	3232				chenriques@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	05/14/2020	2026	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	Boston
H8578	EOB Transfer Contact	Claims Production Manager	Mr.	Decker	Shawn		4132333087				4132333444	sdecker@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	04/28/2023	2026	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	Boston
H8578	Financial Audit Contact	Director of Accounting	Ms	Faford	Rebecca		4132333371				4132333371	rfaford@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/26/2022	2026	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	Boston
H8578	Financial Reporting Contact	Chief Financial Officer	Ms.	Cohen	Lisa		4132333024					lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/25/2021	2026	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	Boston
H8578	Formulary Contact		Ms.	Maloney	Julia		2242312718					julia.maloney@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/01/2020	2026	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	Boston
H8578	Formulary Contact (Secondary)	Director of Pharmacy	Mr.	Tereso	Gary		4137874000	3420			4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2026	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	Boston
H8578	General Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Government Relations Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	HIPAA Privacy Officer	Director of Compliance	Ms	Tulloch	Charmalee		4132333566					ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	01/04/2024	2026	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	Boston
H8578	HIPAA Security Officer	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/07/2021	2026	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	Boston
H8578	Hospice Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	03/01/2018	2026	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	Boston
H8578	Interoperability Contact	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/07/2021	2026	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	Boston
H8578	MA Appeals/Grievances Contact	Complaints & Appeals Manager	Mr.	Farrell	James		4132333231				4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	03/01/2018	2026	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	Boston
H8578	MA Claims Processing Contact for Public Website	Claims Payment Manager	Ms.	Cifone	Tracy		4132333355				0000000000	tcifone@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	11/14/2023	2026	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	Boston
H8578	Marketing Contact	Director of Marketing & Digital Strategy	Ms.	Cordial	Melissa		4132333180					mcordial@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	11/19/2020	2026	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	Boston
H8578	Medical Director	VP & Chief Medical Officer	Dr	McIntosh	Kate		4132333052					kmcintosh@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/07/2021	2026	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	Boston
H8578	Medicare Compliance Officer	Director of Compliance	Ms	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2026	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	Boston
H8578	Medicare Coordinator	Medicare Program and Implementation Lead	Ms.	Redmond	Vernae'		4132333054					vredmond@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/31/2025	2026	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	Boston
H8578	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Mr.	Tereso	Gary		4132333420				4132333420	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2026	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	Boston
H8578	Medication Therapy Management Contact	Clinical Program Manager	Ms.	Russo	Nicole	B	4013441003					nbrusso@magellanhealth.com	Magellan Rx Management	88 Silva Lane, Tech 4	Middletown	RI	02842	04/23/2018	2026	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	Boston
H8578	OffShore Subcontractor Contact	Director of Compliance	Ms	Tulloch	Charmalee		4132333566				4132333566	ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2026	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	Boston
H8578	Online Enrollment Center Contact (Back-up)	Medicare Enrollment Supervisor		Henriques	Christina		4137874000	3232			4132333232	chenriques@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	05/19/2015	2026	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	Boston
H8578	Online Enrollment Center Contact (Optional)	Director of Revenue Managemen & Recovery	Mr.	Carabine	Daniel		4132333339				4132333339	dcarabine@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/17/2020	2026	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	Boston
H8578	Online Enrollment Center Contact (Primary)	Director of Revenue Management & Recovery	Mr.	Carabine	Daniel		4132333339				4132333339	dcarabine@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/26/2021	2026	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	Boston
H8578	Part C Application Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Part C Reporting Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Part D Appeals	Manager, Prior Authorization		Mourad	Hala							hala.mourad@optum.com	2441 Warrenville Rd	Suite 400	Lisle	IL	60532	01/01/2020	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	6303285837				HMO - Health Maintenance Organization		C	Boston
H8578	Part D Appeals Contact (Secondary)	Complaints & Appeals Supervisor	Mr.	Farrell	James						4132333231	jfarrell@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	05/19/2015	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	4137874000	3231			HMO - Health Maintenance Organization		C	Boston
H8578	Part D Application Contact	Director of Medicare Program Development		Powers	Shannon		4132333055				4132333055	spowers@hne.com	One Monarch Place		Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Part D Benefits Contact	PharmD, Clinical Pharmacist	Mr.	Tereso	Gary		4137874000	3420			4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/07/2008	2026	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	Boston
H8578	Part D Claims Submission Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2026	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	Boston
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	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	6303285837				HMO - Health Maintenance Organization		C	Boston
H8578	Part D Exceptions Contact (Secondary)	Director of Pharmacy	Mr.	Tereso	Gary						4127343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	8008424464	3420			HMO - Health Maintenance Organization		C	Boston
H8578	Part D Price File Contact (Back-up)	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2026	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	Boston
H8578	Part D Price File Contact (Optional)	Director of Pharmacy	Mr.	Tereso	Gary		4137874000	3420			4137343356	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2026	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	Boston
H8578	Part D Price File Contact (Primary)	Sr. Business Analyst	Ms.	Moore-Elliott	Shalandria		7637974305					MedOps-planfinder_DL@ds.uhc.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/14/2022	2026	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	Boston
H8578	Part D Quality Assurance Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2026	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	Boston
H8578	Part D Reporting Contact	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Patient Safety Contact	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2026	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	Boston
H8578	Payment Contact	Chief Financial Officer	Ms.	Cohen	Lisa		4132333024				4132333024	lcohen@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	08/26/2021	2026	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	Boston
H8578	Personal Health Record Contact	Director Population Health Clinical Programs	Ms.	Perracchio	Margaret		4132333058				4132333058	mperracchio@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2026	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	Boston
H8578	Pharmacy Director	Director of Pharmacy	Mr.	Tereso	Gary		4132333420				4132333420	gtereso@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/06/2022	2026	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	Boston
H8578	Pharmacy Network Management Contact			Pham	Katie		8178469722					katie.pham@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/01/2020	2026	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	Boston
H8578	Pharmacy Network Management Contact (Secondary)	Pharmacy Services Specialist	Ms.	Bacaj	Blerina		4132333423				4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	01/01/2020	2026	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	Boston
H8578	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir City	Suite 300	Eden Prairie	MN	55344	12/18/2023	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	8003930395				HMO - Health Maintenance Organization		C	Boston
H8578	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Services Specialist	Ms.	Bacaj	Blerina						4132333423	bbacaj@hne.com	One Monarch Place	Suitr 1500	Springfield	MA	01144	12/23/2019	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS		Baystate Health, Inc.	381	Yes	Active	8774433314	3423			HMO - Health Maintenance Organization		C	Boston
H8578	PHR Beneficiary Contact																	02/15/2008	2026	HEALTH NEW ENGLAND, INC.	Local CCP	Health New England Medicare Advantage Plans	HMO/HMOPOS	Health New England, Inc.	Baystate Health, Inc.	381	Yes	Active	8008424464	3439			HMO - Health Maintenance Organization		C	Boston
H8578	Physician Incentive Contact	VP & Chief Medical Officer	Dr.	McIntosh	Kate		4132333052					kmcintosh@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/07/2021	2026	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	Boston
H8578	Plan Directory Contact for Public Website			Services	Member		8774433314					memberservices@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/05/2015	2026	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	Boston
H8578	Plan to Plan Reconciliation Contact	Assistant Controller	Ms.	Faford	Rebecca		4132333371					rfaford@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/31/2025	2026	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	Boston
H8578	Processor Contact	Senior Manager, Benefits Administration		Cassata	Mercedes		6307809152					mercedes.cassata@optum.com	1600  McConnor Parkway		Schaumburg	IL	60173	01/01/2020	2026	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	Boston
H8578	Quality Contact	Healthcare Quality Improvement Manager	Mr	Rogers	Benjamin		4132333360					brogers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	11/15/2018	2026	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	Boston
H8578	Reconciliation Contact	Director of Pharmacy	Mr	Tereso	Gary		4132333420					gtereso@hne.com	One Monarch Place	Suite 1500	Springfield	MA	01144	06/06/2022	2026	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	Boston
H8578	Reconciliation Contact (Secondary)	Director of Medicare Program Development	Ms.	Powers	Shannon		4132333055				4132333055	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Recovery Audit Contact	Director of Revenue Managemen & Recovery	Mr.	Carabine	Daniel		4132333339				4132333339	dcarabine@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	06/17/2020	2026	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	Boston
H8578	Surveillance Contact	Director of Compliance	Ms	Tulloch	Charmalee		4132333566					ctulloch@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	01/04/2024	2026	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	Boston
H8578	System Contact	IT Security Officer and VP of Information  Tech	Mr.	Hossa	Casey		4132333575					chossa@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	12/07/2021	2026	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	Boston
H8578	Third Party Administrator (TPA) Liaison	Medicare Program and Implementation Lead	Ms.	Redmond	Vernae		4132333054					vredmond@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	10/31/2025	2026	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	Boston
H8578	User Access Contact	Medicare Compliance Program Supervisor	Ms.	Powers	Shannon		4132333424				4132333424	spowers@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/06/2024	2026	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	Boston
H8578	Utilization Management Contact	Director Population Health Clinical Programs	Ms.	Perracchio	Margaret		4132333058				4132333058	mperracchio@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2026	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	Boston
H8578	Utilization Review Contact	Director Population Health Clinical Programs	Ms.	Perracchio	Margaret		4132333058				4132333058	mperracchio@hne.com	Health New England, Inc.	One Monarch Place, Suite 1500	Springfield	MA	01144	09/27/2022	2026	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	Boston
H8597	Agent/Broker Compensation Data Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/26/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/30/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/05/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	12/27/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/09/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H8597	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Plan Directory Contact for Public Website	Lead Director, D-SNP Program Management		Penn	Linda		6827600262					PennL1@aetna.com	CVS Irving Tower	750 W. John Carpenter Freeway	Irving	TX	75039	06/21/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	SNP State Contact	Executive Director, National Duals Program		Hughes	Angelique		2482700990					hughesa1@aetna.com	2 Town Square, Suite 275		Southfield	MI	48076	12/09/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Surveillance Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	06/26/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	System Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	06/26/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8597	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA BETTER HEALTH OF TEXAS INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8604	Agent/Broker Compensation Data Contact	Director, Medicare Sales		Christian	Cindy		3308342303					CChristian@healthplan.org	The Health Plan	100 Lillian Gish Blvd	Massillon	OH	44647	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Automated TrOOP Balance Transfer Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Backup User Access Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Best Available Evidence Contact	Manager Medicare Enrollment		Bliss	Tonya		7406996990				7406996164	tbliss@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Bid Audit Contact	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Bid Audit Site Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Bid Primary Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	CAP Report Contact for Public Website	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	CEO - CMS Administrator Contact	VP of Medicare	Ms	Pennybacker	Vicki		3042805069					VickiP@healthplan.org	The Health Plan	1110 Main Streeet	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	CEO - Senior Official for Contracting	CEO	Mr	Knight	Jeff		7406957585					JeffK@healthplan.org	The Health Plan	1110 Main Streeet	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Chief Financial Officer	Chief Financial Officer	Mr	Ralston	Ryan		7406996236				7406996161	rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Chief Operating Officer	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Chief Information Officer	CIO	Mr	Bryan	Ken		7406957877					kbyran@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Chief Information Security Officer	Director, IT Security	Mr.	Brossman	Phil		7406957694					pbros@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	CMS Casework Communication Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Complaints Tracking Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Contact for Fraud Investigations	Director SIU		Howell	Rich		7406957665					rhowell@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Coordination of Benefits Contact	Manager COB		Fetty	Jackie		7406957699				7406996163	jfetty@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Corporate Mailing						7406953585					info@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Customer Service Operations Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	DIR Contact	Controller		Marsh	Jane		7406996121					jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	DIR Contact (Secondary)	Chief Financial Officer		Ralston	Ryan		7406996236					rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Discount Program Payment Contact	Assistant Controller	Mr	Blinco	David		7406996151				7406996161	dblinco@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Emergency Part D Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Emergency Part D Contact (Secondary)	Director, Pharmacy Services		Peluchette	Katelyn		3046392392				3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Employer Waiver Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment		Davis	Matt		7406996283					mdavis@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Enrollment Contact	Manager Medicare Enrollment		Bliss	Tonya		7406996990				7406996164	tbliss@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	EOB Transfer Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Financial Audit Contact	VP of Medicare	Ms	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	09/25/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Financial Reporting Contact	Chief Financial Officer	Mr	Ralston	Ryan		7406996236				7406996161	rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Formulary Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Formulary Contact (Secondary)	Director, Pharmacy Services		Peluchette	Katelyn		3046392392				3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	General Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Government Relations Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	HIPAA Privacy Officer	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	HIPAA Security Officer	Director, IT Security	Mr.	Brossman	Phil		7406957694					pbros@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Hospice Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Interoperability Contact	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	1110 Main Street		Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	MA Appeals/Grievances Contact	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	MA Claims Processing Contact for Public Website	Manager Medicare Claims		Westfall	Vickie		7406957636				7406996163	VickieW@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Marketing Contact	Director, Medicare Sales		Christian	Cindy		3308342303					CChristian@healthplan.org	The Health Plan	100 Lillian Gish Blvd	Massillon	OH	44647	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Medical Director	Medical Director	Dr	Cross	Robert		7406996976				7406955297	rcross@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Medicare Compliance Officer	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Medicare Coordinator	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Medicare Part D Opioid Overutilization Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Medication Therapy Management Contact	Director, Clinical & Trend Solutions		Muralidharan	Adrienne		3143131932					AMuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	OffShore Subcontractor Contact	VP, Compliance		Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Online Enrollment Center Contact (Back-up)	Enrollment Service Representative		Fleming-Henry	Nicole		7406996253					nhenry@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	10/16/2025	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Online Enrollment Center Contact (Primary)	Manager Medicare Enrollment		Bliss	Tonya		7406996990				7406996164	tbliss@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part C Application Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part C Reporting Contact	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Appeals	Appeal & Grievance Supervisor		Devault	Paige						7406996163	appeals_grievances_department@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active	8778477907				PPO - BBA		C	Chicago
H8604	Part D Appeals Contact (Secondary)	VP Compliance		Jones	Heather						7406996163	appeals_grievances_department@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active	8778477907				PPO - BBA		C	Chicago
H8604	Part D Application Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Benefits Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Claims Submission Contact	Director Regulated Markets Medicare Solutions		Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Exceptions Contact	Senior Clinical Pharmacist		Kovalski	Amy						3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active	8006246961	6627			PPO - BBA		C	Chicago
H8604	Part D Exceptions Contact (Secondary)	Director, Pharmacy Services		Peluchette	Katelyn						3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active	8006246961	6608			PPO - BBA		C	Chicago
H8604	Part D Price File Contact (Back-up)	Manager, Regulated Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	Express Scripts	4865 Dixie Hwy	Fairfield	OH	45014	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Price File Contact (Optional)	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Price File Contact (Primary)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	Express Scripts	One Express Way - Building 1	St. Louis	MO	63121	10/28/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Quality Assurance Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Part D Reporting Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Patient Safety Contact	Senior Clinical Pharmacist		Kovalski	Amy		7402324320				3048857592	akovalski@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Payment Contact			Piergallini	Jeremy		7406996138				7406996161	jpiergallini@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Pharmacy Director	Director, Pharmacy Services		Peluchette	Katelyn		3046392392				3048857592	kpeluchette@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	12/17/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Pharmacy Network Management Contact	Network Account Dir, Retail Strategy & Contracting		Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	Express Scripts	One Express Way	St. Louis	MO	63121	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Pharmacy Technical Help Desk Contact	Sr. Director, Customer Service		Sahs	Dale							dale_sahs@express-scripts.com	One Express Way Mail Stop S13NB		St. Louis	MO	63121	10/16/2025	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active	8009221557				PPO - BBA		C	Chicago
H8604	Physician Incentive Contact	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Plan Directory Contact for Public Website	Director Medicare Operations		Staffileno	Penny		7406957597				7406996163	pstaffileno@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Plan to Plan Reconciliation Contact	Controller		Marsh	Jane		7406996121				7406996161	jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Processor Contact	Director, Government Programs, Medicare		Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	Express Scripts	One Expressway	St. Louis	MO	63121	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Quality Contact	VP of Quality Improvement		Tomer	Kerri		7406996168					ktomer@healthplan.org	The Health Plan	1110 Main Street	Wheeling WV	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Reconciliation Contact	Controller		Marsh	Jane		7406996121					jmarsh@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Reconciliation Contact (Secondary)	Chief Financial Officer		Ralston	Ryan		7406996236					rralston@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Recovery Audit Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	SNP Application Contact	VP of Medicare		Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	SNP State Contact	VP of Medicare	Ms.	Pennybacker	Vicki		7406957622					vickip@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Surveillance Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	System Contact	CIO	Mr	Bryan	Ken		7406957877					kbryan@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Third Party Administrator (TPA) Liaison	Assistant Controller		Blinco	David		7406996151					dblinco@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	User Access Contact	VP, Compliance	Ms	Medley	Jill		7406957693					jmedley@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Utilization Management Contact	VP Clinical Services		Jones	Heather		7406996980					hjones@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8604	Utilization Review Contact	VP Clinical Services		Jones	Heather		7406996980					hjones@healthplan.org	The Health Plan	1110 Main Street	Wheeling	WV	26003	08/14/2024	2026	THP INSURANCE COMPANY	Local CCP	The Health Plan	Local PPO		The Health Plan of West Virginia, Inc.	354	Yes	Active					PPO - BBA		C	Chicago
H8614	Automated TrOOP Balance Transfer Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Backup User Access Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Best Available Evidence Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Bid Primary Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	CAP Report Contact for Public Website	Director of Quality & Compliance		Lee	angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	06/13/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	CEO - CMS Administrator Contact	President	Mr.	Gelley	Meir		7322622255	2108			7322769866	Mgelley@nationwidehealthcare.com	21 W. Clarke Ave.		Milford	DE	19963	11/15/2021	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	CEO - Senior Official for Contracting	President	Mr.	Gelley	Meir		7322622255	2108			7322769866	Mgelley@nationwidehealthcare.com	21 W. Clarke Ave.		Milford	DE	19963	11/15/2021	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Chief Financial Officer	CFO	Mr.	Braun	Sheldon		7322622255				7322769866	Sbraun@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	10/10/2021	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Chief Operating Officer	Busines Office Manager	Ms.	Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Chief Information Officer	Director Information Technology	Mr	Forman	Joe		7322622255	2120			7322769866	jforman@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Chief Information Security Officer	Director Information Technology	Mr	Forman	Joe		7322622255	2120			7322769866	jforman@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	CMS Casework Communication Contact	Director of Marketing & Enrollment		Scala	Damian		3028653565	119				dscala@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	06/13/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Complaints Tracking Contact	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Contact for Fraud Investigations	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Coordination of Benefits Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Corporate Mailing						7322622255	2108			7322769866	Mgelley@nationwidehealthcare.com	21 W. Clarke Ave.		Milford	DE	19963	10/21/2021	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	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		7322622255	2120			7322769866	jforman@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	DIR Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Discount Program Payment Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Emergency Part D Contact	Executive Director	Ms.	Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Emergency Part D Contact (Secondary)	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Encounter Data & Risk Adjustment Operations Contact	Executive Director	Ms.	Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Enrollment Contact	Business Office Manager		Debus	Mary		3028653565	108				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	EOB Transfer Contact	Business Office Manager		Debus	Mary		3028653565	102			7322769866	mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Financial Audit Contact	Chief Financial Officer	Mr	Braun	Sheldon		7322622255	2110			7322769866	sbraun@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Financial Reporting Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Formulary Contact	Medical Director	Dr.	Bretzius	Michelle		3028653565					mbretzius@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	02/27/2024	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Formulary Contact (Secondary)	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	General Contact	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	07/31/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Government Relations Contact	Officer	Mr	Halberstam	Yitzchock		7326429142				7322769866	Yhalberstam@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	HIPAA Privacy Officer	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	HIPAA Security Officer	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Interoperability Contact	Executive  Director		Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	MA Appeals/Grievances Contact	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	MA Claims Processing Contact for Public Website	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Marketing Contact	Director of Marketing & Enrollment		Scala	Damian		3028653565	119				dscala@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	06/13/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Medical Director	Medical Director	Dr.	Bretzius	Michelle		3022498333				7322769866	mbretzius@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	02/27/2024	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Medicare Compliance Officer	Director of Quality & Compliance	Mrs.	Lee	Angela		3028653565	101			7322769866	alee@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Medicare Coordinator	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Bretzius	Michelle		3028653565				7322769866	mbretzius@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	02/27/2024	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Medication Therapy Management Contact	Medical Director	Dr.	Bretzius	Michelle		3028653565				7322769866	mbretzius@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	02/27/2024	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part C Application Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave.	Suite1010	Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Appeals	Business Office Manager		Debus	Mary						7322769866	mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active	8337223302	102			PACE - Nat		C	Philadelphia
H8614	Part D Appeals Contact (Secondary)	Executive Director		Felton	Sonja							sfelton@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active	3028653565	108			PACE - Nat		C	Philadelphia
H8614	Part D Application Contact	Executive  Director		Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Benefits Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Claims Submission Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Exceptions Contact	Business Office Manager		Debus	Mary						7322769866	mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active	8337223302	102			PACE - Nat		C	Philadelphia
H8614	Part D Price File Contact (Back-up)	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Price File Contact (Primary)	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Quality Assurance Contact	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Part D Reporting Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Patient Safety Contact	Executive  Director		Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Payment Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Pharmacy Director	Medical Director	Dr.	Bretzius	Michelle		3028653565					mbretzius@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Pharmacy Network Management Contact	Controller		Friedman	Ben		7322622255	2106			7322769866	bfriedman@nationwidehealthcare.com	260 Chambers Ridge Road		Brick	NJ	08723	06/22/2020	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Pharmacy Network Management Contact (Secondary)	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Pharmacy Technical Help Desk Contact	Executive Director		Felton	Sonja						7322769866	sfelton@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active	3028653565	108			PACE - Nat		C	Philadelphia
H8614	Plan Directory Contact for Public Website	Director of Marketing & Enrollment		Scala	Damian		3028653565	119				dscala@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	06/13/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Plan to Plan Reconciliation Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Processor Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Quality Contact	Director of Quality & Compliance		Lee	Angela		3028653565	101				alee@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	04/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Reconciliation Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010	Suite 1010	Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Reconciliation Contact (Secondary)	Executive Director		Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Recovery Audit Contact	Chief Financial Officer	Mr	Braun	Sheldon		7322622255	2110			7322769866	sbraun@nationwidehealthcare.com	260 Chambers Bridge Road		Brick	NJ	08723	06/22/2020	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Surveillance Contact	Executive Director	Ms.	Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.		Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	System Contact	Business Office Manager		Debus	Mary		3028653565	108				mdebus@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Third Party Administrator (TPA) Liaison	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave, Suite 1010		Milford	DE	19963	05/29/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	User Access Contact	Business Office Manager		Debus	Mary		3028653565	102				mdebus@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Utilization Management Contact	Medical Director	Dr	Bretzius	Michelle		3028653565					mbretzius@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	02/27/2024	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8614	Utilization Review Contact	Executive Director		Felton	Sonja		3028653565	108				sfelton@paceyourlifemwv.com	21 W. Clarke Ave.	Suite 1010	Milford	DE	19963	09/10/2025	2026	MILFORD WELLNESS VILLAGE PACE	National PACE	PACE Your LIFE	National PACE		Milford Wellness Village PACE, LLC	782	Yes	Active					PACE - Nat		C	Philadelphia
H8634	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	03/11/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Formulary Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8634	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8634	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8634	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8634	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	8772777898				PPO - BBA		C	Chicago
H8634	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/23/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active	0000000000				PPO - BBA		C	Chicago
H8634	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	09/21/2018	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	09/21/2018	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8634	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	09/21/2018	2026	HEALTH CARE SERVICE CORPORATION	Local CCP	Blue Cross and Blue Shield of IL, NM, OK, TX	Local PPO		Health Care Service Corporation	110	Yes	Active					PPO - BBA		C	Chicago
H8649	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/30/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025286					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/30/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/23/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	2244768116				HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	7132085765				HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	11/12/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4692435213				HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4125803128				HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8002386279				HMO - Health Maintenance Organization		C	Atlanta
H8649	PHR Beneficiary Contact																	08/12/2015	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				HMO - Health Maintenance Organization		C	Atlanta
H8649	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Plan Directory Contact for Public Website			Customer Service	Aetna		8335706670					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/04/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Processor Contact	Director Service Operations		Painting	Melissa		5408725497				8602738880	mcpainting@aetna.com	151 Farmington Avenue	Mail Code RT52	Hartford	CT	06156	07/07/2020	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	SNP State Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8649	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA HEALTH OF UTAH INC.	Local CCP	Aetna Medicare	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H8655	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie		7203929719				3039961600	lteter@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	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	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Operating Officer	Market President	Mr.	Jones	Steve		8049442904				3039961600	sjones2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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 Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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 Information Security Officer	SVP of Information Technology	Mr.	Naus	Cole		7209210443				3039961600	MNaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Complaints Tracking Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Corporate Mailing						3038694664				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	DIR Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	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	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Interoperability Contact	SVP of Applications		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	07/28/2023	2026	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	MA Appeals/Grievances Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	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	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	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 Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	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	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	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 Appeals	Director of Compliance		Licht	Hannah						3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H8655	Part D Appeals Contact (Secondary)	Director of Compliance		Licht	Hannah						3039961600	hlicht@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H8655	Part D Application Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H8655	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Philadelphia
H8655	Part D Price File Contact (Back-up)	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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 Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Quality Assurance Contact	SVP, Clinical Strategic Partnerships Clinical Oper		Cinque	Michael		7207444048				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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 Reporting Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H8655	PHR Beneficiary Contact																	02/14/2025	2026	INNOVAGE VIRGINIA PACE II, LLC	National PACE	InnovAge Virginia PACE - Richmond and Peninsula	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Philadelphia
H8655	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	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	Plan to Plan Reconciliation Contact	Finance and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	akizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	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	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Reconciliation Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	Recovery Audit Contact	Director of Finance	Mrs.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	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	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	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	System Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	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	User Access Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	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	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	01/24/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	04/10/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	04/10/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Road		Tampa	FL	33436	08/18/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Road		Tampa	FL	33436	08/18/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	05/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	04/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Chief Information Officer	Executive VP, Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	04/10/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	07/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Contact for Fraud Investigations	Sr. Director, Special Investigations Unit (SIU)		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	11/05/2021	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/05/2022	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/29/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	07/31/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7676 Forsyth Blvd		Clayton	MO	63105	08/16/2021	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	04/10/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	08/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33436	08/18/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	04/10/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H8711	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H8711	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Benefits Contact	Director, Pharmacy	Mr.	Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		h	TX	77027	06/14/2022	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	09/03/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H8711	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H8711	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	04/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H8711	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500408				PPO - BBA		C	Denver
H8711	PHR Beneficiary Contact																	09/28/2022	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8334449088				PPO - BBA		C	Denver
H8711	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	08/18/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/10/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	CA	91367	12/13/2023	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8711	Utilization Review Contact	Senior VP, Medical Management		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	04/10/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H8730	Part C Application Contact			Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th CT		Vancouver	WA	98682	11/30/2025	2026	KINSHIP PACE OF EAST FLORIDA, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H8730	Part D Application Contact			Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th CT		Vancouver	WA	98682	11/30/2025	2026	KINSHIP PACE OF EAST FLORIDA, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H8764	Agent/Broker Compensation Data Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Automated TrOOP Balance Transfer Contact	Medicare Part D Project Manager		Zlotkus	Steve		8587906250					PartDCAT@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/01/2020	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Backup User Access Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Best Available Evidence Contact	Supervisor Medicare Membership Accounting	Ms.	Saucedo	Sonya		5035844236				5035844234	Sonya.saucedo@phtech.com	3990 Fairview Industrial Drive SE		Salem	OR	97302	02/28/2022	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Bid Audit Contact	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Bid Primary Contact	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	CAP Report Contact for Public Website	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Bush	Bob		8316447412					bob.bush@aspirehealth.org	10 Ragsdale Drive		Monterey	CA	93940	11/21/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Bush	Bob		8316447412					bob.bush@aspirehealth.org	10 Ragsdale Drive		Monterey	CA	93940	11/21/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Chief Financial Officer	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Chief Operating Officer	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Chief Information Officer	VP, Operations	Mr.	Chibaya	Daniel		8316254518					daniel.chibaya@montagehealth.org	P.O. Box HH		Monterey	CA	93942	04/24/2024	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Chief Information Security Officer	VP, Operations	Mr.	Chibaya	Daniel		8316254518					daniel.chibaya@montagehealth.org	P.O. Box HH		Monterey	CA	93942	04/24/2024	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	CMS Casework Communication Contact	Appeals and Grievances Analyst	Ms.	Pummell	Stef		8316447432				8316570703	stef.pummell@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	06/13/2017	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Complaints Tracking Contact	Appeals and Grievances Analyst	Ms.	Pummell	Stef		8316447432				8316570703	stef.pummell@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	06/13/2017	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Contact for Fraud Investigations	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Coordination of Benefits Contact	Supervisor Medicaid Membership Accounting	Ms.	Wilson	Jennifer		5033622818	1251			5035844234	jennifer.wilson@phtech.com	3990 Fairview Industrial Drive SE		Salem	OR	97302	02/28/2022	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Corporate Mailing						8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Customer Service Operations Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	DIR Contact	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	DIR Contact (Secondary)	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Discount Program Payment Contact	Sr Financial Analyst	Ms.	Kaur	Joti		8316254828					joti.kaur@montagehealth.org	10 Ragsdale Drive	Suite 101	Monterey	CA	93940	08/08/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Electronic Health Record Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	06/29/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Emergency Part D Contact	Pharmacy Director	Ms.	Murphy	Eileen		8313926287					Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Employer Waiver Contact	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Encounter Data & Risk Adjustment Operations Contact	Director, Practice Enhancement & Analytics		Dunton	Alison		8316447414					Alison.Dunton@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/18/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Enrollment Contact	Supervisor Medicare Membership Accounting	Ms.	Saucedo	Sonya		5035844236				5035844234	Sonya.saucedo@phtech.com	3990 Fairview Industrial Drive SE		Salem	OR	97302	02/28/2022	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	EOB Transfer Contact	Pharmacy Director	Ms.	Murphy	Eileen		8313926287				8316570703	Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Financial Audit Contact	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Financial Reporting Contact	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Formulary Contact		Ms.	Schoening	Shellie		4026700682					sschoening@apothemetrx.com	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	04/23/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Formulary Contact (Secondary)	Pharmacy Director	Ms.	Murphy	Eileen		8313926287					Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	General Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Government Relations Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	HIPAA Privacy Officer	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	HIPAA Security Officer	VP, Operations	Mr.	Chibaya	Daniel		8316254518					daniel.chibaya@montagehealth.org	P.O. Box HH		Monterey	CA	93942	04/24/2024	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Hospice Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Interoperability Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	MA Appeals/Grievances Contact	Appeals and Grievances Analyst	Ms.	Pummell	Stef		8316447432				8316570703	stef.pummell@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	06/13/2017	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	MA Claims Processing Contact for Public Website	Director of Health Plan Operations	Ms.	Fagan	Elisabeth		8316447419				8316572669	elisabeth.fagan@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	06/13/2017	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Marketing Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Medical Director	Chief Medical Officer	Dr.	Guez	Gilly		8316447467					gilly.guez@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	12/14/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Medicare Compliance Officer	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Medicare Coordinator	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Medicare Part D Opioid Overutilization Contact		Ms.	Schoening	Shellie		4026700682					sschoening@apothemetrx.com	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	04/23/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Medication Therapy Management Contact	Pharmacist	Ms.	Chan	Margaret		8312643956					margaret.chan@aspirehealth.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	04/23/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	OffShore Subcontractor Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409					anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive	Suite 101	Monterey	CA	93940	11/11/2020	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Online Enrollment Center Contact (Back-up)	Enrollment Specialist	Ms.	Flugum	Kathryn		5033622818	1268			5035844234	kathryn.flugum@phtech.com	3990 Fairview Industrial Drive SE		Salem	OR	97302	02/28/2022	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Online Enrollment Center Contact (Optional)	Director of Health Plan Operations	Ms.	Fagan	Elisabeth		8316447419				8316572669	elisabeth.fagan@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Online Enrollment Center Contact (Primary)	Supervisor Medicare Membership Accounting	Ms.	Saucedo	Sonya		5033154121				5035844234	Sonya.saucedo@phtech.com	3990 Fairview Industrial Drive SE		Salem	OR	97302	02/28/2022	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part C Application Contact	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part C Reporting Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part D Appeals	Pharmacy Director	Ms.	Murphy	Eileen							Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive, Suite 101	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	8313926297				HMO - Health Maintenance Organization		C	New York
H8764	Part D Appeals Contact (Secondary)	Manager, Appeals & Grievances		Martin	Dawn							Dawn.Martin@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/01/2020	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	8587907118				HMO - Health Maintenance Organization		C	New York
H8764	Part D Application Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part D Benefits Contact	Pharmacy Director	Ms.	Murphy	Eileen		8313926287					Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part D Claims Submission Contact	Sup Medicare Operations		Rivera-Aquino	Denisse		8582915269					PDE@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/01/2020	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
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	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	8587905846				HMO - Health Maintenance Organization		C	New York
H8764	Part D Exceptions Contact (Secondary)	Pharmacy Director	Ms.	Murphy	Eileen							Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive, Suite 101	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	8313926287				HMO - Health Maintenance Organization		C	New York
H8764	Part D Price File Contact (Back-up)	Pharmacy Director	Ms.	Murphy	Eileen		8313926287					Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part D Price File Contact (Optional)		Ms.	Schoening	Shellie		4026700682					sschoening@apothemetrx.com	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	04/23/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part D Price File Contact (Primary)	Medicare Part D Project Manager		Keller	Sharon		8587907104					PlanFinderCommunications@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	06/15/2022	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part D Quality Assurance Contact	Pharmacy Director	Ms.	Murphy	Eileen		8313926287					Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Part D Reporting Contact	Medicare Part D Project Manager		MacLochlainn	Tine		8587907031					tine.maclochlainn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/23/2020	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Patient Safety Contact	Chief Medical Officer	Dr.	Guez	Gilly		8316447467					gilly.guez@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	04/23/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Payment Contact	Sr Financial Analyst	Ms.	Kaur	Joti		8316254828					joti.kaur@montagehealth.org	10 Ragsdale Drive	Suite 101	Monterey	CA	93940	08/08/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Personal Health Record Contact	Chief Medical Officer	Dr.	Guez	Gilly		8316447467					gilly.guez@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	12/14/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Pharmacy Director	Pharmacy Director	Ms.	Murphy	Eileen		8313926287					Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Pharmacy Network Management Contact	Director Configuration Services		Moe	Kathleen		8587907437					kathlene.moe@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/23/2020	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Pharmacy Network Management Contact (Secondary)	Pharmacy Director	Ms.	Murphy	Eileen		8313926287					Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive, Suite 101	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							Customerservice@Medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	12/09/2024	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	8884953160				HMO - Health Maintenance Organization		C	New York
H8764	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Director	Ms.	Murphy	Eileen							Eileen.Murphy@aspirehealth.org	10 Ragsdale Drive, Suite 101	Suite 200	Monterey	CA	93940	11/05/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active	8313926297				HMO - Health Maintenance Organization		C	New York
H8764	PHR Beneficiary Contact																	02/15/2013	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS	Aspire Health Plan	Montage Health	517	Yes	Active	8005465677				HMO - Health Maintenance Organization		C	New York
H8764	Physician Incentive Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Plan Directory Contact for Public Website	Customer Service Representative		Service	Customer		8555701600				8315744939	csrII@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	02/25/2022	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Plan to Plan Reconciliation Contact	Sr Financial Analyst	Ms.	Kaur	Joti		8316254828					joti.kaur@montagehealth.org	10 Ragsdale Drive	Suite 101	Monterey	CA	93940	04/19/2024	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Processor Contact	SVP,  Government Programs and Services		Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/01/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Quality Contact	Chief Medical Officer	Dr.	Guez	Gilly		8316447467					gilly.guez@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	12/14/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Reconciliation Contact	Sr Financial Analyst	Ms.	Kaur	Joti		8316254828					joti.kaur@montagehealth.org	10 Ragsdale Drive	Suite 101	Monterey	CA	93940	04/19/2024	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Reconciliation Contact (Secondary)	Chief Financial Officer	Ms.	McMahon	Laura		8316254821					Laura.McMahon@montagehealth.org	23625 Holman Highway		Monterey	CA	93940	04/14/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Recovery Audit Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	SNP Application Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	SNP State Contact	Chief Operating Officer	Ms.	Hall	Melissa		8316447415				8316570703	melissa.hall@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	09/08/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Surveillance Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	System Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Third Party Administrator (TPA) Liaison	Sr Financial Analyst	Ms.	Kaur	Joti		8316254828					joti.kaur@montagehealth.org	10 Ragsdale Drive	Suite 101	Monterey	CA	93940	08/08/2025	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	User Access Contact	Compliance Officer	Mr.	Serrano	Anthony		8316447409				8316570703	anthony.serrano@aspirehealthplan.org	10 Ragsdale Drive, Suite 101		Monterey	CA	93940	10/11/2019	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Utilization Management Contact	Chief Medical Officer	Dr.	Guez	Gilly		8316447467					gilly.guez@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	12/14/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8764	Utilization Review Contact	Chief Medical Officer	Dr.	Guez	Gilly		8316447467					gilly.guez@aspirehealth.org	10 Ragsdale Drive	Suite 200	Monterey	CA	93940	12/14/2023	2026	ASPIRE HEALTH PLAN	Local CCP	Aspire Health	HMO/HMOPOS		Montage Health	517	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8768	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				PPO - BBA		C	Boston
H8768	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H8768	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				PPO - BBA		C	Boston
H8768	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				PPO - BBA		C	Boston
H8768	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/14/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8768	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Local CCP	UnitedHealthcare	Local PPO		UnitedHealth Group, Inc.	239	Yes	Active					PPO - BBA		C	Boston
H8769	Automated TrOOP Balance Transfer Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Backup User Access Contact	Quality Coordinator		Haynes	Erin		8102367514				8102367558	erin.haynes1@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Best Available Evidence Contact	Medical Director	Dr.	Dudley	Morgan		8102367471				8102367558	morgan.dudley@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Bid Primary Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	CAP Report Contact for Public Website	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	CEO - CMS Administrator Contact	Interium Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	CEO - Senior Official for Contracting	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Chief Financial Officer	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					brian.cooper@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Chief Operating Officer	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	10/15/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Chief Information Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	2622 W. Central #100		Wichita	KS	67203	04/04/2022	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Chief Information Security Officer	Director of PACE Informatics	Mr.	Rice	Brandon		6202222766					brandon.rice@ascension.org	2622 W. Central #100		Wichita	KS	67203	04/04/2022	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	CMS Casework Communication Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Complaints Tracking Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Contact for Fraud Investigations	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	06/01/2021	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Coordination of Benefits Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Corporate Mailing						8102367500					Craig.berry@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Customer Service Operations Contact	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	DIR Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	DIR Contact (Secondary)	Senior Director of Clinical Services-PACE	Ms.	Goetzinger	Jill		7725215733				4236226048	jill.goetzinger@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	06/01/2021	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Discount Program Payment Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Emergency Part D Contact	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Emergency Part D Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	06/01/2021	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Encounter Data & Risk Adjustment Operations Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Enrollment Contact	Accounting	Ms.	Kennedy	Susan		3169465270					susan.kennedy@ascension.org	250 East 10th Street		Chattanooga	TN	37402	04/11/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	EOB Transfer Contact	Claims Manager	Mr.	Stengele	Brett		8155291077				4236226048	brett.stengele@ascension.org	250 East 10th Street		Chattanooga	TN	37402	04/14/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Financial Audit Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Financial Reporting Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/14/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Formulary Contact	Medical Director	Dr.	Dudley	Morgan		8102367471				8102367558	morgan.dudley@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Formulary Contact (Secondary)	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	General Contact	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Government Relations Contact	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	HIPAA Privacy Officer	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	HIPAA Security Officer	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Interoperability Contact	Interim Executive Director	Ms.	Johnson	Melissa		8102367500					melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	MA Appeals/Grievances Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	MA Claims Processing Contact for Public Website	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Marketing Contact	Marketing Director	Ms.	Downing	Jessica		8102367500				8102367558	jessica.salazar@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Medical Director	Medical Director	Dr.	Dudley	Morgan		8102367471				8102367558	morgan.dudley@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Medicare Compliance Officer	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Medicare Coordinator	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48502	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Medicare Part D Opioid Overutilization Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Medication Therapy Management Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part C Application Contact	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part D Appeals	Director of Quality	Ms.	Fierke	Christina						8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active	8102367472				PACE - Nat		C	Atlanta
H8769	Part D Appeals Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff							jeff.johnson1@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	06/01/2021	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active	8008814443				PACE - Nat		C	Atlanta
H8769	Part D Application Contact	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part D Benefits Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part D Claims Submission Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part D Exceptions Contact	Manager: Accounting and Reporting	Mr.	Webster	Ty						4236226048	ty.webster@ascension.org	250 East 10th Street		Chattanooga	TN	37402	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active	8004418883				PACE - Nat		C	Atlanta
H8769	Part D Exceptions Contact (Secondary)	Compliance Director	Mr.	Johnson	Jeff							jeff.johnson1@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	06/01/2021	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active	8008814443				PACE - Nat		C	Atlanta
H8769	Part D Price File Contact (Back-up)	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part D Price File Contact (Primary)	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	Melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part D Quality Assurance Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Part D Reporting Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	09/22/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Patient Safety Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Payment Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	04/14/2023	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Pharmacy Director	Executive Director	Mr.	Berry	Craig		8102367500				8102367558	craig.berry@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Pharmacy Network Management Contact	Medical Director	Dr.	Dudley	Morgan		8102367471				8102367558	morgan.dudley@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Pharmacy Technical Help Desk Contact	Medical Director	Dr.	Dudley	Morgan						8102367558	morgan.dudley@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active	8102367500				PACE - Nat		C	Atlanta
H8769	Plan Directory Contact for Public Website	Interim Executive Director	Ms.	Johnson	Melissa		8102367500				8102367558	melissa.johnson9@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	12/10/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Plan to Plan Reconciliation Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Processor Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Quality Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Reconciliation Contact	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Reconciliation Contact (Secondary)	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Drive		St. Louis	MO	63134	10/15/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Recovery Audit Contact	Interim Chief Operating Officer	Ms.	Goetzinger	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	10/15/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Surveillance Contact	Compliance Director	Mr.	Johnson	Jeff		3147293562					jeff.johnson1@ascension.org	4600 Edmundson Road		St. Louis	MO	63134	06/01/2021	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	System Contact	Interim Chief Operating Officer	Ms.	Goetzingr	Jill		7725215733					jill.goetzinger@ascension.org	4600 Edmundson Droad		St. Louis	MO	63134	10/15/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Third Party Administrator (TPA) Liaison	Accounting Manager	Mr.	Webster	Ty		3142702497					ty.webster@ascension.org	4600 Edmundson		St. Louis	MO	63134	08/08/2024	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	User Access Contact	Director of Quality	Ms.	Fierke	Christina		8102367472				8102367558	christina.fierke@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Utilization Management Contact	Medical Director	Dr.	Dudley	Morgan		8102367471				8102367558	Morgan.dudley@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8769	Utilization Review Contact	Medical Director	Dr.	Dudley	Morgan		8102367471				8102367558	morgan.dudley@ascension.org	3801 W. Boulevard Drive		Flint	MI	48505	05/23/2025	2026	Center for Gerontology	National PACE	Ascension Living PACE Michigan	National PACE		Ascension Health Alliance	708	Yes	Active					PACE - Nat		C	Atlanta
H8777	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Backup User Access Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Bid Primary Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	CAP Report Contact for Public Website	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs.	McAuliffe	Virginia	A	7162858248	147				mcauliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	09/04/2025	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs.	McAuliffe	Virginia	A	7162858248	147				mcauliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	09/04/2025	2026	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.	Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Operating Officer	Chief Executive Officer	Mrs.	McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Information Officer	Director of Quality and Compliance	Mrs.	Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Information Security Officer	Director of Quality and Compliance	Mrs.	Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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		Cogdill	Maryann		7162858248	128				cogdill@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	08/12/2025	2026	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	Complaints Tracking Contact	Director of Quality and Compliance	Mrs.	Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Contact for Fraud Investigations	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Corporate Mailing						7162858248	111				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	DIR Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	DIR Contact (Secondary)	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Discount Program Payment Contact	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Emergency Part D Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Emergency Part D Contact (Secondary)	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Enrollment Contact	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	EOB Transfer Contact	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Financial Audit Contact	Chief Financial Officer	Mr.	Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Financial Reporting Contact	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Formulary Contact	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Formulary Contact (Secondary)	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	General Contact	DIrector of Quality and Compliance	Mrs.	Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	04/23/2025	2026	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		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	HIPAA Privacy Officer	Director of Quality and Compliance		Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	HIPAA Security Officer	Director of Quality and Compliance		Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Interoperability Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	MA Appeals/Grievances Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	MA Claims Processing Contact for Public Website	Medical Claims Analyst	Ms.	Steffenhagen	Sandra		7162858248	121				steffenhagen@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Marketing Contact	Director of Communications		Gormley	Patrick		7162858248	127				gormley@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Medical Director	Medical Director	Dr.	Sauvageau	Philip		7162858248	109				sauvageau@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Director of Quality and Compliance	Mrs.	Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	04/23/2025	2026	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 Coordinator	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Part D Opioid Overutilization Contact	Medical Director	Dr.	Sauvageau	Philip		7162858248	109				sauvageau@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Medication Therapy Management Contact	Medical Director	Dr.	Sauvageau	Philip		7162858248	109				sauvageau@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	OffShore Subcontractor Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Online Enrollment Center Contact (Back-up)	Executive Director	Mrs.	McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Online Enrollment Center Contact (Optional)	Director of Communications	Mr.	Gormley	Patrick		7162858248	127				gormley@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Online Enrollment Center Contact (Primary)	CSC-PACE Enrollment Coordinator	Mrs.	Gorman	Marianne		7162858248	104				gorman@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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 C Application Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Appeals	Chief Executive Officer		McAuliffe	Virginia							McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	7162858248	147			PACE - Nat		C	New York
H8777	Part D Appeals Contact (Secondary)	Chief Executive Officer		McAuliffe	Virginia							McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	7162858248	147			PACE - Nat		C	New York
H8777	Part D Application Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Benefits Contact	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Claims Submission Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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		McAuliffe	Virginia							McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	7162858248	147			PACE - Nat		C	New York
H8777	Part D Exceptions Contact (Secondary)	Chief Financial Officer		Lynch	Edward							lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	7162858224	114			PACE - Nat		C	New York
H8777	Part D Price File Contact (Back-up)	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Price File Contact (Optional)	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Price File Contact (Primary)	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Quality Assurance Contact	Director of Quality and Compliance	Mrs.	Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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 Reporting Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Patient Safety Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Payment Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Personal Health Record Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Director	Medical Director	Dr.	Sauvageau	Philip		7162858248	109				sauvageau@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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 Network Management Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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 Network Management Contact (Secondary)	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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		Lynch	Edward							lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	7162858224	114			PACE - Nat		C	New York
H8777	Pharmacy Technical Help Desk Contact (Secondary)	Chief Executive Officer		McAuliffe	Virginia							McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE		Health Association of Niagara County, Incorp.	425	Yes	Active	7162858248	147			PACE - Nat		C	New York
H8777	PHR Beneficiary Contact																	03/04/2025	2026	COMPLETE SENIOR CARE, INC.	National PACE	Complete Senior Care	National PACE	Complete Senior Care	Health Association of Niagara County, Incorp.	425	Yes	Active	7162858224	220			PACE - Nat		C	New York
H8777	Plan Directory Contact for Public Website	Director of Communications		Gormley	Patrick		7162858248	127				gormley@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Processor Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Quality Contact	Director of Quality and Compliance	Mrs.	Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	03/04/2025	2026	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	Reconciliation Contact	Chief Financial Officer		Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Reconciliation Contact (Secondary)	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr.	Lynch	Edward		7162858224	114				lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Surveillance Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	System Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Third Party Administrator (TPA) Liaison	Chief Financial Officer		Lynch	Edward		7162858224	114			7162858232	lynch@hanci.com	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	User Access Contact	Chief Executive Officer		McAuliffe	Virginia		7162858248	147				McAuliffe@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Utilization Management Contact	Director of Quality and Compliance		Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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	Utilization Review Contact	Director of Quality and Compliance		Bowes	Jenna		7162858248	131				jbowes@completeseniorcare.org	1302 Main Street		Niagara Falls	NY	14301	11/17/2025	2026	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
H8794	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Backup User Access Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Bid Primary Contact	Actuarial Consultant		Chong	Evelyn		8183319738					KPMedicareBids@kp.org	393 E Walnut St.		Pasadena	CA	91188	06/27/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	CAP Report Contact for Public Website	Medicare Compliance Lead		Piper	Kimberly		2064739504					Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	2064739504				HMO - Health Maintenance Organization		C	Dallas
H8794	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	CMS Casework Communication Contact	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Complaints Tracking Contact	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Corporate Mailing						8004430815					mscc@kp.org	P.O. Box 12916		Oakland	CA	946042916	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Customer Service Operations Contact			Services	Member		8004430815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John		5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	General Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	HIPAA Security Officer	Senior Director	Mr.	Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					Cathy.P.Plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	MA Appeals/Grievances Contact	Executive Director, Member Relations	Ms	Osborne	Susan		5038133924					susan.a.osborne@kp.org	500 NE Multnomah Street	Suite 100	Portland	OR	97232	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Marketing Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	08/22/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Medicare Compliance Officer	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Medicare Coordinator	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					jovan.robinson@kp.org	10740 Fourth Street	2nd Floor, Cubicle 023W02	Rancho Cucamonga	CA	91730	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part C Application Contact	Project Manager Lead		Morgan	Emily	M	5104072515					emily.m.morgan@kp.org	1800 Harrison Street		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part C Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Appeals	Executive Director, Member Relations		Osborne	Susan							Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8774083496				HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Application Contact	Project Manager Lead		Morgan	Emily	M	5104072515					emily.m.morgan@kp.org	1800 Harrison Street		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Benefits Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Claims Submission Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Part D Reporting Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Pharmacy Director	National Pharmacy Benefits, Vice President		Miller	Wayne		5626583674					wayne.i.miller@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Pharmacy Network Management Contact	National Pharmacy Benefits, Project Manager II		Munoz	Vanessa		5624477739					Vanessa.L.Munoz@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Pharmacy Network Management Contact (Secondary)	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8776451282				HMO - Health Maintenance Organization		C	Dallas
H8794	Plan Directory Contact for Public Website			Services	Member		8004430815					mscc@kp.org	10740 Fourth St., Second Floor		Rancho Cucamonga	CA	91730	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	SNP Application Contact	Project Manager Lead		Morgan	Emily	M	5104072515					emily.m.morgan@kp.org	1800 Harrison Street		Oakland	CA	94612	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	SNP State Contact	Medicare Compliance Lead	Ms.	Walden	Chandra		4049850135					chandra.walden@kp.org	3495 Piedmont Road NE	Nine Piedmont Center	Atlanta	GA	303051736	01/02/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Surveillance Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	08/29/2023	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	User Access Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	03/15/2024	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Utilization Management Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8794	Utilization Review Contact	Medicare Compliance Lead	Ms.	Piper	Kimberly		2064739504				2068770645	Kimberly.C.Piper@kp.org	2715 Naches Ave. SW	P.O. Box 9010	Renton	WA	98057	09/08/2025	2026	KAISER FOUNDATION HP, INC.	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8797	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Backup User Access Contact	Medicare Compliance Officer	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	CAP Report Contact for Public Website	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	CEO - CMS Administrator Contact	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	CEO - Senior Official for Contracting	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	01/03/2025	2026	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	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Contact for Fraud Investigations	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd. Suite 300		Westerville	OH	43082	01/03/2025	2026	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		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Corporate Mailing						8447886959					customerservice@perennialadvantage.com	P.O. Box 2190		Glen Allen	VA	230582190	01/03/2025	2026	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		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Discount Program Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					mark.hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Enrollment Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	EOB Transfer Contact			Lowry	Kristy		8448546886				8336102390	kristy.lowry@curanahealth.com	P.O. Box 5849		Glen Allen	VA	23058	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Financial Audit Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Financial Reporting Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	General Contact	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	01/03/2025	2026	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		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	HIPAA Privacy Officer	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	HIPAA Security Officer	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	01/03/2025	2026	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		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Interoperability Contact			Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					patty.rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Marketing Contact	Marketing Director		Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Medical Director		Dr.	Papernek	Holly		9374703285					holly.papanek@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	01/03/2025	2026	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	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	01/03/2025	2026	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 Coordinator	Chief Operating Officer	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 C Reporting Contact	Medicare Compliance Officer		Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	rachel.blair@navitus.com	Navitus Health Solutions, 1025 West Navitus Drive	P.O. Box 1039	Appleton	WI	54913	09/30/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H8797	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H8797	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	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						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	1025 West Navitus Dr.	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H8797	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H8797	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	01/03/2025	2026	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 Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	01/03/2025	2026	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 Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Payment Contact	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	01/03/2025	2026	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 Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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 Network Management Contact			Robinson	Jan		6087291688					jan.robinson@navitus.com	Navitus Health Solutions	1025 West Navitus Drive	Appleton	WI	54913	01/03/2025	2026	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 Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H8797	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H8797	Physician Incentive Contact	Executive Director	Ms.	Elam	Jennifer		5132757952					jennifer.elam@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Plan Directory Contact for Public Website			Sidlinger	Rocio		8558550489	1664				rocio.sidlinger@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Plan to Plan Reconciliation Contact	CFO	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Processor Contact			Vanden Heuvel	Sherry		9202214359				9202214595	sherry.vandenheuvel@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Quality Contact			Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Reconciliation Contact			Lowry	Kristy		8043325119					kristy.lowry@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Reconciliation Contact (Secondary)	CFO	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Recovery Audit Contact	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Rd	Suite 300	Westerville	OH	43082	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Surveillance Contact	SVP Sales and Marketing Strategy		Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	User Access Contact	Compliance Officer	Mr.	Chrisman	Allen		5132164256					allen.chrisman@perennialadvantage.com	9200 Worthington Road	Suite 300	Westerville	OH	43082	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Utilization Management Contact		Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	PERENNIAL ADVANTAGE OF OHIO, INC.	Local CCP	Perennial Advantage	HMO/HMOPOS		Perennial Consortium, LLC	759	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8797	Utilization Review Contact	VP Clinical Programs	Ms.	Murray	Maureen		5074611197					maureen.murray@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	01/03/2025	2026	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.	Rice	Stephanie	M	7163798474				7163798543	srice@homecare-hospice.org	519 North Union Street		Olean	NY	14760	02/19/2024	2026	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	Backup User Access Contact	Communications and Information Systems Co.	Mr.	Smith	Russell		7163722106					rsmith@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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		7163722106					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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	Bid Primary Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	CAP Report Contact for Public Website	CEO	Ms.	Sullivan	Melissa		7163725735				7163723156	msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active	8007197129				PACE - Nat		C	New York
H8800	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Sullivan	Melissa		7163722106					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Sullivan	Melissa		7163722106					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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	Mr	Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Operating Officer	Executive Program Director	Mrs	Padlo	Roxanne		7163798474					rpadlo@totalseniorcare.org	519 North Union Street		Olean	NY	147602135	10/21/2020	2026	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 Information Officer	Communications and Information Systems Co.	Mr	Smith	Russell		7163722106					rsmith@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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 Information Security Officer	Health Information Systems Manager	Mr	Brown	Kalan		7163798474					kbrown@homecare-hospice.org	519 North Union Street		Olean	NY	14760	03/07/2024	2026	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	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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	Complaints Tracking Contact	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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	Contact for Fraud Investigations	Quality and Compliance Director	Mrs	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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.	Rice	Stephanie	M	7163798474				7163798543	srice@homecare-hospice.org	519 North Union Street		Olean	NY	14760	02/19/2024	2026	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	Corporate Mailing						7162282884				7163798543	ckirk@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	06/05/2025	2026	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		7163798474					rpadlo@totalseniorcare.org	519 North Union Street		Olean	NY	147602135	01/31/2022	2026	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	DIR Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	DIR Contact (Secondary)	Accounting Manager	Mrs.	Rice	Stephanie	M	7163798474				7163798543	srice@homecare-hospice.org	519 North Union Street		Olean	NY	14760	02/19/2024	2026	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	Discount Program Payment Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Emergency Part D Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Health Information Systems Manager		Brown	Kalan		7163722106				7163798474	kbrown@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	09/06/2024	2026	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	Enrollment Contact	Enrollment/Intake Services Coordinator	Ms.	McAndrew	Joann		7163798474				7163798543	jmcandrew@totalseniorcare.org	519 North Union Street		Olean	NY	14760	06/15/2018	2026	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	EOB Transfer Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103			7163723156	ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Financial Audit Contact	Chief Financial Officer	Mr	Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Financial Reporting Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Formulary Contact	Executive Program Director	Mrs	Padlo	Roxanne		7163798474					rpadlo@totalseniorcare.org	519 North Union Street		Olean	NY	147602135	09/06/2024	2026	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	General Contact	Chief Executive Officer	Ms	Sullivan	Melissa		7163722106					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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		7163722106					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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	HIPAA Privacy Officer	Quality and Compliance Director	Mrs	Langdon	Angela		7163722106	1143				alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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	HIPAA Security Officer	Health Information Systems Manager	Mr	Brown	Kalan		7163722106	2124				kbrown@homecare-hospice.org	519 N Union St		Olean	NY	14760	09/05/2025	2026	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	Interoperability Contact	Health information systems manager	Mr	Brown	Kalan		7163798474					kbrown@homecare-hospice.org	519 North Union Street		Olean	NY	14760	03/07/2024	2026	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	MA Appeals/Grievances Contact	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Marketing Contact	Director of Organizational Development	Ms	Yanetsko	Meme		7163722106					myanetsko@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/19/2024	2026	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	Medical Director	Medical Director / Primary Care Physician	Dr.	Patel	Arun		7163798474				7163798543	patel14779@icloud.com	519 North Union Street		Olean	NY	14760	11/15/2013	2026	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	Quality and Compliance Director	Mrs	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Olean	NY	14706	02/26/2025	2026	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 Coordinator	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Part D Opioid Overutilization Contact	Executive Program Director		Padlo	Roxanne		7163798474				7163798543	rpadlo@totalseniorcare.org	519 North Union Street		Olean	NY	14760	10/21/2020	2026	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	Medication Therapy Management Contact	Executive Program Director	Ms	Padlo	Roxanne		7163798474					rpadlo@totalseniorcare.org	Total Senior Care	519 North Union Street	Olean	NY	14760	03/10/2021	2026	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	Online Enrollment Center Contact (Primary)	Enrollment/Intake Services Coordinator	Ms.	McAndrew	Joann		7163798474				7163798543	jmcandrew@totalseniorcare.org	519 North Union Street		Olean	NY	14760	09/13/2018	2026	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 C Application Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Appeals	Quality and Compliance Director	Ms	Langdon	Angela							alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active	7163722106				PACE - Nat		C	New York
H8800	Part D Appeals Contact (Secondary)	Quality and Compliance Director		Langdon	Angela							alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active	7163722106				PACE - Nat		C	New York
H8800	Part D Application Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Benefits Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Claims Submission Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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		Kirk	Chad							ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active	7167197129	1103			PACE - Nat		C	New York
H8800	Part D Price File Contact (Back-up)	Chief Executive Officer	Ms	Sullivan	Melissa		7163722106					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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 Price File Contact (Primary)	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Quality Assurance Contact	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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 Reporting Contact	Accounting Manager	Mrs.	Rice	Stephanie	M	7163798474				7163798543	srice@homecare-hospice.org	519 North Union Street		Olean	NY	14760	02/19/2024	2026	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	Patient Safety Contact	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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	Payment Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Director	Chief Executive Officer	Ms	Sullivan	Melissa		7162282884					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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 Network Management Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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 Network Management Contact (Secondary)	Health Information Systems Manager	Mr	Brown	Kalan		7163798474					kbrown@homecare-hospice.org	519 North Union Street		Olean	NY	14760	03/07/2024	2026	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	Brown	Kalan							kbrown@homecare-hospice.org	519 North Union Street		Olean	NY	14760	03/07/2024	2026	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE		Community Care of Western New York, Inc.	472	Yes	Active	7163798474				PACE - Nat		C	New York
H8800	PHR Beneficiary Contact																	07/07/2009	2026	TOTAL SENIOR CARE, INC.	National PACE	Total Senior Care, Inc.	National PACE	Total Senior Care, Inc.	Community Care of Western New York, Inc.	472	Yes	Active	8669398613				PACE - Nat		C	New York
H8800	Plan Directory Contact for Public Website	Director of Organizational Development	Ms.	Yanetsko	Meme		7163798474					myanetsko@homecare-hospice.org	519 North Union Street		Olean	NY	147602135	02/19/2024	2026	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	Plan to Plan Reconciliation Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Processor Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Quality Contact	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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	Reconciliation Contact	Chief Financial Officer		Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Recovery Audit Contact	Chief Financial Officer	Mr	Kirk	Chad		7163722106	1103				ckirk@homecare-hospice.org	115 East Main St		Allegany	NY	14706	09/06/2024	2026	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	Surveillance Contact	Health Information Systems Manager	Mr	Brown	Kalan		7163798474				7163798543	kbrown@homecare-hospice.org	519 North Union St.		Olean	NY	14760	03/07/2024	2026	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	System Contact	Communications and Information Systems Co.	Mr	Smith	Russell		7163722106					rsmith@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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	Third Party Administrator (TPA) Liaison	Chief Executive Officer	Ms	Sullivan	Melissa		7163722106					msullivan@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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	User Access Contact	Communications and Information Systems Co.	Mr	Smith	Russell		7163722106					rsmith@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	12/26/2023	2026	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	Utilization Management Contact	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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	Utilization Review Contact	Quality and Compliance Director	Ms	Langdon	Angela		7163722106					alangdon@homecare-hospice.org	115 East Main Street		Allegany	NY	14706	02/26/2025	2026	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
H8811	Automated TrOOP Balance Transfer Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Backup User Access Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Best Available Evidence Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Bid Primary Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	CAP Report Contact for Public Website	Sr. Director Health Plan Operatoins	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					rpottharst@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					rpottharst@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Chief Financial Officer	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Chief Operating Officer	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Chief Information Officer	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Chief Information Security Officer	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	CMS Casework Communication Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Complaints Tracking Contact	National Director of Quality and Compliance Progra	Dr	Flake	Crissy	L	2138008886					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Contact for Fraud Investigations	National Director of Quality and Compliance Progra	Dr	Flake	Crissy	L	2138008886					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Coordination of Benefits Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Corporate Mailing						8338832889					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Customer Service Operations Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	DIR Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	DIR Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	3800 Kilroy Airport Way #100		Long Beach	CA	90806	02/17/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Discount Program Payment Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Emergency Part D Contact	Sr. Director Health Plan Operations	Ms.	Da	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Emergency Part D Contact (Secondary)	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Encounter Data & Risk Adjustment Operations Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Enrollment Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	EOB Transfer Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851				9295672060	HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Financial Audit Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Ca		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Financial Reporting Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Formulary Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Formulary Contact (Secondary)	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	General Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2138008889					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	02/10/2025	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Government Relations Contact	Chief Executive Officer	Mr.	Pottharst	Robert		9292692222					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	HIPAA Privacy Officer	National Director of Quality and Compliance Progra	Dr	Flake	Crissy	L	2138008886					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	HIPAA Security Officer	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Interoperability Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	MA Appeals/Grievances Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	MA Claims Processing Contact for Public Website	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Marketing Contact	Director - Marketing & Growth	Ms.	Boersma	Amie		2137674984					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	10/29/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Medical Director	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Medicare Compliance Officer	National Director of Quality and Compliance Progra	Dr.	Flake	Crissy	L	2138008886					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Medicare Coordinator	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Medicare Part D Opioid Overutilization Contact	National Director of Quality and Compliance Progra	Dr	Flake	Crissy	L	2138008886					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/10/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Medication Therapy Management Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part C Application Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part D Appeals	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	2137299851				PACE - Nat		C	San Francisco
H8811	Part D Appeals Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert							HPMS@myplacehealth.com	121 S Mountain View Ave	#100	Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	6172247969				PACE - Nat		C	San Francisco
H8811	Part D Application Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part D Benefits Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part D Claims Submission Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part D Exceptions Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	2137299851				PACE - Nat		C	San Francisco
H8811	Part D Exceptions Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	6172247969				PACE - Nat		C	San Francisco
H8811	Part D Price File Contact (Back-up)	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part D Price File Contact (Primary)	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part D Quality Assurance Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Part D Reporting Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Patient Safety Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Payment Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Personal Health Record Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Pharmacy Director	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Pharmacy Network Management Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		6197393775					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Pharmacy Network Management Contact (Secondary)	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Pharmacy Technical Help Desk Contact	VP & Head of Product	Mrs.	Gobalan	Anupama							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	7148584942				PACE - Nat		C	San Francisco
H8811	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra							HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active	2137299851				PACE - Nat		C	San Francisco
H8811	PHR Beneficiary Contact																	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE	myPlace Greater LA PACE Inc	SCAN Group	768	Yes	Active	8338832889				PACE - Nat		C	San Francisco
H8811	Plan Directory Contact for Public Website	Sr. Director Health Plan Operations	Ms.	Da	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Plan to Plan Reconciliation Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Processor Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Quality Contact	VP and National Medical Director	Dr.	Flake	Crissy	L	2137299856					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	10/29/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Reconciliation Contact	Director, Accounting	Mr.	Menchaca	Rafael		2133796438					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Reconciliation Contact (Secondary)	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra	A	2137299851					HPMS@myplacehealth.com	121 South Mountain View Avenue		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Recovery Audit Contact	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Surveillance Contact	Director Marketing & Growth	Ms.	Boersma	Amie		2137674984					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	10/29/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	System Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Third Party Administrator (TPA) Liaison	Sr. Director Health Plan Operations	Ms.	Da Rosa	Cassandra		2137299851					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	05/08/2024	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	User Access Contact	VP & Head of Product	Mrs.	Gobalan	Anupama		7148584942					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Utilization Management Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8811	Utilization Review Contact	VP and National Medical Director	Dr.	Schreiber	Robert		6172247969					HPMS@myplacehealth.com	121 S Mountain View Ave		Los Angeles	CA	90057	11/20/2023	2026	MYPLACE SOUTH LA PACE INC.	National PACE	myPlace PACE	National PACE		SCAN Group	768	Yes	Active					PACE - Nat		C	San Francisco
H8832	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8832	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			PPO - BBA		C	Chicago
H8832	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				PPO - BBA		C	Chicago
H8832	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				PPO - BBA		C	Chicago
H8832	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				PPO - BBA		C	Chicago
H8832	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				PPO - BBA		C	Chicago
H8832	PHR Beneficiary Contact																	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				PPO - BBA		C	Chicago
H8832	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8832	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	ALIGNMENT HEALTH ADVANTAGE PLAN INC	Local CCP	Alignment Health Plan	Local PPO		Alignment Healthcare USA, LLC	612	Yes	Active					PPO - BBA		C	Chicago
H8845	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H8845	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H8845	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H8845	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H8845	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H8845	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF ARIZONA, INC.	Local CCP	Molina Healthcare of Arizona	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H8845	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/12/2020	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@ingenio-rx.com	4 Varesa		Irvine	CA	92620	11/14/2022	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	05/01/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H8849	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H8849	PHR Beneficiary Contact																	02/12/2020	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H8849	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8849	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	WELLPOINT INSURANCE COMPANY	Local CCP	Wellpoint	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8854	Agent/Broker Compensation Data Contact	Director, Medicare Sales	Mr.	Trahan	Donald		4109987538					donald.trahan@carefirst.com	10455 Mill Run Circle	Mailstop OWML1	Owings Mills	MD	21117	09/14/2024	2026	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	Chicago
H8854	Automated TrOOP Balance Transfer Contact	Part D Business Analyst	Ms.	Ellerbee	Ashley		4109984314					Ashley.Ellerbee@carefirst.com	10455 Run Mill Circle		Owings Mills	MD	21117	11/04/2023	2026	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	Chicago
H8854	Backup User Access Contact	Manager, Regulatory Compliance	Ms.	Incorvati	Laura		4106052405					Laura.Incorvatii@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	03/06/2024	2026	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	Chicago
H8854	Best Available Evidence Contact	Manager, Enrollment	Ms.	Knox	Dorothea		4109985559					Dorothea.Knox@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	07/28/2022	2026	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	Chicago
H8854	Bid Audit Contact	Manager, Product Lifecycle	Ms.	Franklin	Lisa		4109984647					Lisa.Franklin@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2022	2026	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	Chicago
H8854	Bid Audit Site Contact	Manager, Product Lifecycle	Ms.	Franklin	Lisa		4109984647					Lisa.Franklin@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2022	2026	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	Chicago
H8854	Bid Primary Contact	Manager, Product Lifecycle	Ms.	Franklin	Lisa		4109984647					Lisa.Franklin@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2022	2026	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	Chicago
H8854	CAP Report Contact for Public Website	CEO, CFCHP-MD	Mr.	Rapach	Mike		4109984601					Mike.Rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Johnson	Ricardo		4105285789					ricardo.johnson@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	11/05/2025	2026	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	Chicago
H8854	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Johnson	Ricardo		4105285789					ricardo.johnson@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	11/05/2025	2026	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	Chicago
H8854	Chief Financial Officer	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2023	2026	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	Chicago
H8854	Chief Operating Officer	COO and SVP of Government Programs	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/20/2025	2026	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	Chicago
H8854	Chief Information Officer	VP, IT Ops and Infrastructure	Ms.	Henderson	Dori		4109985656					Dori.Henderson@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	11/10/2021	2026	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	Chicago
H8854	Chief Information Security Officer	Chief Information Security Officer	Mr.	Suarez	Roberto		4109985716					Roberto.Suarez@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	07/22/2023	2026	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	Chicago
H8854	CMMI Model Point of Contact	CEO, CFCHP-MD	Mr.	Rapach	Mike		4109984601					Mike.Rapach@carefirst.com	PO Box 915		Owings MIlls	MD	21117	09/17/2022	2026	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	Chicago
H8854	CMS Casework Communication Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	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	Chicago
H8854	Complaints Tracking Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	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	Chicago
H8854	Contact for Fraud Investigations	Director, SIU	Ms.	Kennedy	Elizabeth		4105287067					elizabeth.kennedy@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	07/22/2023	2026	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	Chicago
H8854	Coordination of Benefits Contact	VP, Government Programs	Ms.	Toland	Cheryl		4109985107					CFGroupMA@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/25/2025	2026	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	Chicago
H8854	Corporate Mailing						4109987534					Julie.Billman@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	03/02/2021	2026	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	Chicago
H8854	Customer Service Operations Contact	Manager, Member Services	Ms.	Boer	Kelsey		4109985359					Kelsey.Boer@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	07/23/2021	2026	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	Chicago
H8854	DIR Contact	CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	01/10/2025	2026	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	Chicago
H8854	DIR Contact (Secondary)	Manager, Specialty Business	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	03/06/2024	2026	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	Chicago
H8854	Discount Program Payment Contact	Senior Business Analyst	Ms.	Harris	Amanda		4105287839					Amanda.Harris@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/29/2025	2026	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	Chicago
H8854	Emergency Part D Contact	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Emergency Part D Contact (Secondary)	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	Encounter Data & Risk Adjustment Operations Contact	VP, Risk Adjustment, Stars, Quality	Ms.	Haynes	Liz		4104692145					Liz.Haynes@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	09/26/2025	2026	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	Chicago
H8854	Enrollment Contact	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	02/12/2025	2026	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	Chicago
H8854	EOB Transfer Contact	Chief Operations Officer DSNP	Ms.	Toland	Cheryl		4109985107				4109987534	Cheryl.Toland@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Financial Audit Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	10/12/2024	2026	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	Chicago
H8854	Financial Reporting Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	10/12/2024	2026	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	Chicago
H8854	Formulary Contact	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Atueyi	Ifeoma		4109986386					Ifeoma.Atueyi@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	06/25/2025	2026	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	Chicago
H8854	General Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Government Relations Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	11/04/2023	2026	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	Chicago
H8854	HIPAA Privacy Officer	Dir, Privacy & Compliance	Ms.	Gregory	Lauren		4105285066					lauren.gregory@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	HIPAA Security Officer	Chief Information Security Officer	Mr.	Suarez	Roberto		4109985716					Roberto.Suarez@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	07/22/2023	2026	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	Chicago
H8854	Hospice Contact	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	10455 Mill Run Circle		Owing Mills	MD	21117	09/14/2024	2026	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	Chicago
H8854	Interoperability Contact	VP, Enterprise Arch. & Integr.	Mr.	Heyl	Bob		2026806682					Bob.Heyl@carefirst.com	840 First Street, NE		Washington	DC	20065	02/16/2022	2026	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	Chicago
H8854	MA Appeals/Grievances Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	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	Chicago
H8854	MA Claims Processing Contact for Public Website			Services	Member		4107799932					Chery.Toland@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Marketing Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Medical Director	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	04/09/2024	2026	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	Chicago
H8854	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	12/07/2024	2026	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	Chicago
H8854	Medicare Coordinator	Manager, Regulatory Compliance	Ms.	Incorvati	Laura		4106052405					Laura.Incorvati@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	09/26/2025	2026	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	Chicago
H8854	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/20/2024	2026	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	Chicago
H8854	Medication Therapy Management Contact	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	11/04/2023	2026	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	Chicago
H8854	Online Enrollment Center Contact (Back-up)	Chief Ops Officer-DSNP	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	P. O. Box 915		Owings Mills	MD	21117	12/20/2021	2026	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	Chicago
H8854	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Knox	Dorothea		4109985559					Dorothea.Knox@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	09/17/2022	2026	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	Chicago
H8854	Part C Application Contact	CF CHP-MD Chief Executive Officer	Mr.	Rapach	Mike		4109984601					Mike.Rapach@carefirst.com	10455 Mill Run Cirlce		Owings Mills	MD	21117	09/17/2021	2026	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	Chicago
H8854	Part C Reporting Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Part D Appeals	Manager, Clinical Operations	Ms.	Beyda	Trista						7326914838	_REReconsideration@cvscaremark.com	3424 William Penn Hwy,		Pittsburg	PA	15235	07/22/2023	2026	CAREFIRST ADVANTAGE DSNP, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	8889700917				HMO - Health Maintenance Organization		C	Chicago
H8854	Part D Appeals Contact (Secondary)	Medicare Appeals Analyst	Ms.	Gabor-Lyon	Pam						7326914838	Trista.Beyda@cvshealth.com	3424 William Penn Hwy		Pittsburgh	PA	15235	07/22/2023	2026	CAREFIRST ADVANTAGE DSNP, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	8889700917				HMO - Health Maintenance Organization		C	Chicago
H8854	Part D Application Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Part D Benefits Contact	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	Part D Claims Submission Contact	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	Part D Exceptions Contact	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi							Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/15/2023	2026	CAREFIRST ADVANTAGE DSNP, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	4105285053				HMO - Health Maintenance Organization		C	Chicago
H8854	Part D Exceptions Contact (Secondary)	Clinical Pharmacist	Ms	Lee	Catherine							Catherine.Lee@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	04/09/2024	2026	CAREFIRST ADVANTAGE DSNP, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	4105287033				HMO - Health Maintenance Organization		C	Chicago
H8854	Part D Price File Contact (Back-up)	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	Part D Price File Contact (Optional)		Mr.	Loveland	Chet		4806064873					Chet.Loveland@cvshealth.com	9501 E Shea Blvd	MC 121	Scottsdale	AZ	85260	07/22/2023	2026	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	Chicago
H8854	Part D Price File Contact (Primary)	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/15/2023	2026	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	Chicago
H8854	Part D Quality Assurance Contact	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	Part D Reporting Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Patient Safety Contact	Clinical Pharmacist	Ms.	Lee	Catherine		4105287033					Catherine.Lee@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/09/2024	2026	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	Chicago
H8854	Payment Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2023	2026	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	Chicago
H8854	Pharmacy Director	Sr. Director, Pharmacy Evaluation & Oversight	Ms	Poplawski	Mandi		4105285053					Mandi.Poplawski@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/23/2021	2026	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	Chicago
H8854	Pharmacy Network Management Contact	Directory, Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	04/23/2021	2026	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	Chicago
H8854	Pharmacy Network Management Contact (Secondary)	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi		4105285303					Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	08/15/2023	2026	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	Chicago
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	2026	CAREFIRST ADVANTAGE DSNP, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H8854	Pharmacy Technical Help Desk Contact (Secondary)	Part D Business Analyst	Ms	Ellerbee	Ashley							Ashley.Ellerbee@carefirst.com	P.O. Box 915		Owings Mills	MD	21117	11/10/2021	2026	CAREFIRST ADVANTAGE DSNP, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS		CareFirst, Inc.	45	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H8854	PHR Beneficiary Contact																	07/22/2023	2026	CAREFIRST ADVANTAGE DSNP, INC.	Local CCP	CareFirst BlueCross BlueShield Medicare Advantage Dual Prime	HMO/HMOPOS	CareFirst BlueCross Blue Shield Medicare Advantage	CareFirst, Inc.	45	Yes	Active	8552905744				HMO - Health Maintenance Organization		C	Chicago
H8854	Physician Incentive Contact	Manager, Payment Transformation	Mr.	Coffey	Nathan		4104692167					Nathan.Coffey@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Plan Directory Contact for Public Website			Services	Member		8443866762					contactus@ummshealthplans.com	P.O. Box 915		Owings Mills	MD	21117	11/11/2021	2026	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	Chicago
H8854	Plan to Plan Reconciliation Contact	Financial Analyst	Mr.	Murry	Kyle		4106042401					Kyle.Murry@Carefirst.com	P.O. Box 782437		Philadelphia	PA	191782437	08/21/2025	2026	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	Chicago
H8854	Processor Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Quality Contact	Director, Quality	Ms.	Attia	Carol		4105982895					Carol.Attia@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	12/30/2024	2026	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	Chicago
H8854	Reconciliation Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/16/2023	2026	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	Chicago
H8854	Reconciliation Contact (Secondary)	Director, Pharmacy Services	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	11/04/2023	2026	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	Chicago
H8854	SNP Application Contact	Health Plan CEO	Mr.	Rapach	Mike		4109984601					Mike.Rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	SNP State Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	11/04/2023	2026	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	Chicago
H8854	Surveillance Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	11/04/2023	2026	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	Chicago
H8854	System Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	07/22/2023	2026	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	Chicago
H8854	Third Party Administrator (TPA) Liaison	Senior Accountant	Ms.	Mitchell	Patrice	R	4109985273					patrice.mitchell@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	12/12/2023	2026	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	Chicago
H8854	User Access Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	11/04/2023	2026	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	Chicago
H8854	Utilization Management Contact	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	10455 Mill Run Circle		Owing Mills	MD	21117	09/14/2024	2026	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	Chicago
H8854	Utilization Review Contact	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	10455 Mill Run Circle		Owing Mills	MD	21117	09/14/2024	2026	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	Chicago
H8879	Agent/Broker Compensation Data Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Automated TrOOP Balance Transfer Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Backup User Access Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Best Available Evidence Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Bid Audit Contact			Savoy	Vernisha	R	4632315137					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Bid Primary Contact		Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	CAP Report Contact for Public Website			Savoy	Vernisha	R	2192284152					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	CEO - CMS Administrator Contact	President	Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	CEO - Senior Official for Contracting	President	Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Chief Financial Officer	President	Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Chief Operating Officer		Mrs	Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Chief Information Officer		Mr	Hawthrone	Don		2193950667					dhawthrone@bumblebeeitservices.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Chief Information Security Officer	Chief Technology Officer	Mr	Pirtle	Mitch		5714141313					mpirtle@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	CMS Casework Communication Contact	Director, Quality		Snyder	Karen		2192284152					ksnyder@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Complaints Tracking Contact	Director, Quality		Snyder	Karen		2192284152					ksnyder@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Contact for Fraud Investigations	Chief Compliance Officer		Savoy	Vernisha	R	2192284152					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Coordination of Benefits Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Corporate Mailing						2192284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Customer Service Operations Contact		Mrs	Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	DIR Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	DIR Contact (Secondary)		Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Discount Program Payment Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Electronic Health Record Contact	Vice President, Outpatient Clinics		McDermeit	Kelly		6203883002					kmcdermeit@boavidahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Emergency Part D Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Emergency Part D Contact (Secondary)	Director, Pharmacy Services		Roberts	Sarah		2193593301					sroberts@qualexahealthcare.com	10996 Four Seasons Place Crown Point	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment		Sherman	Wanda		4632079028					wsherman@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Enrollment Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	EOB Transfer Contact	COO		Howeth	Teresa		2199009129				3853544396	thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Financial Audit Contact	President	Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Financial Reporting Contact		Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Formulary Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Formulary Contact (Secondary)		Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	General Contact	Chief Compliance Officer	Mrs	Savory	Vernisha		8132151127					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Government Relations Contact		Ms	Savoy	Vernisha		2192284152					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	HIPAA Privacy Officer		Ms	DeAugistine	Jessica		2192284152					jdeaugistine@integra-compliance.us	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	HIPAA Security Officer		Ms	DeAugistine	Jessica		2192284152					jdeaugistine@integra-compliance.us	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Hospice Contact	Vice President, Outpatient Clinics	Ms.	McDermeit	Kelly		6203883006					kmcdermeit@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Interoperability Contact		Mrs	Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	MA Appeals/Grievances Contact		Ms	Snyder	Karen		2192284152					ksnyder@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	MA Claims Processing Contact for Public Website	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Marketing Contact	Chief Compliance Officer	Mrs	Savoy	Vernisha	R	2192284152					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Medical Director	Medical Director	Dr	Box	Samuel		6623692455					sbox@bvfmr.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Medicare Compliance Officer	Chief Compliance Officer	Mrs	Savoy	Vernisha	R	4632315137					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Medicare Coordinator	Chief Compliance Officer	Mrs	Savory	Vernisha		2192284152					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Medication Therapy Management Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Online Enrollment Center Contact (Back-up)	Chief Technology Officer	Mr	Pirtle	Mitch		5714141313					mpirtle@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Online Enrollment Center Contact (Primary)	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part C Application Contact	President	Dr	Singh	Kirnjot		2192284355					ksingh@qualexahealthcare.com	10996 Four Seasons PL 100C		Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part C Reporting Contact	Chief Compliance Officer	Mrs	Savoy	Vernisha	R	4632315137					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Appeals	Directory of Pharmacy Services		Jacobi	Jacqueline							jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active	2192001695				HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Appeals Contact (Secondary)	President	Dr.	Singh	Kirnjot							ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active	2182284355				HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Application Contact	CEO/President	Dr.	Singh	Kirnjot		2192284355					ksingh@qualexahealthcare.com	10996 Four Seasons PL 100C		Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Benefits Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Claims Submission Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Exceptions Contact	Director of Pharmacy Services		Jacobi	Jacqueline							jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active	2192001695				HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Exceptions Contact (Secondary)	COO		Howest	Teresa							thoweth@qualexahealthcare.com	10996 Four Seasons Pl 100C		Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active	2199009129				HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Price File Contact (Back-up)		Mrs	Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Price File Contact (Primary)	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Quality Assurance Contact	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Part D Reporting Contact	Chief Compliance Officer	Mrs	Savoy	Vernisha	R	4632315137					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Patient Safety Contact	Director, Quality	Ms	Snyder	Karen		2192284152					ksnyder@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Payment Contact	President	Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Pharmacy Director	Director of Pharmacy Services		Jacobi	Jacqueline		2192001695					jjacobi@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Pharmacy Network Management Contact		Mrs	Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Pharmacy Network Management Contact (Secondary)			Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Pharmacy Technical Help Desk Contact	COO	Mrs	Howeth	Teresa							thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/05/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active	8332016413				HMO - Health Maintenance Organization		C	Dallas
H8879	Pharmacy Technical Help Desk Contact (Secondary)	Director of Pharmacy Services		Jacobi	Jacqueline							jjacobi@qualexahealthcare.com	10996 Four Seasons Pl 100C		Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active	2192001695				HMO - Health Maintenance Organization		C	Dallas
H8879	Physician Incentive Contact			Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Plan Directory Contact for Public Website	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Plan to Plan Reconciliation Contact	Chief Operating Officer	ms.	Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Processor Contact	COO		Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Quality Contact		Ms	Snyder	Karen		2192284152					ksnyder@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Reconciliation Contact	Chief Operating Officer	Ms.	Howeth	Teresa		2199009129					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Reconciliation Contact (Secondary)	President	Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	12/17/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Recovery Audit Contact	President	Dr	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	SNP Application Contact	Chief Compliance Officer		Savoy	Vernisha	R	4632315137					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	SNP State Contact	President	Dr.	Singh	Kirnjot		2182284355					ksingh@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Surveillance Contact	Chief Compliance Officer	Mrs	Savoy	Vernisha		2192284152					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	System Contact	Chief Compliance Officer	Mrs	Savory	Vernisha	R	2192284152					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Third Party Administrator (TPA) Liaison	COO	Mrs	Howeth	Teresa		3853544396					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	User Access Contact	Chief Compliance Officer	Ms.	Savoy	Vernisha	R	4632315137					vsavoy@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Utilization Management Contact	Chief Operating Officer	Ms.	Howeth	Teresa		2193593301					thoweth@qualexahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8879	Utilization Review Contact	Vice President, Outpatient Clinics	ms.	McDermeit	Kelly		6203883006					kmcdermeit@boavidahealthcare.com	10996 Four Seasons Pl	100C	Crown Point	IN	46307	06/04/2025	2026	Healthy Mississippi, Inc.	Local CCP	Healthy Mississippi, Inc.	HMO/HMOPOS		Singh Holdings LLC	832	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8883	Automated TrOOP Balance Transfer Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Backup User Access Contact		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Best Available Evidence Contact			Cadena	Maria		6505022961					maria.cadena@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Bid Primary Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	CAP Report Contact for Public Website			Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	CEO - CMS Administrator Contact		Ms.	Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	CEO - Senior Official for Contracting		Ms.	Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Chief Financial Officer		Mr.	Zybak	Don		7732436444					don.zybak@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Chief Operating Officer		Ms.	Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		Pasadena	CA	91105	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Chief Information Officer		Ms.	Purushothaman	Bindu		5059038068					bindu.purushothaman@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Chief Information Security Officer		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	CMS Casework Communication Contact	Compliance Director		Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Complaints Tracking Contact	Compliance Director		Costigan	Bobbie		2192106392					Bobbie.Costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Contact for Fraud Investigations			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Coordination of Benefits Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Corporate Mailing						6508626371					matt.patterson@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Customer Service Operations Contact			Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	DIR Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	DIR Contact (Secondary)			Grant	Alexsa		3109963539					alexsa.grant@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Discount Program Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Emergency Part D Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Emergency Part D Contact (Secondary)			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Encounter Data & Risk Adjustment Operations Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Enrollment Contact			Cadena	Maria		6505022961					maria.cadena@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	EOB Transfer Contact			Cadena	Maria		6505022961				6263600082	maria.cadena@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Financial Audit Contact	Senior Accounting Manager	Ms.	Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Financial Reporting Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Formulary Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	General Contact			Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Government Relations Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	HIPAA Privacy Officer			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	HIPAA Security Officer		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Interoperability Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	MA Appeals/Grievances Contact			Costigan	Bobbie		2192106392					bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	MA Claims Processing Contact for Public Website			Grant	Alexsa		6503360300					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Marketing Contact			Castro	Marta		6509186233					marta.castro@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Medical Director	Chief Medical Officer		Hirota	David		8007348041					david.hirota@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/30/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Medicare Compliance Officer		Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Medicare Coordinator			Eidell	Rachel		7142927152					rachel.frank@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Medicare Part D Opioid Overutilization Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/27/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Hirota	David		8007348041					david.hirota@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/30/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part C Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part D Appeals			Costigan	Bobbie							bobbie.costigan@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending	2192106392				PACE - Nat		C	San Francisco
H8883	Part D Application Contact			Harden	Gabriele		3037754823					gabriele.harden@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part D Benefits Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part D Claims Submission Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part D Exceptions Contact	Chief Medical Officer	Dr.	Hirota	David							david.hirota@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/30/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending	8007348041				PACE - Nat		C	San Francisco
H8883	Part D Price File Contact (Back-up)			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part D Price File Contact (Primary)			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part D Quality Assurance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Part D Reporting Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Patient Safety Contact	Chief Medical Officer	Dr.	Le	Mike		7146086457					michael.le@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Payment Contact			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Pharmacy Director			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Pharmacy Network Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Pharmacy Technical Help Desk Contact			Grant	Alexsa							alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending	8007348041				PACE - Nat		C	San Francisco
H8883	Plan Directory Contact for Public Website			Grant	Alexsa		6503360300					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Plan to Plan Reconciliation Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Processor Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Quality Contact			Simon	Jillian		3104296136					jillian.simon@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Reconciliation Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Reconciliation Contact (Secondary)			Kong	Shelley		6508439275					shelley.kong@welbehealth.com	440 N BARRANCA AVE	#4051	Covina	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Recovery Audit Contact	VP Compliance	Ms.	Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Surveillance Contact			Lee	Elizabeth		6505141390					elizabeth.lee@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	System Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Third Party Administrator (TPA) Liaison			Miller	Kentraiell		2094996795					kentraiell.miller@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	User Access Contact		Mr.	Kim	David		6502920551					david.kim@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Utilization Management Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8883	Utilization Review Contact			Grant	Alexsa		3109635394					alexsa.grant@welbehealth.com	440 N BARRANCA AVE #4051		COVINA	CA	91723	06/03/2025	2026	WELBEHEALTH BERGEN PACE, LLC	National PACE	WelbeHealth	National PACE		WelbeHealth LLC.	707	Yes	Pending					PACE - Nat		C	San Francisco
H8889	Agent/Broker Compensation Data Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Automated TrOOP Balance Transfer Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Backup User Access Contact			Berg	Lynnsey		6126326655					lynnsey.berg@optum.com	P.O. Box 9472		Minneapolis	MN	554409472	11/30/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Best Available Evidence Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Bid Audit Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Bid Audit Site Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Bid Primary Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	CAP Report Contact for Public Website	Manager - Compliance		Herbst	Travis		6088272856					Travis Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	09/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	CEO - CMS Administrator Contact	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Chief Financial Officer	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Chief Operating Officer	Chief Operations Officer	Mr	Hjerpe	Adam		6123861065					COO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/11/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Chief Information Officer	VP, Chief Technology Officer	Mr	Peterson	Scott		9529922625					Scott.Peterson@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	09/05/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Chief Information Security Officer		Mr	Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/12/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	CMMI Model Point of Contact			Schaefer	Jennifer		9529912803					jennifer.schaefer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/15/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	CMS Casework Communication Contact	Manager, Consumer Advisor		Blum	Adam		6088274420					Adam.Blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Complaints Tracking Contact	Consumer Affairs Supervisor		Riske	Christina		8002791302					Christina.Riske@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Contact for Fraud Investigations	Director, Special Investigations Unit		Kalin	Dan		9529922587					Daniel.Kalin@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/05/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Coordination of Benefits Contact			Vilendrer	Krista		9529923252					krista.vilendrer@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	04/22/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Corporate Mailing						9529922900					Nichole.MeltonMitchell@medica.com	401 Carlson Parkway	P.O. Box 9310 CP320	Minnetonka	MN	55305	04/09/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Customer Service Operations Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	11/10/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	DIR Contact			Watson	Amy		9529923768					amy.watson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	04/02/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	DIR Contact (Secondary)	VP & Chief Pharmacy Officer		Rogers	Nick		9529923611					Nicholas.Rogers@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Discount Program Payment Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Emergency Part D Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/06/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Emergency Part D Contact (Secondary)			Day	Colton		9529928537					Colton.Day@deancare.com	1277 Deming Way		Madison	WI	53717	01/06/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Employer Waiver Contact			Alness	Stacy		9529923825					stacy.alness@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/19/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Encounter Data & Risk Adjustment Operations Contact	Director- Risk Adjustment Operations		Werwinski	Michelle		6088305958					Michelle.Werwinski@deancare.com	1277 Deming Way		Madison	WI	53717	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Enrollment Contact			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	EOB Transfer Contact			Bourdages	Kathy		9529923653				9529923636	kathy.bourdages@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/25/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Financial Audit Contact	Sr. Director of Finance, Medicaid & Medicare	Ms	Faig	Sara		9529928358					sara.faig@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Financial Reporting Contact			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Formulary Contact			Parr	Ross		9529921767					ross.parr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Formulary Contact (Secondary)			Seabright	Diane		9529922474					diane.valeo-seabright@deancare.com	401 Carlson Parkway		Minnetonka	MN	55305	07/23/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	General Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Government Relations Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	HIPAA Privacy Officer			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/20/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	HIPAA Security Officer		Mr	Young	Dave		9529922316					david.young@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/12/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Hospice Contact			Bourdages	Kathy		9529923653				9529923636	PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/13/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Interoperability Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/14/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	MA Appeals/Grievances Contact	Manager, Consumer Advisor		Blum	Adam		6088274420					Adam.Blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/30/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	MA Claims Processing Contact for Public Website			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Marketing Contact			Teff	Melissa		9529923972					melissa.teff@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Medical Director	Chief Clinical & Provider Strategy Officer		Webster	David		9529922801					david.webster@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/15/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Medicare Compliance Officer	VP Compliance	Mrs	Koranteng	Milly		9529922090					complianceofficer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Medicare Coordinator	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/10/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Medication Therapy Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	OffShore Subcontractor Contact			Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Online Enrollment Center Contact (Primary)			Wood	Donna		9529923843					donna.wood@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/25/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part C Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part C Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Appeals			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/25/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	9529922353				PPO - BBA		C	Dallas
H8889	Part D Appeals Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	6088277576				PPO - BBA		C	Dallas
H8889	Part D Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Benefits Contact			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/09/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Claims Submission Contact			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/02/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Exceptions Contact			Rodine	Bridget							bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/25/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	9529922353				PPO - BBA		C	Dallas
H8889	Part D Exceptions Contact (Secondary)	Director Clinical Pharmacy		Wilhelm	Sue							Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	6088277576				PPO - BBA		C	Dallas
H8889	Part D Price File Contact (Back-up)			Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Farifield	OH	45014	11/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Price File Contact (Optional)			Bourdages	Kathy		9529923653					PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/28/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Price File Contact (Primary)			Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	11/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Quality Assurance Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Part D Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Patient Safety Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Payment Contact			Faig	Sara		9529928358					sara.faig@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Pharmacy Director	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Pharmacy Network Management Contact	Director Clinical Pharmacy		Wilhelm	Sue		6088277576					Sue.Wilhelm@deancare.com	1277 Deming Way		Madison	WI	53717	12/09/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Pharmacy Network Management Contact (Secondary)			Rodine	Bridget		9529922353					bridget.rodine@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/25/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
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	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	8009221557				PPO - BBA		C	Dallas
H8889	Pharmacy Technical Help Desk Contact (Secondary)			Bourdages	Kathy							PharmacySrvcGovtProg@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/09/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active	8009221557				PPO - BBA		C	Dallas
H8889	Plan Directory Contact for Public Website			Service	Customer		8002348755					AskGovtPrograms@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/28/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Plan to Plan Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Processor Contact			Bean	Danielle		9529922864					danielle.bean@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Quality Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Reconciliation Contact			Ricaurte	Angela		9529923748					Angela.Ricaurte@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	05/16/2023	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Reconciliation Contact (Secondary)			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	01/25/2018	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Recovery Audit Contact	Manager Claims Operations	Mr	Foley	Steve		9529924160					steven.foley@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/17/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	SNP Application Contact			Olmscheid	Becky		9529923737					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	10/17/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	SNP State Contact			Zillhardt	John		9529922290					John.Zillhardt@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	02/15/2021	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Surveillance Contact			Swanson	Renee		9529922064					Renee.Swanson@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/26/2019	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	System Contact			Schwartz	Pamela		9529922584					pamela.schwartz@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	08/01/2022	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Third Party Administrator (TPA) Liaison			Schenten	Paul		9529928875					paul.schenten@medica.com	401 Carlson Parkway CP330		Minnetonka	MN	55305	08/05/2020	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	User Access Contact			Harrington	Dana		6122129075					dana.harrington@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Utilization Management Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8889	Utilization Review Contact	Mgr-RN Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	02/22/2024	2026	MEDICA HEALTH PLANS	Local CCP	Medica	Local PPO		Medica Holding Company	439	Yes	Active					PPO - BBA		C	Dallas
H8894	Agent/Broker Compensation Data Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Automated TrOOP Balance Transfer Contact	Manager, Formulary and Pharmacy Benefits	Dr	Chirk	Robert		9096601917					chirk-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Backup User Access Contact	Regulatory Affairs Liaison		Blaine	Janit		9098904608					janit.blaine@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	07/29/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Best Available Evidence Contact	Manager, Business Systems Operations Support		Ramirez	Tiana		9098902073					ramirez-t@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/03/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Bid Audit Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Bid Primary Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	CAP Report Contact for Public Website	Chief Executive Officer	Mr.	McNaughton	Jarrod		9098902010				9098902973	mcnaughton-jb@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/05/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	McNaughton	Jarrod		9097672276					mcnaughton-jb@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	10/02/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	McNaughton	Jarrod		9098902010					mcnaughton-jb@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/25/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Chief Financial Officer	Chief Executive Officer/Interim CFO	Mr.	McNaughton	Jarrod		9098902010					mcnaughton-jb@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/04/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Chief Operating Officer	Chief Operating Officer	Ms.	White	Susie		9098902710				9098902973	white-s@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/05/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Chief Information Officer	Chief Digital and Information Officer	Mr.	Devabhaktuni	Vinil		9099422460					vinil.devabhaktuni@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	08/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Chief Information Security Officer	Chief Digital and Information Officer	Mr.	Devabhaktuni	Vinil		9099422460					vinil.devabhaktuni@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	08/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	CMS Casework Communication Contact	Director, Grievance & Appeals		Wellmaker	Jennifer		9098902701				9098905748	wellmaker-j@iehp.org	PO Box 1800		Rancho Cucamonga	CA	91729	01/04/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Complaints Tracking Contact	Director, Grievance & Appeals		Wellmaker	Jennifer		9098902701				9098905748	wellmaker-j@iehp.org	PO Box 1800		Rancho Cucamonga	CA	91729	01/04/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Contact for Fraud Investigations	SIU Manager		Kondratenko	Alex		9093866422					alex.kondratenko@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	02/06/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Coordination of Benefits Contact	Manager, Formulary & Pharmacy Benefits	Dr	Chirk	Robert		9096601917					chirk-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Corporate Mailing						8772734347				9098905877	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Customer Service Operations Contact	Senior Director, Member Services		Paul	Remington		9092963619					remington.paul@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	08/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	DIR Contact	Manager Pharmacy Informatics		Yip	Richard		9097677368					yip-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	02/27/2023	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	DIR Contact (Secondary)	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Discount Program Payment Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	12/06/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Emergency Part D Contact	Senior Director, Pharmacy Operations		Ornelas	Christina		9097275149					christina.ornelas@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Emergency Part D Contact (Secondary)	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth St		Rancho Cucamonga	CA	91730	12/21/2023	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Encounter Data & Risk Adjustment Operations Contact	Supervisor, Encounter & EDI Operations		Alexander	Mark		9513743119					alexander-m@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	08/06/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Enrollment Contact	Manager, Business Systems Operations Support		Ramirez	Tiana		9098902073					ramirez-t@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	01/03/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	EOB Transfer Contact	Manager, Formulary and Pharmacy Benefits	Dr	Chirk	Robert		9096601917				9518911577	chirk-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Financial Audit Contact	Manager Regulatory Affairs Medicare	Mr.	Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/25/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Financial Reporting Contact	Manager Medicare Regulatory Affairs	Mr.	Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/04/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Formulary Contact	Manager, Formulary & Pharmacy Benefits	Dr.	Chirk	Robert		9096601917					chirk-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Formulary Contact (Secondary)	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	05/24/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	General Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Government Relations Contact	Chief Executive Officer	Mr	McNaughton	Jarrod		9098902010				9098902973	mcnaughton-jb@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	HIPAA Privacy Officer	Vice President, Compliance		Nery	Lourdes		9094205546					nery-l@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	08/06/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	HIPAA Security Officer	Chief Digital and Information Officer		Devabhaktuni	Vinil		9099422460					vinil.devabhaktuni@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	08/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Hospice Contact	Manager, Pharmacy Utilization Management	Dr.	Yu	Adam		9512335584					yu-a@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Interoperability Contact	Manager, Systems Design & Architecture		Singelman	John		9098902173					Singelman-J@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	07/30/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	MA Appeals/Grievances Contact	Director, Grievance & Appeals		Wellmaker	Jennifer		9098902701				9098905748	wellmaker-j@iehp.org	PO Box 1800		Rancho Cucamonga	CA	91729	01/04/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	MA Claims Processing Contact for Public Website	Senior Director of Claims		Baray	David		9098902790				9098902068	baray-d@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Marketing Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	07/30/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Medical Director	Chief Medical Officer	Dr.	Juhn	Edward		9098902930					juhn-e@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	07/11/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Medicare Compliance Officer	Vice President, Compliance	Ms	Nery	Lourdes		9094205546					dgmedicarecomplianceofficer@iehp.org	10801 Sixth St		Rancho Cucamonga	CA	91730	08/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Medicare Coordinator	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy & Patient Safety	Dr.	Blatt	Michael		9092560753				9518911577	blatt-m@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Medication Therapy Management Contact	Director, Clinical Pharmacy & Patient Safety	Dr.	Blatt	Michael		9092560753				9518911577	blatt-m@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part C Application Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part C Reporting Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part D Appeals	Director, Grievance & Appeals		Wellmaker	Jennifer						9098905748	wellmaker-j@iehp.org	PO Box 1800		Rancho Cucamonga	CA	91729	10/28/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active	9098902701				HMO - Health Maintenance Organization		C	New York
H8894	Part D Application Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part D Benefits Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part D Claims Submission Contact	Manager, Formulary & Pharmacy Benefits	Dr.	Chirk	Robert		9096601917					chirk-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part D Exceptions Contact	Manager, Pharmacy Utilization Management	Dr.	Yu	Adam							yu-a@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active	9512335584				HMO - Health Maintenance Organization		C	New York
H8894	Part D Price File Contact (Back-up)	Senior Director, Pharmacy Operations	Dr.	Ornelas	Christina		9097275149					christina.ornelas@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part D Price File Contact (Primary)	Manager, Formulary and Pharmacy Benefits	Dr.	Chirk	Robert		9096601917					chirk-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part D Quality Assurance Contact	Senior Director, Pharmacy Operations	Dr.	Ornelas	Christina		9097275149					christina.ornelas@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Part D Reporting Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Patient Safety Contact	Director, Clinical Pharmacy & Patient Safety	Dr.	Blatt	Michael		9092560753				9518911577	blatt-m@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Payment Contact	Manager Medicare Regulatory Affairs	Mr.	Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/04/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Pharmacy Director	Senior Director, Pharmacy Operations	Dr.	Ornelas	Christina		9097275149					christina.ornelas@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Pharmacy Network Management Contact	Senior Director, Pharmacy Operations	Dr.	Ornelas	Christina		9097275149					christina.ornelas@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
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	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active	8884953147				HMO - Health Maintenance Organization		C	New York
H8894	Plan Directory Contact for Public Website	Member Services		Services	Member		8772734347				9098905877	member_services@IEHP.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	01/12/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Plan to Plan Reconciliation Contact	Director, Accounting Services		Yan Goh	Aileen		9092918057					aileen.yangoh@iehp.org	US Bank Wholesale Lockbox C/O 511966	16420 Valley View Ave.	La Mirada	CA	90638	04/21/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Processor Contact	Manager, Formulary & Pharmacy Benefits	Dr.	Chirk	Robert		9096601917					chirk-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	11/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Quality Contact	Chief Quality Officer		Fick	Genia		9099636835					fick-g@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	07/11/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Reconciliation Contact	Vice President Actuarial Services		Chio	Carol		9092725224					Chio-C@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	05/23/2023	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Reconciliation Contact (Secondary)	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth St		Rancho Cucamonga, CA 91730	CA	92504	02/27/2023	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Recovery Audit Contact	Manager Regulatory Affairs Medicare	Mr.	Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	SNP Application Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	SNP State Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth St.		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Surveillance Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	System Contact	Chief Digital and Information Officer		Devabhaktuni	Vinil		9099422460					vinil.devabhaktuni@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	08/07/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Third Party Administrator (TPA) Liaison	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251					haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	12/06/2024	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	User Access Contact	Manager Regulatory Affairs Medicare		Haines	Randy		9092960251				9098902973	haines-r@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	09/22/2022	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Utilization Management Contact	Director, UM Operations		Roca	Griselda		9098904351					roca-g@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	03/19/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8894	Utilization Review Contact	Director, UM Operations		Roca	Griselda		9098904351					roca-g@iehp.org	10801 Sixth Street		Rancho Cucamonga	CA	91730	03/19/2025	2026	Inland Empire Health Plan	Local CCP	IEHP DualChoice	HMO/HMOPOS		INLAND EMPIRE HEALTH PLAN	285	Yes	Active					HMO - Health Maintenance Organization		C	New York
H8902	Agent/Broker Compensation Data Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Automated TrOOP Balance Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Backup User Access Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Best Available Evidence Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/09/2022	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Bid Audit Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Bid Audit Site Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Bid Primary Contact	CVP Chief Product Officer		Esquivel	Martin		5623082885					m.esquivel@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	09/18/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	CAP Report Contact for Public Website	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	CEO - CMS Administrator Contact	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	CEO - Senior Official for Contracting	CEO	Dr.	Jain	Sachin		5629898314	8314				sjain@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	04/11/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Chief Financial Officer	Chief Financial Officer	Mr.	Plumb	Michael		5629971589					MPlumb@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/10/2022	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Chief Operating Officer	President	Mrs.	Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Chief Information Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Chief Information Security Officer	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823	1205				v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/09/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	CMS Casework Communication Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Complaints Tracking Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Contact for Fraud Investigations	SIU Strategic Project Professional		Czapla	Adrian		5626377350					a.czapla@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Coordination of Benefits Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189	1189			5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Corporate Mailing						5629895100				5629895200	nmonk@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Customer Service Operations Contact	Director, (Customer) Member Services	Ms.	McBeath	Kim		5629971805				5629895181	kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	DIR Contact	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459				5629890101	tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	DIR Contact (Secondary)	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/27/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Discount Program Payment Contact	Director of Accounting	Ms.	Zhang	Lian	E	5629895100	4474				e.zhang@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/31/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Emergency Part D Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/21/2022	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Employer Waiver Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Encounter Data & Risk Adjustment Operations Contact	Chief Data Officer		Leung	Moon		5629895269					mleung@scanhealthplan.com	3800 Kilroy Airport Way suite 100		Long Beach	CA	90806	04/17/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Enrollment Contact	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/09/2022	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	EOB Transfer Contact	Pharmacy Analyst		Banks	Marcia	D	5623081189				5629973196	mcurtis@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Financial Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Financial Reporting Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Formulary Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Truong	Weilan		5629973187				5629973196	wtruong@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	03/21/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	General Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Government Relations Contact	VP of Government Relations		Kazan	Matt		8005593500				5629899439	m.kazan@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	HIPAA Privacy Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	HIPAA Security Officer	VP, Chief Privacy Officer		Rubino	Tracy		8005593500					t.rubino@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/25/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Hospice Contact	Sr Dir Pharm & Formly Ops		Slavina	Yelena		5623082816					yslavina@scanhealthplan.com	3800 Kilroy Airport Way		Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Interoperability Contact	Chief Information Officer		Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way, Suite 100	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	MA Appeals/Grievances Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	MA Claims Processing Contact for Public Website	VP, Operational Excellence		Shafman	Carol		0000000000					c.shafman@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/07/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Marketing Contact	Compliance Specialist	Mr.	Lin	Richard		5623081156					rlin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Medical Director	Medical Director		Kimura	Joe		5623081148	1148			5629899439	j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/01/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Medicare Compliance Officer	Sr. Director Medicare Compliance Officer	Ms.	Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Medicare Coordinator	Director Medicare Compliance		Lim-Heng	Sanaya		5629973183				5629895120	s.lim-heng@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/19/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195				5625529371	c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	07/28/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Medication Therapy Management Contact	Clinical Pharmacist Programs		Lucas	Casey		5629895195					c.lucas@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	OffShore Subcontractor Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131				5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment and Reconciliation	Ms.	Gongora	Irene		5629895209				5629895243	IGongora@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Online Enrollment Center Contact (Primary)	Director, Enrollment & Reconciliation	Mr.	Coronel	Vincent		5626371234				5629895243	vcoronel@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/09/2022	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part C Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part C Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Appeals	Sr. Director of Grievances and Appeals	Ms.	Emrich	Mariah						5629890958	m.emerich@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	08/05/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5629895100	1290			HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Appeals Contact (Secondary)	Sr. Manager   Pharmacy Prior Authorization	Ms.	Herbert	Joshua						5629890958	Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	1290			HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Benefits Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		9145896300					Rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization	Mr.	Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop	S13NB	St. Louis	MO	63121	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	5132920563	733326			HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfiled	OH	45014	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Price File Contact (Optional)	Pharmacy Analyst		Ramirez	Anthony		5623084348	4348			5629973196	a.ramirez@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/26/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Quality Assurance Contact	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Part D Reporting Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Patient Safety Contact	Sr. Director, Pharmacy and Formulary Operations	Ms.	Slavina	Yelena		3237027662				5629973196	yslavina@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	02/05/2024	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Payment Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Pharmacy Director	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Pharmacy Network Management Contact	Network Acct Director, Retail Strategy	Ms.	Kelly	Heather		3146921866				8003579578	hakelly@express-scripts.com	One Express Way		St Louis	MO	63121	01/23/2023	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
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	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Chicago
H8902	Physician Incentive Contact	President		Schulte	Karen		3106121937					kschulte@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	11/17/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Plan Directory Contact for Public Website	Director, (Customer) Member Services	Ms.	McBeath	Kim		8777787226					kmcbeath@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Plan to Plan Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	P2PAdmin@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Processor Contact	Senior Director Government Programs, Medicare	Ms.	Gibson	Sharon		8052361175					sggibson@express-scripts.com	One Express Way		St. Louis	MO	63121	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Quality Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Reconciliation Contact	Vice President, Controller	Ms.	Havai	Virginia		5629898300				5629890101	vhavai@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Reconciliation Contact (Secondary)	VP Pharmacy	Ms.	Davidoff	Bahar		5629898389	8389			5629973196	b.davidoff@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	01/10/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Recovery Audit Contact	Sr. Director Medicare Compliance Officer	Mrs.	Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	SNP Application Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	SNP State Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Surveillance Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	System Contact	Chief Information Officer	Mr.	Kulkarni	Vinay		5623082823					v.kulkarni@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Third Party Administrator (TPA) Liaison	Financial Accounting Specialist	Ms.	McClour	Tina		5629894459					tmcclour@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	12/17/2021	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	User Access Contact	Sr. Director Medicare Compliance Officer		Cordova	Elizabeth		5629973131	3131			5629895120	ecordova@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	10/14/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Utilization Management Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8902	Utilization Review Contact	Chief Medical Officer		Kimura	Joe		5626377346					j.kimura@scanhealthplan.com	3800 Kilroy Airport Way	Suite 100	Long Beach	CA	90806	06/11/2025	2026	SCAN HEALTH PLAN TEXAS, INC.	Local CCP	SCAN Health Plan	HMO/HMOPOS		SCAN Group	768	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H8908	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	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 Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Emergency Part D Contact	Manager, Regulatory Compliance		Licht	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	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 C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H8908	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024989871				HMO - Health Maintenance Organization		C	Kansas City
H8908	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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 Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	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 Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8593219075				HMO - Health Maintenance Organization		C	Kansas City
H8908	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5024682494				HMO - Health Maintenance Organization		C	Kansas City
H8908	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	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 Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	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 Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	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 Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	8008658715				HMO - Health Maintenance Organization		C	Kansas City
H8908	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active	5025800475				HMO - Health Maintenance Organization		C	Kansas City
H8908	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8908	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	Local CCP	Humana	HMO/HMOPOS		Humana Inc.	128	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H8917	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H8917	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H8917	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H8917	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H8917	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H8917	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H8917	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H8917	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8917	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H8928	Agent/Broker Compensation Data Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689722					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Backup User Access Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689722					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Bid Audit Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Bid Audit Site Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Bid Primary Contact	Actuary	Mr.	Nganga	Francis		5087992100	79339				Francis.Nganga@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	CAP Report Contact for Public Website	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	CEO - CMS Administrator Contact	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	CEO - Senior Official for Contracting	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Interim Chief Financial Officer	Mr.	Consolmagno	Anthony		5083689473					Anthony.Consolmagno@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	07/15/2025	2026	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 Operating Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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 Information Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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 Information Security Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Complaints Tracking Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Contact for Fraud Investigations	Director Internal Audit	Ms.	Brown	Velinda		5083689016				5083689111	Velinda.Brown@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Corporate Mailing						5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Director, Customer Service	Mr.	Fregeau	Andrew		5083689958					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/10/2025	2026	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	DIR Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	DIR Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Discount Program Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Emergency Part D Contact	Manager, Customer Service	Mr.	Fregeau	Andrew		9784347996					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Emergency Part D Contact (Secondary)	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Manager, Business Service Delivery	Ms.	Ernst	Alicia		5083689369					Alicia.Ernst@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Enrollment Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	EOB Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089			5088311136	Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Financial Audit Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Financial Reporting Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Formulary Contact	Manager of Pharmacy Ops	Ms.	Doran	Kate		5087992100	79169				Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Formulary Contact (Secondary)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	General Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	HIPAA Privacy Officer	Privacy Officer	Ms.	Sanford	Katrin		5083689838					Katrin.Sanford@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	HIPAA Security Officer	VP IT Operations	Mr.	Petisce	Tony		5083689300					Tony.Petisce@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Govt Programs and Quality Clinical Pharmacist	Mr.	Huynh	Jayce		5087992100	69212				Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	12/01/2025	2026	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	Interoperability Contact	VP, Enterprise Technology Officer	Mr.	Budaj	John		5083689362					john.budaj@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	MA Appeals/Grievances Contact	Director, Care Services Support	Ms.	Ryan	Patricia		5083689771					Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		5087992100	69988				CustomerService@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Marketing Contact	Manager, Medicare Programs	Ms.	Kudron	Julie		5083689591					Julie.Kudron@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Medical Director	SVP & Chief Medical Officer	Dr.	Council	Lora		5083689188					Lora.Council@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Coordinator	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Part D Opioid Overutilization Contact	Supervisor, Formulary Coordinators & Technicians	Ms.	Kendall	Kate		8003332535	79169				Kate.Kendall@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Medication Therapy Management Contact	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	OffShore Subcontractor Contact	Manager, Medicare Compliance & Regulatory Affairs	Ms.	DeForge	Dena		5083689294					dena.deforge@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Online Enrollment Center Contact (Back-up)	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Online Enrollment Center Contact (Optional)	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Online Enrollment Center Contact (Primary)	Enrollment & Billing Operations Coordinator	Ms.	Walsh	Lisa		5083689597					Lisa.Walsh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 C Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 C Reporting Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Appeals	Director, Care Services Support	Ms.	Ryan	Patricia							Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689771				HMO - Health Maintenance Organization		C	Boston
H8928	Part D Appeals Contact (Secondary)	Manager, Member Appeals and Grievances	Ms.	Foulkes	Christina							Christina.Foulkes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689447				HMO - Health Maintenance Organization		C	Boston
H8928	Part D Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Benefits Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Claims Submission Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689790				HMO - Health Maintenance Organization		C	Boston
H8928	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Ops	Ms.	Doran	Kate							Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5087992100	79169			HMO - Health Maintenance Organization		C	Boston
H8928	Part D Price File Contact (Back-up)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Price File Contact (Optional)	VP, Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Price File Contact (Primary)	Govt Programs and Quality Clinical Pharmacist	Mr.	Huynh	Jayce		5087992100	69212				Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Quality Assurance Contact	Sr. Director, Pharmacy Therapeutics	Mr.	Huynh	Jayce		5083689212					Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Reporting Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Patient Safety Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Director	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Network Management Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Network Management Contact (Secondary)	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	8443688734				HMO - Health Maintenance Organization		C	Boston
H8928	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager (OptumRx)		Villanueva	Juan							Juan.Villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/13/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	8007887871				HMO - Health Maintenance Organization		C	Boston
H8928	Physician Incentive Contact	VP, Network Development and Management	Ms.	Keser	Susan		5083689261					Susan.Keser@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Plan Directory Contact for Public Website			Service	Customer		5087992100	69988				CustomerService@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Plan to Plan Reconciliation Contact	Director, Medical Accounting	Mr.	Beaulieu	Michael		5083689020					Michael.Beaulieu@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Processor Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Quality Contact	Director of Quality	Ms.	Little	Dawn		5083689263					Dawn.Little@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Reconciliation Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Reconciliation Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Recovery Audit Contact	Senior Director, Claims Administration	Ms.	Straitiff	Kirsten		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	SNP Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	SNP State Contact	Executive Director, NaviCare	Ms.	Daviau	Deborah		5083689489					Deborah.Daviau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Surveillance Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	System Contact	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Third Party Administrator (TPA) Liaison	Revenue Senior Accountant I	Ms.	Peloquin	Kristin		5083689297					Kristin.Peloquin@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	12/04/2024	2026	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	User Access Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Utilization Management Contact	Director, Utilization Management	Ms.	Meriano	Christina		5083689303					Christina.Meriano@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Utilization Review Contact	VP & Sr Medical Director, Clinical Management	Dr.	Cameron	Carl		5083689801					Carl.Cameron@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active					HMO - Health Maintenance Organization		C	Boston
H8947	Agent/Broker Compensation Data Contact	Director, Medicare	Mrs.	Bazzo	Missy		4127602203				3049743470	melissa.bazzo@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Automated TrOOP Balance Transfer Contact	Operations Manager, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/02/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Backup User Access Contact	Manager, FP&A	Mr.	Hatfield	Charles		5028199909				3049743470	Charles.hatfield@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Best Available Evidence Contact	Manager, Enrollment	Mr.	Cordero	Chris		3049743504	169914			3049743470	christopher.cordero@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Bid Audit Contact	Senior Consulting Actuary	Mr.	Sauter	Matt		7206278669					matts@wakely.com	1660 Wynkoop St	Suite 900	Denver	CO	80202	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Bid Audit Site Contact	CFO	Mr.	Stilwell	Brian		4122985013				3049743470	brian.stilwell@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Bid Primary Contact	Senior Consulting Actuary	Mr.	Sauter	Matt		7206278669					matts@wakely.com	1660 Wynkoop St	Suite 900	Denver	CO	80202	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	CAP Report Contact for Public Website	VP, Provider & Network Service	Mrs.	Rogers	Kim		3049743468				3049743470	kimberly.rogers@peakhealth.org	16 Sterling Drive	Suite 102	Bridgeport	WV	26330	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	CEO - CMS Administrator Contact	CEO	Mr.	Gerber	Ben		3042857185				3049743470	ben.gerber@wvumedicine.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	CEO - Senior Official for Contracting	CEO	Mr.	Gerber	Ben		3042857185				3049743470	ben.gerber@wvumedicine.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Chief Financial Officer	CFO	Mr.	Stilwell	Brian		4122985013				3049743470	brian.stilwell@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Chief Operating Officer	President	Mr.	Ross	Amos		3042857197				3049743470	Amos.Ross@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Chief Information Officer	CIO	Mr.	Venturella	James		3042857153				3049743470	james.venturella@wvumedicine.org	1 Medical Center Drive		Morgantown	WV	26505	02/02/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Chief Information Security Officer	CISO & Director, Operational Analytics	Mr.	Hepler	Jason		3049743462				3049743470	Jason.Hepler@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	CMMI Model Point of Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	CMS Casework Communication Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Complaints Tracking Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Contact for Fraud Investigations	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Coordination of Benefits Contact	Manager, Enrollment	Mr.	Cordero	Chris		3049743504	169914			3049743470	christopher.cordero@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Corporate Mailing						3042853989				3049743470	chelsea.henderson@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Customer Service Operations Contact	Manager, Member & Provider Service	Mr.	Scott	Larry		3049743466				3049743470	larry.scott@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	DIR Contact	Director of Acounting-Controller	Mrs.	Wolfe	Chasity		3042769671				3049743470	chasity.wolfe@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	DIR Contact (Secondary)	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Discount Program Payment Contact	Director of Accounting-Controller	Mrs.	Wolfe	Chasity		3042769671				3049743470	chasity.wolfe@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Electronic Health Record Contact	Director, Medical Management	Mr.	Shuman	Shawn		3049743709	169932			3049743470	shawn.shuman@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Emergency Part D Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Emergency Part D Contact (Secondary)	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Encounter Data & Risk Adjustment Operations Contact	CISO, Director Operational Analytics	Mr.	Hepler	Jason		3049743462				3049743470	jason.hepler@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Enrollment Contact	Manager, Enrollment	Mr.	Cordero	Chris		3049743504	169914			3049743470	christopher.cordero@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	EOB Transfer Contact	Manager, Medicare Claims	Mr.	Tabor	Kevin		3049743463				3049743470	kevin.tabor@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Financial Audit Contact	Director of Accounting-Controller	Mrs.	Wolfe	Chasity		3042769671				3049743470	chasity.wolfe@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Financial Reporting Contact	Director of Accounting-Controller	Mrs.	Wolfe	Chasity		3042769671				3049743470	chasity.wolfe@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Formulary Contact	Sr. Analyst, Formulary Operations		Paddock	Deanna		6087291628				6087292628	deanna.paddock@navitus.com	361 Integrity Drive		Madison	WI	53717	02/03/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Formulary Contact (Secondary)	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	General Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Government Relations Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	HIPAA Privacy Officer	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	HIPAA Security Officer	CISO, Director Operational Analytics	Mr.	Hepler	Jason		3049743462				3049743470	jason.hepler@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Hospice Contact	Director, Medical Management	Mr.	Shuman	Shawn		3049743709	169932				shawn.shuman@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Interoperability Contact	CISO, Director Operational Analytics	Mr.	Hepler	Jason		3042857197				3049743470	jason.hepler@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	MA Appeals/Grievances Contact	Director, Medical Management	Mr.	Shuman	Shawn		3049743709	169932			3049743470	shawn.shuman@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	MA Claims Processing Contact for Public Website	Director, Claims Operations	Mrs.	Domhoff	Angela		3042853989	169906			3049743470	angela.matrozza@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Marketing Contact	Manager, Sales & Marketing	Mr.	Rock	Steven		3042853989				3049743470	steven.rock@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Medical Director	Medical Director	Dr.	Hoffman	Steven		3042851991				3049743470	stephen.hoffmann@wvumedicine.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Medicare Compliance Officer	Compliance Officer	Mr.	Hoover	Mark		4126388952				3049743470	mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Medicare Coordinator	President	Mr.	Ross	Amos		3042857197				3049743470	Amos.Ross@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Medicare Part D Opioid Overutilization Contact	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Medication Therapy Management Contact	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	OffShore Subcontractor Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Online Enrollment Center Contact (Back-up)	Sr. Systems Analyst		Kuhn	Penny		3045984093	73908				penny.kuhn@wvumedicine.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Mr.	Cordero	Chris		3049743504	169914			3049743470	christopher.cordero@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part C Application Contact	CFO	Mr.	Stilwell	Brian		4122985013				3049743470	brian.stilwell@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part C Reporting Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/01/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active	9202214372				PPO - BBA		C	Dallas
H8947	Part D Appeals Contact (Secondary)	Director of Pharmacy Benefits	Mrs.	Yankoski	Nicole						3049743470	nicole.yankoski@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active	8142334568				PPO - BBA		C	Dallas
H8947	Part D Application Contact	CFO	Mr.	Stilwell	Brian		4122985013				3049743470	brian.stilwell@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Benefits Contact	Director of Pharmacy Benefits	Mrs.	Yankoski	Nicole		8142334568				3049743470	nicole.yankoski@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Claims Submission Contact	Manager, Technical Programs		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/02/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Exceptions Contact	Sr. Manager, Clinical Prior Authorization		LeClair	Christophe						9202214904	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/08/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active	9202214404				PPO - BBA		C	Dallas
H8947	Part D Exceptions Contact (Secondary)	Director of Pharmacy Benefits	Mrs.	Yankoski	Nicole						3049743470	nicole.yankoski@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active	8142334568				PPO - BBA		C	Dallas
H8947	Part D Price File Contact (Back-up)			Saeger	Deborah	L	6087291578					plan.finder@navitus.com	361 Integrity Drive		Madison	WI	53717	02/09/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Price File Contact (Optional)	Director of Pharmacy Benefits	Mrs.	Yankoski	Nicole		8142334568				3049743470	nicole.yankoski@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Price File Contact (Primary)			Buie	Megan	N	5122313140					plan.finder@navitus.com	12301 Research Blvd, Suite 350		Austin	TX	78759	02/09/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Quality Assurance Contact	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Part D Reporting Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Patient Safety Contact	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Payment Contact	Director of Accounting-Controller	Mrs.	Wolfe	Chasity		3042769671				3049743470	chasity.wolfe@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Personal Health Record Contact	Director, Medical Management	Mr.	Shuman	Shawn		3049743709	169932			3049743470	shawn.shuman@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Pharmacy Director	VP, Health Plan Pharmacy	Mrs.	Hickey	Meghan		7245943043				3049743470	meghan.hickey@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Pharmacy Network Management Contact	VP, Network Management		Santos	Christina		6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	04/12/2024	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						8665951975	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/08/2023	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active	8662703877				PPO - BBA		C	Dallas
H8947	Physician Incentive Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Plan Directory Contact for Public Website	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Plan to Plan Reconciliation Contact	Senior Analyst Government Programs		McCoy	Erin		3045521061				3049743470	erin.mccoy2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Processor Contact	Director, Claims Operations	Mrs.	Domhoff	Angela		3042853989	169906			3049743470	angela.matrozza@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Quality Contact	Director, Medical Management	Mr.	Shuman	Shawn		3049743709	169932			3049743470	shawn.shuman@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Reconciliation Contact	CFO	Mr.	Stilwell	Brian		4122985013				3049743470	brian.stilwell@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Reconciliation Contact (Secondary)	Director of Accounting-Controller	Mrs.	Wolfe	Chasity		3042769671				3049743470	chasity.wolfe@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Recovery Audit Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Surveillance Contact	President	Mr.	Ross	Amos		3042857197				3049743470	amos.ross@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	System Contact	President	Mr.	Ross	Amos		3042857197				3049743470	Amos.Ross@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Third Party Administrator (TPA) Liaison	Senior Analyst Government Programs		McCoy	Erin		3045521061				3049743470	erin.mccoy2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	User Access Contact	CCO	Mr.	Hoover	Mark		4126388952					mark.hoover2@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Utilization Management Contact	Director, Medical Management	Mr.	Shuman	Shawn		3049743709	169932			3049743470	shawn.shuman@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8947	Utilization Review Contact	Director, Medical Management	Mr.	Shuman	Shawn		3049743709	169932			3049743470	shawn.shuman@peakhealth.org	1085 Van Voorhis Road		Morgantown	WV	26505	12/04/2025	2026	PEAK HEALTH INSURANCE CORPORATION	Local CCP	Peak Health	Local PPO		West Virginia United Health System, Inc.	805	Yes	Active					PPO - BBA		C	Dallas
H8967	Agent/Broker Compensation Data Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Automated TrOOP Balance Transfer Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Backup User Access Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Best Available Evidence Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Bid Audit Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Bid Audit Site Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Bid Primary Contact	Director of Acturial Services	Ms.	Forsythe	Rhea		7152219361					Forsythe.Rhea@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	CAP Report Contact for Public Website	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8007525863				HMO - Health Maintenance Organization		C	Dallas
H8967	CEO - CMS Administrator Contact	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	CEO - Senior Official for Contracting	President	Mr.	Ibrahim	Tommy		6053286851					TommyIbrahimRgltry@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Chief Financial Officer	Chief Financial Officer	Mr.	Custis	Stephen		6129649158					Stephen.Custis@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Chief Operating Officer	Vice President of Operations	Ms.	Foemmel	Sara		7153836634					foemmel.sara@securityhealth.org	1515 North Saint Joseph Avenue		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Chief Information Officer	Cheif Information Officer	Mr.	Reimer	Brad		6053287937					Brad.Reimer@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Chief Information Security Officer	Vice President - Information Security Officer	Ms.	Hogstad	Kimberly		6053287410					Kimberly.Hogstad@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	CMMI Model Point of Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	CMS Casework Communication Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Complaints Tracking Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Contact for Fraud Investigations	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	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 Customer Service	Mr.	Ling	Ryan		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Corporate Mailing						8007525863					memberservices@sanfordhealth.org	PO BOX 91110		Sioux Falls	SD	57109	08/28/2024	2026	SANFORD HEALTH PLAN	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		6053127459					Ryan.Ling@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	DIR Contact	Associate Actuary		Imsdahl	Jack		7152219521				7152219500	imsdahl.jack@securityhealth.org	1515 Saint Joseph Avenue		Marshfield	WI	54449	09/24/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	DIR Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Discount Program Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Emergency Part D Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Emergency Part D Contact (Secondary)	Senior Pharmacist	Mr.	Reuman	Reed		6053122761					Reed.Reuman@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Employer Waiver Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Encounter Data & Risk Adjustment Operations Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Enrollment Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	EOB Transfer Contact	Senior Director of Regulation & Risk	Ms.	Jansick	Aleesa		6053287182				6053286811	Aleesa.Jansick@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Financial Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	09/24/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Financial Reporting Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	11/04/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Formulary Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Formulary Contact (Secondary)	Principal Pharmacy Benefits Specialist		Chen	Honghua		2242312740					Christine.Chen2@optum.com	1600  McConnor Parkway	Suite 201	Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	General Contact	Director of Compliance and Privacy		Wilson	Kelly		7152219960				7152219500	wilson.kelly@securityhealth.org	1515 Saint Joseph Ave.		Marshfield	WI	54449	07/30/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Government Relations Contact	Head of Government Affairs	Mr.	Wheeler	Dylan		6053287186					Dylan.Wheeler@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	HIPAA Privacy Officer	Lead Privacy Officer	Ms.	Sundby	Jennifer		6053625407					Jennifer.Sundby@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	HIPAA Security Officer	Information Security Compliance Officer	Mr.	Otte	Brody		6053126563					Brody.Otte@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Hospice Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Interoperability Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	MA Appeals/Grievances Contact	Manager of Appeals and Grievances	Ms.	Bjorklund	Angela		6053122634					Angela.Bjorklund@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	MA Claims Processing Contact for Public Website	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Marketing Contact	Director of Marketing	Ms.	McCloskey	Diana		6053122762					Diana.Mccloskey@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Medical Director	Chief Medical Officer	Dr.	Faber	Kevin		6053287192					Kevin.Faber@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	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		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Medicare Coordinator	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	07/07/2025	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Medication Therapy Management Contact	Clinical Program Manager	Ms.	Liaqat	Tazeen		6305440541					Tazeen.liaqat@optum.com	1240 South Pine Island Rd.		Plantation	FL	33324	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	OffShore Subcontractor Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Online Enrollment Center Contact (Back-up)	Manager of Inside Sales	Mr.	Arnett	Jack		6053286886					Jack.Arnett@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Online Enrollment Center Contact (Optional)	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Online Enrollment Center Contact (Primary)	Director of Medicare Programs	Mr.	Ovenden	Nathan		6053122606					Nathan.Ovenden@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part C Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part C Reporting Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Appeals	Manager, Prior Authorization Appeals	Ms.	Le	Christina						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Appeals Contact (Secondary)	Pharmacy Technician, PA Appeals	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Application Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Benefits Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Claims Submission Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	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						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Exceptions Contact (Secondary)	Pharmacy Technician, PA	Ms.	Jackson	Shannon	D					8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8884033398				HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms.	Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Price File Contact (Optional)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Price File Contact (Primary)	Senior Business Analyst	Ms.	Lam	Annie		6124286588					Annie.Lam@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Quality Assurance Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Part D Reporting Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Patient Safety Contact	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Payment Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Personal Health Record Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Pharmacy Director	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Perez	Felix		7632833503					Felix.Perez@optum.com	1600 McConnor Parkway , IL 601736801		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations	Ms.	Ashby	Jolynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	08/28/2024	2026	SANFORD HEALTH PLAN	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	Pharmacy Technical Help Desk	Sr.	Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active	8446429090				HMO - Health Maintenance Organization		C	Dallas
H8967	PHR Beneficiary Contact																	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS	Sanford Health Plan	Sanford Health	740	Yes	Active	8882786485				HMO - Health Maintenance Organization		C	Dallas
H8967	Physician Incentive Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Plan Directory Contact for Public Website	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Plan to Plan Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Processor Contact	Director of Billing & Enrollment	Mr.	Reichelt	Daniel		6053122624					Daniel.Reichelt@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Quality Contact	Director of Quality and STARS Strategy	Ms.	Kanta	Misty		6053122788					Misty.Kanta@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Reconciliation Contact	Director of Finance	Ms.	Harris	Debora		6053129344					Debora.Harris@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Reconciliation Contact (Secondary)	Director of Pharmacy	Ms.	Schilling	Gretchen		6053122741					Gretchen.Schilling@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Recovery Audit Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	SNP Application Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	SNP State Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Surveillance Contact	Director of Sales & Retention	Ms.	Nickles	Jennie		6053287185					Jennie.Nickles@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	System Contact	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Third Party Administrator (TPA) Liaison	Senior Director of Regulation and Risk	Ms.	Jansick	Aleesa		6053287182					Aleesa.Jansick@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	User Access Contact	Compliance Officer	Mr.	Yeoman	Dallan		6053286806					Dallan.Yeoman@sanfordhealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Utilization Management Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	Local CCP	Great Plains Medicare Advantage	HMO/HMOPOS		Sanford Health	740	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H8967	Utilization Review Contact	Director of Care and Utilization Management	Ms.	Vandonslear	Barbara		6053286853					Barbara.Vandonslear@SanfordHealth.org	4800 West 57th Street		Sioux Falls	SD	57108	08/28/2024	2026	SANFORD HEALTH PLAN	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		Johnson	Julie		3057518626	68299				JJohnson@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Backup User Access Contact	AVP of PACE		Lane	Maria		3057909730					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Best Available Evidence Contact	AVP PACE		Lane	Maria		3057909730					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Bid Primary Contact	EVP PACE		Hess	Steve		3057518626	66799				SHess@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/29/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	CAP Report Contact for Public Website	AVP PACE		Lane	Maria		3057909730					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	CEO - CMS Administrator Contact	AVP of PACE	Ms.	Lane	Maria		3057909730					Mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	CEO - Senior Official for Contracting	EVP & President	Mr.	Hess	Steve		3057958442					SHess@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	04/11/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Chief Financial Officer	CFO	Mr.	Goldsmith	Alan		3055148585					Agoldsmith@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	04/03/2024	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Chief Operating Officer	AVP of PACE	Mrs	Lane	Maria		3057951890					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	04/14/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Chief Information Officer	Chief Information Officer	Mr.	Larralde	Bernie		3057518626	65499				Blarralde@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Chief Information Security Officer	Chief Information Officer	Mr	Larralde	Bernie		3057518626	65499				Blarralde@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	CMS Casework Communication Contact	AVP of PACE		Lane	Maria		3057909730					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Complaints Tracking Contact	Director of Compliance		Rhodes Resch	Lashandra		3057621407					lresch@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Contact for Fraud Investigations	AVP PACE		Lane	Maria		3057909730					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Coordination of Benefits Contact	AVP PACE		Lane	Maria		3057909730					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Corporate Mailing						3057518626					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Customer Service Operations Contact	AVP PACE	Mr.	Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	DIR Contact	Business Manager		Johnson	Julie		3057623942					jjohnson@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	02/27/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Discount Program Payment Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Emergency Part D Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Encounter Data & Risk Adjustment Operations Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Enrollment Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	EOB Transfer Contact	Business Office Manager		Lewars	Olga		3057518626	68299			3057951855	olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Financial Audit Contact	Business Office Manager	Ms.	Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Financial Reporting Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Formulary Contact	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	General Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Government Relations Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	HIPAA Privacy Officer			Lane	Maria		3057518626	66754				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	03/28/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	HIPAA Security Officer	Chief Information Officer		Larralde	Bernie		3057518626	65499				Blarralde@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Interoperability Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	MA Appeals/Grievances Contact			Lane	Maria		3057518626	66754				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	03/28/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	MA Claims Processing Contact for Public Website	Business Office Manager		Lewars	Olga		3057518626	68299				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Marketing Contact	Client Relations Manager	Ms.	De La Piedra	Stephanie		3052990805					SDelapiedra@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	03/28/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Medical Director	Medical Director		Alzugaray	Edilia		3057518626	66796				EAlzugaray@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Medicare Compliance Officer	AVP PACE	Ms.	Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Medicare Coordinator	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Medication Therapy Management Contact	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part C Application Contact			Lane	Maria		3056999240					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	03/28/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part D Appeals	AVP of PACE		Lane	Maria						3057951855	mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	03/28/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active	3056999240				PACE - Nat		C	Atlanta
H8982	Part D Application Contact			Lane	Maria		3056999240					mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	03/28/2025	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part D Benefits Contact	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part D Claims Submission Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part D Exceptions Contact	Business Office Manager		Lewars	Olga						3057951855	olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active	3057518626	66299			PACE - Nat		C	Atlanta
H8982	Part D Price File Contact (Back-up)	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part D Price File Contact (Primary)	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part D Quality Assurance Contact	QAPI Manager		Orozco	Andrew		3057518626	66754				borozco@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Part D Reporting Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Patient Safety Contact	QAPI Manager		Orozco	Andrew		3057518626	66754				borozco@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Payment Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Pharmacy Director	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Pharmacy Network Management Contact	Director of Pharmacy		Martinez	Mario		3057518626	66299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Pharmacy Technical Help Desk Contact	Director of Pharmacy		Martinez	Mario						3057951855	MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active	3057518626	66299			PACE - Nat		C	Atlanta
H8982	Plan Directory Contact for Public Website	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Plan to Plan Reconciliation Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Processor Contact	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Quality Contact	QAPI Manager		Orozco	Andrew		3057518626	66754				borozco@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Reconciliation Contact	Business Office Manager		Lewars	Olga		3057518626	68299				MMartinez1@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Recovery Audit Contact	AVP PACE	Ms.	Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Surveillance Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	System Contact	Chief Information Officer		Larralde	Bernie		3057518626	65499				Blarralde@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Third Party Administrator (TPA) Liaison	Business Office Manager		Lewars	Olga		3057518626	68299				olewars@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	User Access Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Utilization Management Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8982	Utilization Review Contact	AVP PACE		Lane	Maria		3057518626	66703				mlane@miamijewishhealth.org	5200 NE 2nd Ave		Miami	FL	33137	09/30/2022	2026	BROWARD PACE PROGRAM LLC	National PACE	Broward PACE Program, LLC	National PACE		SFH PACE Holdings LLC	883	Yes	Active					PACE - Nat		C	Atlanta
H8992	Automated TrOOP Balance Transfer Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Backup User Access Contact	Director of Quality and Compliance		Hales	Jessica		8165995552					jhales@pacekc.org	4141 Dr. Martin Luther King Jr. Blvd		Kansas City	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Best Available Evidence Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Bid Primary Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	CAP Report Contact for Public Website			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active	8163213250				PACE - Nat		C	Kansas City
H8992	CEO - CMS Administrator Contact		Mr.	Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	CEO - Senior Official for Contracting		Mr.	Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Chief Financial Officer	CFO	Ms.	Montgomery	Essence		8165995683					EMontgomery@swopehealth.org	4141 Dr. Martin Luther King Jr. Blvd		Kansas City	MO	64130	09/08/2025	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Chief Operating Officer		Mr.	Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Chief Information Officer		Mr.	Smith	Thurston		8165995558					tlsmith@swopehealth.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Chief Information Security Officer		Mr.	Smith	Thurston		8165995558					tlsmith@swopehealth.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	CMS Casework Communication Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Complaints Tracking Contact	Director of Quality and Compliance		Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. Martin Luther King Jr. Blvd		KANSAS CITY	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Contact for Fraud Investigations	Director of Quality and Compliance		Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. Martin Luther King Jr. Blvd		Kansas City	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Coordination of Benefits Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Corporate Mailing						8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Customer Service Operations Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	DIR Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	DIR Contact (Secondary)			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Discount Program Payment Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Emergency Part D Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Encounter Data & Risk Adjustment Operations Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Enrollment Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	EOB Transfer Contact			Rath	Heath		8163213250				8165995996	hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Financial Audit Contact	Senior Accountant	Mr.	Cartwright	Brent		8163213280					bcartwright@swopehealth.org	4141 Dr. Martin Luther King Jr. Blvd		Kansas City	MO	64130	07/24/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Financial Reporting Contact	Senior Accountant		Cartwright	Brent		8163213280					bcartwright@swopehealth.org	4141 Dr. Martin Luther King Jr. Blvd		Kansas City	MO	64130	07/24/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Formulary Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	General Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Government Relations Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	HIPAA Privacy Officer	Director of Quality and Compliance		Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. Martin Luther King Jr. Blvd		KANSAS CITY	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	HIPAA Security Officer	Director of Quality and Compliance		Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. Martin Luther King Jr. Blvd		KANSAS CITY	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Interoperability Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	MA Appeals/Grievances Contact	Director of Quality and Compliance		Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. Martin Luther King Jr. Blvd		KANSAS CITY	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	MA Claims Processing Contact for Public Website			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Marketing Contact			Logan	Mark		8163213261					mlogan@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	04/23/2025	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Medical Director	Medical Director	Dr.	Navato	Alma		8163213268					rath1221@gmail.com	4141 Dr. Martin Luther King Jr. Blvd		KANSAS CITY	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Medicare Compliance Officer	Director of Quality and Compliance	Mrs.	Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. Martin Luther King Jr. Blvd		Kansas City	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Medicare Coordinator			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Medicare Part D Opioid Overutilization Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Medication Therapy Management Contact	Medical Director	Dr.	Navato	Alma		8163213268					rath1221@gmail.com	4141 Dr. Martin Luther King Jr. Blvd		KANSAS CITY	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part C Application Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. Martin Luther King Jr. Blvd.		Kansas City	MO	64130	01/31/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part D Appeals	Director of Quality and Compliance		Hales	Jessica							jhales@pacekc.org	4141 Dr. MLK Blvd.		Kansas City	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active	8336722352				PACE - Nat		C	Kansas City
H8992	Part D Application Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. Martin Luther King Jr. Blvd.		Kansas City	MO	64130	01/31/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part D Benefits Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part D Claims Submission Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part D Exceptions Contact			Rath	Heath							hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active	8163213250				PACE - Nat		C	Kansas City
H8992	Part D Price File Contact (Back-up)			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part D Price File Contact (Primary)			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part D Quality Assurance Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Part D Reporting Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Patient Safety Contact	Director of Quality and Compliance		Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. MLK Blvd.		Kansas City	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Payment Contact	Director of Financial Accounting		Cartwright	Brent		8163213280					bcartwright@swopehealth.org	4141 Dr. Martin Luther King Jr. Blvd		Kansas City	MO	64130	07/24/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Pharmacy Director			Hattaway	Michael		8165995457					MHattaway@swopehealth.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Pharmacy Network Management Contact			Hattaway	Michael		8165995457					MHattaway@swopehealth.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Pharmacy Technical Help Desk Contact			Hattaway	Michael							MHattaway@swopehealth.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active	8165595457				PACE - Nat		C	Kansas City
H8992	Plan Directory Contact for Public Website			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Plan to Plan Reconciliation Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Processor Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Quality Contact	Director of Quality and Compliance		Hales	Jessica		8163213262					jhales@pacekc.org	4141 Dr. MLK Blvd.		Kansas City	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Reconciliation Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Recovery Audit Contact	Executive Director	Mr.	Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Surveillance Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	System Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Third Party Administrator (TPA) Liaison			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	User Access Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Utilization Management Contact			Rath	Heath		8163213250					hrath@pacekc.org	3801 Dr. MLK Blvd.		Kansas City	MO	64130	03/13/2023	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H8992	Utilization Review Contact	Medical Director	Dr.	Navato	Alma		8163213268					anavato@pacekc.org	4141 Dr. MLK Blvd.		Kansas City	MO	64130	02/06/2024	2026	PACE KC, LLC	National PACE	PACE KC	National PACE		Swope Health Services	817	Yes	Active					PACE - Nat		C	Kansas City
H9001	Agent/Broker Compensation Data Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689722					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Automated TrOOP Balance Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Backup User Access Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689722					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Bid Audit Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Bid Audit Site Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Bid Primary Contact	Actuary	Mr.	Nganga	Francis		5087992100	79339				Francis.Nganga@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	CAP Report Contact for Public Website	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	CEO - CMS Administrator Contact	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	CEO - Senior Official for Contracting	President & Chief Executive Officer	Mr.	Lopes	Manny		5083689050				5083689550	Manny.Lopes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Interim Chief Financial Officer	Mr.	Consolmagno	Anthony		5083689473					Anthony.Consolmagno@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	07/15/2025	2026	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 Operating Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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 Information Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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 Information Security Officer	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Complaints Tracking Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Contact for Fraud Investigations	Director Internal Audit	Ms.	Brown	Velinda		5083689016				5083689111	Velinda.Brown@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Corporate Mailing						5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Director, Customer Service	Mr.	Fregeau	Andrew		5083689958					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/10/2025	2026	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	DIR Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	DIR Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Discount Program Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Emergency Part D Contact	Manager, Customer Service	Mr.	Fregeau	Andrew		9784347996					Andrew.Fregeau@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Emergency Part D Contact (Secondary)	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Manager, Business Service Delivery	Ms.	Ernst	Alicia		5083689369					Alicia.Ernst@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Enrollment Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	EOB Transfer Contact	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089			5088311136	Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Financial Audit Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Financial Reporting Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Formulary Contact	Manager of Pharmacy Ops	Ms.	Doran	Kate		5087992100	79169				Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Formulary Contact (Secondary)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	General Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	HIPAA Privacy Officer	Privacy Officer	Ms.	Sanford	Katrin		5083689838					Katrin.Sanford@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	HIPAA Security Officer	VP IT Operations	Mr.	Petisce	Tony		5083689300					Tony.Petisce@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Govt Programs and Quality Clinical Pharmacist	Mr.	Huynh	Jayce		5087992100	69212				Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	12/01/2025	2026	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	Interoperability Contact	VP, Enterprise Technology Officer	Mr.	Budaj	John		5083689362					john.budaj@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	MA Appeals/Grievances Contact	Director, Care Services Support	Ms.	Ryan	Patricia		5083689771					Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		5087992100	69988				CustomerService@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Marketing Contact	Manager, Medicare Programs	Ms.	Kudron	Julie		5083689591					Julie.Kudron@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Medical Director	SVP & Chief Medical Officer	Dr.	Council	Lora		5083689188					Lora.Council@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Coordinator	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Part D Opioid Overutilization Contact	Supervisor, Formulary Coordinators & Technicians	Ms.	Kendall	Kate		8003332535	79169				Kate.Kendall@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Medication Therapy Management Contact	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	OffShore Subcontractor Contact	Manager, Medicare Compliance & Regulatory Affairs	Ms.	DeForge	Dena		5083689294					dena.deforge@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Online Enrollment Center Contact (Back-up)	Enrollment and Billing Operations Manager	Ms.	Farrar	Christina		8003332535	79089				Christina.Farrar@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Online Enrollment Center Contact (Optional)	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Online Enrollment Center Contact (Primary)	Enrollment & Billing Operations Coordinator	Ms.	Walsh	Lisa		5083689597					Lisa.Walsh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 C Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 C Reporting Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Appeals	Director, Care Services Support	Ms.	Ryan	Patricia							Patricia.Ryan@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689771				HMO - Health Maintenance Organization		C	Boston
H9001	Part D Appeals Contact (Secondary)	Manager, Member Appeals and Grievances	Ms.	Foulkes	Christina							Christina.Foulkes@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689447				HMO - Health Maintenance Organization		C	Boston
H9001	Part D Application Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Benefits Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Claims Submission Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David							David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5083689790				HMO - Health Maintenance Organization		C	Boston
H9001	Part D Exceptions Contact (Secondary)	Manager of Pharmacy Ops	Ms.	Doran	Kate							Kate.Doran@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	5087992100	79169			HMO - Health Maintenance Organization		C	Boston
H9001	Part D Price File Contact (Back-up)	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Price File Contact (Primary)	Govt Programs and Quality Clinical Pharmacist	Mr.	Huynh	Jayce		5087992100	69212				Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Quality Assurance Contact	Sr. Director, Pharmacy Therapeutics	Mr.	Huynh	Jayce		5083689212					Jayce.Huynh@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Reporting Contact	Medicare Regulatory Affairs Manager	Mr.	Greiner	Keith		5083689772					Keith.Greiner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Patient Safety Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Payment Contact	Senior Manager Accounting	Mr.	McNamara	Shawn		5083689085					Shawn.McNamara@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Director	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Network Management Contact	VP,  Pharmacy Services	Mr.	Barner	Benjamin		5083689660					Benjamin.Barner@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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 Network Management Contact (Secondary)	Director of Pharmacy Ops and Clinical Programs	Mr.	Sartini	David		5083689790					David.Sartini@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	8443688734				HMO - Health Maintenance Organization		C	Boston
H9001	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager (OptumRx)		Villanueva	Juan							Juan.Villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	12/13/2024	2026	FALLON COMMUNITY HEALTH PLAN	Local CCP	Fallon Health	HMO/HMOPOS		Fallon Community Health Plan, Inc.	88	Yes	Active	8007887871				HMO - Health Maintenance Organization		C	Boston
H9001	Physician Incentive Contact	VP, Network Development and Management	Ms.	Keser	Susan		5083689261					Susan.Keser@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Plan Directory Contact for Public Website			Service	Customer		5087992100	69988				CustomerService@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Plan to Plan Reconciliation Contact	Director, Medical Accounting	Mr.	Beaulieu	Michael		5083689020					Michael.Beaulieu@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Processor Contact	Customer Service Team Lead	Ms.	Ulfves	Heather		5087992100	79275				Heather.Ulfves@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Quality Contact	Director of Quality	Ms.	Little	Dawn		5083689263					Dawn.Little@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Reconciliation Contact	Associate Actuary	Mr.	Braniecki	Nicholas		5083689324	79339				Nicholas.Braniecki@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Reconciliation Contact (Secondary)	Director and Sr. Actuary, Valuation & Forecasting	Mr.	Salciccioli	John		5083689254					John.Salciccioli@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/25/2025	2026	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	Recovery Audit Contact	Senior Director, Claims Administration	Ms.	Straitiff	Kirsten		5083689047					kirsten.straitiff@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Surveillance Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	System Contact	SVP & Chief Operations Officer	Ms.	West	Emily		5083689592					Emily.West@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Third Party Administrator (TPA) Liaison	Revenue Senior Accountant I	Ms.	Peloquin	Kristin		5083689297					Kristin.Peloquin@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	12/04/2024	2026	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	User Access Contact	SrDirector MDCR Programs & MDCR Compliance Officer	Ms.	Lashbrook	Lisa		5083689539					Lisa.Lashbrook@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	09/30/2024	2026	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	Utilization Management Contact	Director, Utilization Management	Ms.	Meriano	Christina		5083689303					Christina.Meriano@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Utilization Review Contact	VP & Sr Medical Director, Clinical Management	Dr.	Cameron	Carl		5083689801					Carl.Cameron@fallonhealth.org	1 Mercantile St., Ste. 400		Worcester	MA	01608	01/06/2025	2026	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	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	09/01/2017	2026	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	Dallas
H9003	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	08/02/2018	2026	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	Dallas
H9003	Backup User Access Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St.		Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	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	Dallas
H9003	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	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	Dallas
H9003	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H9003	Bid Primary Contact	Actuary		Shmelzer	Cameron		5038131826					KPMedicareBids@kp.org	2715 Naches Ave SW		Renton	WA	98057	06/17/2025	2026	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	Dallas
H9003	CAP Report Contact for Public Website	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St.		Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/23/2024	2026	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	Dallas
H9003	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	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	Dallas
H9003	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					Mark.C1.Stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/16/2024	2026	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	Dallas
H9003	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	04/10/2023	2026	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	Dallas
H9003	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/16/2024	2026	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	Dallas
H9003	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Jones	Elliott		6196574452					elliott.jones@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/05/2024	2026	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	Dallas
H9003	CMS Casework Communication Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St.		Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Complaints Tracking Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	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	Dallas
H9003	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	04/28/2022	2026	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	Dallas
H9003	Corporate Mailing						9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St.	Attn: Heidi Lutz, Compliance Dept.	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Customer Service Operations Contact			Services	Member		8004430815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	10/25/2019	2026	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	Dallas
H9003	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	03/09/2020	2026	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	Dallas
H9003	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	07/17/2018	2026	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	Dallas
H9003	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	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	Dallas
H9003	Electronic Health Record Contact	Sr Manager, Meaningful Use PMO		Poole	Dolly		5106255813					dolly.poole@kp.org	1800 Harrison St.		Oakland	CA	94612	07/02/2018	2026	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	Dallas
H9003	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/04/2022	2026	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	Dallas
H9003	Employer Waiver Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Encounter Data & Risk Adjustment Operations Contact	ED, Risk Adjustment Submissions & Data Integrity	Ms.	Kessler	Lisa		3037091869					lisa.m.kessler@kp.org	One Kaiser Plaza		Oakland	CA	94612	08/13/2025	2026	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	Dallas
H9003	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H9003	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John	B	5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/12/2012	2026	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	Dallas
H9003	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	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	Dallas
H9003	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H9003	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/20/2023	2026	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	Dallas
H9003	Formulary Contact (Secondary)	Pharmacy Project Manager		Lin	Clement		5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	08/09/2018	2026	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	Dallas
H9003	General Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	10/10/2014	2026	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	Dallas
H9003	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	11/06/2020	2026	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	Dallas
H9003	HIPAA Security Officer	Senior Director		Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	08/25/2020	2026	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	Dallas
H9003	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	04/24/2023	2026	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	Dallas
H9003	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					cathy.p.plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	11/03/2021	2026	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	Dallas
H9003	MA Appeals/Grievances Contact	Executive Director, Member Relations		Osborne	Susan		5034576663					Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	12/02/2024	2026	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	Dallas
H9003	MA Claims Processing Contact for Public Website	ED, Risk Management & Audit Readiness		Christie	Diana		8188089993					RM_ART_CMS_Requests@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	02/28/2024	2026	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	Dallas
H9003	Marketing Contact	Director, Consumer Marketing and Advertising		Kelly	Meghan		5032015998					KP-MedicareFilings@kp.org	500 NE Multnomah Suite 100		Portland	OR	97232	12/02/2024	2026	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	Dallas
H9003	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	11/16/2020	2026	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	Dallas
H9003	Medicare Compliance Officer	Compliance Consultant, Medicare	Ms.	Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Medicare Coordinator	Director, Medicare		Sage	Brian		5033105368					Brian.E.Sage@kp.org	500 NE Multnomah Suite 100		Portland	OR	97232	08/07/2020	2026	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	Dallas
H9003	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	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	Dallas
H9003	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	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	Dallas
H9003	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					Jovan.Robinson@kp.org	10740 Fourth Street	2nd Floor   Cubicle: 023W02	Rancho Cucamonga	CA	91730	08/26/2020	2026	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	Dallas
H9003	Online Enrollment Center Contact (Back-up)	Senior Team Manager, Medicare Membership Admin		Nugent	Kristin		8586376801					kristin.n.nugent@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H9003	Online Enrollment Center Contact (Optional)	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H9003	Online Enrollment Center Contact (Primary)	Team Manager, Medicare Membership Administration		Covarrubio	Danny		8586143433					danny.x.covarrubio@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H9003	Part C Application Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Part C Reporting Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St.		Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Part D Appeals	Executive Director, Member Relations		Osborne	Susan							Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	10/29/2021	2026	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8774083496				HMO - Health Maintenance Organization		C	Dallas
H9003	Part D Application Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Part D Benefits Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	10/25/2019	2026	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	Dallas
H9003	Part D Claims Submission Contact	Director, Business Process Management		Pappas	Theodore		5033079849					theodore.pappas@kp.org	500 NE Multnomah		Portland	OR	97232	05/15/2018	2026	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	Dallas
H9003	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				HMO - Health Maintenance Organization		C	Dallas
H9003	Part D Price File Contact (Back-up)	Project Manager	Ms.	Kamikawa	Emely		5622998753					Emely.A.Kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	10/31/2019	2026	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	Dallas
H9003	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/26/2023	2026	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	Dallas
H9003	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/26/2023	2026	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	Dallas
H9003	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	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	Dallas
H9003	Part D Reporting Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St.		Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	06/01/2023	2026	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	Dallas
H9003	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H9003	Pharmacy Director	Pharmacy Director		Lyman, Jr.	Alfred	E	5032617926					alfred.e.lyman@kp.org	5725 NE 138th Ave		Portland	OR	97230	04/18/2017	2026	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	Dallas
H9003	Pharmacy Network Management Contact	National Pharmacy Benefits, Project Manager II		Munoz	Vanessa		5624477739					Vanessa.L.Munoz@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	10/25/2019	2026	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	Dallas
H9003	Pharmacy Technical Help Desk Contact			OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	11/02/2016	2026	KAISER FOUNDATION HP OF THE N W	Local CCP	Kaiser Permanente	HMO/HMOPOS		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8887917245				HMO - Health Maintenance Organization		C	Dallas
H9003	Physician Incentive Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Plan Directory Contact for Public Website			Services	Member		8772218221					kaiserpermanente@kp.org	500 NE Multnomah St.,Suite 100		Portland	OR	97232	04/05/2007	2026	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	Dallas
H9003	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/20/2023	2026	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	Dallas
H9003	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	09/05/2023	2026	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	Dallas
H9003	Quality Contact	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	05/25/2022	2026	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	Dallas
H9003	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	03/28/2022	2026	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	Dallas
H9003	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	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	Dallas
H9003	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	08/03/2022	2026	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	Dallas
H9003	Surveillance Contact	Compliance Consultant, Medicare		Lutz	Heidi		9714047562					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Attn: Compliance Department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	09/01/2017	2026	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	Dallas
H9003	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	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	Dallas
H9003	User Access Contact	Compliance Consultant, Medicare		Lutz	Heidi		5038132694					Heidi.A.Lutz@kp.org	500 NE Multnomah St., Suite 100	Att: Compliance department	Portland	OR	97232	11/20/2025	2026	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	Dallas
H9003	Utilization Management Contact	Exec. Director, Network & Utilization Mgmt.		Roberts	Christi		3608015698					Christi.R.Roberts@kp.org	500 NE Multnomah, #100		Portland	OR	97232	12/02/2024	2026	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	Dallas
H9003	Utilization Review Contact	Utilization Review Administrator		Fazio	Kathleen		5033179184					Kathleen.M.Fazio@kp.org	500 NE Multnomah, #100		Portland	OR	97232	12/02/2024	2026	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	Dallas
H9042	Agent/Broker Compensation Data Contact	Vice President, MTA Sales		Ward	Lisa		8123748215					lisa.ward@mytruadvantage.com	417 Washington St		Columbus	IN	47201	05/09/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Automated TrOOP Balance Transfer Contact	Director of Medicare Advantage Technical Services	Mr.	Coleman	Jonathan		8123142500	1022				jonathan.coleman@siho.org	417 Washington Street		Columbus	IN	47201	02/14/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Backup User Access Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@siho.org	417 Washington Street		Columbus	IN	47201	04/10/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Best Available Evidence Contact	Manager of Eligibility		Ralston	Tonya		8123142500	1033				tonya.ralston@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Bid Audit Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47202	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Bid Audit Site Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Bid Primary Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	CAP Report Contact for Public Website	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	CEO - CMS Administrator Contact	President & CEO	Mr.	Sadtler	John		8123738714					john.sadtler@siho.org	417 Washington St		Columbus	IN	47201	10/05/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	CEO - Senior Official for Contracting	President & CEO	Mr.	Sadtler	John		8123738714					john.sadtler@siho.org	417 Washington St		Columbus	IN	47201	10/05/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Chief Financial Officer	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Chief Operating Officer	COO	Mr.	Brey	Austin		8123793514					Austin.Brey@siho.org	417 Washington St		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Chief Information Officer	Vice President, Information Technology	Mr.	Clancy	Mike		8123787052					Mike.Clancy@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Chief Information Security Officer	Director of Technology Services	Mr.	Taylor	Rob		8123787046					Rob.Taylor@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	CMS Casework Communication Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Complaints Tracking Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Contact for Fraud Investigations	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/03/2022	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Coordination of Benefits Contact	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/03/2022	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Corporate Mailing						8123787023					Hannah.Hauser@siho.org	417 Washington Street		Columbus	IN	47201	03/08/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Customer Service Operations Contact	Vice President, MTA Sales		Ward	Lisa		8123748215					lisa.ward@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	05/09/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	DIR Contact	Director, Part D Operations & Vendor Oversight	Ms.	Helsley	Kimberly		8123787028					Kim.helsley@SIHO.org	417 Washington Street		Columbus	IN	47201	08/13/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	DIR Contact (Secondary)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Discount Program Payment Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Electronic Health Record Contact	Director, Care Management & Quality Programs		Albright	Jennifer		3178165183					jennifer.albright@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Emergency Part D Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Emergency Part D Contact (Secondary)	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	03/21/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Encounter Data & Risk Adjustment Operations Contact	VP Operations	Mr.	Massard	Gary		8123787083					Gary.Massard@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Enrollment Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington Street		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	EOB Transfer Contact	Claims Director		Coomer	Dawn		8123142500	1106			3178603632	dawn.coomer@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Financial Audit Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Financial Reporting Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Formulary Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	03/21/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Formulary Contact (Secondary)	Part D Mgr, Formulary Administration & Strategy		Wong	Tim		8582915420					tim.wong@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/22/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	General Contact	COO	Mr.	Brey	Austin		8123793514					Austin.Brey@siho.org	417 Washington St		Columbus	IN	47201	11/11/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Government Relations Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	HIPAA Privacy Officer	Administration and PHO Lead		Prabhune	Sheetal		8123787097	3003				sprabhune@inspirehealthpartners.com	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	HIPAA Security Officer	Director Technology Services	Mr.	Taylor	Rob		8123787046					Rob.Taylor@siho.org	417 Washignton Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Hospice Contact	Medicare Advantage Utilization Management Nurse		Graham	Jessica		8123142500	1016				jessica.graham@siho.org	417 Washington Street		Columbus	IN	47201	03/07/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Interoperability Contact	Director of Provider Relations		Jones	Michelle		8123787107					Michelle.Jones@siho.org	417 Washington Street		Columbus	IN	47201	12/17/2021	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	MA Appeals/Grievances Contact	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	08/03/2022	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	MA Claims Processing Contact for Public Website	Claims Director		Coomer	Dawn		8123142500	1106				dawn.coomer@siho.org	417 Washingotn Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Marketing Contact	Compliance and Reports Coordinator		Keele	Laura		8123142500	1221				laura.keele@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	05/09/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Medical Director	Medical Director	Dr.	Goode	Roy		8123430967					Roy.Goode@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Medicare Coordinator	Reports Specialist	Ms.	Gottman	Melissa		8123142500	1107				Melissa.Gottman@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Medicare Part D Opioid Overutilization Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	12/07/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Medication Therapy Management Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	03/21/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	OffShore Subcontractor Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Online Enrollment Center Contact (Back-up)	Manager of Quality Assurance, G&A, FWA & RA		Do	Nicole		8123142500	1102				Nicole.Do@siho.org	417 Washington Street		Columbus	IN	47201	02/16/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Online Enrollment Center Contact (Optional)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Online Enrollment Center Contact (Primary)	Director of Data Integration & Development	Mr.	Katheeder	Tim		8123787066					Tim.Katheeder@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part C Application Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part C Reporting Contact	Reports Specialist	Ms.	Gottman	Melissa		8123142500	1107				Melissa.Gottman@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Appeals	Manager of Quality Assurance		Do	Nicole							Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	8123142500	1102			PPO - BBA		C	Dallas
H9042	Part D Appeals Contact (Secondary)	Grievances & Appeals Coordinator		Hamilton-Brogdon	Gretchen							gretchen.hamilton@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	8123142500	1031			PPO - BBA		C	Dallas
H9042	Part D Application Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Benefits Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	03/21/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Claims Submission Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	03/21/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Exceptions Contact	Manager of Quality Assurance		Do	Nicole							Nicole.do@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	8123142500	1102			PPO - BBA		C	Dallas
H9042	Part D Exceptions Contact (Secondary)	Grievances & Appeals Coordinator		Hamilton-Brogdon	Gretchen							gretchen.hamilton@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	8123142500	1031			PPO - BBA		C	Dallas
H9042	Part D Price File Contact (Back-up)	General Consultant User		Keller	Sharon		8587907104					PlanFinderCommunications@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	09/19/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Price File Contact (Optional)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Price File Contact (Primary)	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	03/21/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Quality Assurance Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Part D Reporting Contact	Reports Specialist	Ms.	Gottman	Melissa		8123142500	1107				Melissa.Gottman@MyTruAdvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Patient Safety Contact	Director, Part D Operations & Vendor Oversigh	Ms.	Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	08/08/2025	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Payment Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Personal Health Record Contact	Director, Care Management & Quality Programs		Albright	Jennifer		3178165183					jennifer.albright@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Pharmacy Director	Medical Director	Dr.	Goode	Roy		8123430967					Roy.Goode@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Pharmacy Network Management Contact	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly		8123787028					Kim.Helsley@siho.org	417 Washington Street		Columbus	IN	47201	03/21/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Pharmacy Network Management Contact (Secondary)	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Pharmacy Technical Help Desk Contact	Director, Customer Contact Services		Brewer	Kathy							customerservice@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	12/06/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	8774036035				PPO - BBA		C	Dallas
H9042	Pharmacy Technical Help Desk Contact (Secondary)	Director, Part D Operations & Vendor Oversight		Helsley	Kimberly							kim.helsley@siho.org	417 Washington St		Columbus	IN	47201	12/06/2023	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active	8774036035				PPO - BBA		C	Dallas
H9042	PHR Beneficiary Contact																	02/24/2021	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO	Southeastern Indiana Health Organization Inc	SIHO Holding, Inc.	761	Yes	Active	8444254280				PPO - BBA		C	Dallas
H9042	Physician Incentive Contact	Director of Provider Relations		Jones	Michelle		8123787107					Michelle.Jones@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Plan Directory Contact for Public Website	Director of Provider Relations		Jones	Michelle		8123787107					Michelle.Jones@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Plan to Plan Reconciliation Contact	Staff Accountant I		Dobbs	Rachel		8123142500	1202				rachel.dobbs@siho.org	417 Washington Street		Columbus	IN	47201	05/12/2021	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Processor Contact	Senior Executive	Mr.	Massard	Gary		8123787083					Gary.Massard@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Quality Contact	Manager of Quality Assurance		Do	Nicole		8123142500	1102				Nicole.Do@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Reconciliation Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington St		Columbus	IN	47201	08/19/2021	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Reconciliation Contact (Secondary)	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Recovery Audit Contact	Chief Financial Officer	Ms.	Newell	Wendy		8123787040					Wendy.Newell@SIHO.org	417 Washington St		Columbus	IN	47201	08/20/2021	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Surveillance Contact	COO	Mr.	Brey	Austin		8123793514					austin.brey@siho.org	417 Washington St		Columbus	IN	47201	06/17/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	System Contact	Vice President Information Technology	Mr.	Clancy	Mike		8123787052					Mike.Clancy@siho.org	417 Washington Street		Columbus	IN	47201	03/06/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Third Party Administrator (TPA) Liaison	Staff Accountant I		Dobbs	Rachel		8123142500	1202				rachel.dobbs@siho.org	417 Washington Street		Columbus	IN	47201	05/12/2021	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	User Access Contact	Chief Compliance Officer	Mr.	Marx	David		8123787101					David.Marx@mytruadvantage.com	417 Washington Street		Columbus	IN	47201	07/25/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Utilization Management Contact	Medicare Advantage Utilization Management Nurse		Graham	Jessica		8123142500	1016				jessica.graham@siho.org	417 Washington Street		Columbus	IN	47201	03/07/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9042	Utilization Review Contact	Medicare Advantage Utilization Management Nurse		Graham	Jessica		8123142500	1016				jessica.graham@siho.org	417 Washington Street		Columbus	IN	47201	03/07/2024	2026	SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.	Local CCP	MyTruAdvantage	Local PPO		SIHO Holding, Inc.	761	Yes	Active					PPO - BBA		C	Dallas
H9047	Agent/Broker Compensation Data Contact	Director Sales Medicare/Individual		Drotning	Shannon		5035747123					shannon.drotning@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Automated TrOOP Balance Transfer Contact	Business Analyst Systems Coord, Pharmacy		Jundt	Curtis		5035745617				5035748646	curtis.jundt@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Backup User Access Contact	Senior Manager Compliance	Mrs.	Ocheltree	Amy		5035746098					Amy.Ocheltree@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Best Available Evidence Contact	Supervisor- Medicare Membership Accounting		Hopkins	Chantel		5035745723					chantel.hopkins@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Bid Audit Contact	Director Actuarial Analytics		Wu	Kai		9095250435					kai.wu@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Bid Primary Contact	Director Actuarial Analytics		Wu	Kai		9095250435					kai.wu@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	CAP Report Contact for Public Website	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Antonucci	Don		5038035475					don.antonucci@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Antonucci	Don		5038035475					don.antonucci@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Chief Financial Officer	Chief Financial Officer	Ms.	Saadzoi	Lina		5108162526					lina.saadzoi@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Chief Operating Officer	Chief Operating Officer	Mr.	Mathias	Michael		5035748083					michael.mathias@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Chief Information Officer	Chief Information Officer	Mr.	Mathias	Michael		5035748083					michael.mathias@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Chief Information Security Officer	Chief Information Officer	Mr.	Mathias	Michael		5035748083					michael.mathias@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	CMS Casework Communication Contact	Compliance Medicare Consultant		Saucy	Tara		5035747431					tara.saucy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Complaints Tracking Contact	Associate Medicare Compliance Specialist		Smith	Cassie		5035747323	47323				Cassie.smith@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Contact for Fraud Investigations	Director Payment Integrity		Yue	Katherine		5035747165	47165				Katherine.Yue@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Coordination of Benefits Contact	Manager-OFT		Parish	Lori		5035745861					Lori.parish@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Corporate Mailing						3106178718					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Customer Service Operations Contact	Supervisor Service Ops-Customer Service		Aronson	Elizabeth		5035746589					Elizabeth.Aronson@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	DIR Contact	Principal Healthcare Data Analyst		Rodgers	Tyler		5035746351					tyler.rodgers@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	DIR Contact (Secondary)	Business Analyst - Systems Coord, Pharmacy		Williams	Teresa		5035747308					Teresa.Williams@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Discount Program Payment Contact	Principal Healthcare Data Analyst		Rodgers	Tyler		5035746351					tyler.rodgers@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Emergency Part D Contact	VP Health Care Services Administration		Dietzman	Greg		5035503945					gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Emergency Part D Contact (Secondary)	Manager Clinical Pharmacy		Criswell-Cacho	John		5037075857					john.criswell-cacho2@providence.org	P.O. Box 4327		Portland	OR	97208	10/28/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Encounter Data & Risk Adjustment Operations Contact	Manager Analytics Business Intelligence		Viravouth	Tee		9497775247					tee.viravouth@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Enrollment Contact	Supervisor- Medicare Membership Accounting		Hopkins	Chantel		5035745723					chantel.hopkins@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	EOB Transfer Contact	Manager Analytics Business Intelligence, Pharmacy		Perry	Jeff		5035747154				8002497714	Jeffrey.perry@providence.org	P.O. Box 4327		Portland	OR	97208	10/28/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Financial Audit Contact	Vice President, Finance	Ms.	Wise	Ashley		5035746227	46227				Ashley.Wise2@providence.org	4400 NE Halsey Street	Bldg. #2	Portland	OR	97213	09/25/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Financial Reporting Contact	Chief Financial Officer		Saadzoi	Lina		5108162526					lina.saadzoi@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Formulary Contact	Program Manager - Clinical Pharmacy Outcomes	Dr.	Smith	Jenifer		5035747829					Jenifer.Smith@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Formulary Contact (Secondary)	Senior Business Systems Analyst		Clarke	Dana		5035748344					Dana.Clarke@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	General Contact	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Government Relations Contact	Chief Compliance & Risk Officer	Mr.	Bals	Aaron		5035746562					aaron.bals@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	HIPAA Privacy Officer	AVP Risk Management & Privacy		Landon	Brian		5035747234					Brian.Landon@providence.org	P.O. Box 4327		Portland	OR	97208	11/07/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	HIPAA Security Officer	VP of Engineering		Acosta	Fernando		5035748083					Fernando.Acosta@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Hospice Contact	Supervisor Training, Pharmacy		Ahnberg	Chelsea		5035746965					Chelsea.ahnberg@providence.org	P.O. Box 4327		Portland	OR	97208	10/28/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Interoperability Contact	Compliance Medicare Consultant		Saucy	Tara	J	5035747431					Tara.Saucy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	MA Appeals/Grievances Contact	Supervisor Appeals and Grievances		Nichuals	Ronni		5035746236					Ronni.Nichuals@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	MA Claims Processing Contact for Public Website	Manager, Public Programs Claims		Jointer	Priscilla		5035745626					Priscilla.jointer@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Marketing Contact	Medicare Compliance Specialist		Humm	Merry		5035747469					Merry.Humm@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Medical Director	VP Medical Management	Dr.	Soot	Laurel		5035748018				5035746464	laurel.soot@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Medicare Compliance Officer	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Medicare Coordinator	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacy Manager		Rutledge	Shelly		5035748513					Shelly.Rutledge@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Medication Therapy Management Contact	Manager-Pharmacy		Criswell-Cacho	John		5413878245					john.criswell-cacho2@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	OffShore Subcontractor Contact	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Online Enrollment Center Contact (Back-up)	Manager Medicare Membership Accounting		Maust	Cathy		5035745690				5035748627	cathleen.maust@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Online Enrollment Center Contact (Primary)	Supervisor- Medicare Membership Accounting		Hopkins	Chantel		5035745723					chantel.hopkins@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part C Application Contact	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part C Reporting Contact	Sr. Compliance Manager	Mrs.	Ocheltree	Amy		5035746098					amy.ocheltree@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Appeals	Supervisor Part D Appeals	Ms.	Nichuals	Ronni							Ronni.Nichuals@providence.org	PO Box 4158		Portland	OR	97208	01/05/2021	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active	8008784445				HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Appeals Contact (Secondary)	VP Health Care Services Administration	Mr	Dietzman	Greg							gregory.dietzman@providence.org	PO Box 4158		Portland	OR	97208	04/14/2023	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active	8008784445				HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Application Contact	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					Misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Benefits Contact	VP Health Care Services Administration		Dietzman	Greg		5035746413				5035748646	gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Claims Submission Contact	VP Health Care Services Administration		Dietzman	Greg		5035746413					gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Exceptions Contact	Manager Clinical Pharmacy		Criswell-Cacho	John							john.criswell-cacho2@providence.org	P.O. Box 4327		Portland	OR	97208	10/28/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active	8772163644				HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Exceptions Contact (Secondary)	VP Health Care Services Administration		Dietzman	Greg							gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active	5035746413				HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Price File Contact (Back-up)	Business Analyst - Systems Coord, Pharmacy	Mrs.	Williams	Teresa		5035747308					Teresa.Williams@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Price File Contact (Optional)	DST Health Systems		Boileau	Tiffany		5165510627					tiffany.boileau@sscinc.com	210 10th Street		Kansas City	MO	64105	01/05/2023	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Price File Contact (Primary)	DST Health Systems		Joslin	Karen		8167567860					karen.joslin@sscinc.com	210 10th Street		Kansas City	MO	64105	01/05/2023	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Quality Assurance Contact	VP Health Care Services Administration		Dietzman	Greg		5035746413				5035748646	gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Part D Reporting Contact	Sr. Compliance Manager	Mrs.	Ocheltree	Amy		5035746098					amy.ocheltree@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Patient Safety Contact	VP Health Care Services Administration		Dietzman	Greg		5035746413				5035748646	gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Payment Contact	Chief Financial Officer		Saadzoi	Lina		5035747425					lina.saadzoi@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Pharmacy Director	VP Health Care Services Administration		Dietzman	Greg		5035746413				5035748646	gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Pharmacy Network Management Contact	VP Health Care Services Administration		Dietzman	Greg		5035746413				5035748646	gregory.dietzman@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Business	Mrs.	Joffer	Kathleen	M	5035746485					kathleen.joffer@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Pharmacy Technical Help Desk Contact	Supervisor Healthcare Services		Huynh	Hanh							hanh.huynh@providence.org	P.O. Box 4327		Portland	OR	97208	10/28/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active	8884455518				HMO - Health Maintenance Organization		C	Dallas
H9047	Pharmacy Technical Help Desk Contact (Secondary)			Andrade	Chris							chris.andrade@sscinc.com	210 10th Street		Kansas City	MO	64105	01/31/2023	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active	8164352321				HMO - Health Maintenance Organization		C	Dallas
H9047	Physician Incentive Contact	Manager		Meidinger	Kurt		5035746584					kurtis.Meidinger@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Plan Directory Contact for Public Website	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Plan to Plan Reconciliation Contact	Healthcare Data Analyst		Williams	Rachelle		5035746316					rachelle.williams@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Processor Contact	Manager, Analytics Business Intelligence, Pharmacy		Perry	Jeffrey		5035747154					jeffrey.perry@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Quality Contact	Chief Healthcare Experience & Equity Officer		Tarbet	Timshel		5034490359					timshel.tarbet@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Reconciliation Contact	Principal Healthcare Data Analyst		Rodgers	Tyler		5035746351					tyler.rodgers@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Reconciliation Contact (Secondary)	Healthcare Data Analyst		Williams	Rachelle		5035746316					rachelle.williams@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Recovery Audit Contact	Sr. Compliance Manager	Mrs.	Ocheltree	Amy		5035746098					amy.ocheltree@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	SNP Application Contact	Medicare/Medicaid Program Manager	Mrs.	Enger	Deanne		5035746488					Deanne.enger@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	SNP State Contact	Medicare/Medicaid Program Manager	Mrs.	Enger	Deanne		5035746488					deanne.enger@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Surveillance Contact	Sr. Compliance Director - MCO		Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	System Contact	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Third Party Administrator (TPA) Liaison	Healthcare Data Analyst		Williams	Rachelle		5035746316					rachelle.williams@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	User Access Contact	Sr. Compliance Director - MCO	Mrs.	Dunphy	Misty		5035746608					misty.dunphy@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Utilization Management Contact	VP Medical Management PHP	Dr.	Soot	Laurel		5035748018				5035746464	laurel.soot@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9047	Utilization Review Contact	VP Medical Management PHP	Dr.	Soot	Laurel		5035748018				5035746464	laurel.soot@providence.org	P.O. Box 4327		Portland	OR	97208	09/09/2025	2026	PROVIDENCE HEALTH ASSURANCE	Local CCP	Providence Medicare Advantage Plans	HMO/HMOPOS		Providence St Joseph Health	798	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9052	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Backup User Access Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Best Available Evidence Contact	PACE Executive Director	Mr.	Britz	Paul		8104440665					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Bid Primary Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S Euclid Ave		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	CAP Report Contact for Public Website	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	8103886300				PACE - Nat		C	Atlanta
H9052	CEO - CMS Administrator Contact	CEO	Mrs.	Altom	Dayna	M	9898934506					altomd@region7aaa.org	1615 S Euclid Ave	optional	Bay City	MI	48706	10/16/2025	2026	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	Atlanta
H9052	CEO - Senior Official for Contracting	CEO	Mrs.	Altom	Dayna	M	9898934506					altomd@region7aaa.org	1615 S Euclid Ave		BAY CITY	MI	48706	10/16/2025	2026	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	Atlanta
H9052	Chief Financial Officer	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Chief Operating Officer	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	1615 S. Euclid		Bay City	MI	48706	10/16/2025	2026	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	Atlanta
H9052	Chief Information Officer	IT Manager	Mr.	Allen	Solomon		8103886300					allens@region7aaa.org	1615 S. Euclid Avenue		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Chief Information Security Officer	IT Manager	Mr.	Allen	Solomon		8103886300					allens@region7aaa.org	5229 Lakeshore Road		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	CMS Casework Communication Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Complaints Tracking Contact	Quality Manager	Mrs.	Brown	Tara		8103886300					brownt@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	03/19/2025	2026	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	Atlanta
H9052	Contact for Fraud Investigations	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Coordination of Benefits Contact	Business Office Manager	Mrs.	Turner	Jody		8103886300					turnerj@region7aaa.org	5229 Lakeshore Rd		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Corporate Mailing						9898934506					altomd@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	12/19/2024	2026	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	Atlanta
H9052	Customer Service Operations Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	DIR Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	DIR Contact (Secondary)	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Discount Program Payment Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Emergency Part D Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Encounter Data & Risk Adjustment Operations Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Enrollment Contact	Business Office Manager	Mrs.	Turner	Jody		8103886300					turnerj@region7aaa.org	5229 Lakeshore Rd		Fort Gratiot	MI	48059	03/19/2025	2026	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	Atlanta
H9052	EOB Transfer Contact	Business Office Manager	Mrs.	Turner	Jody		8103886300				8103886305	turnerj@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	03/19/2025	2026	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	Atlanta
H9052	Financial Audit Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	09/10/2025	2026	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	Atlanta
H9052	Financial Reporting Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	09/10/2025	2026	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	Atlanta
H9052	Formulary Contact	Medical Director	Dr.	Grech	Tony		8103886300				8103886305	grecht@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	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	Atlanta
H9052	General Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Government Relations Contact	CEO	Mrs.	Altom	Dayna		8103886300					altomd@region7aaa.org	1615 S. Euclid		Bay City	MI	48706	10/16/2025	2026	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	Atlanta
H9052	HIPAA Privacy Officer	IT Manager	Mr.	Allen	Solomon		8103886300	216				allens@region7aaa.org	5229 Lakeshore Road		Fort Gratiot	MI	48059	09/10/2025	2026	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	Atlanta
H9052	HIPAA Security Officer	IT Manager	Mr.	Allen	Solomon		8103886300					allens@region7aaa.org	5229 Lakeshore Road		Fort Gratiot	MI	48059	09/10/2025	2026	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	Atlanta
H9052	Interoperability Contact	IT Manager	Mr.	Allen	Solomon		8103886300	216				allens@region7aaa.org	5229 Lakeshore Road		Fort Gratiot	MI	48059	09/10/2025	2026	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	Atlanta
H9052	MA Appeals/Grievances Contact	Quality Manager	Ms.	Brown	Tara		8103886300					brownt@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	12/19/2024	2026	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	Atlanta
H9052	MA Claims Processing Contact for Public Website	Business Office Manager	Mrs.	Turner	Jody		8103886300					turnerj@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	09/10/2025	2026	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	Atlanta
H9052	Marketing Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Medical Director	Medical Director	Dr.	Grech	Tony		8103886300				8103886305	grecht@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	03/06/2024	2026	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	Atlanta
H9052	Medicare Compliance Officer	CHRO	Mrs.	Johnson	Megan		9898934506					johnsonm@region7aaa.org	1615 S. Euclid		Bay City	MI	48706	10/11/2024	2026	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	Atlanta
H9052	Medicare Coordinator	Business Office Manager	Mrs.	Turner	Jody		8103886300					turnerj@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	03/19/2025	2026	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	Atlanta
H9052	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Grech	Tony		8103886300				8103886305	grecht@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	03/06/2024	2026	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	Atlanta
H9052	Medication Therapy Management Contact	Medical Director	Dr.	Grech	Tony		8103886300				8103886305	grecht@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	03/06/2024	2026	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	Atlanta
H9052	Part C Application Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Part D Appeals	Medical Director	Mr.	Grech	Tony							grechtm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	8103886300				PACE - Nat		C	Atlanta
H9052	Part D Appeals Contact (Secondary)	Medical Director	Mr.	Grech	Tony							grechtm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	8103886300				PACE - Nat		C	Atlanta
H9052	Part D Application Contact	CFO	Mr	Visuri	Elliot		8103886300					visurie@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	09/10/2025	2026	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	Atlanta
H9052	Part D Benefits Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Part D Claims Submission Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300					britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Part D Exceptions Contact	Medical Director	Mr.	Grech	Tony							grechtm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	8103886300				PACE - Nat		C	Atlanta
H9052	Part D Exceptions Contact (Secondary)	Medical Director	Mr.	Grech	Tony							grechtm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	8103886300				PACE - Nat		C	Atlanta
H9052	Part D Price File Contact (Back-up)	Medical Director	Mr.	Grech	Tony		8103886300	216				grecht@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	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	Atlanta
H9052	Part D Price File Contact (Primary)	Medical Director	Dr.	Grech	Tony		8103886300				8103886305	grecht@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	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	Atlanta
H9052	Part D Quality Assurance Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300				8103886305	britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Part D Reporting Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Patient Safety Contact	Medical Director	Dr.	Grech	Tony		8103886300				8103886305	grecht@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	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	Atlanta
H9052	Payment Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Pharmacy Director	Pharmacist	Mr.	Le	Viet		8103886300					viet@kltcpharmacy.com	5229 Lakeshore		Fort Gratiot	MI	48059	08/03/2023	2026	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	Atlanta
H9052	Pharmacy Network Management Contact	Medical Director		Grech	Dr. Tony		8103886300					grecht@region7aaa.org	5229 Lakeshore		Fort Gratiot	MI	48059	03/19/2025	2026	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	Atlanta
H9052	Pharmacy Technical Help Desk Contact	Medical Director	Mr.	Grech	Tony							grechtm@region7aaa.org	5229 Lakeshore Road		FORT GRATIOT	MI	48059	07/05/2024	2026	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE		Region VII Area Agency on Aging, Inc.	778	Yes	Active	8103886300				PACE - Nat		C	Atlanta
H9052	PHR Beneficiary Contact																	02/18/2022	2026	REGION VII AREA AGENCY ON AGING	National PACE	Sunrise PACE	National PACE	Sunrise PACE	Region VII Area Agency on Aging, Inc.	778	Yes	Active	8882912647				PACE - Nat		C	Atlanta
H9052	Plan Directory Contact for Public Website	IT Manager	Mr.	Allen	Solomon		8103886300					allens@region7aaa.org	5229 Lakeshore Road		Fort Gratiot	MI	48059	09/10/2025	2026	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	Atlanta
H9052	Plan to Plan Reconciliation Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Processor Contact	Business Office Manager	Mrs.	Turner	Jody		8103886300					turnerj@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	09/10/2025	2026	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	Atlanta
H9052	Quality Contact	Quality Manager	Ms.	Brown	Tara		8103886300				8103886305	brownt@region7aaa.org	5229 Lakeshore Road		Fort Gratiot	MI	48059	12/19/2024	2026	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	Atlanta
H9052	Reconciliation Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	Recovery Audit Contact	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	09/10/2025	2026	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	Atlanta
H9052	Surveillance Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300				8103886305	britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	System Contact	Business Office Manager	Mrs.	Turner	Jody		8103886300					turnerj@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	03/19/2025	2026	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	Atlanta
H9052	Third Party Administrator (TPA) Liaison	CFO	Mr.	Visuri	Elliott		9898934506					visurie@region7aaa.org	1615 S. Euclid Avenue		Bay City	MI	48706	07/05/2024	2026	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	Atlanta
H9052	User Access Contact	CEO	Mrs.	Altom	Dayna		8103886300					altomd@region7aaa.org	1615 S. Euclid		Bay City	MI	48706	10/16/2025	2026	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	Atlanta
H9052	Utilization Management Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300				8103886305	britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9052	Utilization Review Contact	PACE Executive Director	Mr.	Britz	Paul		8103886300				8103886305	britzp@region7aaa.org	5229 Lakeshore Rd.		Fort Gratiot	MI	48059	10/16/2025	2026	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	Atlanta
H9065	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H9065	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H9065	PHR Beneficiary Contact																	02/04/2019	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H9065	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9065	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	AMH HEALTH, LLC	Local CCP	AMH Health	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9066	Agent/Broker Compensation Data Contact	Exec Vp Strategic Operations	Ms	Lindsay	Tammy		3154779587					tlindsay@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	Automated TrOOP Balance Transfer Contact	Chief Financial Officer		Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	10/04/2023	2026	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	Backup User Access Contact	VP Health Plan Operations	Ms	Frederick	Amanda		3154779275					Afrederick@477home.org	1050 West Genesee St		Syracuse	NY	13204	08/16/2021	2026	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		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/12/2018	2026	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	Bid Audit Contact	Chief Administrative Officer		Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	09/28/2021	2026	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	Bid Audit Site Contact	Chief Administrative Officer		Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	09/28/2021	2026	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	Bid Primary Contact	Chief Administrative Officer		Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	09/28/2021	2026	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	CAP Report Contact for Public Website	VP Performance Excellence		Billington	Janet		3154779233					JBillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/22/2022	2026	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	CEO - CMS Administrator Contact	President/Chief Executive Officer	MS	Rolf	Mary Kate		3154779500	595				mkrolf@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/23/2018	2026	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	CEO - Senior Official for Contracting	President/Chief Executive Officer	MS	Rolf	Mary Kate		3154779500	595				mkrolf@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/23/2018	2026	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	Ms.	Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	10/04/2023	2026	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 Operating Officer		Mr	Twardy	Joseph		3158707763					jtwardy@477home.org	1050 West Genesee St		Syracuse	NY	13204	09/09/2021	2026	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 Information Officer		Ms	Manna	Cheryl		3154779500	594				Cmanna@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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 Information Security Officer		Ms	Billington	Janet		3154779500	233				jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/12/2018	2026	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		3154779304					sginestro@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	Complaints Tracking Contact	UR Manager	MS	Ginestro	Suzanne		3154779304					sginestro@477home.org	1050 West Genesee St		Syracuse	NY	13204	11/27/2019	2026	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	Contact for Fraud Investigations	VP Performance Excellence		Billington	Janet		3154779233					JBillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/22/2022	2026	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		3154779275					afrederick@477home.org	1050 West Genesee St		Syracuse	NY	13204	08/16/2021	2026	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	Corporate Mailing						3158707763					jtwardy@477home.org	1050 West Genesee St		Syracuse	NY	13204	05/28/2021	2026	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		3159601827					tlindsay@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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	DIR Contact	Senior Director	Mr	Farmer	Jim		3308886098					jfarmer@elixirsolutions.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	09/13/2022	2026	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	DIR Contact (Secondary)	Mgr, QC Ops Gov Programs		Houchens	Logan		3308886095					lhouchens@elixirsolutions.com	2181 East Aurora Road Suite 201		Twinsburg	OH	44087	07/21/2023	2026	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	Discount Program Payment Contact	Chief Financial Officer		Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	10/04/2023	2026	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	Electronic Health Record Contact		Ms	Billington	Janet		3154779500	233				jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	Emergency Part D Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	Encounter Data & Risk Adjustment Operations Contact	Chief Adminstrative Officer		castle	June		3154779320					jcastle@477home.org	1050 west genesee St		syracuse	NY	13420	01/21/2020	2026	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	Enrollment Contact		Ms	Billington	Janet		3154779500	233				jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	EOB Transfer Contact		Ms	Billington	Janet		3154779500	233			3158707788	jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	Financial Audit Contact	Chief Administrative Officer	Ms	Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	09/28/2021	2026	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	Financial Reporting Contact	Chief Financial Officer		Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	10/04/2023	2026	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	Formulary Contact	Clinical Formulary Pharmacist		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/16/2025	2026	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	Formulary Contact (Secondary)			Pharmacist	Formulary		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	01/16/2025	2026	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	General Contact	EVP Health Plans	Mr	Twardy	Joseph		3154124684					jtwardy@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	HIPAA Privacy Officer	VP Performance Excellence		Billington	Janet		3154779233					JBillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/22/2022	2026	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	HIPAA Security Officer	VP Performance Excellence	Ms	Billington	Janet		3154779500	233				jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	Interoperability Contact	VP Performance Excellence		Billington	Janet		3154779233					jbillington@477home.org	1050 West Genesse St		Syracuse	NY	13204	01/24/2022	2026	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	MA Appeals/Grievances Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	MA Claims Processing Contact for Public Website		Ms	Billington	Janet		3154779500	233			3158707788	jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	Marketing Contact			Manna	Cheryl		3154779594					Cmanna@nascentiahealth.org	1050 West Genesee St		Syracuse	NY	13204	01/07/2025	2026	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	Medical Director	Medical Director	Dr	Amidon	Joel		3154779500					jamidon@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/19/2021	2026	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	Compliance Officer	Ms.	Billington	Janet		3154779233					JBillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	05/05/2023	2026	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 Coordinator	VP Health Plan Operations	Ms	Frederick	Amanda		3154779275					afrederick@477home.org	1050 West Genesee St		Syracuse	NY	13204	08/16/2021	2026	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 Part D Opioid Overutilization Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/13/2019	2026	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	Medication Therapy Management Contact	Manager Medication Management		Blain	Sarah		8582915382					mtmp@medimpact.com	2181 east Aurora RD	Suite 201	Twinsburg	OH	44087	10/01/2025	2026	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	Online Enrollment Center Contact (Back-up)	Chief of Staff, EVP Strategic Operations   Strateg		Lindsay	Tammy		3154779587					tlindsay@nascentiahealth.org	1050 West Genesee Street		Syracuse	NY	13204	05/04/2023	2026	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	Online Enrollment Center Contact (Primary)	Chief of Staff, EVP Strategic Operations		Lindsay	Tammy		3154779587					tlindsay@nascentiahealth.org	1050 West Genesee Street		Syracuse	NY	13204	10/03/2023	2026	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 C Application Contact	EVP Health Plans	Mr	Twardy	Joseph		3154124684					jtwardy@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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 C Reporting Contact	Chief Clinical Officer	Ms	Lazarek LaQuay	Andrea		3157250130					alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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 Appeals	Utilization Review Manager	Ms	Ginestro	Suzanne							sginestro@477home.org	1050 West Genesee St		Syracuse	NY	13204	12/30/2020	2026	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active	8884774663	9304			HMO - Health Maintenance Organization		C	New York
H9066	Part D Appeals Contact (Secondary)	Dir Clinical Ops		Collins	Andrea							andrea.collins@medimpact.com	8921 Canyon Falls Blvd		Twinsburg	OH	44087	01/16/2025	2026	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	New York
H9066	Part D Application Contact	EVP Health Plans	Mr	Twardy	Joseph		3154124684					jtwardy@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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 Benefits Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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 Claims Submission Contact	Mgr Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	8920 Canyon Falls	Suite 123	Twinsburg	OH	44087	01/16/2025	2026	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	Dir Clin ops		Collins	Andrea							andrea.collins@medimpact.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	01/16/2025	2026	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	New York
H9066	Part D Exceptions Contact (Secondary)	AVP Clinical Operations		Lavignette	Amanda							alavignette@elixirsolutions.com	2181 East Aurora Road Suite 201 Twinsburg		Twinsburg	OH	44087	08/19/2021	2026	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	New York
H9066	Part D Price File Contact (Back-up)	Dir		Campbell	Tim		9547672633					tcampbell@medimpact.com	2181 East Aurora Road Suite 201		Twinsburg	OH	44087	01/16/2025	2026	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 Price File Contact (Optional)			Kessler	Cameron		9179021552					ckessler@elixirsolutions.com	2181 East Aurora Road Suite 201		Twinsburg	OH	44087	09/13/2022	2026	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 Price File Contact (Primary)	Sr Financial Manager Reporting & Analytics		Campbell	Tim		3308886988					tcampbell@elixirsolutions.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/17/2022	2026	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 Quality Assurance Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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 Reporting Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	Patient Safety Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	Payment Contact	Chief Financial Officer		Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	10/04/2023	2026	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 Director	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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 Network Management Contact	Director Pharmacy Network Development and Operatio		Hunt	Brian		8587907092					Brian.hunt@medimpact.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	10/01/2025	2026	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							Todd.Conn@medimpact.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	10/08/2025	2026	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	Local CCP	Nascentia Health Plus	HMO/HMOPOS		VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	703	Yes	Active	8334594424				HMO - Health Maintenance Organization		C	New York
H9066	Plan Directory Contact for Public Website	VP Health Plan Operations		Frederick	Amanda		8884774663					afrederick@nascentiahealth.org	1050 West Genesee St		Syracuse	NY	13204	01/08/2025	2026	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	Plan to Plan Reconciliation Contact	Chief Administrative Officer	Ms	Castle	June		3154779500				3158707788	jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/19/2021	2026	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	Processor Contact		Ms	Billington	Janet		3154779500	233			3158707788	jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	Quality Contact	Chief Clinical Officer	Ms	LaQuay Lazarek	Andrea		3157250130					alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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	Reconciliation Contact	Chief Administrator Officer	Ms	Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	11/27/2019	2026	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	Recovery Audit Contact	Chief Financial Officer	Ms.	Castle	June		3154779320					jcastle@477home.org	1050 West Genesee St		Syracuse	NY	13204	10/04/2023	2026	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	SNP Application Contact	EVP Health Plans	Mr	Twardy	Joseph		3154124684					jtwardy@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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	Surveillance Contact	Exec Vp Strategic Operations	Ms	Lindsay	Tammy		3154779587					tlindsay@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	System Contact	EVP Health Plans	Mr	Twardy	Joseph		3154124684					jtwardy@477home.org	1050 West Genesee St		Syracuse	NY	13204	03/19/2021	2026	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	Third Party Administrator (TPA) Liaison		Ms	Billington	Janet		3154779500	233			3158707788	jbillington@477home.org	1050 West Genesee St		Syracuse	NY	13204	01/13/2020	2026	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	User Access Contact	VP Health Plan Operations		Frederick	Amanda		3154779275					afrederick@477home.org	1050 West Genesee St		Syracuse	NY	13204	12/16/2021	2026	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	Utilization Management Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	Utilization Review Contact	Chief Clinical Officer	MS	Lazarek-Laquay	Andrea		3154779500	598				alaquay@477home.org	1050 West Genesee St		Syracuse	NY	13204	02/11/2018	2026	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	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Backup User Access Contact	Senior Director of Operations	Mr.	McDonough	John		5705223880				5705249068	john.mcdonough@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	09/24/2019	2026	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	President	Mr.	Smith	Shaun	T	5705223889				5705249068	Shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Bid Primary Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	CAP Report Contact for Public Website	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	CEO - CMS Administrator Contact	CEO	Mr.	Smith	Shaun		5705223889				5705249068	shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	12/21/2021	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	CEO - Senior Official for Contracting	CEO	Mr.	Smith	Shaun		5705223880				5705249068	shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	05/24/2012	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Chief Financial Officer	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Chief Operating Officer	COO	Ms.	Fury	Melissa		5705223880				5705249068	mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Chief Information Officer	Senior Director of Operations	Mr.	McDonough	John		5705223880				5705249068	john.mcdonough@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	09/24/2019	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Chief Information Security Officer	Senior Director of Operations	Mr.	McDonough	John		5705223880				5705249068	john.mcdonough@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	09/24/2019	2026	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	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Complaints Tracking Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Contact for Fraud Investigations	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	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	Vice President/ Controller	Ms	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Corporate Mailing						5705223880				5705249068	shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	09/20/2016	2026	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	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	DIR Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	DIR Contact (Secondary)	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Discount Program Payment Contact	President	Mr	Smith	Shaun	T	5705223889					Shaun.smith@asbury.org	5285 Westview Drive		Frederick	MD	21703	10/15/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Emergency Part D Contact	CEO	Mr.	Smith	Shaun		5705223889				5705249068	shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	12/21/2021	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Emergency Part D Contact (Secondary)	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223853				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Encounter Data & Risk Adjustment Operations Contact	Sr. VP of LIFE		Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Enrollment Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	EOB Transfer Contact	Vice President/ Controller	Ms	Ehrenfried	Kimberly		3012502137				5705249068	Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Financial Audit Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Financial Reporting Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Formulary Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Formulary Contact (Secondary)	Senior Director of Operations	Mr.	McDonough	John		5705223880				5705249068	john.mcdonough@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	General Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	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		5705223880				5705249068	shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	05/24/2012	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	HIPAA Privacy Officer	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	HIPAA Security Officer	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Interoperability Contact	President	Mr.	Smith	Shaun		5705223889					Shaun.smith@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	MA Appeals/Grievances Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	MA Claims Processing Contact for Public Website	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Marketing Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Medical Director	Medical Director	Dr.	Brown	Jennna		5705223880				5705249068	Jenna.Brown@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	11/10/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Medicare Compliance Officer	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Medicare Coordinator	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Medicare Part D Opioid Overutilization Contact	Sr. VP of LIFE	Ms.	F	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Medication Therapy Management Contact	Senior VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Online Enrollment Center Contact (Back-up)	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Online Enrollment Center Contact (Optional)	Senior Director of Operations	Mr.	McDonough	John		5705223880				5705249068	john.mcdonough@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	09/24/2019	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part C Application Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Appeals	Corporate Compliance Officer	Ms.	Fury	Melissa						5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	8887910094				PACE - Nat		C	Philadelphia
H9068	Part D Appeals Contact (Secondary)	Sr. Director of Operations	Mr.	McDonough	John						5705249068	john.mcdonough@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	12/29/2020	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	8887910094				PACE - Nat		C	Philadelphia
H9068	Part D Application Contact	Vice President of LIFE	Ms.	Fury	Melissa		5705223880					Mfury@asbury.org	90 MapleWood Drive		Lewisburg	PA	17837	05/22/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Benefits Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Claims Submission Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	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	Ms.	Fury	Melissa						5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	5705223880				PACE - Nat		C	Philadelphia
H9068	Part D Exceptions Contact (Secondary)	Vice President/ Controller	Ms.	Ehrenfried	Kimberly						5705249068	Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	8887910094				PACE - Nat		C	Philadelphia
H9068	Part D Price File Contact (Back-up)	Senior Director of Operations	Mr.	McDonough	John		5705223880				5705249068	john.mcdonough@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Price File Contact (Optional)	Corporate Compliance Officer	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Price File Contact (Primary)	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Quality Assurance Contact	Corporate Compliance Officer	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Part D Reporting Contact	Corporate Compliance Officer	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Patient Safety Contact	Corporate Compliance Officer	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Payment Contact	President	Mr.	Smith	Shaun	T	5705223889					Shaun.smith@asbury.org	5285 Westview Drive		Frederick	MD	21703	10/15/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Personal Health Record Contact	Corporate Compliance Officer	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Pharmacy Director	Director of Pharmacy	Mrs.	Beitz	Krystal		5705233108				5705233109	krystal.beitz@albrightcare.org	110 Maplewood Drive		Lewisburg	PA	17837	02/26/2015	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Pharmacy Network Management Contact	Director of Pharmacy	Mrs.	Beitz	Krystal		5705233108				5705233109	krystal.beitz@albrightcare.org	110 Maplewood Drive		Lewisburg	PA	17837	03/21/2019	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Pharmacy Network Management Contact (Secondary)	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	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						5705233109	krystal.beitz@albrightcare.org	110 Maplewood Drive		Lewisburg	PA	17837	02/26/2015	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	5705233108				PACE - Nat		C	Philadelphia
H9068	Pharmacy Technical Help Desk Contact (Secondary)	Senior VP of LIFE	Ms.	Fury	Melissa						5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active	5705223880				PACE - Nat		C	Philadelphia
H9068	PHR Beneficiary Contact																	07/11/2011	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	Asbury Communities, Inc.	461	Yes	Active	5705223880				PACE - Nat		C	Philadelphia
H9068	Plan Directory Contact for Public Website	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Plan to Plan Reconciliation Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Processor Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Quality Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Reconciliation Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Reconciliation Contact (Secondary)	Senior VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Recovery Audit Contact	Vice President/ Controller	Ms.	Ehrenfried	Kimberly		3012502137					Kehrenfried@asbury.org	5285 Westview Drive		Frederick	MD	21703	01/02/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Surveillance Contact	Senior VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	System Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Third Party Administrator (TPA) Liaison	President	Mr	Smith	Shaun	T	5705223880				5705249068	Shaun.smith@asbury.org	90 Maplewood Drive		Lewisburg	PA	17837	04/25/2025	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	User Access Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Utilization Management Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9068	Utilization Review Contact	Sr. VP of LIFE	Ms.	Fury	Melissa		5705223880				5705249068	Mfury@albrightcare.org	90 Maplewood Drive		Lewisburg	PA	17837	08/15/2024	2026	ALBRIGHT CARE SERVICES	National PACE	ALBRIGHT CARE SERVICES	National PACE		Asbury Communities, Inc.	461	Yes	Active					PACE - Nat		C	Philadelphia
H9081	Part C Application Contact			Liu	Boyu		9495610999					liu.boyu@del-sol.com	820 Diamond Bar Blvd		Diamond Bar	CA	91765	11/02/2025	2026	DEL SOL PACE LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9081	Part D Application Contact			Liu	Boyu		9495610999					liu.boyu@del-sol.com	820 Diamond Bar Blvd		Diamond Bar	CA	91765	11/02/2025	2026	DEL SOL PACE LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9096	Agent/Broker Compensation Data Contact	Director, Sales Effectiveness		Franciscus	Stephanie		9529922196				6082520829	stephanie.franciscus@medica.com	401 Carlson Parkway, CP 265		Minnetonka	MN	55305	04/09/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Automated TrOOP Balance Transfer Contact	Operations Manager, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	Relay.Health@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Backup User Access Contact	Compliance Consultant		Johnston	Rikki		9529923841					rikki.johnston@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Best Available Evidence Contact	Manager - Enrollment & Billing		Kaderabek	Kay		6088281976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Bid Audit Contact	Senior Actuarial Associate	Mr	Chandler	Andrew		6088274318					andrew.chandler@deancare.com	1277 Deming Way		Madison	WI	53717	05/08/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Bid Primary Contact	Director - Product		Schaefer	Jennifer		6124147383					jennifer.schaefer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/22/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	CAP Report Contact for Public Website	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	CEO - CMS Administrator Contact	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Chief Financial Officer	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Chief Operating Officer	Chief Operations Officer	Mr	Hjerpe	Adam		6123861065					COO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/11/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Chief Information Officer	VP, Chief Technology Officer	Mr	Peterson	Scott		9529922625					Scott.Peterson@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	09/05/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Chief Information Security Officer	Sr. Director of Information Risk Management - CISO	Mr.	Abbott	Brad		9529920081					Bradley.Abbott@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	02/01/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	CMS Casework Communication Contact	Manager, Consumer Affairs		Blum	Adam		6088274420					Adam.Blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Complaints Tracking Contact	Manager Customer Service		Riske	Christina		8002791302					Christina.Riske@deancare.com	1277 Deming Way		Madison	WI	53717	08/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Contact for Fraud Investigations	Director, Special Investigations Unit		Kalin	Dan		9529922587					Daniel.Kalin@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/05/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Coordination of Benefits Contact	Manager - Enrollment & Billing		Kaderabek	Kay		6088281976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Corporate Mailing						9529922900					Nichole.MeltonMitchell@medica.com	401 Carlson Parkway	P.O. Box 9310 CP320	Minnetonka	MN	55305	04/09/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Customer Service Operations Contact	Manager Customer Service		Riske	Christina		8002791302					Christina.Riske@deancare.com	1277 Deming Way		Madison	WI	53717	08/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	DIR Contact	Senior Actuarial Associate	Mr	Chandler	Andrew		6088274318					andrew.chandler@deancare.com	1277 Deming Way		Madison	WI	53717	05/08/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	DIR Contact (Secondary)	Manager, Compliance	Mr	Herbst	Travis		6088282856					travis.herbst@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Discount Program Payment Contact	Senior Financial Analyst		Johnson	Derek		8002791302					derek.johnson@deancare.com	1277 Deming Way		Madison	WI	53717	06/06/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Emergency Part D Contact			Bock	Kelly		9529928379					kelly.bock@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Emergency Part D Contact (Secondary)	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	01/06/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Encounter Data & Risk Adjustment Operations Contact	Director - Risk Adjustment Operations		Werwinski	Michelle		6088305958					Michelle.Werwinski@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Enrollment Contact	Manager - Enrollment & Billing		Kaderabek	Kay		6088281976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	EOB Transfer Contact	Clinical Pharmacist		Seabright	Diane		9203514627				6088274212	Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Financial Audit Contact	Manager - Finance	Ms	Nelson	Alyssa		6084060543					alyssa.nelson@deancare.com	1277 Deming Way		Madison	WI	53717	09/21/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Financial Reporting Contact	CFO	Ms	Dusil	Krista		9529923908					Krista.Dusil@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	12/09/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Formulary Contact	Clinical Pharmacist		Valeo-Seabright	Diane		6088361400					Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	deanna.paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	General Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Government Relations Contact	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	HIPAA Privacy Officer	Director of Privacy		Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/25/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	HIPAA Security Officer	Sr. Director of Information Risk Management - CISO		Abbott	Brad		9529920081					Bradley.Abbott@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Hospice Contact	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Interoperability Contact	Director of Privacy		Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/24/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	MA Appeals/Grievances Contact	Manager, Consumer Advisor		Blum	Adam		6088274420					Adam.Blum@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	MA Claims Processing Contact for Public Website	Manager Claims		Sago	Murielle		8002791302					Murielle.Sago@deancare.com	1277 Deming Way		Madison	WI	53717	08/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Marketing Contact	Legal & Regulatory Analyst		Warren	Jennifer		6088305919					jennifer.warren1@deancare.com	1277 Deming Way		Madison	WI	53717	06/22/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Medical Director	Medical Director	MD	Shenkir	Gloria		6088246980					gloria.shenkir@deancare.com	1277 Deming Way		Madison	WI	53717	06/12/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Medicare Compliance Officer	VP Compliance	Mrs	Koranteng	Milly		9529922090					complianceofficer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Medicare Coordinator	VP & GM, Medicare		Orr	Britta		9529923111					Britta.Orr@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/12/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Valeo-Seabright	Diane		6088361400					Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Medication Therapy Management Contact	Manager Pharmacy		Jakowski	Nathan		6088361400					Nathan.Jakowski@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	OffShore Subcontractor Contact	Director of Privacy		Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/24/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Online Enrollment Center Contact (Optional)	Manager - Enrollment & Billing		Kaderabek	Kay		6088281976					kay.kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Online Enrollment Center Contact (Primary)	Manager - Enrollment & Billing		Kaderabek	Kay		6088281976					Kay.Kaderabek@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part C Application Contact	Director - Product		Olmscheid	Rebecca		7638077574					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/22/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part C Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/07/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Application Contact	Director - Product		Olmscheid	Rebecca		7638077574					rebecca.olmscheid@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/22/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Benefits Contact	Clinical Pharmacist		Valeo-Seabright	Diane		6088361400					Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Claims Submission Contact	Manager, Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/09/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Exceptions Contact	Assoc Director, Clinical Prior Authorization		LeClair	Christophe						9202214676	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/09/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Price File Contact (Back-up)	Provider Quality Manager		Seager	Deb		6087291578					Deb.Saeger@navitus.com	361 Integrity Drive		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Price File Contact (Primary)			Plan Finder	Navitus		5122313140					Plan.Finder@navitus.com	361 Integrity Drive		Madison	WI	53717	04/09/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Quality Assurance Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Part D Reporting Contact			Warren	Jennifer		6086580332					Jennifer.Warren1@deancare.com	1277 Deming Way		Madison	WI	53717	03/27/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Patient Safety Contact	Medical Director		Shenkir	Gloria		6088246980					gloria.shenkir@deancare.com	1277 Deming Way		Madison	WI	53717	06/12/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Payment Contact	Senior Financial Analyst		Johnson	Derek		8002791302					derek.johnson@deancare.com	1277 Deming Way		Madison	WI	53717	06/12/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Pharmacy Director	Director of Pharmacy Services		Wilhelm	Sue		6088287576					Sue.Wilhelm@medica.com	1277 Deming Way		Madison	WI	53717	02/01/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Pharmacy Network Management Contact	VP, Network Management		Santos	Christina		6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	04/09/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/09/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H9096	Plan Directory Contact for Public Website	Customer Service		Service	Customer		8772327566					DHP.CustomerRelationsResolutionTeam@medica.com	1277 Deming Way		Madison	WI	53717	02/01/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Plan to Plan Reconciliation Contact	Senior Actuarial Associate	Mr	Chandler	Andrew		6088274318					andrew.chandler@deancare.com	1277 Deming Way		Madison	WI	53717	05/08/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Processor Contact	Clinical Pharmacist		Valeo-Seabright	Diane		6088361400					Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Quality Contact	Stars Program Leader		Smith	Julee		6088287579					Julee.Smith@deancare.com	1277 Deming Way		Madison	WI	53717	08/12/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Reconciliation Contact	Senior Actuarial Associate	Mr	Chandler	Andrew		6088274318					andrew.chandler@deancare.com	1277 Deming Way		Madison	WI	53717	05/08/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Recovery Audit Contact	Manager - Compliance	Mr.	Herbst	Travis		6088272856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Surveillance Contact	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	System Contact	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Third Party Administrator (TPA) Liaison	Senior Financial Analyst		Johnson	Derek		8002791302					derek.johnson@deancare.com	1277 Deming Way		Madison	WI	53717	06/06/2024	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	User Access Contact			Harrington	Dana		6122129075					dana.harrington@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Utilization Management Contact	Clinical Pharmacist		Valeo-Seabright	Diane		6088361400					Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9096	Utilization Review Contact	Manager RN - Utilization Management		Drake	Amy		6088282807					Amy.Drake@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH PLAN, INC.	Local CCP	Dean Advantage	HMO/HMOPOS		Medica Holding Company	439	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9147	Agent/Broker Compensation Data Contact	Director, Financial Systems		Lazar	Lisa		9197653359					Lisa.Lazar@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/28/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations		Hanson	Michelle		6127776706					eobp2p@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Backup User Access Contact	EDI Analyst		Umstead	Kamala		9197654363					kamala.umstead@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	02/06/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Bid Audit Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Bid Audit Site Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Bid Primary Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	CAP Report Contact for Public Website	Manager, Internal Communications		Stinneford	Mark		9197653005					media.inquiry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/20/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	CEO - CMS Administrator Contact	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	CEO - Senior Official for Contracting	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	9197653923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	02/06/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Chief Operating Officer	SVP, Chief Operations & Member Experience Officer	Ms.	Mizelle	Karla		9849603787					karla.mizelle@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/22/2021	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Chief Information Officer	AVP, IT Solution Delivery	Mrs.	Moum	Aldara		9196160924					Aldara.Moum@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	08/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Chief Information Security Officer	Chief Information Security Officer	Mr.	Chilton	Richard		9197652021					Rick.Chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	02/06/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	CMS Casework Communication Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Complaints Tracking Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Contact for Fraud Investigations	Manager, Special Investigations Unit		Meyer	John		9842752360					John.Meyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Coordination of Benefits Contact	Team Lead, Operations		Pridgen	David		3362014141					David. Pridgen@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Corporate Mailing						3362014460				3366592969	deborah.washington-mcneill@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		9197657057					Renita.Woods@bcbsnc.com	4613 University Drive		Durham	NC	27707	03/26/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	DIR Contact	Director, Actuarial Services		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	03/15/2021	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Discount Program Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					Tola.Onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Emergency Part D Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Emergency Part D Contact (Secondary)	Head of CIG Operations		Perry	Endya		9197775504					endya.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Employer Waiver Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment		Kimbrell	Tammy		9844448393					Tammy.Kimbrell2@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Enrollment Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	EOB Transfer Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536				9197657291	Corporate.pharmacy@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Financial Audit Contact	Director, Audit	Ms.	Ferrell	Kim		3362014038					kim.ferrell@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Financial Reporting Contact	Director, Subsidiary Reporting		Hill	Adam		5044950050					Adam.Hill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/05/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Formulary Contact	Manager, Pharmacy Programs		Hiller	Debra		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics Inc	2900 Ames Crossing Road	Eagan	MN	55121	03/07/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	General Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Government Relations Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	HIPAA Privacy Officer	Director, Privacy, Ethics & Corp Policies		Hamlet	Lynne		9197657416					lynne.hamlet@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/18/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	HIPAA Security Officer	Chief Information Security Official		Chilton	Rick		9197652021					rick.chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	02/06/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Hospice Contact	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Interoperability Contact	Director, Corporate Compliance Official		Haith	Elenor		9842125897					Elenor.Haith@bcbsnc.com	PO Box 2291		Durham	NC	27702	07/20/2022	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	MA Appeals/Grievances Contact	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna		9197654061					Adonna.McFall@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/22/2021	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	MA Claims Processing Contact for Public Website	Manager, Operations		Cooper	Eva		9197651808					Eva.Cooper@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Marketing Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Medical Director	VP, Chief Medical Officer	Dr.	Wallace	Marcus		9843891622					Marcus.Wallace@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	06/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Medicare Compliance Officer	Director, Corporate Compliance	Mrs.	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/09/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Medicare Coordinator	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Medicare Part D Opioid Overutilization Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Medication Therapy Management Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	OffShore Subcontractor Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Online Enrollment Center Contact (Back-up)	Manager, Membership Services		Brackett	Latrese		3362019770					latrese.brackett@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Online Enrollment Center Contact (Primary)	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part C Application Contact		Ms.	Washington-McNeill	Deborah		3362014460					deborah.washington-mcneill@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part C Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Appeals	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna							Adonna.McFall@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/22/2021	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882987520				HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Appeals Contact (Secondary)	Mgr, MA and PDP Appeals and Grievances		Lanier	Paige						8883758836	paige.lanier@bcbsnc.com	PO Box 17509	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8774947647				HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Benefits Contact	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Claims Submission Contact	Functional Business Consultant - Govt Prgms		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2900  Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Exceptions Contact	Director, Pharmacy		Moore	Jim							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	04/18/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882969790				HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Exceptions Contact (Secondary)	Team Leader, Clinical Pharmacy Reviews - Medicare		Parikh	Swati							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	01/04/2022	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8882969790				HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Price File Contact (Back-up)	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Price File Contact (Optional)	Price File Analyst Sr		Trudeau	Ashley		6127771338					ashley.trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Price File Contact (Primary)	Medicare Pharmacy Operations Administrator		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	03/22/2021	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Quality Assurance Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Part D Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3362014460					deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Patient Safety Contact	Manager, Pharmacy		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	10/03/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Pharmacy Director	VP, Pharmacy Services		Trautman	Suzanne		7045988684					Suzanne.Trautman@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	10/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Pharmacy Network Management Contact	AVP, Corporate Pharmacy		Rooker	Todd		6024181702					Todd.Rooker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							bret.schultz@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8772777893				HMO - Health Maintenance Organization		C	Atlanta
H9147	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Bunch	Jon							jonathan.bunch@primetherapeutics.com	Prime Therapeutics, LLC 2900 Ames Crossing Road		Eagan	MN	55121	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active	8772777893				HMO - Health Maintenance Organization		C	Atlanta
H9147	Physician Incentive Contact	AVP, Provider Network and Reimbursement		Page	Troy		9197652408					troy.page@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	09/17/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Plan Directory Contact for Public Website	Call Center support		Services	Member		8882969790					renita.woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Plan to Plan Reconciliation Contact	Sr Accountant		Taylor	Krystal		9849603607					krystal.taylor@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	02/28/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Processor Contact	Dir Govt Programs & Ops		Zeien	Daniel		6127776775					daniel.zeien@primetherapeutics.com	Prime Therapeutics, LLC	2655 Eagan Woods Drive	Eagan	MN	55122	02/06/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Quality Contact	VP, Quality, Health Equity and Risk Adjustment		Bartholomew	Charmaine		6789208681					Charmaine.Bartholomew@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/24/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Reconciliation Contact	Director, Actuarial Services		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	03/11/2021	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Recovery Audit Contact	Director, Corporate Compliance	Mrs	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina,	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	SNP Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	SNP State Contact	Mgr, CMS Contract Administration		Brown	Alison		9198674599					alison.brown@bcbsnc.com	PO Box 2291		Durham	NC	27702	07/27/2021	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Surveillance Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	System Contact	Director, IT Solution Delivery		Keltner	Doug		9194607400					Doug.Keltner@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Third Party Administrator (TPA) Liaison	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	User Access Contact	Electronic Data Interchange Analyst		Dunn	Lorrie		9197653669					lorrie.dunn@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	02/06/2020	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Utilization Management Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9147	Utilization Review Contact	Director, Clinical Teams		Perdue	Angela		3362014352					angela.perdue@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH	Local CCP	Blue Cross and Blue Shield of North Carolina	HMO/HMOPOS		CuraCor Solutions Corp.	884	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9153	Agent/Broker Compensation Data Contact	FDR Oversight Manager		Risher	Laura		5138140651				5136056845	laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Automated TrOOP Balance Transfer Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Backup User Access Contact	Compliance Specialist		Nadler	Kristina		5138018146					kristina.nadler@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Best Available Evidence Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Bid Audit Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Bid Audit Site Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Bid Primary Contact	VP Operations		Muldowney	Jessica		5138355228					jmuldowney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	CAP Report Contact for Public Website	Chief Compliance Officer		Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	CEO - CMS Administrator Contact	CEO	Mr.	Hager	Robert		5133564280				5136056845	rhager@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	01/23/2024	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	CEO - Senior Official for Contracting	CEO	Mr.	Hager	Robert		5133564280				5136056845	rhager@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	01/23/2024	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Chief Financial Officer	CFO	Mr.	Heimgarter	Jeremy		3043431950				3043431949	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	01/23/2024	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Chief Operating Officer	CFO	Mr.	Heimgarter	Jeremy		3043431950				3043431949	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	01/23/2024	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Chief Information Officer	CFO	Mr.	Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Chief Information Security Officer	CFO	Mr.	Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	CMS Casework Communication Contact	VP Healthcare and Quality Operations		Parente	Robin		5138026452				5136056845	Robin.Parente@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Complaints Tracking Contact	Member Advocate/ Grievance Specialist		Lightfoot	Matt		5134699587					mlightfoot@communicare-advantage.com	700 Chappell Rd.		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Contact for Fraud Investigations	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Coordination of Benefits Contact	CFO		Heimgartner	Jeremy		5134698545					jheimgartner@communicare-advantage.com	700 Chappell Rd.		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Corporate Mailing						3047579333					rhager@Communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	01/23/2024	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Customer Service Operations Contact	Vice President of Operations		Muldowney	Jessica		5138358228					jmuldowney@communicare-advantage.com	700 Chappell Rd.		Charleston	WV	25304	09/25/2024	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	DIR Contact	Program Manager, Gov Program and Services		Anwar	Khawar		8587903097					khawar.anwar@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	DIR Contact (Secondary)	Program Manager, Gov Program and Services		Hayes	Khalif		8582915016					khalif.hayes@MedImpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Discount Program Payment Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Emergency Part D Contact	Pharmacy Services Manager		Warner	Betsy		3044448811					betsy.warner@CommuniCare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Emergency Part D Contact (Secondary)	Vice President of Clinical Pharmacy		Lewis	Katherine		3305238212					Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Encounter Data & Risk Adjustment Operations Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Enrollment Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	EOB Transfer Contact	CFO		Heimgartner	Jeremy		5132404810				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Financial Audit Contact	Chief Compliance Officer	Mr.	Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Financial Reporting Contact	CFO		Heimgartner	Jeremy		5132404810				5136056845	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Formulary Contact	Vice President of Clinical Pharmacy		Lewis	Katherine		3305238212					Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Formulary Contact (Secondary)	Manager Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	General Contact	Chief Compliance Officer		Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Government Relations Contact			Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	HIPAA Privacy Officer	Chief Compliance Officer		Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	HIPAA Security Officer	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Hospice Contact	CMO	Dr.	Char	Kalpana		4127209956					Kalpana.Char@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	05/20/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Interoperability Contact	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	MA Appeals/Grievances Contact	Member Advocate/ Grievance Specialist		Lightfoot	Matt		5134699587					mlightfoot@communicare-advantage.com	700 Chappell Rd.		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	MA Claims Processing Contact for Public Website	Appeal Analyst		Colangelo	Krystle		5133790316					krystle.colangelo@communicare-advantage.com	700 Chappell Rd.		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Marketing Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Medical Director	CMO	Dr.	Char	Kalpana		4127209956					Kalpana.Char@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Ehrman	James		5139170302					James.Ehrman@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	02/03/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Medicare Coordinator	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Medicare Part D Opioid Overutilization Contact	Pharmacy Services Manager		Warner	Betsy		3044448811					betsy.warner@CommuniCare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Medication Therapy Management Contact	VP Clinical Pharmacy		Lewis	Katherine		3305238212				5136056845	Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Online Enrollment Center Contact (Back-up)	Associate Director Enrollment and Fulfillment Ops		Torres	Rosalie		8132442081					Rosalie.Torres@HealthAxis.com	400 N. Ashley Dr.	Suite 920	Tampa	FL	33602	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Online Enrollment Center Contact (Primary)	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part C Application Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part C Reporting Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063					kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Appeals	Pharmacy Services Manager		Warner	Betsy						8662254179	betsy.warner@CommuniCare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3044448811				HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Appeals Contact (Secondary)	Director Clinical Operations		Collins	Andrea						3304058081	andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Application Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Benefits Contact	Pharmacy Services Manager		Warner	Betsy		3044448811				8662254179	betsy.warner@CommuniCare-advantage.com	700 Chappell		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Exceptions Contact	Pharmacy Services Manager		Warner	Betsy							betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	01/15/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3044448811				HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Exceptions Contact (Secondary)	Director Clinical Operations		Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Price File Contact (Back-up)	Director Reporting & Analytics, Govt. Programs		Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Price File Contact (Primary)	Manager of Reporting & Analytics		Wentz	Christophe		9547672633					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Quality Assurance Contact	Pharmacy Services Manager		Warner	Betsy		3044448811					betsy.warner@CommuniCare-advantage.com	700 Chappell Rd		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Part D Reporting Contact	Director of Medicare Compliance		McBratney	Kimberly		7852246063				5136056845	kmcbratney@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Patient Safety Contact	CMO	Dr.	Char	Kalpana		4127209956					kalpana.char@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Payment Contact	CFO		Heimgartner	Jeremy		3043431959				3043431949	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Pharmacy Director	Vice President of Clinical Pharmacy		Lewis	Katherine		3305238212				5136056845	Katherine.Lewis@chs-corp.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Pharmacy Network Management Contact	Pharmacy Services Manager		Warner	Betsy		3044448811					betsy.warner@CommuniCare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	01/15/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Pharmacy Network Management Contact (Secondary)	Director Pharmacy Network Administration		Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Pharmacy Technical Help Desk Contact	MedImpact VP Operations		Conn	Todd							todd.conn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active	8336978516				HMO - Health Maintenance Organization		C	Chicago
H9153	Physician Incentive Contact	VP of Network and Provider Operations		Acker	Amy		7037891929					aacker@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Plan Directory Contact for Public Website	FDR Oversight Manager		Risher	Laura		8448546888					laura.risher@communicare-advantge.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Plan to Plan Reconciliation Contact	CFO		Heimgartner	Jeremy		5132404810				5136056845	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Processor Contact	CFO		Heimgarter	Jeremy		3043431950				3043431949	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Quality Contact	Director of Health Plan Quality		Dawson	Jennifer		5133790334				5132470589	jdawson@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Reconciliation Contact	Chief Financial Officer		Heimgartner	Jeremy		5132404810				5136056845	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	12/28/2022	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Reconciliation Contact (Secondary)	Pharmacy Services Manager		Warner	Betsy		3044448811					betsy.warner@CommuniCare-advantage.com	700 Chappell Road		Charleston	WV	25304	05/31/2024	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Recovery Audit Contact	CFO	Mr	Heimgartner	Jeremy		3043431959				3043431949	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	10/31/2022	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	SNP Application Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Surveillance Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	System Contact	CFO		Heimgartner	Jeremy		5132404810				5136056845	jheimgartner@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Third Party Administrator (TPA) Liaison	CFO		Heimgartner	Jeremy		5134698545				5136056845	jheimgartner@communicare-advantage.com	700 Chappell Road		Charleston	WV	25304	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	User Access Contact	FDR Oversight Manager		Risher	Laura		5138140651					laura.risher@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Utilization Management Contact	VP Healthcare & Quality Operations		Parente	Robin		5138026452					Robin.Parente@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9153	Utilization Review Contact	VP Healthcare & Quality Operations		Parente	Robin		5138026452					Robin.Parente@communicare-advantage.com	10123 Alliance Road	Suite 240	Blue Ash	OH	45242	08/19/2025	2026	WEST VIRGINIA SENIOR ADVANTAGE, INC.	Local CCP	West Virginia Senior Advantage	HMO/HMOPOS		SNP Holdings, LLC	758	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Agent/Broker Compensation Data Contact	Director of Sales		Dues	Travis		6145463157				6145463131	Travis.Dues@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		6145463183				6145463131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Backup User Access Contact	Sr. Application Specialist		Crawford	Carl		6145463215				6145463144	ccrawford@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Bid Audit Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463211	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Bid Audit Site Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Bid Primary Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	CAP Report Contact for Public Website	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	CEO - CMS Administrator Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	Jack.Randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/06/2025	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	CEO - Senior Official for Contracting	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		6145463211				6145463131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Chief Operating Officer	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Chief Information Officer	VP Service Optimization	Mr.	Trimmer	Matt		3017547190					matt.trimmer@trinity-health.org	3100 Easton Square Place		Columbus	OH	43219	07/17/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Chief Information Security Officer	Sr Security Manager, Enterprise Information Securi	Mr.	Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	CMS Casework Communication Contact	Compliance Specialist	Mr.	Jordan	David	A	6147068474				6142348372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Complaints Tracking Contact	Compliance Specialist	Mr	Jordan	David	A	6147068474					djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Contact for Fraud Investigations	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Corporate Mailing						4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Customer Service Operations Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	DIR Contact	CEO		Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square  Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	DIR Contact (Secondary)	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Discount Program Payment Contact	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Electronic Health Record Contact	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Emergency Part D Contact	Chief Compliance Officer		Suffern	Patricia		4124780244				6145463132	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Emergency Part D Contact (Secondary)	Pharmacy Director	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/17/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Employer Waiver Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Reconciliation Analyst		Sloan	Mike		6145463134					mike.sloan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Enrollment Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	EOB Transfer Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Financial Audit Contact	Chief Compliance Officer	Ms.	Suffern	Patricia	A	4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/24/2025	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Financial Reporting Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Formulary Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	General Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Government Relations Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	HIPAA Privacy Officer	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	HIPAA Security Officer	Sr Security Manager, Enterprise Information Securi		Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Interoperability Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	MA Appeals/Grievances Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	MA Claims Processing Contact for Public Website	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Marketing Contact	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Medical Director	MD	Dr.	Wise	Greg		6145463151				6145463131	gwise@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Medicare Coordinator	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Medicare Part D Opioid Overutilization Contact	Sr Pharmacy Data Analyst	Ms.	Houk	Kim		6145463183					kulrich@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/15/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Medication Therapy Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	OffShore Subcontractor Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment	Ms	Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Online Enrollment Center Contact (Optional)	Director, Enrollment and Premium Billing		Caudle	Jeff		6145463224				6145463148	jcaudle@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part C Application Contact	Director, Product Management and Business Devlpt		Mauck	Brandon		6145955681					brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part C Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Appeals	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Appeals Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Application Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Claims Submission Contact	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Exceptions Contact	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Exceptions Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Price File Contact (Back-up)	Formulary Consultant		Scott	Sarah		4803109219					sarah.scott@CVSHealth.com	9501 E. Shea		Scottsdale	AZ	85260	05/02/2025	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Price File Contact (Primary)	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Quality Assurance Contact	Director of Pharmacy, Health Plans	Ms.	McGhee	Anna		2165345375				6142346481	anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Part D Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Patient Safety Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Payment Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Pharmacy Director	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Pharmacy Network Management Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H9179	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Data Analyst	Mrs	Miller	Kim							kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H9179	PHR Beneficiary Contact																	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS	MediGold	Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9179	Physician Incentive Contact	Interim VP, Health Services	Ms	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Plan Directory Contact for Public Website	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Processor Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Quality Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Reconciliation Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Reconciliation Contact (Secondary)	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Recovery Audit Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Surveillance Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	System Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Third Party Administrator (TPA) Liaison	Sr Finance Analyst		Fountain	Lisa		6145463220					lfountain@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	User Access Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	02/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Utilization Management Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9179	Utilization Review Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	TRINITY HEALTH PLAN OF MICHIGAN INC	Local CCP	Trinity Health Plan of Michigan	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9185	Automated TrOOP Balance Transfer Contact	Health Plan Specialist I		Wahl	Beth		9892727610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Backup User Access Contact	Health Plan Specialist I		Wahl	Beth		9892727610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Best Available Evidence Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Bid Primary Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	CAP Report Contact for Public Website	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	CEO - CMS Administrator Contact	Program Director	Mr.	Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	CEO - Senior Official for Contracting	Program Director	Mr.	Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Chief Financial Officer	Chief Financial Officer	Mr.	Sen	Tuhin		9892727610					sen70@cs.com	3378 Fashion Square Blvd		Saginaw	MI	48603	07/19/2018	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Chief Operating Officer	Program Director	Mr.	Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Chief Information Officer	Program Director	Mr.	Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Chief Information Security Officer	Program Director	Mr.	Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	CMS Casework Communication Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Complaints Tracking Contact	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Contact for Fraud Investigations	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Coordination of Benefits Contact	Health Plan Specialist I		Wahl	Beth		9892727610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Corporate Mailing						9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Customer Service Operations Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	DIR Contact	Program Director	Mr	Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	DIR Contact (Secondary)	Health Plan Specialist I		Wahl	Beth		9892727610					bwahl@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	02/19/2021	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Discount Program Payment Contact			Wahl	Beth		9892727610					Bwahl@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	12/09/2024	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Emergency Part D Contact	Program Director		Benjamin	David		9892727610	108			9892727669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	12/30/2020	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Emergency Part D Contact (Secondary)	Health Plan Specialist 1	Mrs.	Wahl	Beth		9892727610	2727610			9892727669	bwahl@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	12/30/2020	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Encounter Data & Risk Adjustment Operations Contact	Health Plan Specialist 1		Wahl	Beth		9892727610				9892727669	bthompson@greatlakespace.org	3378 Fashion Square Blvd.		Saginaw	MI	48603	10/24/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Enrollment Contact	Health Plan Specialist I		Wahl	Beth		9892727610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	EOB Transfer Contact	Program Director	Mr.	Benjamin	David		9892727610				9892727669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Financial Audit Contact	Health Plan Specialist I	Mrs	Wahl	Beth		9892727610				9892727669	bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Financial Reporting Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Formulary Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	General Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Government Relations Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	HIPAA Privacy Officer	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	HIPAA Security Officer	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Interoperability Contact			Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	02/22/2022	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	MA Appeals/Grievances Contact	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	MA Claims Processing Contact for Public Website	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Marketing Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	10/24/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Medical Director	Medical Director	Mr.	Argyle	Michael		9892727610					margyle@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	07/19/2018	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Medicare Compliance Officer	Quality Assurance Coordinator	Mrs	Hurley	Ashley		9892727610				9892727669	ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Medicare Coordinator	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Medicare Part D Opioid Overutilization Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/15/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Medication Therapy Management Contact	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part C Application Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part D Appeals	Program Director	Mr.	Benjamin	David						9892727669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active	8444457223				PACE - Nat		C	Atlanta
H9185	Part D Appeals Contact (Secondary)	Program Director	Mr.	Benjamin	David	S					9892727669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	12/30/2020	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active	8444457223				PACE - Nat		C	Atlanta
H9185	Part D Application Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part D Benefits Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part D Claims Submission Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part D Exceptions Contact	Program Director	Mr.	Benjamin	David						9892727669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active	8444457223				PACE - Nat		C	Atlanta
H9185	Part D Exceptions Contact (Secondary)	Quality Assurance Coordinator		Hurley	Ashley							ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active	9892727610				PACE - Nat		C	Atlanta
H9185	Part D Price File Contact (Back-up)	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part D Price File Contact (Primary)	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part D Quality Assurance Contact	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Part D Reporting Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Patient Safety Contact	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Payment Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Pharmacy Director	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Pharmacy Network Management Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Pharmacy Technical Help Desk Contact	Program Director	Mr.	Benjamin	David						9892727669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active	8444457223				PACE - Nat		C	Atlanta
H9185	Plan Directory Contact for Public Website	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Plan to Plan Reconciliation Contact	Health Plan Specialist I		Wahl	Beth		9892727610					bthompson@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Processor Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Quality Contact	Quality Assurance Coordinator		Hurley	Ashley		9892727610					ahurley@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	04/18/2019	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Reconciliation Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Recovery Audit Contact	Program Director	Mr.	Benjamin	David		9892727610				9892727669	dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Surveillance Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	System Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Third Party Administrator (TPA) Liaison			Wahl	Beth		9892727610					bwahl@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	12/09/2024	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	User Access Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Utilization Management Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9185	Utilization Review Contact	Program Director		Benjamin	David		9892727610					dbenjamin@greatlakespace.org	3378 Fashion Square Blvd		Saginaw	MI	48603	03/14/2017	2026	A&D CHARITABLE FOUNDATION, INC.	National PACE	Great Lakes PACE	National PACE		A&D Charitable Foundation, Inc.	608	Yes	Active					PACE - Nat		C	Atlanta
H9191	Agent/Broker Compensation Data Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Automated TrOOP Balance Transfer Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Backup User Access Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Best Available Evidence Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Bid Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Bid Audit Site Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Bid Primary Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	CAP Report Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	CEO - CMS Administrator Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	CEO - Senior Official for Contracting	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Chief Financial Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Chief Operating Officer	CFO	Mr	Persinger	Keith		4104563946					kpersinger@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Chief Information Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Chief Information Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Complaints Tracking Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Contact for Fraud Investigations	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Coordination of Benefits Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Corporate Mailing						4104240772					info@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Customer Service Operations Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	DIR Contact	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	DIR Contact (Secondary)	Manager Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	Discount Program Payment Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Emergency Part D Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Emergency Part D Contact (Secondary)	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Encounter Data & Risk Adjustment Operations Contact	Senior Software Engineer	Mr	Rifkin	Joshua		4108977578					jrifkin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Enrollment Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	EOB Transfer Contact	VP of Operations	Mr	Brain	Jay		2403672626				8448134544	JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Financial Audit Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Financial Reporting Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Formulary Contact	Formulary Administration & Strategy		Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	General Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Government Relations Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	HIPAA Privacy Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	HIPAA Security Officer	Director of Information Technology	Mr	Boyer	Brantdon		4438131738					Bboyer@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Hospice Contact	Director of Operations	Ms	Winton	Linde		8173743812					lwinton@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Interoperability Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	MA Appeals/Grievances Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	MA Claims Processing Contact for Public Website	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Marketing Contact	VP of Plan Management	Ms	Radice	Sue		4109913213				8444623091	sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Medical Director	Medical Director	Dr	Kimmel	Alan		4102183691					akimmel@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Medicare Compliance Officer	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Medicare Coordinator	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Medicare Part D Opioid Overutilization Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Medication Therapy Management Contact	Mgr Medication Management	Ms	Blain	Sarah		8582915382					mtmp@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	OffShore Subcontractor Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Part C Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Part C Reporting Contact	Medicare Advantage Reporting Process Manager	Ms	Butler	Christina		2403532930					cbutler@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Part D Appeals	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H9191	Part D Appeals Contact (Secondary)	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565	0409			HMO - Health Maintenance Organization		C	Dallas
H9191	Part D Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Part D Benefits Contact	VP of Pharmacy	Dr	Ford	James	E	4432759810					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Part D Claims Submission Contact	Manager Client Data		Prunty	Ethan		3308191667					ethan.prunty@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	Part D Exceptions Contact	Director Clinical Operations	Ms	Collins	Andrea							andrea.collins@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	3304103565				HMO - Health Maintenance Organization		C	Dallas
H9191	Part D Exceptions Contact (Secondary)	VP of Pharmacy	Dr	Ford	James	E						jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	4432759801				HMO - Health Maintenance Organization		C	Dallas
H9191	Part D Price File Contact (Back-up)	Manager Reporting & Analytics, Govt.Programs	Mr	Wentz	Christophe		3304864910					cwentz@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	Part D Price File Contact (Optional)	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Part D Price File Contact (Primary)	Director of Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@medimpact.com	10181 Scripps Gateway Ct.		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	Part D Quality Assurance Contact	Pharmacy Operations Manager	Dr	Brown	Latrese		4437621114					lbrown@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Part D Reporting Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Patient Safety Contact	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Payment Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Pharmacy Director	VP of Pharmacy	Dr	Ford	James	E	4432759801					jford@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Pharmacy Network Management Contact	Director Pharmacy Network Administration		Hunt	Brian		8587907092				3304058094	Brian.hunt@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	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	Dallas
H9191	Pharmacy Technical Help Desk Contact	Vice President of Operations	Mr	Conn	Todd							tconn@medimpact.com	10181 Scripps Gateway Ct		San Diego	CA	92131	07/07/2025	2026	PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.	Local CCP	Provider Partners Health Plans	HMO/HMOPOS		Rifkin Managed Care Holding, LLC	673	Yes	Active	8448468007				HMO - Health Maintenance Organization		C	Dallas
H9191	Plan Directory Contact for Public Website	VP of Plan Management	Ms	Radice	Sue		4109913213					Sradice@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Plan to Plan Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Processor Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Quality Contact	Director of Quality	Mr	Kirwan	Mark		4104240411					mkirwan@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Reconciliation Contact	VP of Finance	Ms	McIntyre	Mary Beth		4109672097					mmcintyre@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Reconciliation Contact (Secondary)	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Recovery Audit Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	SNP Application Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	SNP State Contact	President & CEO	Mr	Grindrod	Rick		4109137653					rgrindrod@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Surveillance Contact	Chief Compliance Officer	Mr	Nunez	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	System Contact	VP of Operations	Mr	Brain	Jay		2403672626					JBrain@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Third Party Administrator (TPA) Liaison	Corporate Controller	Mr	Goddin	John		5183650599					jgoddin@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	User Access Contact	Chief Compliance Officer	Mr	N	Kenneth		8132301048					knunez@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Utilization Management Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9191	Utilization Review Contact	Director of Utilization Management	Mr	Derby	Thomas		4846823923					tderby@pphealthplan.com	8820 Columbia 100 Parkway	Suite 430	Columbia	MD	21045	07/03/2025	2026	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	Dallas
H9207	Agent/Broker Compensation Data Contact	Vice President, Sales		Olmstead	Jim		2158499606					jolmstead@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Automated TrOOP Balance Transfer Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	troop@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	02/26/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Backup User Access Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Best Available Evidence Contact	AVP, Enrollment		Johnson	Chris		2158499606				2159679267	cjohnson@hpplans.com	1101 Market Street	Suite	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Bid Audit Contact	Director, Product Development  & Growth		Fisher	Craig		2158499606					cfisher1@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	04/24/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Bid Audit Site Contact	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market St	STE 3000	Philadelphia	PA	19107	04/24/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Bid Primary Contact	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market St	STE 3000	Philadelphia	PA	19107	04/24/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	CAP Report Contact for Public Website	Compliance Officer		Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	CEO - CMS Administrator Contact	President and Senior Official for Contracting	Mrs.	Hoglund	Krista		2158454747					krista.hoglund@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	03/31/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	CEO - Senior Official for Contracting	President and Senior Official for Contracting	Mrs.	Hoglund	Krista		2158454747					krista.hoglund@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	03/31/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Chief Financial Officer	Chief Financial Officer	Mr.	Czar	Gregory	J	2152873338					gregory.czar@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	06/10/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Chief Operating Officer	Chief Operating Officer	Mr.	McTiernan	Chris		2157797914					cmctiernan@jeffersonhealthplans.com	1101 Market Street	30th Floor	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Chief Information Officer	Vice President, Information Services & Technology	Mr.	Yetter	Mike		2155035110					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Chief Information Security Officer	Vice President, Information Security	Mr.	Odom	Mark		2155032439					Mark.Odom@jefferson.edu	833 Chestnut		Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	CMMI Model Point of Contact	Director, Product Development  & Growth		Fisher	Craig		2159914090					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	CMS Casework Communication Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2159914023					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Complaints Tracking Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2158499606					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Contact for Fraud Investigations	Director, SIU		Sondergaard	Christian		2159914046					csondergaard@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Coordination of Benefits Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	cob@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	02/26/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Corporate Mailing						2158499606				2155921034	jbaker@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Customer Service Operations Contact	General Manager, Health Plan Operations		Dans	Kim		2158499606					kdans@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	DIR Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					DIR@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/14/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	DIR Contact (Secondary)	Director Actuarial Services		Rudi	Brian		2159914077					brudi@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	03/06/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Discount Program Payment Contact	Manager, Pharmacy Regulations and Implementations		McCaffrey	Hannah		2159657142				2159679263	hlivengood@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	09/02/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Emergency Part D Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	rvangala@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	12/19/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Emergency Part D Contact (Secondary)	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					pharmacymedicare@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Encounter Data & Risk Adjustment Operations Contact	Director, Encounter Data Reporting		Raupp	Mike		2158499606					mraupp@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Enrollment Contact	AVP, Enrollment		Johnson	Chris		2158499606					cjohnson@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	EOB Transfer Contact	AVP, Claims		McConaghy	Sandy		2158499606				2159679261	smcconaghy@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Financial Audit Contact	Chief Financial Officer	Mr.	Czar	Gregory	J	2152873338					gregory.czar@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	10/13/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Financial Reporting Contact	Vice President, Finance	Mr.	Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	03/06/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Formulary Contact	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					Formulary@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	07/22/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Formulary Contact (Secondary)	Formulary Pharmacist		Vaisberg	Fallan		2158499606					fvaisberg@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	07/22/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	General Contact	AVP Compliance		Bellito	Lisa		2159914090					lbellito@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Government Relations Contact	SVP, Government Affairs		Jones	Kearline		2158499606					kdjones@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	HIPAA Privacy Officer	Manager, Privacy		Dahiya	Prerna		2158499606					pdahiya@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	HIPAA Security Officer	Manager, Privacy		Dahiya	Prerna		2158499606					pdahiya@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Hospice Contact	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2158499606					pharmacymedicare@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Interoperability Contact	Vice President, Health Plan Systems		Yetter	Michael		2152729971					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	MA Appeals/Grievances Contact	Manager, Complaints, Grievances and Appeals		Watkins	Leah		2158499606					Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	MA Claims Processing Contact for Public Website	AVP, Claims		McConaghy	Sandy		2158499606					smcconaghy@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Marketing Contact	Director, Marketing Communications		Grzyb	Sarah		2158499606					sgrzyb@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Medical Director	Senior Medical Director		Harris-Williams	Merleen		2158499606					mhwilliams@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Medicare Compliance Officer	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Medicare Coordinator	Director, Product Development  & Growth		Fisher	Craig	W	4129131294					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	05/14/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Medicare Part D Opioid Overutilization Contact	Clinical Programs Pharmacist		Olchowecky	Kateryna		2158499606				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	02/06/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Medication Therapy Management Contact	Director, Pharmacy Services		Dolores	Danielle		2158499606				2159679270	MTM@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	OffShore Subcontractor Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Support		Polkus	Megan		2159674561					mpolkus@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Online Enrollment Center Contact (Primary)	AVP, Enrollment		Johnson	Chris		2158499606				2159679267	cjohnson@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part C Application Contact			Fisher	Craig		2159914090					cfisher1@jeffersonhealthplans.com	1101 Market	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part C Reporting Contact			Fisher	Craig		2159914077					cfisher1@jeffersonhealthplans.com	1101 Market Street		Philadephia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Appeals	Manager, Complaints, Grievances and Appeals		Watkins	Leah							Lwatkins@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active	2159914023				HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Appeals Contact (Secondary)	Supervisor, Complaints, Grievances and Appeals		Rostovskis	Tara							trostovskis@hpplans.com	901 Market Street	Suite 500	Philadelphia	PA	19107	01/24/2023	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active	2673853491				HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Application Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Benefits Contact			Fisher	Craig		2159914077					cfisher1@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Claims Submission Contact	Manager, Pharmacy Benefit Design and Audit		Chan	Kay		2159914197				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Exceptions Contact	Director, Pharmacy Services		Dolores	Danielle						8663713239	Exceptions@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active	2159914329				HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Price File Contact (Back-up)	Mgr, Pharmacy Regulations & Implementations		McCaffrey	Hannah		2159657142					Formulary@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	07/22/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Price File Contact (Primary)	Manager, Pharmacy Benefit Design and Audit		Chan	Kay		2159914197				2159679270	Overutilization@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Quality Assurance Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					rvangala@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	02/26/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Part D Reporting Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864					DIR@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Patient Safety Contact	Director, Pharmacy Services		Dolores	Danielle		2159914329					ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Payment Contact	Vice President, Finance		Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	03/06/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Pharmacy Director	Director, Pharmacy Services		Dolores	Danielle		2159914328				8663713239	ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Pharmacy Network Management Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	Pharmacynetwork@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Services		Dolores	Danielle		2159914329				8663713239	ddolores@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Pharmacy Technical Help Desk Contact	Director, Pharmacy Services		Dolores	Danielle						2159679270	Formulary@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H9207	Pharmacy Technical Help Desk Contact (Secondary)	Supervisor Pharmacy Technician		Mahler	Brandi						2159679270	bmahler@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H9207	Plan Directory Contact for Public Website	Director, Marketing Communications		Grzyb	Sarah		6098657999					sgrzyb@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Plan to Plan Reconciliation Contact	Pharmacy Regulatory Business Coordinator		Rutledge-Glazov	Rose	A	2159657142				2159679263	P2P@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/06/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Processor Contact	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	rvangala@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Quality Contact	AVP Quality Improvement & Performance		Mullen	Alyssa		6095054006					amullen@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Reconciliation Contact	Vice President, Finance		Diebold	Gene		2159914249					ediebold@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	03/06/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Reconciliation Contact (Secondary)	VP, Pharmacy Operations		Vangala	Ramesh		2152197864				2159674482	DIR@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Recovery Audit Contact	SVP, Health Care Data Analytics	Mrs.	Potts	Carol		2158499606					cpotts@hpplans.com	1101 Market Street	Suite	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	SNP Application Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	12/21/2023	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	SNP State Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	12/21/2023	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Surveillance Contact	Vice President, Sales		Olmstead	Jim		7176093994					jolmstead@hpplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	System Contact	Vice President, Health Plan Systems		Yetter	Michael		2152729971					myetter@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Third Party Administrator (TPA) Liaison	Manager, Pharmacy Regulations and Implementations		McCaffrey	Hannah		2159657142				2159679263	hlivengood@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	09/02/2025	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	User Access Contact	Compliance Officer	Mrs.	Lloyd	Angela		2159914090					alloyd@jeffersonhealthplans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Utilization Management Contact	Interim VP, Medical Management		Sinni	Jennifer		2158454757					jmsinni@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9207	Utilization Review Contact	Interim VP, Medical Management		Sinni	Jennifer		2158454757					jmsinni@JeffersonHealthPlans.com	1101 Market Street	Suite 3000	Philadelphia	PA	19107	01/29/2024	2026	HEALTH PARTNERS PLANS, INC.	Local CCP	Jefferson Health Plans	HMO/HMOPOS		Thomas Jefferson University	523	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9219	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Automated TrOOP Balance Transfer Contact	Manager II, Membership		Miller	Karen		9205391417					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	10/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/12/2020	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Coordination of Benefits Contact	Staff VP Cost Optimization		Franke	Beth		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Government Relations Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	HIPAA Security Officer	VP and Chief Information Security Officer	Mr.	Wilcox	Dustin		4632245212					dustin.wilcox@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	06/28/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Medicare Compliance Officer	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/10/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active	5133167654				PPO - BBA		C	Chicago
H9219	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active	7577562058				PPO - BBA		C	Chicago
H9219	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Exceptions Contact	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active	5133167654				PPO - BBA		C	Chicago
H9219	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active	7577562058				PPO - BBA		C	Chicago
H9219	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Pharmacy Director	Clinical Pharmacy Program Director	Ms.	Gibson	Cathy		5132550202					cathy.j.gibson@carelon.com	4592 Whispering Oak Trail		Cincinnati	OH	45247	02/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active	8333774266				PPO - BBA		C	Chicago
H9219	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active	8333774266				PPO - BBA		C	Chicago
H9219	PHR Beneficiary Contact																	02/12/2020	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	No	Active	8004671199				PPO - BBA		C	Chicago
H9219	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9219	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	AMH HEALTH PLANS OF MAINE, INC.	Local CCP	AMH Health	Local PPO		Elevance Health, Inc.	1	No	Active					PPO - BBA		C	Chicago
H9231	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H9231	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H9231	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H9231	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H9231	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H9231	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H9231	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H9231	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9252	Automated TrOOP Balance Transfer Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Backup User Access Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Best Available Evidence Contact	Director PACE Program Development & Implementation		Kiefert	Mary	D	9042344338					mary.kiefert@msmc.com	4300 Alton Rd		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Bid Primary Contact	Director PACE Program Development & Implementation		Kiefert	Mary	D	9042344338					mary.kiefert@msmc.com	4300 Alton Rd		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	CAP Report Contact for Public Website	Director PACE Program Development & Implementation		Kiefert	Mary		7865845560					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/04/2024	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	CEO - CMS Administrator Contact	VP of Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/24/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	CEO - Senior Official for Contracting	VP Managed Care & Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/24/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Chief Financial Officer	EVP and Chief Financial Officer	Mr.	Mendez	Alex		3056742089					alex.mendez@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Chief Operating Officer	SVP and Chief Operating Officer	Mr.	Pallin	Angel		8506742520					angel.pallin@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Chief Information Officer	SVP and Chief Information Officer	Mr.	Gillette	Tom		3056742730					tom.gillette@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Chief Information Security Officer	SVP and Chief Information Officer	Mr.	Gillette	Tom		3056742730					tom.gillette@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	CMS Casework Communication Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Complaints Tracking Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Contact for Fraud Investigations	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Coordination of Benefits Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Corporate Mailing						7865845560					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Customer Service Operations Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	DIR Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	DIR Contact (Secondary)	VP Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Discount Program Payment Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Emergency Part D Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Emergency Part D Contact (Secondary)	VP Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Encounter Data & Risk Adjustment Operations Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Enrollment Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	EOB Transfer Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338				3055353438	mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Financial Audit Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Financial Reporting Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Formulary Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Formulary Contact (Secondary)	VP Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	General Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Government Relations Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	HIPAA Privacy Officer	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	HIPAA Security Officer	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Interoperability Contact	PACE Program Director		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 ALTON ROAD	WARNER BLDG., 5TH FLOOR	MIAMI BEACH	FL	33140	09/05/2022	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	MA Appeals/Grievances Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	MA Claims Processing Contact for Public Website	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Marketing Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Medical Director	Medical Director	Dr.	Medina	Clifford		7865845560	5083			7865845060	clifford.medina@msmc.com	6050 W. 20th Avenue	Suite 2001	Hialeah	FL	33016	02/20/2023	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Medicare Compliance Officer	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Medicare Coordinator	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Medicare Part D Opioid Overutilization Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Medication Therapy Management Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	OffShore Subcontractor Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		3056742121	50920				mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Online Enrollment Center Contact (Back-up)	VP Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Online Enrollment Center Contact (Primary)	Director PACE Program Development & Implementation		Kiefert	Mary		3056742121	50920				mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Part C Application Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Part D Appeals			Kiefert	Mary							mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active	8333520939				PACE - Nat		C	Atlanta
H9252	Part D Appeals Contact (Secondary)			Barcelo	Lynda							lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active	3055353306				PACE - Nat		C	Atlanta
H9252	Part D Application Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Part D Benefits Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Part D Claims Submission Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					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	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active	9042344338				PACE - Nat		C	Atlanta
H9252	Part D Exceptions Contact (Secondary)			Barcelo	Lynda							lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active	3055353306				PACE - Nat		C	Atlanta
H9252	Part D Price File Contact (Back-up)	VP Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Part D Price File Contact (Primary)	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Part D Quality Assurance Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Part D Reporting Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Patient Safety Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Payment Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Personal Health Record Contact	Director PACE Program Development & Implementation		Kiefert	Mary		3056742121	50920				mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Pharmacy Director	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Pharmacy Network Management Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Pharmacy Network Management Contact (Secondary)	VP Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					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	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active	9042344338				PACE - Nat		C	Atlanta
H9252	Pharmacy Technical Help Desk Contact (Secondary)			Barcelo	Lynda								4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active	3055353306				PACE - Nat		C	Atlanta
H9252	PHR Beneficiary Contact																	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE	Mount Sinai Eldercare	Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active	3056742121	50920			PACE - Nat		C	Atlanta
H9252	Plan Directory Contact for Public Website	Director PACE Program Development & Implementation		Kiefert	Mary		7865845560					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/04/2024	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Plan to Plan Reconciliation Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Processor Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Quality Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Reconciliation Contact	Director PACE Program Development & Implementation		Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Reconciliation Contact (Secondary)	VP Managed Care and Population Health	Ms.	Barcelo	Lynda		3055353306					lynda.barcelo@msmc.com	4300 Alton Road		Miami Beach	FL	33140	06/20/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Recovery Audit Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Surveillance Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	System Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Third Party Administrator (TPA) Liaison	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	User Access Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Utilization Management Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9252	Utilization Review Contact	Director PACE Program Development & Implementation	Ms.	Kiefert	Mary		9042344338					mary.kiefert@msmc.com	4300 Alton Road		Miami Beach	FL	33140	11/12/2021	2026	MOUNT SINAI ELDERCARE, INC.	National PACE	Mount Sinai Eldercare	National PACE		Mount Sinai Medical Center of Florida, Inc.	799	Yes	Active					PACE - Nat		C	Atlanta
H9266	Automated TrOOP Balance Transfer Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Backup User Access Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	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 Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Bid Primary Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				9199339201	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	09/25/2023	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	CAP Report Contact for Public Website	Executive Director, Piedmont Health SeniorCare	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	9195457341				PACE - Nat		C	Atlanta
H9266	CEO - CMS Administrator Contact	Dr.	Mrs.	Jaime-Colina	Daniella		9195377494				9199339201	colinad@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	01/23/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	CEO - Senior Official for Contracting	Dr.	Mrs.	Jaime-Colina	Daniella		9195377494				9199339201	colinad@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	01/23/2024	2026	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	Finance Director	Ms.	Bleil	Marcia		9195377483				9199339201	Bleilm@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hil	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Chief Operating Officer	PACE Executive Director	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Chief Information Officer	IT Manager	Mrs.	Smith	Samatha		9195377491					smiths@piedmonthealth.org	PHS corporate office	88 Vilcom Center Drive, Suite 110	Chapel Hill	NC	27514	12/05/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Chief Information Security Officer	IT Manager	Mrs.	Smith	Samatha		9195377491					smiths@piedmonthealth.org	PHS corporate office	88 Vilcom Center Drive, Suite 110	Chapel Hill	NC	27514	12/05/2025	2026	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		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Complaints Tracking Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Contact for Fraud Investigations	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				9199339201	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	09/25/2023	2026	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 Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Corporate Mailing						9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	09/03/2021	2026	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 Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	DIR Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	DIR Contact (Secondary)	Chief Pharmacy Officer	Mrs.	Stout	Kelly		3365060441				3365320001	stoutk@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Discount Program Payment Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		3365060441				3365320001	stoutk@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Emergency Part D Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Emergency Part D Contact (Secondary)	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Encounter Data & Risk Adjustment Operations Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Enrollment Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	EOB Transfer Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Financial Audit Contact	Chief Pharmacy Officer	Ms.	Stout	Kelly		9195377493				9199339201	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Financial Reporting Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Formulary Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Formulary Contact (Secondary)	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	General Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	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.	Sumpter	Jeffery		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	HIPAA Privacy Officer	IT Manager	Mrs.	Smith	Samatha		9195377491					smiths@piedmonthealth.org	PHS corporate office	88 Vilcom Center Drive, Suite 110	Chapel Hill	NC	27514	12/05/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	HIPAA Security Officer	IT Manager	Mrs.	Smith	Samatha		9195377491					smiths@piedmonthealth.org	PHS corporate office	88 Vilcom Center Drive, Suite 110	Chapel Hill	NC	27514	12/05/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Interoperability Contact		Mrs.	Smith	Samatha		9195377491					smiths@piedmonthealth.org	PHS Corporate Office	88 Vilcom Center Drive , Suite 110	Chapel Hill	NC	27514	12/05/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	MA Appeals/Grievances Contact	Quality Manager	Ms.	Moody	Margaret		3365320000	2619			3365320001	moodym@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	MA Claims Processing Contact for Public Website	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Marketing Contact	Marketing and Enrollment Manager	Mr.	Johnson	Shani		3365320000				3365320001	johnsonsh@piedmonthealth.org	1214 Vaughn Road		Burlington	NC	27217	12/05/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Medical Director	Piedmont Health SeniorCare Medical Director	Dr.	Stoneking	Sarah		3365065853				3365320001	stonekis@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	04/17/2025	2026	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		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Medicare Coordinator	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Medicare Part D Opioid Overutilization Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Medication Therapy Management Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	OffShore Subcontractor Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Online Enrollment Center Contact (Back-up)	PACE Executive Director	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Online Enrollment Center Contact (Optional)	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Online Enrollment Center Contact (Primary)	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Part C Application Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	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 Appeals	Chief Pharmacy Officer	Mrs.	Stout	Kelly						3365320001	stoutk@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	02/02/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	8777142100				PACE - Nat		C	Atlanta
H9266	Part D Appeals Contact (Secondary)	Executive DIrector	Mr.	Sumpter	Jeffery						9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	9195457341				PACE - Nat		C	Atlanta
H9266	Part D Application Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	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 Benefits Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	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 Claims Submission Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				9199339201	stoutk@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	12/05/2025	2026	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	Chief Pharmacy Officer	Mrs.	Stout	Kelly						3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	9195377493				PACE - Nat		C	Atlanta
H9266	Part D Exceptions Contact (Secondary)	Health Plan Director		White	Cre'shawna						9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	8777142100				PACE - Nat		C	Atlanta
H9266	Part D Price File Contact (Back-up)	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	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 Price File Contact (Optional)	PACE Executive Director	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	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 Price File Contact (Primary)	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	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 Quality Assurance Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	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 Reporting Contact	Chief Pharmacy Officer	Ms.	Stout	Kelly		9195377493				9199339201	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Patient Safety Contact	Piedmont Health SeniorCare Medical Director	Dr.	Stoneking	Sarah		3365065853				3365320001	stonekis@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Payment Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Personal Health Record Contact	Piedmont Health SeniorCare Medical Director	Dr.	Stoneking	Sarah		3365065853				3365320001	stonekis@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Pharmacy Director	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				9199339201	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	09/25/2023	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Pharmacy Network Management Contact	Chief Pharmacy Officer	Mrs.	Stout	Kelly		9195377493				3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Pharmacy Network Management Contact (Secondary)	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	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	Chief Pharmacy Officer	Mrs.	Stout	Kelly						3365320001	stoutk@piedmonthealth.org	88 Vilcom Center Drive	Suite 110	Chapel Hill	NC	27514	04/15/2024	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	9195377493				PACE - Nat		C	Atlanta
H9266	Pharmacy Technical Help Desk Contact (Secondary)	Health Plan Director		White	Cre'shawna						9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	8777142100				PACE - Nat		C	Atlanta
H9266	PHR Beneficiary Contact																	09/09/2008	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE	Piedmont Health SeniorCare	PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active	8777142100				PACE - Nat		C	Atlanta
H9266	Plan Directory Contact for Public Website	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Plan to Plan Reconciliation Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Processor Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Quality Contact	Piedmont Health SeniorCare Medical Director	Dr.	Stoneking	Sarah		3365065853				3365320001	stonekis@piedmonthealth.org	1214 Vaughn Rd		Burlington	NC	27217	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Reconciliation Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Reconciliation Contact (Secondary)	PACE Executive Director	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Recovery Audit Contact	Executive Director, Piedmont Health SeniorCare	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Surveillance Contact	PACE Executive Director	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	System Contact	PACE Executive Director	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Third Party Administrator (TPA) Liaison	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	User Access Contact	PACE Executive Director	Mr.	Sumpter	Jeffrey		9195457341				9199339201	sumpterj@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	06/11/2021	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Utilization Management Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9266	Utilization Review Contact	Health Plan Director		White	Cre'shawna		9199338494	2645			9199339201	whitec@piedmonthealth.org	88 Vilcom Center Drive, Suite 110		Chapel Hill	NC	27514	04/17/2025	2026	PIEDMONT HEALTH SERVICES, INC.	National PACE	Piedmont Health SeniorCare	National PACE		PIEDMONT HEALTH SERVICES, INC.	383	Yes	Active					PACE - Nat		C	Atlanta
H9289	Automated TrOOP Balance Transfer Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Backup User Access Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Best Available Evidence Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Bid Primary Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	CAP Report Contact for Public Website	CMO	Dr.	Kossari	Sean		8188955200					SKossari@cffhae.org	6609 Van Nuys Blvd	Suite 102	Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	CEO - CMS Administrator Contact	CEO	Mr	Kashani	Daryoush		8188955200					DKashani@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	CEO - Senior Official for Contracting	CEO	Mr	Kashani	Daryoush		8188955200					DKashani@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Chief Financial Officer	CFO	Mr	Landeros	Cesar		8188955200					CLanderos@cffhae.org	6609 Van Nuys Blvd	Suite 102	Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Chief Operating Officer	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Chief Information Officer	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Chief Information Security Officer	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	CMS Casework Communication Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Complaints Tracking Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Contact for Fraud Investigations			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Coordination of Benefits Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Corporate Mailing						8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd	Suite 102	Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Customer Service Operations Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	DIR Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Discount Program Payment Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Emergency Part D Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Encounter Data & Risk Adjustment Operations Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Enrollment Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	EOB Transfer Contact			Landeros	Cesar		8188955200				8186911241	clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Financial Audit Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Financial Reporting Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Formulary Contact	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	General Contact	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Government Relations Contact	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	HIPAA Privacy Officer	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	HIPAA Security Officer	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Interoperability Contact	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	MA Appeals/Grievances Contact	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	MA Claims Processing Contact for Public Website	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Marketing Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Medical Director	CMO	Mr	Kossari	Sean		8188955200					SKossari@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Medicare Compliance Officer	CEO	Mr	Kashani	Daryoush		8188955200					DKashani@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Medicare Coordinator	CEO	Mr	Kashani	Daryoush		8188955200					DKashani@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Medicare Part D Opioid Overutilization Contact	CMO	Mr	Kossari	Sean		8188955200					SKossari@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Medication Therapy Management Contact	CMO	Mr	Kossari	Sean		8188955200					SKossari@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part C Application Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	01/03/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part D Appeals			Kossari	Sean							SKossari@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending	8188955200				PACE - Nat		C	San Francisco
H9289	Part D Application Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	01/03/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part D Benefits Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part D Claims Submission Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part D Exceptions Contact			Kossari	Sean							SKossari@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending	8188955200				PACE - Nat		C	San Francisco
H9289	Part D Price File Contact (Back-up)	CEO	Mr	Kashani	Daryoush		8188955200					DKashani@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part D Price File Contact (Primary)			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part D Quality Assurance Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Part D Reporting Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Patient Safety Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Payment Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Pharmacy Director	COO	Mr	Barkhash	Asya		8188955200					ABarkhash@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Pharmacy Network Management Contact			Landeros	Cesar		8188995555					clanderos@cffhae.org	8727 Van Nuys Boulevard, #101		Panorama City	CA	91402	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Pharmacy Technical Help Desk Contact			Kossari	Sean							SKossari@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending	8188955200				PACE - Nat		C	San Francisco
H9289	Plan Directory Contact for Public Website	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Plan to Plan Reconciliation Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Processor Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Quality Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Reconciliation Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Recovery Audit Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Surveillance Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	System Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Third Party Administrator (TPA) Liaison	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	User Access Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Utilization Management Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9289	Utilization Review Contact	CFO	Mr	Landeros	Cesar		8188955200					clanderos@cffhae.org	6609 Van Nuys Blvd		Van Nuys	CA	91405	03/22/2024	2026	COMPLETE CARE PACE PROGRAM	National PACE	Complete Care PACE Program	National PACE		Center for Family Health and Education	847	Yes	Pending					PACE - Nat		C	San Francisco
H9306	Agent/Broker Compensation Data Contact	Chief Marketing Officer	Mr	Davis	James		4438849082				4108015865	jdavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Automated TrOOP Balance Transfer Contact	Clinical Pharmacist	Mr	Njoku	Samual		4435977812				4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Backup User Access Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Best Available Evidence Contact	Medicare Program Director	Ms	Zahangir	Nadia		3473075868				4433181060	nzahangir@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Bid Audit Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Bid Audit Site Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Bid Primary Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	CAP Report Contact for Public Website	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506					aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8446757664				HMO - Health Maintenance Organization		C	Seattle
H9306	CEO - CMS Administrator Contact	President & CEO	Mr	Puente	Mark		4102185543				4435587809	mpuente@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	CEO - Senior Official for Contracting	President & CEO	Mr	Puente	Mark		4438849116				4435587809	mpuente@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Chief Financial Officer	Chief Financial Officer	Mr	Yancisin	Matt		4438849108				4435587809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Chief Operating Officer	Chief Development Officer	Mr	Bechtold	Paul		4438849087				4435587809	pbechtold@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	09/01/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Chief Information Officer	Chief Information Officer	Mr	Myers	Dan		4438849075				4435587809	dmyers@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Chief Information Security Officer	Chief Information Officer	Mr	Myers	Dan		4438849075				4435587809	dmyers@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	CMMI Model Point of Contact	Chief Health & Quality Officer	Ms	Bavis	Jill		4438849083				4435587809	jbavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	CMS Casework Communication Contact	Chief Compliance Officer	Mr	Burch	Aaron		4104466506				4108015704	aburch@alterwoodhealth.com	10090 Red Run Blvd		Owings Mills	MD	21117	12/10/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Complaints Tracking Contact	Chief Compliance Officer	Mr	Burch	Aaron		4104466506				4108015704	aburch@alterwoodhealth.com	10090 Red Run Blvd		Owings Mills	MD	21117	12/10/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Contact for Fraud Investigations	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Coordination of Benefits Contact	Medicare Program Director	Ms	Zahangir	Nadia		3473075868				4433181060	nzahangir@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Corporate Mailing						4104466506				4435587809	aburch@alterwoodhealth.com	10090 Red Run Blvd		Owings Mills	MD	21117	12/10/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Customer Service Operations Contact	Director of Operations	Ms	Goss	April		6672905601				4108015704	agoss@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	DIR Contact	Manager, Health Plans Finance	Mr	Parkin	Frank		2038148504					fparkin@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	DIR Contact (Secondary)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Discount Program Payment Contact	Chief Financial Officer	Mr	Yancisin	Matt		4438849108				4435587809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Electronic Health Record Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506					aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8446757664				HMO - Health Maintenance Organization		C	Seattle
H9306	Emergency Part D Contact	Director, Member & Provider Engagement	Mr	Wheeler	Throop		4432556517				4108015703	twheeler@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Emergency Part D Contact (Secondary)	Clinical Pharmacist	Mr	Njoku	Samuel		4435977812				4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	06/23/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Employer Waiver Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Encounter Data & Risk Adjustment Operations Contact	Chief Information Officer	Mr	Myers	Dan		4438849075				4435587809	dmyers@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	08/28/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Enrollment Contact	Medicare Program Director	Ms	Zahangir	Nadia		3473075868				4433181060	nzahangir@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	EOB Transfer Contact	Chief Development Officer	Mr	Bechtold	Paul		4438849087				4435587809	pbechtold@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	08/28/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Financial Audit Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				4435587809	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	09/20/2023	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Financial Reporting Contact	Chief Financial Officer	Mr	Yancisin	Matt		4438849108				4435587809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Formulary Contact	Clinical Pharmacist	Mr	Njoku	Samual	D	4435977812				4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Formulary Contact (Secondary)	Formulary Contact	Ms	Shaw	Andrea		4405038080					anshaw@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	02/14/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	General Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Government Relations Contact	Chief Marketing Officer	Mr	Davis	James		4438849082				4108015865	jdavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	HIPAA Privacy Officer	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	HIPAA Security Officer	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Hospice Contact	Chief Health & Quality Officer	Ms	Bavis	Jill		4438849083				4435587809	jbavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	06/23/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Interoperability Contact	Chief Information Officer	Mr	Myers	Dan		4438849075				4435587809	dmyers@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	MA Appeals/Grievances Contact	Manager of A&G	Ms	Greenspan	Amy		6672822623				4108015863	agreenspan@alterwoodhealth.com	10090 Red Run Blvd		Owings Mills	MD	21117	12/10/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	MA Claims Processing Contact for Public Website	Chief Marketing Officer	Mr	Davis	James		4438849082					memberservcies@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	08/28/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Marketing Contact	Chief Marketing Officer	Mr	Davis	James		4438849082				4108015865	jdavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Medical Director	Medical Director	Mr	Yanuck	Michael		4108016066				4435587809	myanuck@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/22/2023	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Medicare Compliance Officer	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Medicare Coordinator	Chief Compliance Officer	Mr	Burch	Aaron	J	4104466506				4435587809	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	08/28/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist	Mr	Njoku	Samual		4435977812				4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Medication Therapy Management Contact	Clinical Pharmacist	Mr	Njoku	Samual		4435977812				4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	OffShore Subcontractor Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Online Enrollment Center Contact (Back-up)	Medicare Program Director	Ms	Zahangir	Nadia		3473075868				4433181060	nzahangir@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Online Enrollment Center Contact (Optional)	Director of Sales & Marketing	Ms	Mullinix	Kaitlynn		4438849097				4108015865	kmullinix@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Online Enrollment Center Contact (Primary)	Medicare Program Director	Ms	Zahangir	Nadia		3473075868				4433181060	nzahangir@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part C Application Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part C Reporting Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Appeals	Clinical Pharmacist	Mr	Njoku	Samual						4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8662673144				HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Ms	McCauley	Angela						3304058081	Appeals@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8662673144				HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Application Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506					aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Benefits Contact	Director, Member & Provider Engagement	Mr	Wheeler	Throop		6673515118				4108015703	twheeler@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Claims Submission Contact	Senior Account Manager	Ms	Voss	Laurie		2342123780					lvoss@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Exceptions Contact	Clinical Pharmacist	Mr	Njoku	Samual						4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8662673144				HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Exceptions Contact (Secondary)	Pharmacy Supervisor, Coverage Determinations	Mr	Larkins	Casey						3302859685	clarkins@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8662673144				HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Price File Contact (Back-up)	Manager, Reporting & Analytics	Mr	Wentz	Christophe		3304864910					cwentz@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Price File Contact (Optional)	Director, Member & Provider Engagement	Mr	Wheeler	Throop		6673515118				4108015703	twheeler@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Price File Contact (Primary)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Quality Assurance Contact	Director, Member & Provider Engagement	Mr	Wheeler	Throop		6673515118				4108015703	twheeler@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Part D Reporting Contact	Director, Member & Provider Engagement	Mr	Wheeler	Throop		6673515118				4108015703	twheeler@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Patient Safety Contact	Chief Health & Quality Officer	Ms	Bavis	Jill		4438849083				4435587809	jbavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	06/23/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Payment Contact	Chief Financial Officer	Mr	Yancisin	Matt		4438849108				4435587809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Personal Health Record Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Pharmacy Director	Chief Health & Quality Officer	Ms	Bavis	Jill		4438849083				4435587809	jbavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Pharmacy Network Management Contact	Director Pharmacy Network Dev and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	02/14/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Pharmacy Network Management Contact (Secondary)	Director, Member & Provider Engagement	Mr	Wheeler	Throop		6673515118				4108015703	twheeler@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Pharmacy Technical Help Desk Contact	VP Operations	Mr	Conn	Todd							tconn@elixirsolutions.com	7801 Freedom Way NW		N. Canton	OH	44720	02/14/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8336932189				HMO - Health Maintenance Organization		C	Seattle
H9306	Pharmacy Technical Help Desk Contact (Secondary)	Clinical Pharmacist	Mr	Njoku	Samuel						4108015703	snjoku@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/10/2024	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active	8662673144				HMO - Health Maintenance Organization		C	Seattle
H9306	PHR Beneficiary Contact																	04/22/2021	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS	Alterwood Advantage	LifeBridge Health, Inc.	770	Yes	Active	8446757664				HMO - Health Maintenance Organization		C	Seattle
H9306	Physician Incentive Contact	Chief Development Officer	Mr	Bechtold	Paul		4104466506				4435587809	pbechtold@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Plan Directory Contact for Public Website	Chief Marketing Officer	Mr	Davis	James		4438849082					providers@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	08/28/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Plan to Plan Reconciliation Contact	Chief Financial Officer	Mr	Yancisin	Matt		4438849108				4435587809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Processor Contact	Chief Development Officer	Mr	Bechtold	Paul		4438849087				4435587809	pbechtold@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	08/28/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Quality Contact	Chief Health & Quality Officer	Ms	Bavis	Jill		4438849083				4435587809	jbavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	06/23/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Reconciliation Contact	Chief Financial Officer	Mr	Yancisin	Matt		4438849108				4435587809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/15/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Reconciliation Contact (Secondary)	Vice President of Finance	Mr	Johnson	Brett		4103680990				4435587809	bjohnson@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/15/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Recovery Audit Contact	Chief Financial Officer	Mr	Yancisin	Matt		4438849108				4435587809	myancisin@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	08/28/2025	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	SNP Application Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	SNP State Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Surveillance Contact	Director of Sales & Marketing	Ms	Mullinix	Kaitlynn		4438849097				4108015865	kmullinix@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	System Contact	Chief Information Officer	Mr	Myers	Dan		4438849075				4435587809	dmyers@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Third Party Administrator (TPA) Liaison	Vice President of Finance	Mr	Johnson	Brett		4103680990				4435587809	bjohnson@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	01/21/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	User Access Contact	Vice President, Business & Regulatory Affairs	Mr	Burch	Aaron		4104466506				2402019079	aburch@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	02/07/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Utilization Management Contact	Chief Health & Quality Officer	Ms	Bavis	Jill		4438849083				4435587809	jbavis@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	06/23/2022	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9306	Utilization Review Contact	Medical Director	Mr	Yanuck	Michael		4108016066				4435587809	myanuck@alterwoodhealth.com	PO Box 4175		Timonium	MD	21094	05/22/2023	2026	ALTERWOOD ADVANTAGE, INC.	Local CCP	Alterwood Advantage	HMO/HMOPOS		LifeBridge Health, Inc.	770	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9314	Agent/Broker Compensation Data Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Best Available Evidence Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	12/08/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	CMS Casework Communication Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Complaints Tracking Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Coordination of Benefits Contact	Phamacy Director		Vergil	Gina		4026997768					VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Corporate Mailing						4107525721				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		6146537335					PhillipsL1@aetna.com	7400 Campus Road		New Albany	OH	43054	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/04/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Emergency Part D Contact (Secondary)	Pharmacy Director		Nkurunziza	Natalie		8609006247					NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Employer Waiver Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Encounter Data & Risk Adjustment Operations Contact	Director, Informatics		Sevchik	Melissa		6026591404					sevchikm@aetna.com	4750 S. 44th Place		Phoenix	AZ	85040	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Enrollment Contact	Lead Director Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Formulary Contact (Secondary)	Director, Pharmacy		Stekol	Ilona		3478806082					stekoli@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4802360860				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	06/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	HIPAA Privacy Officer	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	HIPAA Security Officer	Chief Information Security Officer	Ms.	McMahon	Chandra		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Hospice Contact	Lead Director, Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Interoperability Contact	Exec. Dir. , Interoperability & Transpcy		Midyette	Carol		2032479966					midyettec@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	MA Appeals/Grievances Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Medical Director	CMO		Coates	Deborah		6143810339					coatesd@aetna.com	Aetna Better Health of Michigan, Inc.	2 Towne Square, Suite 275	Southfield	MI	48076	11/25/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Medicare Coordinator	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	OffShore Subcontractor Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	03/14/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part C Reporting Contact	Lead Dir., Bus. Compliance, Medicare Ops. Int.		Blankley	Barbara		2067018041					blankleyb@aetna.com	600 University Street		Seattle	WA	98101	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Appeals	Supervisor, Clinical Pharmacy	Ms.	Spencer	Tiffane						8772700148	MedicareCoverageDeterminationMMP-SNP@AETNA.com	4750 South 44th Place		Phoenix	AZ	85040	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	6025589172				HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Appeals Contact (Secondary)	Pharmacy Director	Ms.	Vergil	Gina						8553658108	VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4026997768				HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8602738849				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Exceptions Contact	Pharmacy Director		Vergil	Gina							Vergilg@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4026997768				HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Exceptions Contact (Secondary)	Pharmacy Director		Nkurunziza	Natalie							NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8609006247				HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Part D Reporting Contact	Lead Dir., Bus. Compliance, Medicare Ops. Int.		Blankley	Barbara		2067018041					blankleyb@aetna.com	600 University Street		Seattle	WA	98101	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Payment Contact	Lead Director, FP&A	Ms.	Stefanich	Anita		3129283105					StefanichA@cvshealth.com	333 West Wacker Drive	Suite 2100	Chicago	IL	60606	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Personal Health Record Contact	CMO		Coates	Deborah		6143810339					coatesd@aetna.com	Aetna Better Health of Michigan, Inc.	2 Towne Square, Suite 275	Southfield	MI	48076	11/27/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Pharmacy Network Management Contact (Secondary)	Pharmacy Director		Nkurunziza	Natalie		8609006247					NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Pharmacy Technical Help Desk Contact	Phamacy Director		Vergil	Gina							VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8553196287				HMO - Health Maintenance Organization		C	Atlanta
H9314	Physician Incentive Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Plan Directory Contact for Public Website	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/08/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Processor Contact	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Reconciliation Contact (Secondary)	Lead Director, FP&A	Ms.	Stefanich	Anita		3129283105					StefanichA@cvshealth.com	333 West Wacker Drive	Suite 2100	Chicago	IL	60606	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	SNP State Contact	Executive Director, National Duals Program		Hughes	Angelique		2482700990					hughesa1@aetna.com	2 Town Square, Suite 275		Southfield	MI	48076	12/09/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Surveillance Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	System Contact	Executive Director, Duals Market Enablement	Ms.	Tanzillo	Hollie	M	7407398501					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Utilization Management Contact	AVP, Clinical Health Services		McKenna	Judith		2157758411					mckennaja@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9314	Utilization Review Contact	Director Clinical Health Services		Patel	Parul	P	2243633232					patelp12@aetna.com	7400 W. Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH OF MICHIGAN INC.	Local CCP	Aetna Medicare HIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9317	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Best Available Evidence Contact	Executive Director	Mr	Williams	Rob		8547680800					rwilliams@boldagepace.com	2801 Ashley Phosphate Road		North Charleston	SC	29418	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	CAP Report Contact for Public Website	Director of Compliance	Mr.	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	CMS Casework Communication Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcoooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Customer Service Operations Contact	Executive Director	Mr	Williams	Rob		8547680800					rwilliams@boldagepace.com	2801 Ashley Phosphate Road		North Charleston	SC	29418	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Formulary Contact	Finance Specialist		Partlow	Jennie		6406501565					jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	General Contact	Executive Director	Mr	Williams	Rob		8547680800					rwilliams@boldagepace.com	2801 Ashley Phosphate Road		North Charleston	SC	29418	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	HIPAA Privacy Officer	Director of Compliance		Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation		Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Medical Director	Medical Director	Dr.	Fornadel	Brian		7325923400					bfornadol@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Medicare Coordinator	Executive Director	Mr	Williams	Rob		8547680800					rwilliams@boldagepace.com	2801 Ashley Phosphate Road		North Charleston	SC	29418	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Medicare Part D Opioid Overutilization Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Medication Therapy Management Contact	Medical Director	Dr	Fornadel	Brian		9548395000				7325923500	bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		8558012653					maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part D Appeals	Director of Compliance	Ms	Cooper	Wanda							wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	2675751196				PACE - Nat		C	New York
H9317	Part D Appeals Contact (Secondary)	Chief Health Plan Operations		Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7328063224				PACE - Nat		C	New York
H9317	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part D Exceptions Contact	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H9317	Part D Exceptions Contact (Secondary)	Finance Specialist		Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H9317	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part D Quality Assurance Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Patient Safety Contact	Finance Specialist		Partlow	Jennie		9548395000					jpartlow@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Pharmacy Director	Medical Director	Dr	Fornadel	Brian		9548395000					bfornadol@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H9317	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H9317	PHR Beneficiary Contact																	09/24/2024	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE	Beacon of Life SC	Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H9317	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Plan to Plan Reconciliation Contact	Financial Specialist		Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Surveillance Contact	Executive Director	Mr	Williams	Rob		8547680800					rwilliams@boldagepace.com	2801 Ashley Phosphate Road		North Charleston	SC	29418	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	User Access Contact	Business Administrator		Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9317	Utilization Review Contact	Executive Director	Mr	Williams	Rob		8547680800					rwilliams@boldagepace.com	2801 Ashley Phosphate Road		North Charleston	SC	29418	05/06/2025	2026	BEACON OF LIFE SC, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Automated TrOOP Balance Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Backup User Access Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Best Available Evidence Contact	Business Operations Manager	Mr	Liskowitz	Christian		7327164600				7325923500	cliskowitz@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Bid Primary Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	CAP Report Contact for Public Website	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923501	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	CEO - CMS Administrator Contact	Chief Executive Officer	Ms	Austin	Mary		7327164600				7325923500	maustin@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	CEO - Senior Official for Contracting	Chief Administrative Officer	Mr	Czermak	Michael		7327164600				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	12/06/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Chief Financial Officer	Chief Financial Officer	Mr	Schlesinger	David		8476124588					dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	03/21/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Chief Operating Officer	Chief Operating Officer	Mr	Steibigel	Glenn		7327164600				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Chief Information Officer	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Ave	Suite B	Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Chief Information Security Officer	Director of Compliance	Ms	Cooper	Wanda		7325923400					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	CMS Casework Communication Contact	Director of Compliance	Ms.	Cooper	Wanda		2675751196				7325923500	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Complaints Tracking Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Contact for Fraud Investigations	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Coordination of Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Corporate Mailing						7326643786					jray@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Customer Service Operations Contact	Executive Director	Dr	Gagliano	Melissa		7325923400					mgagliano@beaconpace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/08/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	DIR Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	DIR Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	10 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Discount Program Payment Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Emergency Part D Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Emergency Part D Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7325923500	jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Encounter Data & Risk Adjustment Operations Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Enrollment Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	EOB Transfer Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Financial Audit Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Financial Reporting Contact	Chief Financial Officer	Mr	Schlesinger	David		7328063224				7328063324	dschlesinger@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	12/12/2023	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Formulary Contact	Medical Director	Dr	McCoy	Kristine		6406501565					kmccoy@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Formulary Contact (Secondary)	Director of Compliance	Ms	Cooper	Wanda		7325923400					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	General Contact	Executive Director	Dr	Gagliano	Melissa		7327164600				7325923500	mgagliano@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Government Relations Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400					michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	HIPAA Privacy Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	HIPAA Security Officer	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Interoperability Contact	Chief Administrative Officer	Mr	Czermak	Michael		7325923400				7325923500	michaelc@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	MA Appeals/Grievances Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	MA Claims Processing Contact for Public Website	Chief of Health Plan Operation	Mr	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Marketing Contact	Director of Business Development	Ms	Hull	Leigh		3036383788					lhull@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Medical Director	Medical Director	Dr.	McCoy	Kristine		7325923400					kmccoy@boldagepace.com	1075 Stephenson Ave.	Suite B	Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Medicare Compliance Officer	Director of Compliance	Ms	Cooper	Wanda		7325923400					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Medicare Coordinator	Executive Director	Dr	Gagliano	Melissa		7325923400					mgagliano@beaconpace.com	1075 Stephenson Ave Suite B		Oceanport	NJ	07757	05/06/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Medicare Part D Opioid Overutilization Contact	Director of Compliance		Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Medication Therapy Management Contact	Medical Director	Dr	McCoy	Kristine		9548395000				7325923500	kmccoy@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part C Application Contact	Chief Executive Officer	Ms	Austin	Mary		7328063224				7328063324	maustin@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part D Appeals	Director of Compliance		Cooper	Wanda						2675751196	wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7325923407				PACE - Nat		C	New York
H9323	Part D Appeals Contact (Secondary)	Chief Health Plan Operations	Mr.	Ternay	Jennifer						7328063324	jternay@boldagepace.com	106 Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	7328063224				PACE - Nat		C	New York
H9323	Part D Application Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part D Benefits Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part D Claims Submission Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part D Exceptions Contact	Finance Specialist	Dr	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/11/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H9323	Part D Exceptions Contact (Secondary)	Finance Specialist	Dr	Partlow	Jennie							jpartlow@boldagepace.com	106 W Moore Ave	Suite A	Mooresville	NC	28115	09/11/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	9548395000				PACE - Nat		C	New York
H9323	Part D Price File Contact (Back-up)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part D Price File Contact (Primary)	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part D Quality Assurance Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Part D Reporting Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Patient Safety Contact	Director of Compliance		Cooper	Wanda		2675751196					wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Payment Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Personal Health Record Contact	Director of Compliance	Ms	Cooper	Wanda		7325923400					wcooper@boldagepace.com	1075 Stephenson Avenue	Suite B	Oceanport	NJ	07757	06/13/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Pharmacy Director	Medical Director	Dr	McCoy	Kristine		9548395000					kmccoy@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/11/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Pharmacy Network Management Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Pharmacy Network Management Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Pharmacy Technical Help Desk Contact	Financial Specialist	Ms	Partlow	Jennie							jpartlow@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H9323	Pharmacy Technical Help Desk Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer							jternay@boldagepace.com	106 Moore Avenue Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active	8558012653				PACE - Nat		C	New York
H9323	Plan Directory Contact for Public Website	Director of Business Development	Ms	Hull	Leigh		7328063224				7328063324	lhull@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Plan to Plan Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	10/10/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Processor Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Quality Contact	Director of Compliance	Ms	Cooper	Wanda		2675751196				7325923507	wcooper@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	04/22/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Reconciliation Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224				7328063324	jpartlow@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Reconciliation Contact (Secondary)	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224					jternay@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Recovery Audit Contact	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Surveillance Contact	Interim Executive Director	Dr	Gagliano	Melissa		7325923400				7325923507	mgagliano@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	04/08/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	System Contact	Financial Specialist	Ms	Partlow	Jennie		7328063224					jpartlow@boldagepace.com	106 W Moore Avenue	Suite A	Mooresville	NC	28115	01/03/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Third Party Administrator (TPA) Liaison	Chief Health Plan Operations	Ms	Ternay	Jennifer		7328063224				7328063324	jternay@boldagepace.com	106 Moore Ave Suite A		Mooresville	NC	28115	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	User Access Contact	Business Administrator	Ms	Gaffney	Karen		9804201351					kgaffney@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	11/05/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Utilization Management Contact	Chief Operating Officer	Mr	Steibigel	Glenn		3125052580				7325923500	gsteibigel@boldagepace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	09/23/2024	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9323	Utilization Review Contact	Interim Executive Director	Dr	Gagliano	Melissa		7327164600				7325923500	mgagliano@beaconpace.com	1075 Stephenson Avenue Suite B		Oceanport	NJ	07757	04/08/2025	2026	BEACON OF LIFE CENTRAL NJ, LLC	National PACE	BoldAge PACE	National PACE		Beacon Care Ventures LLC DBA BoldAge PACE	820	Yes	Active					PACE - Nat		C	New York
H9326	Agent/Broker Compensation Data Contact	Senior Director Planning and Implementation		Klein	Maria		3074322793					maria.klein@bcbswy.com	4000 House Ave		Cheyenne	WY	82001	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Automated TrOOP Balance Transfer Contact	Sr. Business Analyst		Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Pairie	MN	55344	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Backup User Access Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Best Available Evidence Contact			McLemore	Emily		7134439643					emily.mclemore@usthealthproof.com	5 Polaris Way		Alisa Veijo	CA	92656	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Bid Audit Contact	Director, Compliance Office		Weicker	Brian		3132259571					bweicker@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Bid Primary Contact			Galande	Anant		6169776156					agalande@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	CAP Report Contact for Public Website	Managing Director, MA Oversight		Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	3132259513				PPO - BBA		C	Chicago
H9326	CEO - CMS Administrator Contact	Plan President	Mr	Martinez	Jeremy		3074322931					jeremy.martinez@bcbswy.com	4000 House Avenue		Cheyenne	WY	82001	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	CEO - Senior Official for Contracting	Plan President	Mr	Martinez	Jeremy		3074322931					jeremy.martinez@bcbswy.com	4000 House Avenue		Cheyenne	WY	82001	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Chief Financial Officer	SVP, Controller	Mr	Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Chief Operating Officer		Mr	Manthey	Michael		2486654349					michael.manthey@emergient.com	1000 Town Center		Southfield	MI	48075	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Chief Information Officer	Managing Director, MA Oversight	Ms	Krause	Amy		3132256638					akrause@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Chief Information Security Officer	Managing Director, MA Oversight	Mr	Cieszynski	Brent		3132258766					bciezynski@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	CMS Casework Communication Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Complaints Tracking Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48226	07/03/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Coordination of Benefits Contact	Manager		Mercurio	Corrin		6032607717					corrin.mercurio@advantasure.com	5 Polaris Way		Alisa Veijo	CA	92656	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Corporate Mailing						3074322931					jeremy.martinez@bcbswy.com	4000 House Avenue		Cheyenne	WY	82001	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Customer Service Operations Contact	Manager		Williams	Dena		7703091524					dena.williams@usthealthproof.com	5 Polaris Way		Alisa Veijo	CA	92656	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	DIR Contact	Managing Director, MA Oversight		Jones	Marini		3135706777					marini.jones@emergient.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Discount Program Payment Contact			MacDonald	Lauren		6099414190					lauren.macdonald@emergentholdingsinc.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Electronic Health Record Contact			Yende	Namita		3132259513					nyende@bcbsm.com	600 Lafayette East		Detroit	MI	48226	09/10/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	3132259513				PPO - BBA		C	Chicago
H9326	Emergency Part D Contact			Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		DeHommel	David		2487437024					ddehommel@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	09/10/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Enrollment Contact			Izzi	Jodi		2032145825					jodi.izzi@usthealthproof.com	5 Polaris Way		Alisa Veijo	CA	92656	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	EOB Transfer Contact			Devereux	Mary		8472244888				8472244888	government.programsEOB@optum.com	11000 Optum Circle		Eden Pairie	MN	55344	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Financial Audit Contact	Director, Compliance Office	Mr	Weicker	Brian		3132259571					bweicker@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Financial Reporting Contact			Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Formulary Contact	Director, Pharmacy Operations		Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	General Contact	Manager, Program Oversight		Martell	Stacey		3138065905					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Government Relations Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	HIPAA Privacy Officer	VP Enterprise Compliance		Lange	Kelly		3132258554					klange@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	HIPAA Security Officer	VP Enterprise Compliance		Lange	Kelly		3132258554					klange@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Hospice Contact	Director, Pharmacy Operations		Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Interoperability Contact	Manager, Functional Operations		Kingsley	Christophe		6167580917					christopher.kingsley@emergient.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	MA Appeals/Grievances Contact	Manager		Rivera-White	Wilma		8029621253					Wilma.Rivera-White@usthealthproof.com	5 Polaris Way		Alisa Veijo	CA	92656	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	MA Claims Processing Contact for Public Website			Wickson	Michelle		5083300573					michelle.wickson@advantasure.com	5 Polaris Way		Alisa Veijo	CA	92656	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Marketing Contact			Manthey	Michael		2486654349					michael.manthey@emergient.com	1000 Town Center		Southfield	MI	48075	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Medical Director	Sr Medical Director & Associate CMO		Yende	Namita		3132259513					nyende@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Medicare Compliance Officer	VP Enterprise Compliance	Ms	Lange	Kelly		3132258554					MedComplianceOfficer2@bcbsm.com	600 Lafayette East		Detroit	MI	48226	04/14/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Medicare Coordinator	Managing Director, MA Oversight	Ms	Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Medicare Part D Opioid Overutilization Contact			Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Medication Therapy Management Contact	Director, Pharmacy Operations		Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part C Application Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part C Reporting Contact	Manager, Program Oversight		Martell	Stacey		3138065905					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part D Appeals	Manager, Pharmacy PA Appeals		Bricker	Bryce							bryce.m.bricker@optum.com	11000 Optum Circle		Eden Pairie	MN	55344	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8558124036				PPO - BBA		C	Chicago
H9326	Part D Application Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part D Benefits Contact	Director, Pharmacy Operations		Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part D Claims Submission Contact			Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Pairie	MN	55344	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part D Exceptions Contact			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	7148253783				PPO - BBA		C	Chicago
H9326	Part D Price File Contact (Back-up)			Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part D Price File Contact (Primary)			Lyman	Dorothy		6514955369					dorothy.lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part D Quality Assurance Contact	Director, Pharmacy Operations		Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Part D Reporting Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Patient Safety Contact	Sr Medical Director & Associate CMO	Dr.	Yende	Namita		3132259513					nyende@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Payment Contact			Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Pharmacy Director			Clark	Erica		6167580917					Erica.Clark@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Pharmacy Network Management Contact			Perez	Felix		3053313044					felix.perez@optum.com	11000 Optum Circle		Eden Pairie	MN	55344	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Pharmacy Technical Help Desk Contact	Manager		Villanueva	Juan							Juan.Villanueva@optum.com	Telecommute		Costa Mesa	CA	92626	12/17/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8007887871				PPO - BBA		C	Chicago
H9326	Pharmacy Technical Help Desk Contact (Secondary)	Manager		Betten	Brad							bradley.betten@optum.com	Telecommute		Costa Mesa	CA	92626	12/17/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8007887871				PPO - BBA		C	Chicago
H9326	Plan Directory Contact for Public Website	Director of Provider Affairs		Trautwein	Logan		3078293384					logan.trautwein@bcbswy.com	4000 House Avenue		Cheyenne	WY	82001	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Plan to Plan Reconciliation Contact			Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Processor Contact			Wickson	Michelle		5083300573					michelle.wickson@advantasure.com	5 Polaris Way		Alisa Veijo	CA	92656	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Quality Contact		Dr.	Yende	Namita		3132259513					nyende@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Reconciliation Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		5869801504					jennifer.zylstra@emergient.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Recovery Audit Contact	Manager, Program Oversight	Ms	Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Surveillance Contact	Director, JV Member Acquistion	Ms	Woods	Cheyenne		2486654028					cheyenne.woods@emergient.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	System Contact	Manager, Program Oversight		Martell	Stacey		2486654028					smartell@bcbsm.com	600 Lafayette East		Detroit	MI	48226	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Third Party Administrator (TPA) Liaison	Supervisor	Mr	Cole	Terrence		5177086127					terrence.cole@emergentholdingsinc.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	User Access Contact	Administrative Assistant		Eddy	Chris		3132683879					CEddy@bcbsm.com	600 East Lafayette		Detroit	MI	48226	07/03/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Utilization Management Contact	Managing Director	Ms	Schaefer	Deborah		2486654252					dschaefer@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9326	Utilization Review Contact	Managing Director	Ms	Schaefer	Deborah		2486654252					dschaefer@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	01/13/2025	2026	WYOBLUE ADVANTAGE INC	Local CCP	WyoBlue Advantage	Local PPO		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active					PPO - BBA		C	Chicago
H9360	Automated TrOOP Balance Transfer Contact			Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street		Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Backup User Access Contact			Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street		Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Best Available Evidence Contact			Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street		Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Bid Primary Contact			Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street		Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	CAP Report Contact for Public Website			Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	CEO - CMS Administrator Contact		Mr.	Ng	Peter		2138081701					png@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	CEO - Senior Official for Contracting		Mr.	Ng	Peter		2138081701					png@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Chief Financial Officer	CFO	Ms.	Ramos	Yeryca		2138081702					yramos@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/22/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Chief Operating Officer	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Chief Information Officer	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Chief Information Security Officer	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	CMS Casework Communication Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Complaints Tracking Contact	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	A	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Contact for Fraud Investigations	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Coordination of Benefits Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Corporate Mailing						2138081700					info@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Customer Service Operations Contact	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	DIR Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	DIR Contact (Secondary)	PACE Operations Director		Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Discount Program Payment Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Emergency Part D Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Emergency Part D Contact (Secondary)	PACE Operations Director		Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St		Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Encounter Data & Risk Adjustment Operations Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Enrollment Contact	PACE Operations Director	Mrs.	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	EOB Transfer Contact			Cheng	Jack		2138081709				2137162634	jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Financial Audit Contact	CFO	Ms.	Ramos	Yeryca		2138081702					yramos@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Financial Reporting Contact		Ms.	Ramos	Yeryca		2138081702					yramos@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Formulary Contact	Medical Director	Mr.	Wang	John		6269888006					jowang@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	General Contact	CEO	Mr.	Ng	Peter		2138081701					png@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/22/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Government Relations Contact	CEO	Mr.	Ng	Peter		2138081701					png@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/22/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	HIPAA Privacy Officer	COO		Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street		Los Angeles	CA	90012	12/22/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	HIPAA Security Officer	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Interoperability Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	MA Appeals/Grievances Contact	PACE Operations Director	Mrs.	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	MA Claims Processing Contact for Public Website	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Marketing Contact	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Medical Director	Medical Director	Dr.	Wang	John		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Medicare Compliance Officer	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Medicare Coordinator	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Wang	John		6269888006					jowang@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Medication Therapy Management Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Online Enrollment Center Contact (Back-up)	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Part C Application Contact	CEO		Ng	Peter		2138081701					png@cscla.org	767 N. Hill Street #400		Los Angeles	CA	90012	12/22/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Part D Appeals	PACE Operations Director	Mrs.	Tran	Phoi							ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active	6269888006				PACE - Nat		C	San Francisco
H9360	Part D Application Contact	CEO		Ng	Peter		2138081701					png@cscla.org	767 N. Hill Street #400		Los Angeles	CA	90012	12/22/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Part D Benefits Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Part D Claims Submission Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					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	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active	2138081709				PACE - Nat		C	San Francisco
H9360	Part D Price File Contact (Back-up)			Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Part D Price File Contact (Primary)			Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Part D Quality Assurance Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Part D Reporting Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Patient Safety Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Payment Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Pharmacy Director	Medical Director	Dr	Wang	John		6269888006					jowang@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Pharmacy Network Management Contact	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Pharmacy Technical Help Desk Contact	PACE Operations Director	Mrs.	Tran	Phoi							ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active	6269888006				PACE - Nat		C	San Francisco
H9360	Plan Directory Contact for Public Website	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Plan to Plan Reconciliation Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Processor Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Quality Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Reconciliation Contact		Ms.	Ramos	Yeryca		2138081702					yramos@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Recovery Audit Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Surveillance Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	System Contact	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Third Party Administrator (TPA) Liaison	COO	Mr.	Cheng	Jack		2138081709					jacheng@cscla.org	767 N. Hill Street	Suite 400	Los Angeles	CA	90012	12/16/2021	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	User Access Contact	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Utilization Management Contact	PACE Operations Director	Mrs	Tran	Phoi		6269888006					ptran@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9360	Utilization Review Contact	Medical Director	Mr.	Wang	John		6269888006					jowang@cscla.org	726 E. Main St	A	Alhambra	CA	91801	03/24/2025	2026	CHINATOWN SERVICE CENTER	National PACE	www.cscpace.org	National PACE		CHINATOWN SERVICE CENTER	856	Yes	Active					PACE - Nat		C	San Francisco
H9364	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Rd		Tampa	FL	33436	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H9364	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H9364	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H9364	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H9364	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H9364	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H9364	PHR Beneficiary Contact																	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Denver
H9364	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd	Attn: P2P Department	Tampa	FL	33634	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9364	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	06/18/2024	2026	WELLCARE OF MAINE, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9387	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/18/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132063350				PPO - BBA		C	Denver
H9387	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132066534				PPO - BBA		C	Denver
H9387	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8132067152				PPO - BBA		C	Denver
H9387	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	6023080218				PPO - BBA		C	Denver
H9387	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H9387	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active	8337500202				PPO - BBA		C	Denver
H9387	PHR Beneficiary Contact																	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO	Member Services	Centene Corporation	351	Yes	Active	8665498289				PPO - BBA		C	Denver
H9387	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9387	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	SUNFLOWER STATE HEALTH PLAN, INC.	Local CCP	Wellcare	Local PPO		Centene Corporation	351	Yes	Active					PPO - BBA		C	Denver
H9391	Automated TrOOP Balance Transfer Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Backup User Access Contact	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Best Available Evidence Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Bid Primary Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	CAP Report Contact for Public Website	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	CEO - CMS Administrator Contact	CEO	Mrs.	Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	CEO - Senior Official for Contracting	CEO	Mrs.	Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Chief Financial Officer	CEO	Mrs.	Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Chief Operating Officer	CEO	Mrs.	Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Chief Information Officer	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Chief Information Security Officer	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	CMS Casework Communication Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Complaints Tracking Contact	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Contact for Fraud Investigations	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Coordination of Benefits Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Corporate Mailing						3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Customer Service Operations Contact	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	DIR Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Discount Program Payment Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Emergency Part D Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Encounter Data & Risk Adjustment Operations Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Enrollment Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	EOB Transfer Contact	CEO	Mrs.	Beker	Lena		3239381155				8184625854	lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Financial Audit Contact	CEO	Mrs.	Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Financial Reporting Contact	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Formulary Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	General Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Government Relations Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	HIPAA Privacy Officer	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	HIPAA Security Officer	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Interoperability Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	MA Appeals/Grievances Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	MA Claims Processing Contact for Public Website	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Marketing Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Medical Director	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/19/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Medicare Compliance Officer	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Medicare Coordinator	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Medication Therapy Management Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part C Application Contact			Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way, Suite 101		Reseda	CA	91335	04/26/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part D Appeals	Chief Compliance Officer		Beker	Alon							alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending	8183267166				PACE - Nat		C	San Francisco
H9391	Part D Application Contact			Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way, Suite 101		Reseda	CA	91335	04/26/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part D Benefits Contact	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part D Claims Submission Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part D Exceptions Contact	Chief Compliance Officer		Beker	Alon							alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending	8183267166				PACE - Nat		C	San Francisco
H9391	Part D Price File Contact (Back-up)	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part D Price File Contact (Primary)	Corp. Secretary	Mr.	Beker	Alon		3239381155					alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part D Quality Assurance Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Part D Reporting Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Patient Safety Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Payment Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Pharmacy Director	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Pharmacy Network Management Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Pharmacy Technical Help Desk Contact	Chief Compliance Officer		Beker	Alon							alon@roseroomhospice.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending	8183267166				PACE - Nat		C	San Francisco
H9391	Plan Directory Contact for Public Website	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Plan to Plan Reconciliation Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Processor Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Quality Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Reconciliation Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Recovery Audit Contact	CEO	Mrs.	Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Surveillance Contact	CEO	Mrs.	Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	System Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Third Party Administrator (TPA) Liaison	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	User Access Contact	CEO		Beker	Lena		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Utilization Management Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9391	Utilization Review Contact	Chief Medical Officer		Cartmel DO	Ana		3239381155					lena@rozeroom.org	18107 Sherman Way Suite 101		Reseda	CA	91335	06/20/2023	2026	ROZE ROOM PACE, INC.	National PACE	Roze Room PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9411	Automated TrOOP Balance Transfer Contact	Program Director		Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	Suite 200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Backup User Access Contact	CEO		Ko	David	S	8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Best Available Evidence Contact	CEO		Ko	David	S	8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Bid Primary Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	CAP Report Contact for Public Website	Program Director		Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	CEO - CMS Administrator Contact	CEO	Mr.	Ko	David	S	8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	CEO - Senior Official for Contracting	CEO	Mr.	Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Chief Financial Officer	CFO	Mrs.	Ko	Audrey		8888041118					audrey.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/04/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Chief Operating Officer	COO	Ms.	Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Chief Information Officer	Program Director	Ms.	Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Chief Information Security Officer	CEO	Mr.	Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	CMS Casework Communication Contact	CEO	Mr.	Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Complaints Tracking Contact	CCO	Mr	Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	Suite 200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Contact for Fraud Investigations	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Coordination of Benefits Contact	Executive Director	Ms.	Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Corporate Mailing						8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Customer Service Operations Contact	General Manager	Mr.	Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	DIR Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Discount Program Payment Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Emergency Part D Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Encounter Data & Risk Adjustment Operations Contact	Executive Director		lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Enrollment Contact	General Manager	Mr.	Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	EOB Transfer Contact	General Manager	Mr.	Lee	Daniel		8888041118				2135969119	daniel.lee@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Financial Audit Contact	CEO	Mr.	Ko	David	S	8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/09/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Financial Reporting Contact	CFO	Mrs.	Ko	Audrey	W	8888041118					audrey.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/04/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Formulary Contact	CEO		Ko	David	S	8888041118					david.ko@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	General Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	06/05/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Government Relations Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	HIPAA Privacy Officer	CEO		Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	06/05/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	HIPAA Security Officer	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Interoperability Contact	CEO		Ko	David		8888041118					ahhc.ceo@gmail.com	1818 S. Western Ave,  Suite 100		Los Angeles	CA	90006	10/02/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	MA Appeals/Grievances Contact	Executive Director	Ms.	Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	MA Claims Processing Contact for Public Website	CEO		Ko	David		8888041118					ahhc.ceo@gmail.com	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	09/30/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Marketing Contact	General Manager	Mr.	Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Medical Director		Dr.	Tracy	Robert		8888041118					robert.tracy@heritagepace.org	1818 S. Western Ave	#100	Los Angeles	CA	90006	11/28/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Medicare Compliance Officer	CEO	Mr.	Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave		Los Angeles	CA	90006	06/05/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Medicare Coordinator	General Manager	Mr.	Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave		Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Medicare Part D Opioid Overutilization Contact		Dr.	Tracy	Robert		8888041118					robert.tracy@heritagepace.org	1818 S. Western Ave		Los Angeles	CA	90006	11/28/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Medication Therapy Management Contact		MD	Tracy	Robert		8888041118					robert.tracy@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	11/28/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part C Application Contact			Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part D Appeals			Ko	David							david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active	2135969119				PACE - Nat		C	San Francisco
H9411	Part D Application Contact			Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave		Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part D Benefits Contact	Executive Director		Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part D Claims Submission Contact	General Manager		Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part D Exceptions Contact	CEO		Ko	David							david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active	2135969119				PACE - Nat		C	San Francisco
H9411	Part D Price File Contact (Back-up)	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part D Price File Contact (Primary)	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part D Quality Assurance Contact	CEO		Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Part D Reporting Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Patient Safety Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Payment Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Pharmacy Director		Dr.	Tracy	Robert		8888041118					robert.tracy@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	11/28/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Pharmacy Network Management Contact		Dr.	Tracy	Robert		8888041118					robert.tracy@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	11/28/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Pharmacy Technical Help Desk Contact			Ko	David							david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active	2135969119				PACE - Nat		C	San Francisco
H9411	Plan Directory Contact for Public Website	General Manager	Mr.	Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Plan to Plan Reconciliation Contact	Executive Director		Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Processor Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Quality Contact	Executive Director	Mr.	Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Reconciliation Contact	General Manager	Mr.	Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Recovery Audit Contact	CEO	Mr.	Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	06/05/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Surveillance Contact	CEO		Ko	David		8888041118					david.ko@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	System Contact	General Manager	Mr.	Lee	Daniel		8888041118					daniel.lee@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Third Party Administrator (TPA) Liaison	CEO		Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	Suite 100	Los Angeles	CA	90006	06/05/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	User Access Contact	Executive Director		Lau	Pablo		8888041118					pablo.lau@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/06/2024	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Utilization Management Contact	Executive Director	Ms.	Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	#200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9411	Utilization Review Contact	Executive Director	Ms.	Kim	Audrey		8888041118					audrey.kim@heritagepace.org	1818 S. Western Ave	Suite 200	Los Angeles	CA	90006	12/15/2025	2026	1818 WESTERN, LLC	National PACE	HeritAge PACE	National PACE		1818 WESTERN LLC	858	Yes	Active					PACE - Nat		C	San Francisco
H9412	Agent/Broker Compensation Data Contact	Manager, Sales Operations	Ms.	Martz	Andrea	L	5705094265					amartz3@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223910	12/21/2021	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Automated TrOOP Balance Transfer Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Backup User Access Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Best Available Evidence Contact	Director, Health Plan Operations - Enrollment	Ms.	Felix	Noelle	C	5702149270					ncfelix@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Bid Audit Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Bid Audit Site Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Bid Primary Contact	VP, Government Programs	Ms.	Mastrandrea	Mary		4103037972					mmastrandrea@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/31/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Torrey	Sue		5702042180					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	CEO - Senior Official for Contracting	President, Geisinger Health Plan	Ms.	Murphy	Karen		5702718777					kmurphy12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	02/05/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Chief Financial Officer	Chief Financial Officer, Geisinger Health Plan	Mr.	Mccullough	Mark		5702143200					mmccullough2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	04/29/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Chief Operating Officer	Chief Operating Officer	Ms.	Torrey	Sue		5702143679					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/19/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Chief Information Officer	Chief Information Officer	Mr.	Bennett	Daniel		5702143120					drbennett@geisinger.edu	Geisinger Health System	100 N. Academy Aveneu	Danville	PA	178223025	10/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Chief Information Security Officer	Chief Information Security Officer	Mr.	Gable	Zachary	A	5702142452					zagable@geisinger.edu	Geisinger Information Security Office	100 N. Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	CMS Casework Communication Contact	Senior Appeals Coordinator		Fracalossi	Kathleen		5702144533					kmfracalossi@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/21/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Complaints Tracking Contact	Senior Appeals Coordinator		Fracalossi	Kathleen		5702144533					kmfracalossi@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/21/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Contact for Fraud Investigations	Manager Program Integrity	Ms.	Coslett	Kathy	B	5702140639					kbcoslett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Coordination of Benefits Contact	Supervisor, Health Plan COB	Ms.	Corrall	Theresa		5702145414					COB@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223251	03/19/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Corporate Mailing						5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Customer Service Operations Contact	Director, Health Plan Operations, Customer Care	Mr.	Sanders	John	R	5702148046					jrsanders@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	DIR Contact	Pharmacy Data Analyst Lead	Ms.	Bertollo	Krista	L	5702145059				5702146768	klbertollo@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	DIR Contact (Secondary)	Manager, Pharmacy Data and Reporting	Ms.	Chesnick	Candy		5702715555	59687			5702146768	cjchesnick@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Discount Program Payment Contact	Manager	Mr.	Merkel	Patrick	W	5702144692				5702144692	pwmerkel@thehealthplan.com	Geisinger Health Plan, Federal Government Programs	100 North Academy Avenue	Danville	PA	17822	02/11/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Emergency Part D Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/26/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Emergency Part D Contact (Secondary)	Chief Operating Office	Ms.	Torrey	Sue		5702042180					storrey@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/26/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Encounter Data & Risk Adjustment Operations Contact	Actuarial Director		Trafton	Kristina	L	5702145043					kltrafton@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223225	10/29/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Enrollment Contact	Director, Health Plan Operations - Enrollment	Ms.	Felix	Noelle	C	5702149270					ncfelix@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	EOB Transfer Contact	Pharmacy Data Analyst Lead	Ms.	Bertollo	Krista		5702145059				5702146768	EOBP2P@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Financial Audit Contact	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Financial Reporting Contact	VP Financial Reporting and Operations	Mr.	Teska	Christophe	S	5702146766					csteska@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223251	04/17/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Formulary Contact	Medicare Pharmacy Coordinator	Dr.	Astleford	Leslie		5702141230				5702146768	lastleford@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	05/29/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Formulary Contact (Secondary)	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702146597				5702146768	tsponenberg@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	05/01/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	General Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Government Relations Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	HIPAA Privacy Officer	Chief Privacy Officer	Mr.	Friesen, JD	Jonathan	R	5702716525					jfriesen@geisinger.edu	Geisinger Privacy Office	100 North Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	HIPAA Security Officer	Chief Privacy Officer	Mr.	Friesen, JD	Jonathan	R	5702716525					jfriesen@geisinger.edu	Geisinger Privacy Office	100 North Academy Avenue Mail Code 40-38	Danville	PA	178223003	07/25/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Hospice Contact	Claims and Benefits Auditor, GHP Pharmacy	Ms.	Seabrook	Naiki	A	5702147851				5703002122	naseabrook@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Interoperability Contact	Sr. Director Information Technology	Mr.	Niedjaco	Felix	C	5708088538					fcniedjaco@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223911	03/23/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	MA Appeals/Grievances Contact	Director, Member Resolution Team	Ms.	Piepszowski	BethAnn		5702717166				5702717225	bapiepszowski@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	10/31/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	MA Claims Processing Contact for Public Website	Manager GHP Customer Service Operations/Claims	Ms.	George	Karen	M	5702140876					kmgeorge@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	12/22/2021	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Marketing Contact	Sr. Director, Health Plan Marketing	Ms.	Kimberland	Kelly		4122983841				5702717218	kkimberland@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Medical Director	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Medicare Coordinator	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Medicare Part D Opioid Overutilization Contact	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702146597					tsponenberg@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	06/02/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Medication Therapy Management Contact	Health Plan Pharmacist	Dr.	Scheib	Kristen		5702149238					kmscheib@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	OffShore Subcontractor Contact	Associate Vice President Legal Counsel	Mr.	Davis	F. Kelly		5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan Legal Services	100 N. Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Online Enrollment Center Contact (Back-up)	Supervisor Customer Service	Ms.	Biehl	Lori		5708082168					lbiehl@thehealthplan.com	Geisinger Health Plan Enrollment	100 N. Academy Avenue	Danville	PA	178222580	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Online Enrollment Center Contact (Primary)	Manager Customer Service Operations	Mr.	D'Elia	Russell		5708085038					rdelia@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178222580	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part C Application Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435					krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/26/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part C Reporting Contact	Operations Specialist	Ms.	Utt	Bobbi	J	5702146718				5702148921	bjutt@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Appeals	Manager, Pharmacy Cust. Srvc.	Ms	Bitler	Jessie	M						jmbitler@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/30/2020	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8009884861				PPO - BBA		C	Dallas
H9412	Part D Application Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435				5702148921	krwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	12/26/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Benefits Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Claims Submission Contact	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K	5702149379				5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223229	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Exceptions Contact	Director, Pharmacy Services	Dr.	Miller	Jamie						5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/22/2017	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8009884861				PPO - BBA		C	Dallas
H9412	Part D Exceptions Contact (Secondary)	Manager, Medicare Pharmacy Operations	Dr.	Bender	Kristen	K					5702146768	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8009884861				PPO - BBA		C	Dallas
H9412	Part D Price File Contact (Back-up)	Medicare Pharmacist	Dr.	Sponenberg	Todd		5702145059				5702146597	tsponenberg@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	10/29/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Price File Contact (Optional)			Plan Finder	Navitus		5122313140					Plan.Finder@navitus.com	361 Integrity Drive		Madison	WI	53717	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Price File Contact (Primary)	Manager, Government Programs Pharmacy Operations	Dr.	Bender	Kristen		5702715555	59687			5702149379	kkbender@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17821	07/10/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Quality Assurance Contact	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Part D Reporting Contact	Operations Specialist	Ms.	Utt	Bobbi	J	5702146718				5702148921	bjutt@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	09/22/2015	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Patient Safety Contact	Chief Medical Officer	Dr.	Bulger, DO, MBA	John		5702147020				5702715268	jbulger@geisinger.edu	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223008	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Payment Contact	Actuarial Director		Trafton	Kristina	L	5702145043					kltrafton@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223225	10/29/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Pharmacy Director	Director, Pharmacy Services	Dr.	Miller	Jamie		5702715730				5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/22/2017	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Pharmacy Network Management Contact	VP, Network Management, Navitas	Ms.	Santos	Christina		6088204408					Christina.Santos@navitus.com	Navitus	361 Integrity Drive	Madison	WI	53717	01/02/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Services	Dr.	Miller	Jamie		5702715730				5702146768	jlmiller12@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223245	12/22/2017	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts	Ms	Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus	1025 West Navitus Drive	Appleton	WI	54913	01/02/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active	8662703877	4224			PPO - BBA		C	Dallas
H9412	Physician Incentive Contact	Manager, Provider Management	Ms.	Profit	Massiel		5704920147					mprofit@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	08/01/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Plan Directory Contact for Public Website	Geisinger Health Plan		Care	Customer		5704989731				5702715871	ghp_customer+service@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223229	11/13/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Plan to Plan Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	eobp2p@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	10/31/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Processor Contact	Manager, Technical Operations, Part D Claims	Mr.	Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus	1025 West Navitus Drive	Appleton	WI	54913	01/02/2024	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Quality Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Reconciliation Contact	Manager, Government Programs	Mr.	Merkel	Patrick		5702144692				5702141367	pwmerkel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	02/22/2021	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Reconciliation Contact (Secondary)	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Recovery Audit Contact	Associate Vice President Legal Counsel	Mr.	Davis	F Kelly		5702716836				5702145305	fkdavis@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	05/17/2023	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	SNP Application Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435				5702718921	kwright2@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	SNP State Contact	Director, Federal Government Programs	Mr.	Malett	Terry	L	5702142193					tlmalett@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/24/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Surveillance Contact	Medicare Compliance Officer	Ms.	Marine	Deborah		2487563771					dlmarine@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	06/12/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	System Contact	Technical Analyst Lead		Sholder	Richard	J	5702717895				5702715162	rjsholder@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	07/25/2022	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Third Party Administrator (TPA) Liaison	PDE/Part D Analyst	Mr.	Baylor	Blaze	A	5702144692				5702141367	babaylor1@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	17822	02/11/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	User Access Contact	Data Analyst	Ms.	Wright	Kelly	R	5702146435				5702148921	kwright@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	01/30/2025	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Utilization Management Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9412	Utilization Review Contact	Sr. Director, Medical Management	Mr.	Hummel	Eric		5702146405					ehummel@thehealthplan.com	Geisinger Health Plan	100 North Academy Avenue	Danville	PA	178223220	11/01/2019	2026	GEISINGER QUALITY OPTIONS, INC.	Local CCP	Geisinger Gold	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9431	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/30/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/02/2020	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/24/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	2244768116				PPO - BBA		C	Atlanta
H9431	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	7132085765				PPO - BBA		C	Atlanta
H9431	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4692435213				PPO - BBA		C	Atlanta
H9431	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	4125803128				PPO - BBA		C	Atlanta
H9431	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active	8002386279				PPO - BBA		C	Atlanta
H9431	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	01/25/2018	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9431	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	Local CCP	Aetna Medicare	Local PPO		CVS Health Corporation	49	Yes	Active					PPO - BBA		C	Atlanta
H9434	Part C Application Contact			Monize	Alexis		7746448185					venturesaeg@gmail.com	202 Pleasant Street		Rehoboth	MA	02769	11/30/2025	2026	AEG VENTURES, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9434	Part D Application Contact			Monize	Alexis		7746448185					venturesaeg@gmail.com	202 Pleasant Street		Rehoboth	MA	02769	11/30/2025	2026	AEG VENTURES, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9438	Automated TrOOP Balance Transfer Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Backup User Access Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Best Available Evidence Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Bid Primary Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	CAP Report Contact for Public Website	PACE Operations Director	Ms	Lefort	Chris		6205045917				6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	CEO - CMS Administrator Contact	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	CEO - Senior Official for Contracting	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Chief Financial Officer	CFO	Mr.	Schrag	Jerol		3162842900				3162840173	jerols@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Chief Operating Officer	PACE Operations Director	Ms	Lefort	Chris		6205045917				6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Chief Information Officer	IT Director	Mr.	Hardesty	Bryan		3168364852					bryanh@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/07/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Chief Information Security Officer	IT Director	Mr.	Hardesty	Bryan		3168364852					bryanh@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/07/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	CMS Casework Communication Contact	PACE Operations Director	Ms.	Lefort	Chris		6205045917				6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Complaints Tracking Contact	QAPI Coordinator		Hilburn	Sandy		6205045901				6245045674	sandyh@bluestemks.org	113 South Ash		McPherson	KS	67460	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Contact for Fraud Investigations	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Coordination of Benefits Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Corporate Mailing						6205045900				6205045674	justinl@bluestemks.org	113 South Ash St		McPherson	KS	67460	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Customer Service Operations Contact	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	DIR Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	DIR Contact (Secondary)	CFO		Schrag	Jerol		3168364827				3162840173	jerols@bluestemks.org	3001 Ivy Dr		North Newton	KS	67117	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Discount Program Payment Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/07/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Emergency Part D Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Emergency Part D Contact (Secondary)	PACE Operations Director	Ms	Lefort	Chris		6205045917				6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Encounter Data & Risk Adjustment Operations Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	113 South Ash St		McPherson	KS	67460	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Enrollment Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	EOB Transfer Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Financial Audit Contact	PACE Director of Accounting	Ms.	Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Financial Reporting Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Formulary Contact	Medical Director	Dr.	Casimir	Jon		6205045908				6205045678	jonc@bluestemks.org	113 South Ash		McPherson	KS	67460	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	General Contact	Exec Director	Ms	Rains	Emilie		6205045900				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Government Relations Contact	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	HIPAA Privacy Officer	CFO		Schrag	Jerol		3162842900				3162840173	jerols@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	HIPAA Security Officer	CFO		Schrag	Jerol		3162842900				3162840173	jerols@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Interoperability Contact	PACE Operations Director		Lefort	Christina		6205045900					christinal@blustemks.org	113 South Ash		McPherson	KS	67460	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	MA Appeals/Grievances Contact	QAPI Coordinator		Hilburn	Sandy		6205045901				6245045674	sandyh@bluestemks.org	113 South Ash		McPherson	KS	67460	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	MA Claims Processing Contact for Public Website	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Marketing Contact	Marketing/Intake Director		Rains	Emilie		6205045919				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/01/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Medical Director	Medical Director	Dr.	Casimir	Jon		6205045908				6205045678	jonc@bluestemks.org	113 South Ash		McPherson	KS	67460	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Medicare Compliance Officer	Accountant	Ms	Morgan	Traci		6203273404				6203274262	tracim@bluestem.org	3001 Ivy Drive		North Newton	KS	67117	12/15/2025	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Medicare Coordinator	PACE Operations Director	Ms	Brumleu	Kim		6205045916				6205045674	kimb@bluestem.org	113 South Ash		McPherson	KS	67460	12/11/2025	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Casimir	Jon		6205045908				6205045678	jonc@bluestemks.org	113 South Ash		McPherson	KS	67460	03/20/2019	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Medication Therapy Management Contact	Medical Director	Dr.	Casimir	Jon		6205045908				6205045674	jonc@bluestemks.org	113 South Ash		McPherson	KS	67460	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Online Enrollment Center Contact (Optional)	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Online Enrollment Center Contact (Primary)	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part C Application Contact	Exec Director	Ms	Rains	Emilie		6205045900				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part D Appeals	PACE Director of Accounting		Conner	Dee						3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active	8445887223				PACE - Nat		C	San Francisco
H9438	Part D Appeals Contact (Secondary)	PACE Operations Director	Ms	Lefort	Chris						6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active	8445887223				PACE - Nat		C	San Francisco
H9438	Part D Application Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part D Benefits Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part D Claims Submission Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part D Exceptions Contact	PACE Director of Accounting		Conner	Dee						3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active	8008364880				PACE - Nat		C	San Francisco
H9438	Part D Exceptions Contact (Secondary)	PACE Operations Director	Ms	Lefort	Chris						6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active	8445887223				PACE - Nat		C	San Francisco
H9438	Part D Price File Contact (Back-up)	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part D Price File Contact (Primary)	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part D Quality Assurance Contact	QAPI Coordinator		Hilburn	Sandy		6205045901				6245045674	sandyh@bluestemks.org	113 South Ash		McPherson	KS	67460	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Part D Reporting Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Patient Safety Contact	QAPI Coordinator		Hilburn	Sandy		6205045901				6245045674	sandyh@bluestemks.org	113 South Ash		McPherson	KS	67460	04/19/2022	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Payment Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Personal Health Record Contact	PACE Operations Director	Ms	Lefort	Chris		6205045917				6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Pharmacy Director	Medical Director	Dr.	Casimir	Jon		6205045908				6205045674	jonc@bluestemks.org	113 South Ash		McPherson	KS	67460	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Pharmacy Network Management Contact	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Pharmacy Network Management Contact (Secondary)	PACE Operations Director	Ms	Lefort	Chris		6205045917				6205045674	christinal@bluestemks.org	113 South Ash		McPherson	KS	67460	01/27/2017	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Pharmacy Technical Help Desk Contact			Schrag	Jerol						3162840173	jerols@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	07/15/2015	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active	3162842900				PACE - Nat		C	San Francisco
H9438	Plan Directory Contact for Public Website	Exec Director	Ms	Rains	Emilie		6205045900				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Plan to Plan Reconciliation Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Processor Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Quality Contact			Hilburn	Sandy		6205045901				6245045674	sandyh@bluestemks.org	113 South Ash		McPherson	KS	67460	03/23/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Reconciliation Contact	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Recovery Audit Contact	PACE Director of Accounting	Ms.	Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Surveillance Contact	Exec Director	Ms	Rains	Emilie		6205045950				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	System Contact	Exec Director	Ms	Rains	Emilie		6205045900				6205045674	emilier@bluestemks.org	113 South Ash		McPherson	KS	67460	08/02/2023	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Third Party Administrator (TPA) Liaison	PACE Director of Accounting		Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	3001 Ivy Drive		North Newton	KS	67117	03/07/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	User Access Contact	PACE Director of Accounting	Ms	Conner	Dee		3168364880				3168364250	deeannac@bluestemks.org	113 South Ash		McPherson	KS	67460	10/07/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Utilization Management Contact	Medical Director	Dr.	Casimir	Jon		6205045908				6205045674	jonc@bluestemks.org	113 South Ash		McPherson	KS	67460	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9438	Utilization Review Contact	Medical Director	Dr.	Casimir	Jon		6205045908				6205045674	jonc@bluestemks.org	113 South Ash		McPherson	KS	67460	03/02/2016	2026	BLUESTEM PACE, INC.	National PACE	Bluestem PACE	National PACE		Bluestem Communities, Inc.	645	Yes	Active					PACE - Nat		C	San Francisco
H9460	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H9460	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H9460	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H9460	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H9460	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H9460	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H9460	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9460	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9468	Automated TrOOP Balance Transfer Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Backup User Access Contact	Director of Training and Operational Development		Sheeder	Shelby		8145927615					shelby.sheeder@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Best Available Evidence Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Bid Primary Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	CAP Report Contact for Public Website	VP, Controller		Williams	kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Atlanta
H9468	CEO - CMS Administrator Contact	Interim CEO	Mr.	Worland	Craig		8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	CEO - Senior Official for Contracting	Interim CEO	Mr.	Worland	Craig		8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Chief Financial Officer	CFO	Mr.	Phillips	Jeff		8144565433					jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Chief Operating Officer	Chief Operating Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	09/09/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Chief Information Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Chief Information Security Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	CMS Casework Communication Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Complaints Tracking Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Contact for Fraud Investigations	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Coordination of Benefits Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Corporate Mailing						8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Customer Service Operations Contact	Chief Operating Officer		Worland	Craig	M	8144565433					craig.worland@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	DIR Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	DIR Contact (Secondary)	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Discount Program Payment Contact	CFP		Phillips	Jeffrey		4127205118					Jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Emergency Part D Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Emergency Part D Contact (Secondary)	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Encounter Data & Risk Adjustment Operations Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Enrollment Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	EOB Transfer Contact	Director Revenue Cycle		Toward	Karrie		8144565433				8144542500	Karrie.Toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Financial Audit Contact	VP, Controller	Ms.	Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Financial Reporting Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Formulary Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Formulary Contact (Secondary)	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	General Contact	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Government Relations Contact	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	HIPAA Privacy Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	HIPAA Security Officer	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Interoperability Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	MA Appeals/Grievances Contact	Chief Compliance Officer	Mrs	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	MA Claims Processing Contact for Public Website	Director of Network & Special Projects		Feldmann	William		8144565433					william.feldmann@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Marketing Contact	VP, Marketing and Intakes		Campbell	Marcie		8144565433					Marcie.Campbell@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Medical Director	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Medicare Coordinator	Chief Quality Officer		Lyons	Laura		8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Medicare Part D Opioid Overutilization Contact	Chief Compliance Officer		Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Medication Therapy Management Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part C Application Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part D Appeals	VP, Controller		Williams	Kelly							kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Atlanta
H9468	Part D Appeals Contact (Secondary)	Chief Compliance Officer		Kennedy	Jennifer						8144542500	jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8444565433				PACE - Nat		C	Atlanta
H9468	Part D Application Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part D Benefits Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part D Claims Submission Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part D Exceptions Contact	Medical Director	Dr.	Rummel	James							james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Atlanta
H9468	Part D Exceptions Contact (Secondary)	Chief Compliance Officer		Kennedy	Jennifer							jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Atlanta
H9468	Part D Price File Contact (Back-up)	CFO		Phillips	Jeff		8144565433					jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part D Price File Contact (Primary)	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part D Quality Assurance Contact	Chief Compliance Officer		Kennedy	Jennifer	M	8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Part D Reporting Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Patient Safety Contact	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Payment Contact	Director of Revenue		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Personal Health Record Contact	Chief Compliance Officer		Kennedy	Jennifer		8144565433					jennifer.kennedy@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Pharmacy Director	Medical Director	Dr.	Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Pharmacy Network Management Contact	Director of Network & Special Projects		Feldmann	William		8144565433					wfeldmann@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Pharmacy Network Management Contact (Secondary)	Medical Director		Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Pharmacy Technical Help Desk Contact	VP, Controller		Williams	Kelly							kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Atlanta
H9468	Pharmacy Technical Help Desk Contact (Secondary)	Director of Network & Special Projects		Feldmann	William							william.feldmann@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active	8144565433				PACE - Nat		C	Atlanta
H9468	Plan Directory Contact for Public Website	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Plan to Plan Reconciliation Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Processor Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Quality Contact	Chief Quality Officer		Lyons	Laura	M	8144565433					Laura.lyons@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Reconciliation Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Reconciliation Contact (Secondary)	CFO		Phillips	Jeff		8144565433					jphillips@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Recovery Audit Contact	VP, Controller	Mrs.	Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Surveillance Contact	VP, Marketing and Intake		Campbell	Marcie		8144565433					Marcie.Campbell@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	System Contact	Director Revenue Cycle		Toward	Karrie		8144565433					karrie.toward@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Third Party Administrator (TPA) Liaison	CFO		Phillips	Jeffrey		4127205118					Jeffrey.phillips@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	User Access Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Utilization Management Contact	VP, Controller		Williams	Kelly		8144565433					kelly.williams@oneseniorcare.com	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9468	Utilization Review Contact	Medical Director		Rummel	James		8144565433					james.rummel@lifenwpa.org	100 State Street	Suite 200	Erie	PA	16507	06/25/2025	2026	ONE SENIOR CARE KENTUCKY, LLC	National PACE	Mountain View PACE	National PACE		One Senior Care, Inc.	553	Yes	Active					PACE - Nat		C	Atlanta
H9485	Agent/Broker Compensation Data Contact	VP, Sales		Gabryjelski	Andre		9783608216					agabryjelski@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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	Automated TrOOP Balance Transfer Contact	Vice President, Business Operations		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Backup User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Bid Audit Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Bid Primary Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	01701	02/04/2025	2026	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	CAP Report Contact for Public Website	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	CEO - CMS Administrator Contact	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	CEO - Senior Official for Contracting	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Chief Financial Officer	Ms	Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Operating Officer	Chief Operations Officer	Mr	Mcormick	Mark		8572823180					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Information Officer	Chief Information Officer	Mr	Bundela	Yogi		8572822863					ybundela@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Information Security Officer	Chief Information Security and Privacy Officer	Mr	Tsuchida	Toby		8572823518					ttsuchida@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Complaints Tracking Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Contact for Fraud Investigations	Director, Special Investigation Unit		Roy	Jessica		6179594150					jroy22@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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		8572829131					cryan17@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Corporate Mailing						8572823348					bbowen1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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		Armstrong	Carolyn		4134270087					carmstrong6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	DIR Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Discount Program Payment Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Emergency Part D Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Vice President, Risk Adjustment		Keefe	Kevin		8572826420					kkeefe6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Enrollment Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	EOB Transfer Contact	Vice President, Business Operations		Malvo	Donovan		8572823015				1111111111	dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Financial Audit Contact	Finance Director	Ms.	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Financial Reporting Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Formulary Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Formulary Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	General Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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		8572823376					jsullivan77@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	HIPAA Privacy Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	HIPAA Security Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Interoperability Contact	Vice President, Legal and Regulatory Affairs		Richardson	Stephanie		5087760489					srichardson1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	MA Appeals/Grievances Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Marketing Contact	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Medical Director	Chief Medical Director	Dr	Yoon	Ed		2074581035					ebyoon@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/03/2025	2026	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		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Coordinator	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Drive		Somerville	MA	02145	02/04/2025	2026	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 Part D Opioid Overutilization Contact	Director, Pharmacy		Gallagher	Angela		8572823348					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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	Medication Therapy Management Contact	Director, Pharmacy		Gallagher	Angela		8572822645					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 C Application Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 C Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Appeals	Director, Appeals and Grievances		Swasey	Andrea							aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active	8004335556	105			PPO - BBA		C	Boston
H9485	Part D Application Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Benefits Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Claims Submission Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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							agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active	8572822493				PPO - BBA		C	Boston
H9485	Part D Price File Contact (Back-up)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Price File Contact (Optional)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	01/09/2024	2026	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 Price File Contact (Primary)	Director, Pharmacy		Gallagher	Angela		8572822438					agallagher1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Quality Assurance Contact	Director, Pharmacy		Gallagher	Angela		8572822438					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Patient Safety Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Payment Contact	Chief Financial Officer		Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Director	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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 Network Management Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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							agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active	8443688732				PPO - BBA		C	Boston
H9485	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen							mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	Mass General Brigham Health Plan, Inc.	Local CCP	Mass General Brigham Health Plan	Local PPO		Mass General Brigham Incorporated	784	Yes	Active	8572825333				PPO - BBA		C	Boston
H9485	Plan Directory Contact for Public Website	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Plan to Plan Reconciliation Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Processor Contact	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Quality Contact	Sr. Director, Clinical Operations		Gargasz	Reagan		2079394468					rgargasz@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	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	Reconciliation Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Recovery Audit Contact	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Surveillance Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	System Contact	Director, Business Systems Configuration		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Third Party Administrator (TPA) Liaison	Lead Financial Analyst		Boyadjian	James		2018323300					jboyadjian@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Utilization Management Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Utilization Review Contact	Director, Utilization Management		Wilson-Smith	Tamisha		2079394468					twilson-smith@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	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	Agent/Broker Compensation Data Contact	Product Coordinator		Armstrong	Chris		8023713250					carmstrong@bcbsvt.com	P.O. Box 186		Montpelier	VT	05601	02/07/2020	2026	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	Automated TrOOP Balance Transfer Contact	Manager, Business Process		Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/14/2022	2026	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	Bid Primary Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director		Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette	TC 1301	Detroit	MI	48226	03/05/2024	2026	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	CEO - CMS Administrator Contact	Plan President	Ms.	Getsie	Pamela		8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	01/06/2025	2026	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	CEO - Senior Official for Contracting	Plan President	Ms.	Getsie	Pamela		8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	04/27/2022	2026	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		2486654348					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	VT	05601	02/07/2020	2026	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 Operating Officer	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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 Information Officer	IT Director II	Mrs.	Krause	Amy		3132256638					akrause@bcbsm.com	600 East Lafayette		Detroit	MI	48826	06/17/2022	2026	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 Information Security Officer	VP Chief Information Security Officer	Mr.	Cieszynski	Brent		3132258766					bcieszynski@bcbsm.com	600 Lafayette East		Detroit	MI	48226	08/22/2022	2026	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	CMMI Model Point of Contact	Vice President	Mr.	Manthey	Michael		2482284724					Mmanthey@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Complaints Tracking Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/28/2022	2026	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		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Corporate Mailing						8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	04/27/2022	2026	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		3132250555					jweber@bcbsm.com	600 East Lafayette		Detroit	MI	48226	11/15/2021	2026	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	DIR Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	DIR Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.Zylstra@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Discount Program Payment Contact	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	Electronic Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Emergency Part D Contact	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	01/04/2023	2026	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	Emergency Part D Contact (Secondary)	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Employer Waiver Contact	Director		Nelson	Jessica		2483209946					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		King	Aleesha		9194303434					aking12@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	04/10/2025	2026	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	Enrollment Contact	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	EOB Transfer Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880				9528375607	Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					bweicker@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Formulary Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Formulary Contact (Secondary)	Manager		Jones	Marini		3135706777					Marini.Jones@emergient.com	1000 Town Center		Southfield	MI	48075	03/05/2024	2026	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	General Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	HIPAA Privacy Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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	HIPAA Security Officer	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					klange@bcbsm.com	600 East Lafayette		Detroit	MI	48226	06/17/2022	2026	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		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/08/2022	2026	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	Interoperability Contact	Manager, Functional Operations		Kingsley	Chris		2484444160					Christopher.kingsley@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	MA Appeals/Grievances Contact	Chief Operating Officer		Hower	Johanna		8048594034					Johanna.Hower@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	MA Claims Processing Contact for Public Website	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Marketing Contact	Plan President	Ms.	Getsie	Pamela		8025053449					Pamela.Getsie@VermontBlueAdvantage.com	P.O. Box 186		Montpelier	VT	05601	04/27/2022	2026	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	Medical Director	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette		Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director, Medicare Advantage Compliance		Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette	TC 1301	Detroit	MI	48226	03/05/2024	2026	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 Part D Opioid Overutilization Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/02/2022	2026	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	Medication Therapy Management Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	06/02/2022	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	05/31/2022	2026	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	Online Enrollment Center Contact (Back-up)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Online Enrollment Center Contact (Optional)	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	Online Enrollment Center Contact (Primary)	Manager		LaMontagne	Amanda		5084399720					amanda.lamontagne@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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 C Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 C Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Appeals	Manager, Pharmacy PA/Appeals		Bricker	Bryce							bryce.m.bricker@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8552075871				HMO - Health Maintenance Organization		C	Chicago
H9489	Part D Appeals Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8003443405	733326			HMO - Health Maintenance Organization		C	Chicago
H9489	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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 Claims Submission Contact	Manager, Business Process		Diaz	Mario		7143172628					OptumRx-SupportServices@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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	Manager, Pharmacy PA/Appeals		Bricker	Bryce							bryce.m.bricker@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8552075871				HMO - Health Maintenance Organization		C	Chicago
H9489	Part D Exceptions Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer							Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	9544985880				HMO - Health Maintenance Organization		C	Chicago
H9489	Part D Price File Contact (Back-up)	Vice President		Siuta	Lori		2242312298					lori.siuta@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Price File Contact (Optional)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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 Price File Contact (Primary)	Sr. Business Analyst, Medicare Operations		Vargas	Danielle		4437101262					danielle.wooten@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Quality Assurance Contact	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/05/2024	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	12/05/2024	2026	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	Payment Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Personal Health Record Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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 Director	Director		Clark	Erica		6167580917					eclark3@bcbsm.com	1000 Town Center		Southfield	MI	48075	12/05/2024	2026	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 Network Management Contact	Sr. Account Manager, Network Account Management		Brown	Casey		6126427367					casey.brown@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	01/11/2023	2026	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 Network Management Contact (Secondary)	Senior Analyst, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.zylstra@emergient.com	1000 Town Center		Southfield	MI	48075	05/31/2022	2026	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	Senior Manager		Villanueva	Juan							Juan.Villanueva@optum.com	11000 Optum Cir		Eden	MN	55344	01/03/2024	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8009038346				HMO - Health Maintenance Organization		C	Chicago
H9489	Pharmacy Technical Help Desk Contact (Secondary)	Senior Manager		Villanueva	Juan							claimsmanager-client-support@optum.com	11000 Optum Cir		Eden	MN	55344	01/03/2024	2026	VERMONT BLUE ADVANTAGE, INC.	Local CCP	Vermont Blue Advantage	HMO/HMOPOS		Blue Cross Blue Shield of Michigan Mutual Ins. Co.	25	Yes	Active	8007887871				HMO - Health Maintenance Organization		C	Chicago
H9489	Physician Incentive Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Plan Directory Contact for Public Website	Director		Nelson	Jessica		8448395122					Jessica.Nelson@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/05/2024	2026	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	Plan to Plan Reconciliation Contact	SVP, Controller		Pisarik	Jason		5177085285					jason.pisarik@emergentholdingsinc.com	200 N. Grand Ave.		Lansing	MI	48901	02/06/2020	2026	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	Processor Contact	Director		Patel	Birju		3136430780					Birju.patel@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	03/06/2024	2026	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	Quality Contact	Medical Director		Yende	Namita		3132259513					Nyende@bcbsm.com	600 East Lafayette	MC 516F	Detroit	MI	48226	03/05/2024	2026	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	Reconciliation Contact	Manager, Pharmacy Operations		Jones	Marini		3135706777					Marini.Jones@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Pharmacy Operations		Zylstra	Jennifer		9544985880					Jennifer.Zylstra@emergient.com	600 East Lafayette		Detroit	MI	48226	03/05/2025	2026	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	Recovery Audit Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	SNP Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Surveillance Contact	Director		Woods	Cheyenne		2484173449					cheyenne.woods@emergient.com	600 East Lafayette	MC 1504	Detroit	MI	48226	12/03/2024	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Accounting Supervisor		Cole	Terrence		2484280228					terrence.cole@emergentholdingsinc.com	200 North Grand Avenue	PO Box 40790	Lansing	MI	48901	12/04/2024	2026	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	User Access Contact	Administrative Assistant		Eddy	Chris		3132683879					CEddy@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/03/2024	2026	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	Utilization Management Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Utilization Review Contact	Managing Director, Medical Management	Dr.	Park	Gerald		2485047408					Gerald.Park@advantasure.com	5 Polaris Way		Aliso Viejo	CA	92656	12/05/2024	2026	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	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H9525	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H9525	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	5133167654				HMO - Health Maintenance Organization		C	Chicago
H9525	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	7577562058				HMO - Health Maintenance Organization		C	Chicago
H9525	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H9525	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS		Elevance Health, Inc.	1	Yes	Active	8333774266				HMO - Health Maintenance Organization		C	Chicago
H9525	PHR Beneficiary Contact																	11/05/2015	2026	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	Local CCP	Anthem Blue Cross and Blue Shield	HMO/HMOPOS	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				HMO - Health Maintenance Organization		C	Chicago
H9525	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Part D Program Manager	Ms.	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Backup User Access Contact	Quality Director	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	01/03/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Best Available Evidence Contact	Quality Director	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	01/03/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Bid Primary Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	CAP Report Contact for Public Website	Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	CEO - CMS Administrator Contact	Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	CEO - Senior Official for Contracting	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Chief Financial Officer	CFO	Mr.	Zamanasky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Townsend center		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Chief Operating Officer	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Chief Information Officer	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Chief Information Security Officer	CEO	Mr.	Sawyer	James		6102336654					James.Sawyer@edenbridgehealth.org	2211 Town center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	CMS Casework Communication Contact	CEO	Mr.	Sawyer	James		5716220555					James.Sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Complaints Tracking Contact	Director of Quality and Compliance	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive, SE		Washington	DC	20020	03/06/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Contact for Fraud Investigations	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Drive SE		washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Coordination of Benefits Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town center drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Corporate Mailing						5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive, SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Customer Service Operations Contact	Vice President and Executive Director	Ms.	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	DIR Contact	Vice President and Executive Director	Ms.	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Wahsington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	DIR Contact (Secondary)	Part D Program Manager	Ms	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Drive SE		Wahsington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Discount Program Payment Contact	Part D Program Manager	Ms	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Emergency Part D Contact	Part D Program Manager	Ms	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Drive SE		Wahsington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Emergency Part D Contact (Secondary)	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Wahsington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Encounter Data & Risk Adjustment Operations Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Drive SE		Wahsington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Enrollment Contact	Vice President and Executive Director	Mr.	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	EOB Transfer Contact	CFO	Mr.	Zamansky	Andrew		7817152394				0000000000	AndrewZ@Elementcare.org	2211 Town  Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Financial Audit Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Drive, SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Financial Reporting Contact	CFO	Mr.	Zamansky	ANdrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Drive, SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Formulary Contact	Part D Program Manager	MS	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Drive, SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	General Contact	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Government Relations Contact	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	HIPAA Privacy Officer	Director of Quality and Compliance	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive, SE		Washington	DC	20020	03/07/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	HIPAA Security Officer	Director of Quality and Compliance		Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive, SE		Washington	DC	20020	03/06/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Interoperability Contact	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	MA Appeals/Grievances Contact	Director of Quality and Compliance	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive, SE		Washington	DC	20020	03/06/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	MA Claims Processing Contact for Public Website	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Marketing Contact	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Medical Director	Chief Medical Officer	Dr.	Schoenburg	Rachel		2024507331					rachel.schoenburg@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Medicare Compliance Officer	Director of Quality & Compliance	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	03/06/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Medicare Coordinator		Mr.	Bailey	Jasmine		2409357120					jasmine.bailey@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Medicare Part D Opioid Overutilization Contact	Chief Medical Officer	Dr.	Schoenburg	Rachel		2024507331					rachel.schoenburg@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Medication Therapy Management Contact	Chief Medical Officer	Dr.	Schoenburg	Rachel		2024507331					rachel.schoenburg@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part C Application Contact	Vice President and Executive Director	Ms.	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Appeals	Part D Program Manager	MS	Dennison	Martha							MDennison@elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active	7819342936				PACE - Nat		C	Philadelphia
H9564	Part D Application Contact	Vice President and Executive Director	Ms.	Saw	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Benefits Contact	Part D Program Manager	Ms	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Claims Submission Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Exceptions Contact	Part D Program Manager	Ms	Dennison	Martha							MDennison@elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active	7819342936				PACE - Nat		C	Philadelphia
H9564	Part D Exceptions Contact (Secondary)	Vice President and Executive Director	Mr	Sawyer	James							james.sawyer@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active	5716220555				PACE - Nat		C	Philadelphia
H9564	Part D Price File Contact (Back-up)	Part D Program Manager	Ms	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Price File Contact (Optional)	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Dr. SE		Wasington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Price File Contact (Primary)	Part D Program Manager	MS	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Quality Assurance Contact	Part D Program Manager	Ms	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Part D Reporting Contact	Part D Program Manager	MS	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Patient Safety Contact	Director of Quality and Compliance	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive, SE		Washington	DC	20020	03/07/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Payment Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Personal Health Record Contact	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Pharmacy Director	Chief Medical Officer	Mr.	Schoenburg	Rachel		2024507331					rachel.schoenburg@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Pharmacy Network Management Contact	Chief Medical Officer	Dr.	Schoenburg	Rachel		2024507331					rachel.schoenburg@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Pharmacy Technical Help Desk Contact	Chief Medical Officer	Dr.	Schoenburg	Rachel							rachel.schoenburg@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active	2024507331				PACE - Nat		C	Philadelphia
H9564	Plan Directory Contact for Public Website	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Plan to Plan Reconciliation Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Processor Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Quality Contact	Director of Quality and Compliance	Ms.	Weeks	Willa		5716220555					willa.weeks@edenbridgehealth.org	2211 Town Center Drive, SE		Washington	DC	20020	03/07/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Reconciliation Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Reconciliation Contact (Secondary)	Part D Program Manager	MS	Dennison	Martha		7819342936					MDennison@elementcare.org	2211 Town Center Drive SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Recovery Audit Contact	CFO	Mr.	Zamansky	Andrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Surveillance Contact	Vice President and Executive Director	Mr	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	System Contact	Vice President and Executive Director	Mr.	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Third Party Administrator (TPA) Liaison	CFO	Mr.	Zamansky	ANdrew		7817152394					AndrewZ@Elementcare.org	2211 Town Center Dr. SE		Washington	DC	20020	12/16/2025	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	User Access Contact	Vice President and Executive Director	Ms.	Sawyer	James		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Drive SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Utilization Management Contact	Vice President and Executive Director	Ms.	Sawyer	james		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9564	Utilization Review Contact	Vice President and Executive Director	Mr	Sawyer	james		5716220555					james.sawyer@edenbridgehealth.org	2211 Town Center Dr. SE		Washington	DC	20020	12/17/2024	2026	PACE4DC LLC	National PACE	PACE4DC LLC	National PACE		Element Care INC.	801	Yes	Active					PACE - Nat		C	Philadelphia
H9572	Agent/Broker Compensation Data Contact	Manager	Mr.	Delaney	Brandon		3134482712					bdelaney@bcbsm.com	600 East Lafayette Blvd.	MC 520J	Detroit	MI	48226	03/16/2022	2026	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	Automated TrOOP Balance Transfer Contact	Manager	Mr.	Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		3132256662					BHall@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	06/17/2022	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2026	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	Bid Primary Contact	Manager		Wilkins	Shannon		2486654009					swilkins@bcbsm.com	600 East Lafayette	MC 1501	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	09/27/2021	2026	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	CEO - CMS Administrator Contact	President and CEO	Mrs.	Keith	Tricia		3132250452					tkeith@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	01/14/2025	2026	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	CEO - Senior Official for Contracting	President and CEO	Mrs.	Keith	Tricia		3132250452					tkeith@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	01/14/2025	2026	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	3132257939					PMozak@bcbsm.com	600 East Lafayette Blvd.	MC 2104	Detroit	MI	48226	03/07/2023	2026	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 Operating Officer	President and CEO	Ms.	Keith	Tricia		3132250452					TKeith@bcbsm.com	600 East Lafayette Blvd.	MC 2000	Detroit	MI	48226	01/14/2025	2026	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 Information Officer	Senior Vice President	Mr.	Fandrich	William		3132255800					Wfandrich@bcbsm.com	600 East Lafayette Blvd.	MC 2010	Detroit	MI	48226	11/15/2019	2026	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 Information Security Officer	Senior Vice President	Mr.	Fandrich	William		3132255800					Wfandrich@bcbsm.com	600 East Lafayette Blvd.	MC 2010	Detroit	MI	48226	11/15/2019	2026	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	Senior Analyst		Whitener	David		3136546885					DWhitener@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/04/2024	2026	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	Complaints Tracking Contact	Senior Analyst		Whitener	David		3136546885					DWhitener@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/04/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48226	07/03/2025	2026	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.	Adams	Ronnie		2486654591					radams@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	01/04/2024	2026	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	Corporate Mailing						2483955887					vpickens@bcbsm.com	600 East Lafayette Blvd.	MC TC1301	Detroit	MI	48226	03/14/2022	2026	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		3132255856					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2026	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	DIR Contact	Manager	Mr.	Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	MC 1309	Detroit	MI	48226	03/07/2023	2026	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	DIR Contact (Secondary)	Senior Healthcare Analyst	Ms.	Desaraju	Vidhya		2486654514					vdesaraju@bcbsm.com	600 East Lafayette Blvd.	MC 1309	Detroit	MI	48226	11/18/2021	2026	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	Discount Program Payment Contact	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette		Detroit	MI	48226	04/21/2025	2026	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	Emergency Part D Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	12/27/2024	2026	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	Emergency Part D Contact (Secondary)	Director	Mrs.	Underhill	Molly		6163753398					MUnderhill@bcbsm.com	600 East Lafayette Blvd.	TC 1300	Detroit	MI	48226	12/28/2020	2026	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	Encounter Data & Risk Adjustment Operations Contact	Managing Dir, MI Risk Adj Ops		King	Aleesha		9194303434					aking12@bcbsm.com	200 N Grand Ave		Lansing	MI	48901	03/17/2025	2026	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	Enrollment Contact	Manager, MA Enrollment Oversight and Defect Manage		Carlisle-Brant	Terrie		3132256881					TBrant@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	08/22/2022	2026	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	EOB Transfer Contact	Manager	Mrs.	Rawson	Lori		6169565796				8773459942	lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	12/27/2021	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	Manager		Ellis	Carol		3132257492					cellis@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/17/2025	2026	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	Formulary Contact	Manager		Siess	Hac		3134480140					hsiess@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	Formulary Contact (Secondary)	Supervisor	Ms.	Lota	Amardeep		2486654537					Alota@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/17/2022	2026	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	General Contact	Compliance Consultant	Ms.	White	Jasmin		2486654235					jwhite4@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/04/2024	2026	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	Managing Director	Ms.	Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	02/23/2024	2026	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	HIPAA Privacy Officer	VP, Enterprise Compliance and Privacy Official	Ms.	Lange	Kelly		3132258554					KLange@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	12/27/2021	2026	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	HIPAA Security Officer	VP, Enterprise Compliance and Privacy Official	Ms.	Lange	Kelly		3132258554					KLange@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	12/27/2021	2026	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		6169565796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Interoperability Contact	Director	Mr.	Kett	James		3132250224					jkett@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	02/11/2022	2026	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	MA Appeals/Grievances Contact	Manager	Ms.	Whetstone	Angela		3132250208				8773482251	AWhetstone@bcbsm.com	P.O. Box 2627		Detroit	MI	48231	01/04/2024	2026	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	MA Claims Processing Contact for Public Website	Manager	Ms.	Findley	Teri		3139830672					Tfindley@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	11/16/2020	2026	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	Marketing Contact	Director		Parrish	Loralie		3135007876					lparrish1@bcbsm.com	600 East Lafayette Blvd.	MC 1401	Detroit	MI	48226	03/05/2024	2026	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	Medical Director	Senior Medical Director	Dr.	Yende	Namita		3132259513					nyende@bcbsm.com	600 East Lafayette Blvd.	MC 516D	Detroit	MI	48226	03/17/2025	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	09/13/2021	2026	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 Part D Opioid Overutilization Contact	Manager		Mates	Bianca		8002874163				8778958667	MedicarePartDOverutilizationMonitoring@bcbsm.com	600 East Lafayette Blvd.	512J	Detroit	MI	48226	12/11/2025	2026	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	Medication Therapy Management Contact	Manager		Pallisco	Amy		2486654777					Apallisco@bcbsm.com	600 East Lafayette	MC 512J	Detroit	MI	48226	07/14/2025	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	10/16/2019	2026	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	Online Enrollment Center Contact (Back-up)	Manager, MA Enrollment Oversight and Defect Manage		Carlisle-Brant	Terrie		3132256881					TBrant@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	08/22/2022	2026	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	Online Enrollment Center Contact (Primary)	Business Systems Analyst Sr		Hall	Barbara		3132256662					BHall@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	06/17/2022	2026	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 C Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 C Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Appeals	Manager		Lewis	Letoretoys						8666014428	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1408	Detroit	MI	48226	03/04/2024	2026	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	8004373803				PPO - BBA		C	Chicago
H9572	Part D Appeals Contact (Secondary)	Supervisor	Ms.	Agnew	Amber						8666014428	dramspriorauthmedicared@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	8004373803				PPO - BBA		C	Chicago
H9572	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Manager	Mrs.	Rawson	Lori		6169565796					lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	11/18/2021	2026	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 Claims Submission Contact	Manager		Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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		Lewis	Letoretoys						8666014428	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1408	Detroit	MI	48226	03/04/2024	2026	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	8004373803				PPO - BBA		C	Chicago
H9572	Part D Exceptions Contact (Secondary)	Supervisor	Ms.	Agnew	Amber						8666014428	dramspriorauthmedicared@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	8004373803				PPO - BBA		C	Chicago
H9572	Part D Price File Contact (Back-up)	Senior Health Care Analyst		McGuire	Donald		2486654548					dmcguire2@bcbsm.com	500 Renaissance Center	512A	Detroit	MI	48243	02/26/2025	2026	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 Price File Contact (Primary)	Manager	Mr.	Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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 Quality Assurance Contact	Director	Ms.	Underhill	Molly		2483955505					munderhill@bcbm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/16/2020	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Director		Connelly	Theresa		2483955529					Tconnelly@bcbsm.com	500 Renaissance Center	505A	Detroit	MI	48243	12/04/2024	2026	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	Payment Contact	Manager		Ellis	Carol		3132257492					cellis@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/17/2025	2026	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 Director	Director	Ms.	Underhill	Molly		6163753398					munderhill@bcbm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/18/2021	2026	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 Network Management Contact	Director		Underhill	Molly		2483955505					munderhill@bcbsm.com	600 East Lafayette Blvd.	TC1308	Detroit	MI	48226	03/04/2024	2026	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 Network Management Contact (Secondary)	Manager	Mrs.	Rawson	Lori		6169565796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Manager	Mr.	Nalamolu	Chandra							hnalamolu@bcbsm.com	600 East Lafayette Blvd	MC 1309	Detroit	MI	48226	12/10/2025	2026	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	8558100007				PPO - BBA		C	Chicago
H9572	Pharmacy Technical Help Desk Contact (Secondary)	Manager	Ms.	Rawson	Lori							lrawson@bcbsm.com	600 East Lafayette Blvd	TC 1309	Detroit	MI	48226	12/10/2025	2026	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	8558100007				PPO - BBA		C	Chicago
H9572	Plan Directory Contact for Public Website	Director	Ms.	Judson	Johanna		8663091719					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2026	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	Plan to Plan Reconciliation Contact	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette Blvd.	Attn: P2P Mail Code 0807 - G Dillard-Brown	Detroit	MI	48226	04/21/2025	2026	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	Processor Contact	Manager		Rawson	Lori		6169565796					LRawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Quality Contact	Director		West	Lynn		2486654621				8773797314	Mwest@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	04/28/2025	2026	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	Reconciliation Contact	Manager		Ellis	Carol		3132257492					cellis@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/12/2025	2026	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	Reconciliation Contact (Secondary)	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette		Detroit	MI	48226	04/21/2025	2026	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	Recovery Audit Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2026	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	SNP Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Surveillance Contact	Director		Crawford	Constance		2486654231					ccrawford@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	06/17/2022	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette		Detroit	MI	48226	04/21/2025	2026	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	User Access Contact	Analyst	Mr.	Teklinski	Greg		2486654284					gteklinski@bcbsm.com	600 East Lafayette Blvd.	MC S140	Detroit	MI	48226	03/16/2022	2026	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	Utilization Management Contact	Director		Szydlowski	Taryn		2487996453					Tszydlowski@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	04/28/2025	2026	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	Utilization Review Contact	Director		Szydlowski	Taryn		2487996453					Tszydlowski@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	04/28/2025	2026	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
H9589	Agent/Broker Compensation Data Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Automated TrOOP Balance Transfer Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Backup User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Bid Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Bid Audit Site Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Bid Primary Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	CAP Report Contact for Public Website	Compliance Director	Ms.	Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Chief Operating Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Chief Information Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Chief Information Security Officer	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	CMMI Model Point of Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Complaints Tracking Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Contact for Fraud Investigations	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Corporate Mailing						8476968500					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway		Park Ridge	IL	60068	10/02/2025	2026	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	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	DIR Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	DIR Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Discount Program Payment Contact	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	Thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Emergency Part D Contact	Chief Executive Officer	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Emergency Part D Contact (Secondary)	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Encounter Data & Risk Adjustment Operations Contact		Ms	Teibowei	Gladys		2142872625					gladys.teibowei@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Enrollment Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	EOB Transfer Contact			Lange	Tracie		8476968503				8008861082	tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Financial Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Financial Reporting Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Formulary Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Formulary Contact (Secondary)	Pharmacy Director		Lopez	Eduardo		7542085867					elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	General Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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	Mr.	Parker	Jim		3179319666					Jim.Parker@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	HIPAA Privacy Officer	Vice President, Compliance	Ms.	Cornish	Sameria		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	HIPAA Security Officer	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539				8555158166	Eric.Annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Hospice Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Interoperability Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	MA Appeals/Grievances Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	MA Claims Processing Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Marketing Contact	VP of Marketing	Ms.	Branco	Margaret		7187957495					margaret.branco@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Medical Director	Medical Director	Dr.	Butt, MD	Tariq		3125458471					tariq.butt@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	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		8432761153					sameria.cornish@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Medicare Coordinator	Compliance Specialist	Ms.	Wilcox	Hailey		8476968503					Hailey.wilcox@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Medicare Part D Opioid Overutilization Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Medication Therapy Management Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3304058084	Elopez@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	OffShore Subcontractor Contact		Mrs.	Lange	Tracie		8476968503				8476923225	Tracie.Lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part C Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part C Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Appeals			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	7148253783				PPO - BBA		C	Chicago
H9589	Part D Application Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Benefits Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867				3308886015	Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Claims Submission Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	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			Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	7148253783				PPO - BBA		C	Chicago
H9589	Part D Price File Contact (Back-up)			Lyman	Dorothy		6514955369					Dorothy.Lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Price File Contact (Optional)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Price File Contact (Primary)			Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Quality Assurance Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Part D Reporting Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Patient Safety Contact	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Payment Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Pharmacy Director	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Pharmacy Network Management Contact			Perez	Felix		3053313044				3053313044	Felix.perez@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Pharmacy Network Management Contact (Secondary)	Vice President, Pharmacy	Mr.	Lopez	Eduardo		7542085867					Elopez@clearspringhealthcare.com	3601 SW 160th Avenue	Suite 450	Miramar	FL	33027	10/02/2025	2026	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	Manager, Pharmacy Help Desk		Villanueva	Juan							juan.villanueva@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	8004611308				PPO - BBA		C	Chicago
H9589	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Help Desk		Bretten	Brad							bradley.betten@optum.com	P.O. Box 2975		Mission	KS	66201	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active	8004611308				PPO - BBA		C	Chicago
H9589	Physician Incentive Contact		Ms.	Wilcox-Lange	Tracie		8476968503				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Plan Directory Contact for Public Website	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Plan to Plan Reconciliation Contact	Senior Accountant	Ms.	Wrenn	Alisa		2249855588				3124290194	Alisa.Wrenn@Clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Processor Contact			Cosey	April		6304533406					April.Cosey@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Quality Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Reconciliation Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Recovery Audit Contact	Chief Financial Officer	Mr.	Wolski	Keith		6302448733				8476923225	Keith.Wolski@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	SNP Application Contact		Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	SNP State Contact		Ms.	Wilcox-Lange	Tracie		8476968502				7735988422	tracie.lange@clearspringhealthcare.com	322 South Green Street	Suite 400	Chicago	IL	60607	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Surveillance Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	System Contact	Vice President, Infrastructure & Development	Mr.	Annafi	Eric		8476968539					eric.annafi@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Third Party Administrator (TPA) Liaison	Finance Manager, Part D Products	Mr.	Wenner	Thomas		7176230783				8476923225	thomas.wenner@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	User Access Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Utilization Management Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9589	Utilization Review Contact	Director, Compliance	Ms.	Wilcox-Lange	Tracie		8476968503					tracie.lange@clearspringhealthcare.com	250 South Northwest Highway	Suite 302	Park Ridge	IL	60068	10/02/2025	2026	CLEAR SPRING HEALTH (GA), INC.	Local CCP	Clear Spring Health	Local PPO		Group 1001	689	Yes	Active					PPO - BBA		C	Chicago
H9590	Agent/Broker Compensation Data Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Automated TrOOP Balance Transfer Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Backup User Access Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Best Available Evidence Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Bid Audit Contact			Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Bid Audit Site Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Bid Primary Contact		Mr.	Granow	Les		5614440709					Les.Granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	CAP Report Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	CEO - CMS Administrator Contact		Mr.	Lerer	Ben		5614440780					Ben.lerer@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	09/25/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	CEO - Senior Official for Contracting		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Chief Financial Officer		Mr.	Granow	Les		5614440709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Chief Operating Officer		Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Chief Information Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Chief Information Security Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	CMS Casework Communication Contact			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Complaints Tracking Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Contact for Fraud Investigations			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Coordination of Benefits Contact		Ms.	Crowl	Lacey		7657921412					Lacey.crowl@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Corporate Mailing						5616901134					compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Customer Service Operations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	DIR Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	DIR Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Discount Program Payment Contact		Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	Longevity Health Plan	485 Madison Avenue Suite 202	New York	NY	10022	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Electronic Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Emergency Part D Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Emergency Part D Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Encounter Data & Risk Adjustment Operations Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Enrollment Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	EOB Transfer Contact		Ms.	Socoski	Beth		5616901134				5616901134	Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Financial Audit Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Financial Reporting Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Formulary Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Formulary Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	General Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Government Relations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	HIPAA Privacy Officer	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	HIPAA Security Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Hospice Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Interoperability Contact	CIO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	MA Appeals/Grievances Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	MA Claims Processing Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Marketing Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Medical Director		Mr.	Orgain	Javette		3127206656					javette.orgain@longevityhealthplan.com	Longevity Health Plan	1611 Church Street	Evanston	IL	60201	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Medicare Compliance Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Medicare Coordinator	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Medicare Part D Opioid Overutilization Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Medication Therapy Management Contact		Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	OffShore Subcontractor Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part C Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part C Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Appeals Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Benefits Contact		Mr.	Latko	Jeff		6363352997					JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		8002040016					Rosario_dovico@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Exceptions Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8002040016				HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Price File Contact (Back-up)	Product Manager Advisor	Ms.	Williams	Stephanie		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Price File Contact (Optional)	Medicare Compliance Director	Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Price File Contact (Primary)	sr mgr, Government Programs		Dolfi	Amanda		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Quality Assurance Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Part D Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Patient Safety Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Payment Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Personal Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Pharmacy Director	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		8002040016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Pharmacy Network Management Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						8882358551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H9590	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Account Manager	Ms.	Lennox	Melyssa							Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	Seattle
H9590	Physician Incentive Contact		Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Plan Directory Contact for Public Website	Medicare Compliance Director	Ms.	Socoski	Beth		8883133609					Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Plan to Plan Reconciliation Contact		Ms.	Ajayi	Bisi		5616328915					bisi.ajayi@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Processor Contact		Mr.	Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Quality Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Reconciliation Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Reconciliation Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Recovery Audit Contact	VP Compliance	Ms.	Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	SNP Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	SNP State Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Surveillance Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	System Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Third Party Administrator (TPA) Liaison	COO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	User Access Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Utilization Management Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9590	Utilization Review Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	Local CCP	Longevity Health	HMO/HMOPOS		Longevity Health Founders, LLC	697	Yes	Active					HMO - Health Maintenance Organization		C	Seattle
H9592	Automated TrOOP Balance Transfer Contact			Lyfoung	Tsuleng		6128072260					tlyfoung@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Backup User Access Contact	CEO		Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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		5125072010					dlongoria@innovativeih.com	2042 Kern Sreet		Fresno	CA	93721	05/21/2021	2026	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	Bid Primary Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	CAP Report Contact for Public Website			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern St.		Fresno	CA	93721	05/17/2024	2026	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	CEO - CMS Administrator Contact		Mr.	Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	CEO - Senior Official for Contracting		Mr.	Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Operating Officer		Mr.	Marouf	Ghanim		5594006420					gmarouf@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Information Officer		Mr.	Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Sreet		Fresno	CA	93721	05/21/2021	2026	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 Information Security Officer		Mr.	Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	Complaints Tracking Contact			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	Contact for Fraud Investigations			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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		9492925586					zshayan@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Corporate Mailing						5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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.	Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	DIR Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	DIR Contact (Secondary)			Lyfoung	Tsuleng		6128072260					tlyfoung@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Discount Program Payment Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Emergency Part D Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Emergency Part D Contact (Secondary)			Lyfoung	Tsuleng		6128072260					tlyfoung@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Encounter Data & Risk Adjustment Operations Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Enrollment Contact			Seita	Steve		5594006420					sseita@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	EOB Transfer Contact			Shayan	Zohreh		9492925586				8776410513	zshayan@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Financial Audit Contact	Vice President of Finance	Mr.	Lyfoung	Tsuleng		6128072260					tlyfoung@innovativeih.com	2042 Kern Street		Fresno	CA	93721	09/24/2025	2026	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	Financial Reporting Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Formulary Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	General Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	HIPAA Privacy Officer			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	HIPAA Security Officer			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	Interoperability Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/10/2022	2026	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	MA Appeals/Grievances Contact			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	MA Claims Processing Contact for Public Website			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	06/08/2021	2026	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	Marketing Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Medical Director			Masatsugu	Miles		5594006420					mmasatsugu@innovativeih.com	2042 Kern Street		Fresno	CA	93721	04/18/2025	2026	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		Ms	Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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 Coordinator			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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 Part D Opioid Overutilization Contact			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	Medication Therapy Management Contact			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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 C Application Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Appeals			Longoria	Daniel							dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active	5125072010				PACE - Nat		C	San Francisco
H9592	Part D Appeals Contact (Secondary)			Elser	Eva							eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active	9495085840				PACE - Nat		C	San Francisco
H9592	Part D Application Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Benefits Contact			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	06/08/2021	2026	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 Claims Submission Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	2026	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active	5125072010				PACE - Nat		C	San Francisco
H9592	Part D Price File Contact (Back-up)			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Price File Contact (Primary)			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Quality Assurance Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Reporting Contact			Longoria	Daniel		5125072010				8776410513	dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Patient Safety Contact			Elser	Eva		9495085840					eelser@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/17/2024	2026	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	Payment Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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 Director			Masatsugu	Miles		9493759308					mmasatsugu@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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 Network Management Contact			Masatsugu	Miles		9493759308					mmasatsugu@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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			Masatsugu	Miles							mmasatsugu@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active	9493759308				PACE - Nat		C	San Francisco
H9592	Plan Directory Contact for Public Website			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	06/08/2021	2026	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	Plan to Plan Reconciliation Contact			Lyfoung	Tsuleng		6128072260					tlyfoung@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Processor Contact			Shayan	Zohreh		9492925586					zshayan@fresnopace.org	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Quality Contact			Vang	Anita		5594006420					anitav@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Reconciliation Contact			Longoria	Daniel		5125072010					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	05/21/2021	2026	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	Recovery Audit Contact	CEO	Mr.	Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Surveillance Contact			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	System Contact			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Third Party Administrator (TPA) Liaison			Lyfoung	Tsuleng		6128072260					tlyfoung@innovativeih.com	2042 Kern Street		Fresno	CA	93721	04/18/2025	2026	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	User Access Contact			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Utilization Management Contact			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	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	Utilization Review Contact			Longoria	Daniel		5594006420					dlongoria@innovativeih.com	2042 Kern Street		Fresno	CA	93721	02/08/2023	2026	INNOVATIVE INTEGRATED HEALTH, INC.	National PACE	Innovative Integrated Health Inc.	National PACE		Innovative Integrated Health, Inc.	710	Yes	Active					PACE - Nat		C	San Francisco
H9615	Agent/Broker Compensation Data Contact	Director, Sales Administration		Sheehy	Cathryn		5189913973					csheehy@mvphealthcare.com	625 State Street		Schenectady	NY	12305	04/15/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Backup User Access Contact	Compliance Coordinator		Carter	Marlo		5189913814					mcarter@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Best Available Evidence Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	RMoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Bid Audit Contact	Sr. Director, Internal Audit		Hillerman	Stephen		5189913995					shillerman@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Bid Audit Site Contact	VP, Acting Chief Actuary		Lombardo	Matt		5189913845				5183882311	mlombardo@mvphealthcare.com	625 State Street		Schenectady	NY	12305	07/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Bid Primary Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	CAP Report Contact for Public Website	Corporate Compliance Officer		Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	CEO - CMS Administrator Contact	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	CEO - Senior Official for Contracting	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Chief Financial Officer	Chief Financial Officer	Ms.	Austen	Karla		5183882357					kausten@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/26/2014	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Chief Operating Officer	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Chief Information Officer	Sr Leader, Information Technology & Transformation	Mr.	Della Villa	Michael		5183882323					mdellavilla@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/22/2020	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Chief Information Security Officer	VP, Office of the CDIO & CISO	Mr.	Swits	David		5189913694					dswits@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/11/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	CMS Casework Communication Contact	Leader, Medicare Appeals		Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Complaints Tracking Contact	Leader, Medicare Appeals		Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Contact for Fraud Investigations	Leader, Special Investigations Unit		Cordato	Rocco		5189010613					rcordato@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Coordination of Benefits Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Corporate Mailing						8006657924					memberservices@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Customer Service Operations Contact	Sr. Leader, Customer Care & Support Services		Greenberg	Melissa		5189913731					mgreenberg@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	DIR Contact	Leader, State & Federal Plan BIlling		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	DIR Contact (Secondary)	Sr. Director, Actuarial		Jaiman	Rajshree		5189913834					rjaiman@mvphealthcare.com	625 State St.		Schenectady	NY	12305	02/28/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Discount Program Payment Contact	Analyst		Bates	Marcus		5853272286					mbates@mvphealthcare.com	625 State St		Schenectady	NY	12305	11/10/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Emergency Part D Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Emergency Part D Contact (Secondary)	Professional, Compliance Coordinator		Dunham	Kristina		5857208250					kdunham@mvphealthcare.com	20 South Clinton Ave		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Encounter Data & Risk Adjustment Operations Contact	Director, Ops Vendor Compliance & Transaction Mgt		Shader	Michelle		5189913778					mshader@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/30/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Enrollment Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	rmoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	EOB Transfer Contact	Director, Pharmacy Management		Colin	Wendy		5858852435				8004010915	wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Financial Audit Contact	Sr. Director, Internal Audit	Mr.	Hillerman	Stephen		5189913995				5188363202	shillerman@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Financial Reporting Contact	Sr. Leader, Accounting & Assistant Controller		Cenzano	Jennifer		5189010623					jcenzano@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Formulary Contact	Professional, Pharmacy Program Management		Berube	Leah		5183951264					lberube@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/17/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Formulary Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	General Contact	Medicare Compliance Officer		Borges	Linda		5189913308					mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/15/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Government Relations Contact	Medicare Compliance Officer		Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	HIPAA Privacy Officer	Corporate Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	HIPAA Security Officer	Corporate Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Hospice Contact	Director, Pharmacy Management		Colin	Wendy		5858852435				8004010915	WColin@mvphealthcare.com	20 S. Clinton Ave		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Interoperability Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	MA Appeals/Grievances Contact	Leader, Medicare Appeals		Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	MA Claims Processing Contact for Public Website	Sr. Leader, Govt Programs, Commercial & IH Claims		Santilli	RJ		5189913775					rsantilli@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Marketing Contact	Sr. Director, Medicare Marketing & Strategic Partn		Regan	Jennifer		5189010772					jregan@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/06/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Medical Director	Chief Medical Officer		Merola	Jason		5853272208					jmerola@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	12/12/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Medicare Coordinator	Leader, Compliance Audits		Barlie	Diana		5189913587					dbarile@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Management		Colin	Wendy		5858852435				8004010915	wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Medication Therapy Management Contact	Leader, Pharmacy Clinical Operations		MacArthur	Carly		5183867483					cmacarthur@mvphealthcare.com	625 State St.		Schenectady	NY	12305	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	OffShore Subcontractor Contact	Sr. Director, Cyber Security and Cyber GRC		Rich	John		5189913674					jrich@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/11/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Online Enrollment Center Contact (Primary)	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	rmoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part C Application Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part C Reporting Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/28/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Appeals	Leader, Medicare Appeals		Allen	Amy						5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	5852588096				PPO - BBA		C	Boston
H9615	Part D Appeals Contact (Secondary)	Compliance Coordinator, Medicare Appeals		Stepnowski	Ashley							astepnowski@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	5857208126				PPO - BBA		C	Boston
H9615	Part D Application Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Benefits Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Claims Submission Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Exceptions Contact	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	5858852435				PPO - BBA		C	Boston
H9615	Part D Exceptions Contact (Secondary)	Leader, Pharmacy Clinical Operations		MacArthur	Carly							cmacarthur@mvphealthcare.com	625 State St		Schenectady	NY	12305	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	5183867483				PPO - BBA		C	Boston
H9615	Part D Price File Contact (Back-up)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Price File Contact (Optional)	Professional, Pharmacy Compliance Coordinator		Dunham	Kristina		5857208250					KDunham@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Price File Contact (Primary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Quality Assurance Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Part D Reporting Contact	Professional, Pharmacy Compliance Coordinator		Dunham	Kristina		5857208250					Kdunham@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Patient Safety Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Payment Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Pharmacy Director	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd. MC 080		Scottsdale	AZ	85260	07/18/2018	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
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	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	8666934620				PPO - BBA		C	Boston
H9615	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active	5858852435				PPO - BBA		C	Boston
H9615	Physician Incentive Contact	VP, Network, Provider Relations and Vendor Mgmt		MacKinnon	Matthew		5858852485					mmackinnon@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Plan Directory Contact for Public Website	Director, Provider Data Management		Santilli	Richard		5189913775					rsantilli@mvphealthcare.com	625 State St		Schenectady	NY	12305	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Plan to Plan Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Processor Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Quality Contact	Sr. Leader, Quality Performance & Reporting		Rocklein	Lisa		5858852510					lrocklein@mvphealthcare.com	20 South Clinton Avenue		rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					YMarcus@mvphealthcare.com	625 State St		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Reconciliation Contact (Secondary)	Sr. Director, Actuarial		Jaiman	Rajshree		5189913834					rjaiman@mvphealthcare.com	625 State St.		Schenectady	NY	12305	02/28/2023	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	SNP Application Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Surveillance Contact	Medicare Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	System Contact	VP, Office of the CDIO & CISO		Swits	David		5189913694					dswits@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Third Party Administrator (TPA) Liaison	Analyst		Bates	Marcus		5853272286					mbates@mvphealthcare.com	625 State St		Schenectady	NY	12305	11/10/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	User Access Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Utilization Management Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9615	Utilization Review Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	Local CCP	MVP HEALTH CARE	Local PPO		MVP Health Care, Inc.	197	Yes	Active					PPO - BBA		C	Boston
H9616	Automated TrOOP Balance Transfer Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Backup User Access Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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		6196624100	4165				Disrael@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Bid Primary Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	CAP Report Contact for Public Website	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	CEO - CMS Administrator Contact	President and CEO	Mr.	Mattson	Kevin		6196624100	6322				kmattson@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	CEO - Senior Official for Contracting	President and CEO	Mr.	Mattson	Kevin		6196624100	6322				kmattson@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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 Operating Officer	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472	3488				vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	01/24/2024	2026	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 Information Officer	VP & CIO	Mr.	Howard	Daniel		6196624100	1941				daniel.howard@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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 Information Security Officer	VP & CIO	Mr.	Howard	Daniel		6196624100	1941				daniel.howard@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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		6196624100	3442				alfredo.ballasteros@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Complaints Tracking Contact	Executive Vice President	Ms.	Dela Rosa	Veronica		6196624100	3459				veronica.delarosa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Contact for Fraud Investigations	Executive Vice President	Ms.	Dela Rosa	Veronica		6196624100	3459				veronica.delarosa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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 Marketing & Enrollment	Mr.	Perez	Gerardo		6192054585					gerardo.perez@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	01/24/2024	2026	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	Corporate Mailing						6196624100					sdpace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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 & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	DIR Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	DIR Contact (Secondary)	Director of Finance/Controller	Ms.	Weisiger	Amy		6192056339					amy.weisiger@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Discount Program Payment Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Emergency Part D Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Emergency Part D Contact (Secondary)	Director of Finance/Controller	Ms.	Weisiger	Amy		6192056339					amy.weisiger@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Encounter Data & Risk Adjustment Operations Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Enrollment Contact	Director, Marketing & Enrollment	Mr.	Perez	Gerardo		6196624100	3578				gerardo.perez@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	03/31/2023	2026	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	EOB Transfer Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472				6192056373	vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Financial Audit Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Financial Reporting Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Formulary Contact	PACE Pharmacy Manager	Ms.	Pham	Kim-Anh		6192054585	4008				kim-anh.pham@syhealth.org	3364 Beyer Blvd.		San Diego	CA	92173	10/26/2023	2026	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	General Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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		6196624100	6378				Amelgoza@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	HIPAA Privacy Officer	Interim Chief Compliance Officer	Ms.	Muller	Beate		6196624100	3492				beate.muller@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	09/29/2025	2026	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	HIPAA Security Officer	Interim Chief Compliance Officer	Ms.	Muller	Beate		6196624100	3492				beate.muller@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	09/29/2025	2026	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	Interoperability Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	MA Appeals/Grievances Contact	Executive Vice President	Ms.	Dela Rosa	Veronica		6196624100	3459				veronica.delarosa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	MA Claims Processing Contact for Public Website	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Marketing Contact	Director, Marketing & Enrollment	Mr.	Perez	Gerardo		6196624100	3578				gerardo.perez@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	03/31/2023	2026	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	Medical Director	CMO	Dr.	Carriedo	Maria		6196624100	4103				Mcarriedo@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Interim Chief Compliance Officer	Ms.	Muller	Beate		6196624100	3492				beate.muller@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	09/29/2025	2026	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 Coordinator	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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 Part D Opioid Overutilization Contact	PACE Pharmacy Manager	Ms.	Pham	Kim-Anh		6192054585	4008				kim-anh.pham@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Medication Therapy Management Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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 C Application Contact	President and CEO	Mr.	Mattson	Kevin		6192056322				6192056373	kmattson@syhealth.ORG	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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 Appeals	CFO	Mr.	Wallace	William	B						brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	6192056339				PACE - Nat		C	San Francisco
H9616	Part D Appeals Contact (Secondary)	Sr. Director of Finance		Thompson	Diana							diana.thompson@syhealth.org	8080 Dagget Street		San Diego	CA	92111	05/07/2025	2026	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	6199625333				PACE - Nat		C	San Francisco
H9616	Part D Application Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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 Benefits Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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 Claims Submission Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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 Manager	Ms.	Pham	Kim-Anh							kim-anh.pham@syhealth.org	3364 Beyer Blvd.		San Diego	CA	92173	10/26/2023	2026	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	6192054585	4008			PACE - Nat		C	San Francisco
H9616	Part D Price File Contact (Back-up)	Director of Finance/Controller	Ms.	Weisiger	Amy		6192056339					amy.weisiger@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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 Price File Contact (Optional)	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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 Price File Contact (Primary)	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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 Quality Assurance Contact	Executive Vice President	Ms.	Dela Rosa	Veronica		6196624100	3459				veronica.delarosa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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 Reporting Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Patient Safety Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Payment Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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 Director	Director of Pharmacy	Ms.	Ochoa	Maricela		6196624100	1611				maricela.ochoa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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 Network Management Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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 & Chief Strategy Officer	Ms.	Todd	Vernita							vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	6199412472				PACE - Nat		C	San Francisco
H9616	Plan Directory Contact for Public Website	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Plan to Plan Reconciliation Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Processor Contact	Director of Revenue Cycle	Mr.	Nubia	Charles		6196624100	4140				charles.nubia@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Quality Contact	Executive Vice President	Ms.	Dela Rosa	Veronica		6196624100	3459				veronica.delarosa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	Reconciliation Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Reconciliation Contact (Secondary)	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Recovery Audit Contact	CFO	Mr.	Wallace	William	B	6192056339					brian.wallace@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	12/06/2019	2026	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	Surveillance Contact	Executive Vice President	Ms.	Dela Rosa	Veronica		6196624100	3459				veronica.delarosa@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	04/14/2022	2026	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	System Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Third Party Administrator (TPA) Liaison	Senior Director of Finance	Ms.	Thompson	Diana		6199625333					diana.thompson@syhealth.org	8080 Dagget Street		San Diego	CA	92111	05/06/2025	2026	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	User Access Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Utilization Management Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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	Utilization Review Contact	Vice President & Chief Strategy Officer	Ms.	Todd	Vernita		6199412472					vernita.todd@syhealth.org	1601 Precision Park Lane		San Diego	CA	92173	10/26/2023	2026	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
H9623	Agent/Broker Compensation Data Contact	Chief Finance Officer	Ms.	Dersch	Sarah		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Automated TrOOP Balance Transfer Contact	Manager Project & Program Management	Ms.	Chesling	Beth		6127774823					EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	11/20/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Backup User Access Contact	Medicare Compliance Manager	Ms.	Gomez-Garcia	Brenda		8054375987					bgomez-garcia@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Best Available Evidence Contact	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Bid Audit Contact	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Bid Primary Contact	CEO	Dr.	Nunez	Felix		8059143747					fnunez@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	06/02/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	CAP Report Contact for Public Website	Chief Compliance Officer	Mr.	Franco	Robert		8059106447					rfranco@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	CEO - CMS Administrator Contact	Chief Compliance Officer	Mr.	Franco	Robert		8059106447					rfranco@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	12/11/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	CEO - Senior Official for Contracting	Chief Executive Officer	Dr.	Nunez	Felix		8054375852					fnunez@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Chief Financial Officer	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Chief Operating Officer	Chief Operating Officer	Ms.	Simcoe	Suma		8058147750					ssimcoe@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	12/11/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Chief Information Officer	Chief Information/System Modernization Officer	Mr.	Torres	Alan		8054375609					atorres@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Chief Information Security Officer	Chief Information/System Modernization Officer	Mr.	Torres	Alan		8054375609					atorres@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	CMS Casework Communication Contact	Medicare Compliance Manager	Ms.	Gomez-Garcia	Brenda		8054375987					bgomez-garcia@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Complaints Tracking Contact	Medicare Compliance Manager	Ms.	Gomez-Garcia	Brenda		8054375987					bgomez-garcia@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Contact for Fraud Investigations	Privacy Officer	Ms.	Warner	Victoria		8054375781					vwarner@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Coordination of Benefits Contact	Sr. Manager, Operations Claims	Mr.	Cooper	Thomas		8054375725					tcooper@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Corporate Mailing						8054375500					communications@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/03/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Customer Service Operations Contact	Sr. Director, Operations	Ms.	Krull	Holly		8056039827					hkrill@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	DIR Contact	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Discount Program Payment Contact	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Emergency Part D Contact	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Encounter Data & Risk Adjustment Operations Contact	Sr. Manager, Medicare Financial Analysis	Mr.	VerHaar	Paul		8054375962					pverhaar@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Enrollment Contact	Chief Member Experience/External Affairs Officer	Ms.	Torres	Marlen		8054375535					mtorrres@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	EOB Transfer Contact	Sr. Manager, Operations Claims	Mr.	Cooper	Thomas		8054375725				8052487641	tcooper@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Financial Audit Contact	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Financial Reporting Contact	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Formulary Contact	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Formulary Contact (Secondary)	Pharmacist Supervisor, Operations - PBM	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	General Contact	Director, Dual Special Needs Plan	Ms.	Marquez-Johnson	Kimberley		8054375944					kmarquez-johnson@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Government Relations Contact	Manager, Government Relations	Ms.	Armstrong	Alison		8054375829					aarmstrong@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	HIPAA Privacy Officer	Privacy Officer	Ms.	Warner	Victoria		8054375781					vwarner@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	HIPAA Security Officer	Director, IT Infrastucture/Security Operations	Mr.	Ortloff	Kevin		8054375532					kortloff@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Hospice Contact	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Interoperability Contact	Director, Business Solutions	Mr.	Kirkpatrick	David		8054375775					dkirkpatrick@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	MA Appeals/Grievances Contact	Director, Operations	Ms.	Luney	Stacy		8054375575					sluney@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	MA Claims Processing Contact for Public Website	Sr. Manager, Operations Claims	Mr.	Cooper	Thomas		8054375725					tcooper@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Marketing Contact	Medicare Marketing/Communications Manager	Ms.	Uchimiya	Karen		8054375500					kuchimiya@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Medical Director	Chief Medical Officer	Dr.	Cruz	James		8054375907					jacruz@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	10/21/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Franco	Robert		8059106447					rfranco@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Medicare Coordinator	Chief Innovation Officer	Ms.	Gelb	Eve		8059143699					egelb@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists - PBM	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Medication Therapy Management Contact	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part C Application Contact	Director, Dual Special Needs Plan	Ms.	Marquez Johnson	Kimberley		8054375944					Kmarquez-johnson@goldchp.org	711 E. Daily	Suite 106	Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part C Reporting Contact	Medicare Compliance Manager	Ms.	Gomez-Garcia	Brenda		8054375987					bgomez-garcia@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part D Appeals	Regulatory Pharmacist - PBM	Mr.	Spears	Scott							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	11/20/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	New York
H9623	Part D Application Contact	Director, Dual Special Needs Plan	Ms.	Marquez Johnson	Kimberley		8054375944					Kmarquez-johnson@goldchp.org	711 E. Daily	Suite 106	Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part D Benefits Contact	Sr. Director, Benefit Operations - PBM	Ms.	Icaza	Ashley		5073018360					ashely.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part D Claims Submission Contact	Health Data Analyst Sr.		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/06/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part D Exceptions Contact	Regulatory Pharmacist Sr.- PBM	Mr.	Spears	Scott							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	CA	93010	11/20/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	New York
H9623	Part D Exceptions Contact (Secondary)	Sr. Audit/Regulatory Pharmacist - PBM	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	New York
H9623	Part D Price File Contact (Back-up)	Quality Assurance Specialist - PBM	Ms.	Tastad	Emily		6127771699					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part D Price File Contact (Primary)	Business Solution Analyst Sr.		Trudeau	Ashley		6127771338					ashley.trudeau@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	11/24/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part D Quality Assurance Contact	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Part D Reporting Contact	Medicare PBM Sr. Operations Manager	Mr.	Davidson	Dean		8059148634					ddavidson@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Patient Safety Contact	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Payment Contact	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Pharmacy Director	Director, Pharmacy	Ms.	Yip	Lily		8054375873					lyip@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Pharmacy Network Management Contact	VP, Network Management		Conlin	Marci		6127772837					marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/06/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr	Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/16/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active	8556819590				HMO - Health Maintenance Organization		C	New York
H9623	Plan Directory Contact for Public Website	Director, Dual Special Needs Plan	Ms.	Marquez-Johnson	Kimberley		8054375944					kmarquez-johnson@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Plan to Plan Reconciliation Contact	Chief Finance Officer	Ms.	Dersch	Sara		8054375918					sdersch@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Processor Contact	Sr. Manager, Operations Claims	Mr.	Cooper	Thomas		8054375725					tcooper@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93003	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Quality Contact	Sr. Director, Quality Improvement	Ms.	Timmerman	Kimberly		8054375533					ktimmerman@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Reconciliation Contact	Controller	Mr.	Register	Jeff		8059109700					jregister@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Recovery Audit Contact	Controller	Mr.	Register	Jeff		8059109700					jregister@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/03/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	SNP Application Contact	Director, Dual Special Needs Plan	Ms.	Marquez-Johnson	Kimberley		8054375944					kmarquez-johnson@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Surveillance Contact	Medicare Marketing/Communications Manager	Ms.	Uchimiya	Karen		8054375500					kuchimiya@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	System Contact	Director, Business Solutions	Mr.	Kirkpatrick	David		8054375775					dkirkpatrick@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Third Party Administrator (TPA) Liaison	Director, Dual Special Needs Plan	Ms.	Marquez-Johnson	Kimberley		8054375500					kmarquez-johnson@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	User Access Contact	Chief Compliance Officer	Mr.	Franco	Robert		8059106447					rfranco@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Utilization Management Contact	Sr. Director, Utilization Management	Ms.	Kanter	Nicole		8054375629					nkanter@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9623	Utilization Review Contact	Sr. Director, Utilization Management	Ms.	Kanter	Nicole		8054375629					nkanter@goldchp.org	711 E. Daily Suite 106		Camarillo	CA	93010	02/18/2025	2026	Ventura County Medi-Cal Managed Care Commission	Local CCP	Gold Coast Health Plan	HMO/HMOPOS		Ventura County Medi-Cal Managed Care Commission	867	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9630	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/18/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H9630	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H9630	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H9630	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H9630	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H9630	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H9630	PHR Beneficiary Contact																	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H9630	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9630	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9641	Part C Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd., Suite 140		Columbia	SC	29209	11/03/2025	2026	SUN RIVER HEALTH PACE	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9641	Part D Application Contact			Tucker	John		8039601154					john.tucker@paceadvisorygroup.org	4500 Fort Jackson Blvd., Suite 140		Columbia	SC	29209	11/03/2025	2026	SUN RIVER HEALTH PACE	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9649	Automated TrOOP Balance Transfer Contact	Controller	Ms	Moores	Carla		9702557223					cmoores@hopewestco.org	2754 Compass Drive	Unit B	Grand Junction	CO	81506	07/26/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Backup User Access Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@HopeWestCO.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Best Available Evidence Contact	Controller	Ms	Moores	Carla	J	9702572372					cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	06/01/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Bid Primary Contact	Chief Financial Officer	Mr	Bair	Carter		9702572366					cbair@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/27/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	CAP Report Contact for Public Website	Director of PACE Enrollment & Engagement	Mr	Caudillo	Ramel		9706440306					rcaudillo@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	08/14/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	CEO - CMS Administrator Contact	Chief Executive Officer	Mrs	Silva	Deneen		9702572370	2370				dsilva@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	CEO - Senior Official for Contracting	Chief Executive Officer	Mrs	Silva	Deneen		9702572370					dsilva@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Chief Financial Officer	Chief Financial Officer	Mr	Bair	Carter		9702572366					cbair@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/21/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Chief Operating Officer	Chief Operating Officer	Ms	Rock	Georgia		9702557220					grock@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	08/22/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Chief Information Officer	Chief Financial Officer	Mr	Bair	Carter		9702572366					cbair@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/21/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Chief Information Security Officer	Director of Information Technology	Mr	Facuri	Mark		9702572418					MFacuri@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	06/26/2020	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	CMS Casework Communication Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Complaints Tracking Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Contact for Fraud Investigations	Sr. Vice President & Chief Administrative Officer	Ms	Walter	Terri		9702572363					twalter@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	06/26/2020	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Coordination of Benefits Contact	Controller	Ms	Moores	Carla		9702572372	2372				cmoores@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/14/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Corporate Mailing						9702412212				9702572400	ccopp@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	06/26/2020	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Customer Service Operations Contact	Director of Quality/Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	DIR Contact	PACE Executive Director		Barrios	Tracy		9702557207	7207				tbarrios@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	DIR Contact (Secondary)	Controller		Moores	Carla	K	9702572372				9702557208	cmoores@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	02/24/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Discount Program Payment Contact	Chief Executive Officer	Ms	Silva	Deneen		9702572370					dsilva@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Emergency Part D Contact	Controller	Ms	Moores	Carla		9702572372	2372				cmoores@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	02/15/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Emergency Part D Contact (Secondary)	Business Office Process Lead	Ms	Collins	Jeanette		9702557223					jcollins@hopewestco.org	2754 Compass Drive	Unit B	Grand Junction	CO	81506	07/26/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Encounter Data & Risk Adjustment Operations Contact	Controller	Ms	Moores	Carla		9702572372	2372				cmoores@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	02/15/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Enrollment Contact	Director of PACE Enrollment & Engagement	Mr	Caudillo	Ramel		9706440306					rcaudillo@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/14/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	EOB Transfer Contact	Controller	Ms	Moores	Carla		9702572372	2372			9702572400	cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/19/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Financial Audit Contact	Controller	Ms	Moores	Carla		9702572372					cmoores@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	09/25/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Financial Reporting Contact	Chief Financial Officer	Mr	Bair	Carter		9702572366					cbair@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/21/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Formulary Contact	PACE Executive Director		Barrios	Tracy		9702557207	7207				tbarrios@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Formulary Contact (Secondary)	Medical Director	Dr.	Marlin	Heidi		9702544021	4021				hmarlin@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	General Contact	PACE Executive Director		Barrios	Tracy		9702557207	7207				tbarrios@hopewestco.org	2754 Compass Dr		Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Government Relations Contact	Sr. Vice President/Chief Administrative Officer	Ms	Walter	Terri		9702572363	2363				twalter@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	04/08/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	HIPAA Privacy Officer	Sr. Vice President & Chief Administrative Officer	Ms	Walter	Terri		9702572363					twalter@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	06/26/2020	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	HIPAA Security Officer	Director of Information Technology	Mr	Facuri	Mark		9702572418					MFacuri@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	06/26/2020	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Interoperability Contact	Controller	MS	Moores	Carla	J	9702572372					cmoores@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	06/01/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	MA Appeals/Grievances Contact	Director, Quality/Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	MA Claims Processing Contact for Public Website	Controller	Ms	Moores	Carla		9702572372					cmoores@hopewestco.org	2754 Compass Drive	Unit B	Grand Junction	CO	81506	07/26/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Marketing Contact	Director of PACE Enrollment & Engagement	Mr	Caudillo	Ramel		9706440306					rcaudillo@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/14/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Medical Director	Chief Medical Director - PACE	Dr.	Marlin	Heidi		9702412212	4021				hmarlin@HopeWestCO.org	2754 Compass Drive		Grand Junction	CO	81506	08/14/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Medicare Compliance Officer	Sr. Vice President/Chief Administrative Officer	Ms.	Walter	Terri		9702572363	2363				twalter@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	04/10/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Medicare Coordinator	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Medicare Part D Opioid Overutilization Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Medication Therapy Management Contact	Medical Director	Dr.	Marlin	Heidi		9702544021	4021				hmarlin@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part C Application Contact	Chief Executive Officer	Ms	Silva	Deneen		9702572370					dsilva@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Appeals	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha							neldridgedavies@HopeWestCO.org	2754 Compass Dr		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	9702632197	2197			PACE - Nat		C	San Francisco
H9649	Part D Appeals Contact (Secondary)	Sr. Vice President/Chief Administrative Officer	Ms	Walter	Terri							twalter@HopeWestCO.org	3090 N. 12th St.	Unit B	Grand Junction	CO	81506	04/08/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	9702572363	2363			PACE - Nat		C	San Francisco
H9649	Part D Application Contact	Chief Executive Officer	Ms	Silva	Deneen		9702572370					dsilva@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Benefits Contact	Controller	Ms	Moores	Carla		9702572372	2372				cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/19/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Claims Submission Contact	Controller	Ms	Moores	Carla		9702572372	2372				cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/19/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Exceptions Contact	Medical Director	Dr.	Marlin	Heidi							hmarlin@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	9702544021	4021			PACE - Nat		C	San Francisco
H9649	Part D Exceptions Contact (Secondary)	Associate Medical Director	Ms	Owens	Crystal							cowens@hopewestco.org	2754 Compass Dr		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	9702557220	7220			PACE - Nat		C	San Francisco
H9649	Part D Price File Contact (Back-up)	Chief Financial Officer	Mr	Bair	Carter		9702572366					cbair@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/27/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Price File Contact (Optional)	Controller	Ms	Moores	Carla		9702572372					cmoores@hopewestco.org	2754 Compass Dr		Grand Junction	CO	81506	08/14/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Price File Contact (Primary)	Chief Executive Officer	Ms	Silva	Deneen		9702572370					dsilva@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Quality Assurance Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Part D Reporting Contact	Business Office Process Lead	Ms	Collins	Jeanette		9702557223					jcollins@HopeWestCO.org	2754 Compass Dr		Grand Junction	CO	81506	07/26/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Patient Safety Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@HopeWestCO.org	2754 Compass Dr	Unit B	Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Payment Contact	Chief Financial Officer	Mr	Bair	Carter		9702572366					cbair@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/21/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Personal Health Record Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compas		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Pharmacy Director	Medical Director	Dr.	Marlin	Heidi		9702544021	4021				hmarlin@HopeWestCO.org	2754 Compass Drive		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Pharmacy Network Management Contact	Interim Executive Director/COO	Ms	Rock	Georgia		9702557220	7220				grock@HopeWestCO.org	2754 Compass Drive		Grand Junction	CO	81506	12/19/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Pharmacy Network Management Contact (Secondary)	Medical Director	Dr.	Marlin	Heidi		9702544021	4021				hmarlin@hopewestco.org	2754 Compass Dr		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Pharmacy Technical Help Desk Contact	Executive Director	Ms	Barrios	Tracy							Tbarrios@HopeWestCO.org	2754 compass Drive		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	9702557207	7207			PACE - Nat		C	San Francisco
H9649	Pharmacy Technical Help Desk Contact (Secondary)	Medical Director	Dr.	Marlin	Heidi							hmarlin@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/13/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active	9702544021	4021			PACE - Nat		C	San Francisco
H9649	Plan Directory Contact for Public Website	Director of PACE Enrollment & Engagement	Mr	Caudillo	Ramel		9706440306					rcaudillo@HopeWestCO.org	2754 Compass Drive		Grand Junction	CO	81506	08/14/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Plan to Plan Reconciliation Contact	Controller	Ms	Moores	Carla		9702572372	2372				cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/19/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Processor Contact	Controller	Ms	Moores	Carla		9702572372					cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/24/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Quality Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Reconciliation Contact	Chief Financial Officer	Mr	Bair	Carter		9702572366					cbair@hopewestco.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/21/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Reconciliation Contact (Secondary)	Controller	Ms	Moores	Carla		9702572372					cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/19/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Recovery Audit Contact	Chief Executive Officer	Ms	Silva	Deneen		9702572370					dsilva@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	02/10/2025	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Surveillance Contact	Director of PACE Enrollment & Engagement	Mr.	Caudillo	Ramel		9706440306					rcaudillo@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	09/25/2024	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	System Contact	Interim Executive Director/COO	Ms	Rock	Georgia		9702557220					grock@HopeWestCO.org	2754 Compass Drive		Grand Junction	CO	81506	12/19/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Third Party Administrator (TPA) Liaison	Controller	Ms	Moores	Carla		9702572372					cmoores@HopeWestCO.org	3090 North 12th Street	Unit B	Grand Junction	CO	81506	01/19/2022	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	User Access Contact	Interim Executive Director/COO	Ms	Rock	Georgia		9702557220					grock@HopeWestCO.org	2754 Compass Dr.		Grand Junction	CO	81506	12/19/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Utilization Management Contact	Interim Executive Director/COO	Ms	Rock	Georgia		9702557220					grock@HopeWestCO.org	2754 Compass Dr		Grand Junction	CO	81506	12/19/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9649	Utilization Review Contact	Director of Quality and Compliance	Ms	Eldridge-Davies	Natasha		9702632197	2197				neldridgedavies@hopewestco.org	2754 Compass Drive		Grand Junction	CO	81506	08/21/2023	2026	HOPEWEST	National PACE	HopeWest PACE	National PACE		Hopewest	766	Yes	Active					PACE - Nat		C	San Francisco
H9675	Automated TrOOP Balance Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Backup User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Best Available Evidence Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Bid Primary Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	CAP Report Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H9675	CEO - CMS Administrator Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	CEO - Senior Official for Contracting	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Chief Financial Officer	CEO	Mrs.	Garay	Lisa		2016755663					lgaray@kinshiphs.com	63 Karen Drive		Mahwah	NJ	07430	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Chief Operating Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Chief Information Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Chief Information Security Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	CMS Casework Communication Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Complaints Tracking Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Contact for Fraud Investigations	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Coordination of Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Corporate Mailing						7274175819					ahulon@kinshiphs.com	885 3rd Ave	29th Floor	New York	NY	10022	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Customer Service Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	DIR Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Discount Program Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Emergency Part D Contact	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Encounter Data & Risk Adjustment Operations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Enrollment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	EOB Transfer Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371				5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Financial Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Financial Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Formulary Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	General Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Government Relations Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	HIPAA Privacy Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	HIPAA Security Officer	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Interoperability Contact	VP of Business Development & Compliance	Mrs	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138th Ct		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	MA Appeals/Grievances Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	MA Claims Processing Contact for Public Website	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Marketing Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Medical Director	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Medicare Compliance Officer	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Medicare Coordinator	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Medicare Part D Opioid Overutilization Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Medication Therapy Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part C Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part D Appeals	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H9675	Part D Application Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part D Benefits Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part D Claims Submission Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part D Exceptions Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia							GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H9675	Part D Price File Contact (Back-up)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part D Price File Contact (Primary)	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part D Quality Assurance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Part D Reporting Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Patient Safety Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Payment Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Pharmacy Director	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Pharmacy Network Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Pharmacy Technical Help Desk Contact	Regional Program Director	Mrs	KornBlatt	Georgia						5592389224	GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending	5703717371				PACE - Nat		C	
H9675	Plan Directory Contact for Public Website	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Plan to Plan Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Processor Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Quality Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Reconciliation Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Reconciliation Contact (Secondary)	VP of Business Development & Compliance	Mrs.	Hulon	Amber		7274175819					ahulon@kinshiphs.com	9907 NE 138 CT		Vancouver	WA	98682	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Recovery Audit Contact	Senior Vice President of Operations	Mrs.	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Surveillance Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	System Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Third Party Administrator (TPA) Liaison	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	User Access Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Utilization Management Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9675	Utilization Review Contact	Senior Vice President of Operations	Mrs	KornBlatt	Georgia		5703717371					GKornblatt@kinshiphs.com	1529 Garfield Ave		Reading	PA	19610	11/26/2025	2026	KINSHIP PACE OF MIAMI-DADE, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9678	Agent/Broker Compensation Data Contact	VP, Associate General Counsel	Ms.	Jan	Munizeh		6467675166					mjan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Automated TrOOP Balance Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Backup User Access Contact	Manager, LTC Programs	Ms.	Duker	Stephanie		3324554464					sduker@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Best Available Evidence Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Bid Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Bid Audit Site Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Bid Primary Contact	Director, Medicare Strategy	Ms.	Wheeler	Jillian		2073222422					jiwheeler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	CAP Report Contact for Public Website	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	CEO - CMS Administrator Contact	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	CEO - Senior Official for Contracting	President & CEO	Ms.	Wang	Pat		2128011500					pwang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Chief Financial Officer	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Chief Operating Officer	SVP, Operations	Ms.	Weinseiss	Karen		6466773595					kweinseiss@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Chief Information Officer	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Chief Information Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	CMS Casework Communication Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Complaints Tracking Contact	Director, Appeal & Grievance Operations	Mr.	Craig	Jeffrey		6467675642					jcraig@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	05/01/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Contact for Fraud Investigations	VP, Associate General Counsel	Mr.	Kianovsky	Nahum		2128013240					nkianovsky@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Coordination of Benefits Contact	Director, Payment Integrity Team	Ms.	Hutchinson	Chris		9176982415					chutchinson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Corporate Mailing						6463138967					clogreira@healthfirst.org	Healthfirst Medicare Plan	100 Church Street, 18th Floor	New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Customer Service Operations Contact	VP,  Member Services	Ms.	O'Connor	Kimberly		2128011639					koconnor@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	DIR Contact	Manager, Pharmacy Finance	Mr.	Sheridan	Justin		2124535509					jsheridan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	DIR Contact (Secondary)	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					Tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Discount Program Payment Contact	VP, Controller	Mr.	Barattin	Craig		2125191780					cbarattin@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Emergency Part D Contact	VP, Pharmacy	Mr.	Modi	Bhavesh		2122096442					bmodi@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Emergency Part D Contact (Secondary)	Director, Pharmacy Regulatory & Compliance	Ms.	Andreu	Kim		6462732839					kandreu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters	Mr.	Miller	Robert		2125193011					rmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Enrollment Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	EOB Transfer Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753				6463134645	jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Financial Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Financial Reporting Contact	Chief Financial Officer	Ms.	Kang	Judy		7184845489					jkang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Formulary Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Formulary Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	General Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Government Relations Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	HIPAA Privacy Officer	AVP, Chief Privacy Officer	Ms.	Radler	Laurie		9172863902					lradler@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	HIPAA Security Officer	VP, Chief Security Information Officer	Mr.	Miller	Brian		6467675750					bmiller@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Hospice Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Interoperability Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	MA Appeals/Grievances Contact	VP, Appeals & Grievances	Ms.	Johnston	Meredith		6467674748					mjohnston@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	MA Claims Processing Contact for Public Website	VP Application Development	Mr.	Brexel	CJ		2128232481					cbrexel@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/08/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Marketing Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Medical Director	Chief Clinical Officer	Dr.	Schechtman	Jay		2128016170					jschechtman@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Medicare Compliance Officer	Chief Compliance Officer & Head of Internal Audit	Mr.	Hackendorn	John		2124534495					jhackendorn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Medicare Coordinator	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Medicare Part D Opioid Overutilization Contact	Manager, Pharmacy Benefits	Ms	Baja	Melody		6468565983					mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	08/22/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Medication Therapy Management Contact	Pharmacy Manager	Ms.	Ziu	Rezarta		6463134678					rziu@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Online Enrollment Center Contact (Primary)	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					jhowell@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part C Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part C Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Appeals	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active	3013464234				PPO - BBA		C	Chicago
H9678	Part D Appeals Contact (Secondary)	Sr. Manager, Pharmacy Regulatory & Compliance	Ms.	Alenkina	Karolina							kalenkina@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active	8882601010				PPO - BBA		C	Chicago
H9678	Part D Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Benefits Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Claims Submission Contact	Manager, Pharmacy Benefits	Ms.	Grodzitsky	Janet		6467675231					jparedes@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Exceptions Contact	Manager, Pharmacy Benefits	Mr.	Sohn	Eric							esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active	8882601010				PPO - BBA		C	Chicago
H9678	Part D Exceptions Contact (Secondary)	Clinical Pharmacist, Pharmacy Benefits	Ms.	Baja	Melodie							mbaja@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active	8882601010				PPO - BBA		C	Chicago
H9678	Part D Price File Contact (Back-up)	Sr. Manager, Financial Operations	Ms.	Stauffer	Grace		4804798023					grace.stauffer@cvshealth.com	CVS Health	9501 E. Shea Blvd, MC121	Scottsdale	AZ	85260	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Price File Contact (Optional)	Advisor, Med D Finance	Mr.	Pertgen	Richard		8045258502					richard.pertgen@cvshealth.com	CVS Health	9501 E Shea Blvd, MC121	Scottsdale	AZ	85260	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Price File Contact (Primary)	Manager, Pharmacy Benefits	Mr.	Sohn	Eric		3013464234					esohn@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Quality Assurance Contact	AVP, Pharmacy	Ms.	Kourlas	Helen		2122096456					hkourlas@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Part D Reporting Contact	Sr. Manager, Medicare Products	Ms.	Kennedy	Raine		2124018804					rkennedy@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Patient Safety Contact	Manager, Pharmacy	Ms.	Gandara Rodriguez	Alexandra		2124792775					agandararodriguez@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Payment Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Pharmacy Director	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Pharmacy Network Management Contact	AVP, Pharmacy Benefits Operations	Mr.	Suri	Tarun		6463541168					tsuri@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Pharmacy Network Management Contact (Secondary)	Clinical Pharmacist	Ms.	An	Diana		3476911405					dan@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Pharmacy Technical Help Desk Contact	AVP Customer Care	Mr.	Jackson	Scott							scott.jackson@cvshealth.com	CVS Health	800 NW Chipman Rd, Ste 5830	Lees Summit	MO	64063	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active	8666934620				PPO - BBA		C	Chicago
H9678	Plan Directory Contact for Public Website			Services	Provider		8888011660					hfprovsrvs@healthfirst.org	P.O. Box 5168		New York	NY	102745168	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Plan to Plan Reconciliation Contact	Sr. Manager, Enrollment & Billing	Mr.	Howell	Justin		6467675753					P2P@healthfirst.org	100 Church Street, 18th Floor	Attn:  Treasury Department	New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Processor Contact	Executive Director	Mr.	Mangin	Marty		3124981167					martin.mangin@cvshealth.com	CVS Health	3100 Sanders Rd	Northbrook	IL	60062	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Quality Contact	VP, Clinical Quality	Ms.	Washington	Laisha		2128016186					lawashington@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Reconciliation Contact	VP, Actuarial Services	Ms.	Liang	Angela		2124535538					aliang@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Recovery Audit Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	SNP Application Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	SNP State Contact	VP, Regulatory Affairs	Ms.	Logreira	Christine		6463138967					clogreira@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Surveillance Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	System Contact	SVP, CIO	Mr.	Sweeney	GT		6467675199					gtsweeney@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Third Party Administrator (TPA) Liaison	Sr. Manager, Accounting	Ms.	Tyme	Denise		6462732814					dtyme@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	User Access Contact	AVP, Regulatory Affairs	Mr.	Husmann	Michael		2124534457					mhusmann@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Utilization Management Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9678	Utilization Review Contact	VP, Utilization Management	Ms.	Gunderson	Christine		2123242688					cgunderson@healthfirst.org	100 Church Street, 18th Floor		New York	NY	10007	04/29/2025	2026	HEALTHFIRST INSURANCE COMPANY, INC.	Local CCP	Healthfirst Medicare Plan	Local PPO		Healthfirst, Inc.	391	Yes	Active					PPO - BBA		C	Chicago
H9686	Agent/Broker Compensation Data Contact	VP, Sales		Simonds	Kristina		6572187635					KSimonds@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Automated TrOOP Balance Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H9686	Backup User Access Contact	Compliance Director		Spitzer	Chandra		6572745530					CSpitzer@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Best Available Evidence Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Bid Audit Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Bid Audit Site Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Bid Primary Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	CAP Report Contact for Public Website	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	CEO - CMS Administrator Contact	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	CEO - Senior Official for Contracting	CEO	Ms.	Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Chief Financial Officer	Chief Financial Officer	Mr.	Head	James	M	6572187612					Jhead@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Chief Operating Officer	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Chief Information Officer	SVP, Chief Technology Officer	Mr.	Kardes	Hakan		6572187772					hkardes@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Chief Information Security Officer	VP, Technology Delivery & CISO	Mr.	MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	CMMI Model Point of Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	CMS Casework Communication Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Complaints Tracking Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Contact for Fraud Investigations	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Coordination of Benefits Contact	Director, Membership & Eligibility		Starks	Heather		6614330187					HStarks@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Corporate Mailing						6572187713				8443202247	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Customer Service Operations Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	DIR Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	DIR Contact (Secondary)	AVP, Pharmacy		Liu	Ruby		6572137658					RLiu@AHCUSA.com	1100 W. Town & Country Rd., Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Discount Program Payment Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074634	adelatorre@ahcusa.com	1100 W. Town and Country Rd., Ste. 300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Electronic Health Record Contact	AVP, Platform Product		Brown Hayes	Michael		7144979628					MBrown-Hayes@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Emergency Part D Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Emergency Part D Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		3108667966				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Employer Waiver Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Encounter Data & Risk Adjustment Operations Contact	VP Risk Adjustment		Bogdanov	Eyosef		5623666179					ebogdanov@ahcusa.com	1100 W. Town and Country Rd.	Suite 1600	Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Enrollment Contact	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	EOB Transfer Contact	Manager Project and Program Management		Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H9686	Financial Audit Contact	AVP, Compliance & Regulatory Affairs	Mr.	Hertel	Glenn		7026220148					GHertel@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	09/24/2025	2026	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	Chicago
H9686	Financial Reporting Contact	Sr. Director, Accounting & Reporting		Tran	Sue Anne		6572187673	7673				stran@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Formulary Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Formulary Contact (Secondary)	Supervisor Pharcists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H9686	General Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Government Relations Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	HIPAA Security Officer	VP, Technology & CISO		MacLeod	David		3033967531					DMacLeod@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Hospice Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Interoperability Contact	VP, Data Engineering & BI CTO Data and Al		Sam	Georgie		8188807212					gsam@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	MA Appeals/Grievances Contact	AVP, Member Experience		Wendt	Lily		5622074530					LWendt@ahcusa.com	1100  W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	MA Claims Processing Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Marketing Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Medical Director	SVP Market Management WCR	Dr.	Kim	John		6572187640				5622074617	JKim@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Medicare Compliance Officer	SVP, Chief Compliance Officer	Ms.	Lynch	Cindy	B	6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Medicare Coordinator	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Medicare Part D Opioid Overutilization Contact	PBM - Manager, Clinical Pharmacists		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	07/02/2025	2026	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	Chicago
H9686	Medication Therapy Management Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	OffShore Subcontractor Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	CLynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Online Enrollment Center Contact (Back-up)	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Online Enrollment Center Contact (Optional)	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394				5622074621	clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Online Enrollment Center Contact (Primary)	Director, Membership & Eligibility		Starks	Heather		6614330187				5622074623	HStarks@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Part C Application Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Part C Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H9686	Part D Appeals Contact (Secondary)	Sr. Manager, Appeals & Grievance		Jimenez	Gudelia							GJimenez@ahcusa.com	1100 W. Town and Country Road, Suite #300		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187488	2188			HMO - Health Maintenance Organization		C	Chicago
H9686	Part D Application Contact	CEO		Maroney	Dawn		5623346192				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Part D Benefits Contact	Senior Director, Benefit Operations		Icaza	Ashley		5073018360					ashley.icaza@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H9686	Part D Claims Submission Contact	PBM - Functional Business Consultant Govt Programs		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	2655 Eagan Woods Drive		Eagan	MN	55122	06/19/2025	2026	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	Chicago
H9686	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Chicago
H9686	Part D Exceptions Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali							AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	6572187709				HMO - Health Maintenance Organization		C	Chicago
H9686	Part D Price File Contact (Back-up)	PBM - Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H9686	Part D Price File Contact (Optional)	PBM - QA Analyst		Tastad	Emily		6127776931					emily.tastad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H9686	Part D Price File Contact (Primary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Part D Quality Assurance Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Part D Reporting Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Patient Safety Contact	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Payment Contact	CEO		Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Personal Health Record Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Pharmacy Director	SVP, Medicare Programs		Farrokhroo	Ali		6572187709				5622074630	AFarrokhroo@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Pharmacy Network Management Contact	PBM - VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	06/19/2025	2026	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	Chicago
H9686	Pharmacy Network Management Contact (Secondary)	SVP, Medicare Programs		Farrokhroo	Ali		6572187709	7709				AFarrokhroo@ahcusa.com	1100 W. Town and Country Rd #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554570622				HMO - Health Maintenance Organization		C	Chicago
H9686	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS		Alignment Healthcare USA, LLC	612	Yes	Active	8554571209				HMO - Health Maintenance Organization		C	Chicago
H9686	PHR Beneficiary Contact																	06/19/2025	2026	ALIGNMENT HEALTH PLAN OF NEVADA, INC.	Local CCP	Alignment Health Plan	HMO/HMOPOS	Alignment Health Plan	Alignment Healthcare USA, LLC	612	Yes	Active	8666342247				HMO - Health Maintenance Organization		C	Chicago
H9686	Physician Incentive Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Plan Directory Contact for Public Website	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Plan to Plan Reconciliation Contact	Manager, Financial Operations		De La Torre	Angelo		6572187422				5622074266	adelatorre@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722					MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/19/2025	2026	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	Chicago
H9686	Quality Contact	AVP, Quality Management/ Delegation Oversight		Lacock	Lisa		6572187638					LLacock@ahcusa.com	1100 W. Town and Country Road #300		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Reconciliation Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Reconciliation Contact (Secondary)	Manager, Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Recovery Audit Contact	CEO	Mrs.	Maroney	Dawn		8443102247				8443202247	DMaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	SNP Application Contact	Director, Product Management		Aguirre	Christian		6572187634					CAguirre@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	SNP State Contact	CEO		Maroney	Dawn		8443102247				8443202247	dmaroney@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Surveillance Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	System Contact	VP, AVA Health Plan Systems & Operations		Bates	Patrick		6572187636	7636				PBates@ahcusa.com	1100 W. Town & Country Road, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	Third Party Administrator (TPA) Liaison	Manager. Financial Operations		De La Torre	Angelo		6572187422					adelatorre@ahcusa.com	1100 W. Town and Country Rd, Suite 1600		Orange	CA	92868	06/19/2025	2026	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	Chicago
H9686	User Access Contact	SVP, Chief Compliance Officer		Lynch	Cindy		6573835394					clynch@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Utilization Management Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9686	Utilization Review Contact	AVP, Utilization Management		Moore	Lorena		6572187671	7671				LMoore@ahcusa.com	1100 W. Town and Country Road #1600		Orange	CA	928684600	06/19/2025	2026	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	Chicago
H9690	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Chief Financial Officer	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Chief Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Chief Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Chief Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Customer Service Operations Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8446570447				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Ms	Brimm	Angie		8446570447				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8446570447				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Medicare Coordinator	SVP, Operations	Mr	Haney	Jason		3149607231				8442805360	jhaney@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Medicare Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Exceptions Contact	Associate VP of Clinical Operations	Ms.	Lavignette	Amanda						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Part D Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Pharmacy Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Pharmacy Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8335026757				HMO - Health Maintenance Organization		C	Dallas
H9690	Pharmacy Technical Help Desk Contact (Secondary)			Sanchez	Lynn						4056015627	lsanchez@amhealthplans.com	909 S. Meridian Ave. Ste 425		Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8555210627				HMO - Health Maintenance Organization		C	Dallas
H9690	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8446570447				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	SNP State Contact	SVP, Operations	Mr	Haney	Jason		3149607231				8442805360	jhaney@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9690	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/15/2023	2026	AMERICAN HEALTH PLAN OF INDIANA INC	Local CCP	American Health Advantage of Indiana	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9699	Agent/Broker Compensation Data Contact	Manager, Individual Sales Agent		Creasman	Matthew		5013993923					mdcreasman@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Automated TrOOP Balance Transfer Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Backup User Access Contact	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Best Available Evidence Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Bid Audit Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72001	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Bid Audit Site Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Bid Primary Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72001	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	CAP Report Contact for Public Website	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	CEO - CMS Administrator Contact	VP Government Programs & Enterprise Analytics	Mr.	Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	CEO - Senior Official for Contracting	Executive VP	Mr.	Dillard	Gray		5013782436					gddillard@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/13/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Chief Financial Officer	Treasurer	Mr.	Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/13/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Chief Operating Officer	Chief Operating Officer	Mr.	Dillard	Gray		5013782436					gddillard@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/13/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Chief Information Officer	VP Infrastructure & Operations	Mr.	Martin	David		5012940910					dbmartin@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/16/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Chief Information Security Officer	Chief Security Officer	Mr.	Shirley	Devin		5016880747					dmshirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	CMS Casework Communication Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Complaints Tracking Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Contact for Fraud Investigations	Director, Performance Mgt. & Investigations		Gunter	Debbie		5013786610					dsgunter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/13/2017	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Coordination of Benefits Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Corporate Mailing						5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Customer Service Operations Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	DIR Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines St.		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	DIR Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Discount Program Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Emergency Part D Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Emergency Part D Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/03/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Encounter Data & Risk Adjustment Operations Contact	Director Risk Adjustment		Dotson	Adonica		5012941964					andotson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Enrollment Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	EOB Transfer Contact	Account Manager		Ellinger	David		4802408415				4803146066	David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Financial Audit Contact	Medicare Compliance Manager	Mr.	Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Financial Reporting Contact	Director, Financial Reporting & Payroll		Russell	Holly		5013993954					hkrussell@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Formulary Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Formulary Contact (Secondary)	Clinical Advisor		Seto	Kim		6193460146					Kim.Seto@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	General Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72001	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		5013782103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/28/2019	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	HIPAA Privacy Officer	Chief Privacy Officer		Gardner	Anne		5013932994					aegardner@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	HIPAA Security Officer	Physical Security/Chief Security Officer		Shirley	Devin		5016880747					DMShirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/11/2023	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		5013783743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Interoperability Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	MA Appeals/Grievances Contact	Supervisor, Medicare Member Services		Taylor	Alicia		5013783743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	MA Claims Processing Contact for Public Website	Manager, Medicare Claims Operations		Pilkington Ross	Amanda		5013013452					ampilkington@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Marketing Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72001	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Medical Director	Associate Medical Director	Dr.	Becker	Thomas		5013964196					tebecker@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/31/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Medicare Compliance Officer	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/05/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Medicare Coordinator	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72001	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Medicare Part D Opioid Overutilization Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Medication Therapy Management Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	OffShore Subcontractor Contact	Director, Medicare Operations		Bradford	Wanda		5013782387					wlbradford@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/20/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Online Enrollment Center Contact (Back-up)	Supervisor, Medicare Operations		Kaiser	Ashley		5012941625					aekaiser@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part C Application Contact	Manager Medicare Advantage Product Development		Pepper	Chad		5012941697					wcpepper@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part C Reporting Contact	Director, Medicare Operations		Bradford	Wanda		5013782387					wlbradford@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/20/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part D Appeals	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				HMO - Health Maintenance Organization		C	New York
H9699	Part D Appeals Contact (Secondary)	Senior Counsel, Appeals		Phillips	Ashleigh						5013783366	adphillips@arkbluecross.com	PO Box 2181	Attn: Legal Appeals	Little Rock	AR	72203	01/11/2021	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	5013782025				HMO - Health Maintenance Organization		C	New York
H9699	Part D Application Contact	Manager Medicare Advantage Product Development		Pepper	Chad		5012941697					wcpepper@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part D Benefits Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part D Claims Submission Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part D Exceptions Contact	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				HMO - Health Maintenance Organization		C	New York
H9699	Part D Exceptions Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza							mbegovic@arkbluecross.com	601 S Gaines St.		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	5013932813				HMO - Health Maintenance Organization		C	New York
H9699	Part D Price File Contact (Back-up)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part D Price File Contact (Primary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part D Quality Assurance Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Part D Reporting Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Patient Safety Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Pharmacy Director	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Pharmacy Network Management Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Pharmacy Network Management Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Pharmacy Technical Help Desk Contact			Customer Service	CVS								9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/10/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	8442805833				HMO - Health Maintenance Organization		C	New York
H9699	Pharmacy Technical Help Desk Contact (Secondary)	CVS Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active	4802408415				HMO - Health Maintenance Organization		C	New York
H9699	Plan Directory Contact for Public Website			Service	Customer		8442014934					MediPakAdvRx@arkbluecross.com	P O Box 3648		Little Rock	AR	72203	11/10/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		5012942491				5013783258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Processor Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Quality Contact	Director, Clinical Quality & HEDIS		Mattson	Sarah		5012943643					spmattson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Reconciliation Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines St.		Little Rock	AR	72201	12/18/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Reconciliation Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Recovery Audit Contact	Financial Analyst	Ms.	Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Surveillance Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	System Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Third Party Administrator (TPA) Liaison	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	User Access Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Utilization Management Contact	Director, Health Management		Seleski-Lopez	Verna		5013409235					vlseleskilopez@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	12/16/2025	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9699	Utilization Review Contact	Associate Medical Director	Dr.	Becker	Thomas		5013964196					tebecker@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/31/2020	2026	USABLE HMO, INC.	Local CCP	Arkansas Blue Medicare	HMO/HMOPOS		USAble Mutual Insurance Company	421	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9700	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H9700	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Boston
H9700	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Boston
H9700	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H9700	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Boston
H9700	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Boston
H9700	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Boston
H9700	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9700	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NORTH CAROLINA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Boston
H9706	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H9706	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H9706	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	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	Dallas
H9706	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H9706	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	11/06/2020	2026	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	Dallas
H9706	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H9706	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	11/06/2020	2026	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	Dallas
H9706	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H9706	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H9706	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H9706	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	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	Dallas
H9706	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H9706	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	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	Dallas
H9706	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	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	Dallas
H9706	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H9706	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	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	Dallas
H9706	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H9706	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	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	Dallas
H9706	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	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	Dallas
H9706	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H9706	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	08/09/2019	2026	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	Dallas
H9706	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	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	Dallas
H9706	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H9706	Encounter Data & Risk Adjustment Operations Contact	DVP Encounters Analytics & Solutions	Mr.	Hill	Lyle		6159751183					lyle_hill@bcbsil.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H9706	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H9706	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	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	Dallas
H9706	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	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	Dallas
H9706	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	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	Dallas
H9706	Formulary Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	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	Dallas
H9706	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	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	Dallas
H9706	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H9706	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/30/2025	2026	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	Dallas
H9706	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	08/09/2019	2026	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	Dallas
H9706	Interoperability Contact	Exec Dir Clinical Oversight and Operations Support	Ms.	Wahmann	Cara		3126538426					cara_wahmann@bcbsil.com	3500 Lacey Road		Downers Grove	IL	60515	09/30/2025	2026	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	Dallas
H9706	MA Appeals/Grievances Contact	DVP Customer Service	Ms.	Hoffman	Allison		3126534026				0000000000	Allison_L_Hoffman@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/04/2021	2026	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	Dallas
H9706	MA Claims Processing Contact for Public Website	Deputy General Manager	Ms.	Dempsey	Caressa		5703822395	836195			0000000000	Caressa.Dempsey@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H9706	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	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	Dallas
H9706	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H9706	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	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	Dallas
H9706	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	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	Dallas
H9706	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	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	Dallas
H9706	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	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	Dallas
H9706	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H9706	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	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	Dallas
H9706	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	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	Dallas
H9706	Part C Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H9706	Part C Reporting Contact	Unit Mgr. Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	Part D Appeals	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H9706	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H9706	Part D Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H9706	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	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	Dallas
H9706	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	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	Dallas
H9706	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H9706	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/22/2025	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8006936651				HMO - Health Maintenance Organization		C	Dallas
H9706	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H9706	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	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	Dallas
H9706	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H9706	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H9706	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	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	Dallas
H9706	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	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	Dallas
H9706	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richard	TX	75082	09/30/2025	2026	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	Dallas
H9706	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	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	Dallas
H9706	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	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	Dallas
H9706	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	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	Dallas
H9706	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/22/2021	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8772777898				HMO - Health Maintenance Organization		C	Dallas
H9706	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/23/2022	2026	HCSC INSURANCE SERVICES COMPANY	Local CCP	Blue Cross and Blue Shield of Texas	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	0000000000				HMO - Health Maintenance Organization		C	Dallas
H9706	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	02/07/2019	2026	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	Dallas
H9706	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661324				9727664360	niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive,	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H9706	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	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	Dallas
H9706	Quality Contact	Exec Dir Medicare Solutions	Mr	Tortorello	Anthony		3126533190					anthony_tortorello@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H9706	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	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	Dallas
H9706	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	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	Dallas
H9706	Recovery Audit Contact	Dir Medicaid Programs	Ms	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H9706	SNP Application Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H9706	SNP State Contact	Director, Medicare Solutions	Ms.	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	02/14/2022	2026	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	Dallas
H9706	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/30/2025	2026	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	Dallas
H9706	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/30/2025	2026	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	Dallas
H9706	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	08/09/2019	2026	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	Dallas
H9706	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	07/29/2020	2026	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	Dallas
H9706	Utilization Management Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	02/07/2019	2026	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	Dallas
H9706	Utilization Review Contact	DVP, Gov't Programs, Clinical Operations	Ms.	Spaulding	Felicia		5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	02/07/2019	2026	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	Dallas
H9725	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Coordination of Benefits Contact	Operations Senior Manager	Ms.	Rice	Sarah		4802159884					sarah.rice@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Customer Service Operations Contact	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Electronic Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Encounter Data & Risk Adjustment Operations Contact	Business Analytics Sr Manager	Mr.	White	Kevin	S	6152585176					kevin.white@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Enrollment Contact	Enrollment/Billing Manager	Ms.	Jackson	Tina		5714015655					tina.jackson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Hospice Contact	Enrollment/Billing Manager	Ms.	Headd	Ginean	R	6152340043	2340043				ginean.headd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	MA Appeals/Grievances Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	MA Claims Processing Contact for Public Website	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Online Enrollment Center Contact (Back-up)	Enrollment/Billing Senior Supervisor	Ms.	Crawford	Lorraine		8609029598					loraine.crawford@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Online Enrollment Center Contact (Primary)	Enrollment Sr. Supervisor	Mr.	Steinbrink	David		6232771216					david.steinbrink@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part C Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part C Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H9725	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H9725	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	4805480643				HMO - Health Maintenance Organization		C	New York
H9725	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8609024668				HMO - Health Maintenance Organization		C	New York
H9725	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8009221557				HMO - Health Maintenance Organization		C	New York
H9725	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active	8603389867				HMO - Health Maintenance Organization		C	New York
H9725	Plan Directory Contact for Public Website	Customer Service Senior Manager	Mr.	Rich	Jared	R	6156364554					jared.rich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Quality Contact	Medicare Director - Appeals, Grievances, and CTM	Ms.	Leskovac	Tara		6146870295					tara.leskovac@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	SNP Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	SNP State Contact	Mgr Medical Duals Product	Ms.	Valdez	Tamara		7736125588					tamara_valdez@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Utilization Management Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9725	Utilization Review Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	BRAVO HEALTH PENNSYLVANIA, INC.	Local CCP	HealthSpring	HMO/HMOPOS		Health Care Service Corporation	110	Yes	Active					HMO - Health Maintenance Organization		C	New York
H9730	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H9730	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H9730	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H9730	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H9730	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/17/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H9730	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Denver
H9730	PHR Beneficiary Contact																	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H9730	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9730	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9734	Part C Application Contact			Waschevski	Susan		3175093202					swaschevski@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	10/30/2025	2026	CPV South, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9734	Part D Application Contact			Waschevski	Susan		3175093202					swaschevski@habitathealth.com	39 Arkansas Street		San Francisco	CA	94107	10/30/2025	2026	CPV South, LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9771	Agent/Broker Compensation Data Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Best Available Evidence Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Bid Audit Site Contact	Executive Director, Actuarial		Martens	Dave		3149205281					dmartens@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	12/08/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	CMS Casework Communication Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Complaints Tracking Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Coordination of Benefits Contact	Phamacy Director		Vergil	Gina		4026997768					VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Corporate Mailing						4107525721				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Customer Service Operations Contact	Director, Service Operations		Phillips	Tish		6146537335					PhillipsL1@aetna.com	7400 Campus Road		New Albany	OH	43054	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/04/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Emergency Part D Contact (Secondary)	Pharmacy Director		Nkurunziza	Natalie		8609006247					NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Employer Waiver Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Encounter Data & Risk Adjustment Operations Contact	Director, Informatics		Sevchik	Melissa		6026591404					sevchikm@aetna.com	4750 S. 44th Place		Phoenix	AZ	85040	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Enrollment Contact	Lead Director Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Formulary Contact (Secondary)	Pharmacy Director		Nkurunziza	Natalie		8609006247					NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4802360860				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	06/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	HIPAA Privacy Officer	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	HIPAA Security Officer	Chief Information Security Officer	Ms.	McMahon	Chandra		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Hospice Contact	Lead Director, Service Operations		Truitt	Michelle		7176716847					MLTruitt@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Interoperability Contact	Exec. Dir. , Interoperability & Transpcy		Midyette	Carol		2032479966					midyettec@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	MA Appeals/Grievances Contact	Lead Director, Complaint and Appeals	Ms.	Mougey	Melissa		7408191678					mougeym@aetna.com	109 Hunters Trl		Wheelersburg	OH	45694	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Medical Director	Sr.  Medical Director		Hudson, MD	Karla		7739324873					hudsonk2@aetna.com	3200 Highland Ave.	MC F661	Downers Grove	IL	60515	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Medicare Coordinator	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	OffShore Subcontractor Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	03/14/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part C Reporting Contact	Lead Dir., Bus. Compliance, Medicare Ops. Int.		Blankley	Barbara		2067018041					blankleyb@aetna.com	600 University Street		Seattle	WA	98101	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Appeals	Supervisor, Clinical Pharmacy	Ms.	Spencer	Tiffane						8772700148	MedicareCoverageDeterminationMMP-SNP@AETNA.com	4750 South 44th Place		Phoenix	AZ	85040	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	6025589172				HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Appeals Contact (Secondary)	Pharmacy Director	Ms.	Vergil	Gina						8553658109	VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4026997768				HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	05/20/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Exceptions Contact	Pharmacy Director		Vergil	Gina							Vergilg@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	4026997768				HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Exceptions Contact (Secondary)	Pharmacy Director		Nkurunziza	Natalie							NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8609006247				HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Quality Assurance Contact	Phamacy Director		Vergil	Gina		4026997768					VergilG@aetna.com	7400 West Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Part D Reporting Contact	Lead Dir., Bus. Compliance, Medicare Ops. Int.		Blankley	Barbara		2067018041					blankleyb@aetna.com	600 University Street		Seattle	WA	98101	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	11/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Payment Contact	Lead Director, FP&A		Stefanich	Anita		3129283105					StefanichA@cvshealth.com	333 West Wacker Drive	Suite 2100	Chicago	IL	60606	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Personal Health Record Contact	Sr.  Medical Director		Hudson, MD	Karla		7739324873					hudsonk2@aetna.com	3200 Highland Ave.	MC F661	Downers Grove	IL	60515	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Pharmacy Director	Pharmacy Director		Nkurunziza	Natalie		8609006247					NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Pharmacy Network Management Contact	Pharmacy Director		Nkurunziza	Natalie		8609006247					NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Pharmacy Network Management Contact (Secondary)	Pharmacy Director		Nkurunziza	Natalie		8609006247					NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Pharmacy Technical Help Desk Contact	Pharmacy Director		Nkurunziza	Natalie							NkurunzizaN@aetna.com	1421 Round Hill Road		Harrisburg	PA	17110	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active	8553642975				HMO - Health Maintenance Organization		C	Atlanta
H9771	Physician Incentive Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Plan Directory Contact for Public Website	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/08/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Processor Contact	Executive Director, Duals Markets		Tanzillo	Hollie		6145727033					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Reconciliation Contact (Secondary)	Lead Director, FP&A	Ms.	Stefanich	Anita		3129283105					StefanichA@cvshealth.com	333 W. Wacker Drive	Suite 2100	Chicago	IL	60606	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	SNP Application Contact	Executive Director, Duals Markets		Hughes	Angelique		2482700990					MAPDApp@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/18/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	SNP State Contact	Executive Director, National Duals Program		Hughes	Angelique		2482700990					hughesa1@aetna.com	2 Town Square, Suite 275		Southfield	MI	48076	12/09/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Surveillance Contact	Lead Director, Compliance		Brown	Kristen	J	6144395370					brownk5@aetna.com	7400 West Campus Road, Mail Code F494		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	System Contact	Executive Director, Duals Market Enablement	Ms.	Tanzillo	Hollie	M	7407398501					tanzilloh@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Utilization Management Contact	AVP, Clinical Health Services		McKenna	Judith		2157758411					mckennaja@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9771	Utilization Review Contact	Director Clinical Health Services		Patel	Parul	P	2243633232					patelp12@aetna.com	7400 W. Campus Road		New Albany	OH	43054	11/01/2024	2026	AETNA BETTER HEALTH PREMIER PLAN MMAI INC.	Local CCP	Aetna Medicare FIDE	HMO/HMOPOS		CVS Health Corporation	49	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9772	Automated TrOOP Balance Transfer Contact			Alley	Brad		7208142154					BAlley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Backup User Access Contact	Controller		Reasons	Kara		7202434606					kreasons@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Best Available Evidence Contact	CFO		Alley	Brad		7208142154					BAlley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Bid Primary Contact	CFO		Alley	Brad		7208142154					BAlley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	CAP Report Contact for Public Website	Executive Director		Petersen	Emily		7208142354					EPetersen@coloradoPACE.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	CEO - CMS Administrator Contact	CEO	Mr	Bowen	Tim		3033986226					TBowen@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	CEO - Senior Official for Contracting	CEO	Mr	Bowen	Tim		3033986226					TBowen@caresynergynetowrk.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Chief Financial Officer	CFO	Mr	Alley	Brad		7208142154					BAlley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Chief Operating Officer		Ms	Petersen	Emily	D	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Chief Information Officer	CIO	Mr	Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Chief Information Security Officer	CIO	Mr	Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	CMS Casework Communication Contact			Petersen	Emily		7208142354					Epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Complaints Tracking Contact			Petersen	Emily		7208142354					Epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Contact for Fraud Investigations			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Coordination of Benefits Contact			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Corporate Mailing						3033861270					PathwaysPace@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Customer Service Operations Contact			Nailing	Grace		7208148447					GNailing@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	DIR Contact			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Discount Program Payment Contact			Alley	Brad		7208142154					BAlley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Emergency Part D Contact			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Encounter Data & Risk Adjustment Operations Contact			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Enrollment Contact	Executive Director of PACE Programs		Petersen	Emily	D	7208042354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	EOB Transfer Contact	Executive Director of PACE Programs		Petersen	Emily	D	7208142354				3033810157	epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Financial Audit Contact	CFO	Mr	Alley	Brad		7208142154					BAlley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Financial Reporting Contact			Reasons	Kara		7202434606					kreasons@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Formulary Contact	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	General Contact			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Government Relations Contact			Petersen	Emily		7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	HIPAA Privacy Officer			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	HIPAA Security Officer			Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Interoperability Contact			Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	MA Appeals/Grievances Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	MA Claims Processing Contact for Public Website			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Marketing Contact			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Medical Director	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Medicare Compliance Officer		Ms	Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Medicare Coordinator			Nailing	Grace		7204158447					GNailing@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Medication Therapy Management Contact	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part C Application Contact			Mehnert	Patricia		3038955085					PMehnert@CareSynergyNetwork.org	8289 E. Lowry Boulevard		Denver	CO	80230	07/09/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part D Appeals	Medical Director	Dr	Longino	August	A						alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending	8019033258				PACE - Nat		C	San Francisco
H9772	Part D Application Contact			Mehnert	Patricia		3038955085					PMehnert@CareSynergyNetwork.org	8289 E. Lowry Boulevard		Denver	CO	80230	07/09/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part D Benefits Contact			Petersen	Emily	P	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part D Claims Submission Contact			Petersen	Emily	P	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part D Exceptions Contact			Petersen	Emily	D						epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending	7208142354				PACE - Nat		C	San Francisco
H9772	Part D Price File Contact (Back-up)			Alley	Brad		7208142345					balley@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part D Price File Contact (Primary)			Petersen	Emily	P	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part D Quality Assurance Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Part D Reporting Contact			Petersen	Emily	P	7208142354					epetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Patient Safety Contact			Nailing	Grace		7208148447					GNailing@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Payment Contact			Reasons	Kara		7202434606					kreasons@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Pharmacy Director	Medical Director	Dr	Longino	August	A	8019033258					alongino@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	10/02/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Pharmacy Network Management Contact			Enders-Jack	Danielle		4124490680					DanielleEnders-Jack@Granerx.com	3251 N. Revere St		Aurora	CO	80011	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Pharmacy Technical Help Desk Contact			Enders-Jack	Danielle								3251 N. revere Street		Aurora	CO	80011	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending	8003813737				PACE - Nat		C	San Francisco
H9772	Plan Directory Contact for Public Website			Enders-Jack	Danielle		4124490680					DanielleEnders-Jack@GraneRx.com	3251 No Revere Street		Aurora	CO	80011	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Plan to Plan Reconciliation Contact			Enders-Jack	Danielle		4124490680					DanielleEnders-Jack@Granerx.com	3251 N. Revere Street		Aurora	CO	80011	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Processor Contact			Enders-Jack	Danielle		4124490680					DanielleEnders-Jack@Granerx.com	3251 N. Revere Street		Aurora	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Quality Contact			Nailing	Grace		7204158447					GNailing@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Reconciliation Contact			Petersen	Emily		7208142354					EPetersen@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	06/06/2025	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Recovery Audit Contact	Compliance Officer	Ms	Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Surveillance Contact			Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	System Contact			Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Third Party Administrator (TPA) Liaison			Alley	Brad		7208142154					BAlley@caresybergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	User Access Contact			Blaschke	John		3033986244					JBlaschke@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Utilization Management Contact			Nailing	Grace		7204158477					GNailing@coloradopace.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9772	Utilization Review Contact			Mehnert	Patricia		3033986231					PMehnert@caresynergynetwork.org	8289 E. Lowry Blvd		Denver	CO	80230	09/05/2024	2026	PATHWAYS	National PACE	Pathways PACE	National PACE				Yes	Pending					PACE - Nat		C	San Francisco
H9802	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H9802	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Atlanta
H9802	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Atlanta
H9802	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H9802	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Atlanta
H9802	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Atlanta
H9802	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Atlanta
H9802	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9802	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Atlanta
H9808	Agent/Broker Compensation Data Contact	Director, Sales & Marketing		Dunn	John		3363651395					jdunn@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Automated TrOOP Balance Transfer Contact	Manager, Business Systems & Data		Rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Backup User Access Contact	Chief Operations Officer	Dr	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Best Available Evidence Contact	Business Analyst		Bhupatiraju	Adarsh		5088047430	7260				Adarsh.Bhupatiraju@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	01/11/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Bid Audit Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Bid Primary Contact	Chief Financial Officer		Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	CAP Report Contact for Public Website	President & CEO		Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	CEO - CMS Administrator Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	CEO - Senior Official for Contracting	President	Mr.	Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Chief Financial Officer	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Chief Operating Officer	Chief Operations Officer	Dr.	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Chief Information Officer	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Chief Information Security Officer	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	CMS Casework Communication Contact	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Complaints Tracking Contact	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Contact for Fraud Investigations	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Coordination of Benefits Contact	Manager, Business Systems  & Data		Rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	01/11/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Corporate Mailing						8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Customer Service Operations Contact	Director of Operations	Ms.	Cotten	Ashley		8889651965					acotten@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	10/16/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	DIR Contact	Chief Administrative Officer		Wickremeratne	Aruna		5088046923					aruna.w@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	DIR Contact (Secondary)	Manager, Pharmacy Network Analytics		Chaudhary	Sudhakar		5085973931					sudhakar.chaudhary@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Discount Program Payment Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Emergency Part D Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Emergency Part D Contact (Secondary)	Pharmacy Manager	Dr.	Ruedinger	Kevin		3366602249					kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Encounter Data & Risk Adjustment Operations Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Enrollment Contact	Manager, Business Systems & Data		Rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	01/11/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	EOB Transfer Contact	Operations Analyst		Durden	Dillion		8133998273				8133998273	dillon.durden@nirvanahealth.com	600 North Westshore Boulevard	suite 900	Tampa	FL	33607	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Financial Audit Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Financial Reporting Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Formulary Contact	Chief Operations Officer	Dr.	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Avenue	STE 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Formulary Contact (Secondary)	Director, PBM Clinical Operations		Adorno	Zelys		5085326745					Zelys.Adorno@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	05/23/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	General Contact	President & CEO		Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Government Relations Contact	President & CEO		Hodges	Brendan		3367904392					bhodges@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	HIPAA Privacy Officer	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	HIPAA Security Officer	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Hospice Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Interoperability Contact	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	MA Appeals/Grievances Contact	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	MA Claims Processing Contact for Public Website	Director of Operations		Leppin	Amy		3366600562					aleppin@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Marketing Contact	Medicare Marketing & Communications Manager	Ms	Pritchett	Lee		3362688676					lpritchett@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	02/02/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Medical Director	Medical Director	Dr.	Evans	Stephen		3369006094					sevans@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Medicare Compliance Officer	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Medicare Coordinator	Director Strategic Growth & Product Development		McCloy	Tracey		3369005953					tmccloy@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	02/02/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Medicare Part D Opioid Overutilization Contact	Pharmacy Manager	Dr.	Ruedinger	Kevin		3366602249					kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Medication Therapy Management Contact	Chief Operations Officer	Dr.	Homer	Deanna	M	3367904385					dhomer@htanc.com	300 East Wendover Avenue	STE 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	OffShore Subcontractor Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Online Enrollment Center Contact (Back-up)	Director, IT Operations		Inavilli	Ram		5088046864				5088046864	ram.inavilli@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Online Enrollment Center Contact (Primary)	Manager, Business Systems & Data		Rao	Chanukya		5088046892				5088046892	chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part C Application Contact	Manager of Product Development		McCloy	Tracey		3367904525					tmccloy@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part C Reporting Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Appeals	Pharmacy Manager	Dr.	Ruedinger	Kevin							kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active	3366602249				PPO - BBA		C	Dallas
H9808	Part D Appeals Contact (Secondary)	Chief Operations Officer	Dr	Homer	Deanna							dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active	3367904385				PPO - BBA		C	Dallas
H9808	Part D Application Contact	Manager of Product Development		McCloy	Tracey		3367904525					tmccloy@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Benefits Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Claims Submission Contact	Manager, Business Systems & Data		Rao	Chanukya		5088046892					chanukya.rao@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Exceptions Contact	Clinical Advisor		Morgan	Madeline						5082827171	madeline.morgan@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active	8002371992				PPO - BBA		C	Dallas
H9808	Part D Exceptions Contact (Secondary)	Pharmacy Manager	Dr.	Ruedinger	Kevin							kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/18/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active	3366602249				PPO - BBA		C	Dallas
H9808	Part D Price File Contact (Back-up)	Manager, Pharmacy Network Analytics		Chaudhary	Sudhakar		5085973931					sudhakar.chaudhary@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Price File Contact (Optional)	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Price File Contact (Primary)	Technical Business Analyst		Parmar	Vihan		5085973999					vihan.parmar@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Quality Assurance Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Part D Reporting Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Patient Safety Contact	Pharmacy Manager	Dr.	Ruedinger	Kevin		3366602249					kruedinger@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/18/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Payment Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Pharmacy Director	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Pharmacy Network Management Contact	Chief Administrative Officer		Wickremeratne	Aruna		5088046923					aruna.w@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	12/12/2022	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Pharmacy Network Management Contact (Secondary)	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Pharmacy Technical Help Desk Contact	Consumer Services Operations Manager		Carrera	Heylen						5083106372	heylen.carrera@nirvanahealth.com	600 North Westshore Boulevard	suite 900	Tampa	FL	33607	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active	8002371992				PPO - BBA		C	Dallas
H9808	Pharmacy Technical Help Desk Contact (Secondary)	Chief Operations Officer	Dr.	Homer	Deanna							dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active	3367904385				PPO - BBA		C	Dallas
H9808	Plan Directory Contact for Public Website			Service	Customer		8889651965					conciergehta@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Plan to Plan Reconciliation Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Processor Contact	Account Manager		Pradeep	Sneha		5088047369				5088047369	sneha.pradeep@nirvanahealth.com	136 Turnpike Road		Southborough	MA	01772	06/10/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Quality Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Reconciliation Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Recovery Audit Contact	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	SNP Application Contact	Chief Operations Officer	Dr.	Homer	Deanna		3367904385					dhomer@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	01/28/2024	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Surveillance Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	System Contact	VP of Information Technology	Mr	Short	David		3365106190					dshort@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	05/27/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Third Party Administrator (TPA) Liaison	Chief Financial Officer	Ms.	Donoghue	Trish		3367904386					tdonoghue@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	User Access Contact	Compliance Officer	Ms	Moore	Teresa		8145042687					teresa.moore@conehealth.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	07/02/2025	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Utilization Management Contact	Medical Director	Dr.	Evans	Steve		3366606094					sevans@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9808	Utilization Review Contact	Medical Director	Dr.	Evans	Steve		3366606094					sevans@htanc.com	300 East Wendover Avenue	Suite 121	Greensboro	NC	27401	06/02/2023	2026	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	Local CCP	HealthTeam Advantage	Local PPO		Risant Health, Inc.	96	Yes	Active					PPO - BBA		C	Dallas
H9811	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Best Available Evidence Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	07/17/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Complaints Tracking Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					takiyah.l.grant@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/28/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Customer Service Operations Contact	Director, Contact Center Operations		Lewis	Jesse		7264442205					jesse.lewis2@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	09/05/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	09/05/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Encounters		Yella	Inaja		7183936122					inaja.yella@centene.com	25-01 Jackson Ave.		Long Island City	NY	11101	07/31/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Medical Director	Chief Medical Director	Dr.	Lucas	Brad		8662464356					blucas@centene.com	3700 Embassy Parkway, Suite 200		Akron	OH	44333	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Online Enrollment Center Contact (Back-up)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd.		Woodland Hills	CA	91367	08/12/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Online Enrollment Center Contact (Optional)	Director, Business Operations		Demirchyan	Ovsanna		8186766079					ovsanna.demirchyan@centene.com	21271 Burbank Blvd		Woodland Hills	CA	91367	08/22/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Online Enrollment Center Contact (Primary)	Business Compliance Consultant		Oh	Sonja		8186766028					sonja.oh@centene.com	21281 Burbank Boulevard		Woodland Hills	CA	91367	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Denver
H9811	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Denver
H9811	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		Houston	TX	77027	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Denver
H9811	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Denver
H9811	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	01/09/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H9811	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/03/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500202				HMO - Health Maintenance Organization		C	Denver
H9811	PHR Beneficiary Contact																	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS	Member Services	Centene Corporation	351	Yes	Active	8665498289				HMO - Health Maintenance Organization		C	Denver
H9811	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@CENTENE.COM	4349 Easton Parkway	Suite 200	Columbus	OH	43219	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9811	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	07/05/2024	2026	MAGNOLIA HEALTH PLAN, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Denver
H9818	Part C Application Contact			Zamora	Matty		5624772353					mzamora@samaritana.us	4055 E. Olympic Blvd.		Los Angeles	CA	90023	11/02/2025	2026	KIZ LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9818	Part D Application Contact			Zamora	Matty		5624772353					mzamora@samaritana.us	4055 E. Olympic Blvd.		Los Angeles	CA	90023	11/02/2025	2026	KIZ LLC	National PACE		National PACE				Yes	Pending					PACE - Nat		C	
H9826	Agent/Broker Compensation Data Contact	VP, Community Partnership & Sales	Mr	Guerra	Rodolfo		7132956722					rodolfo.guerra@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77054	08/29/2024	2026	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	Automated TrOOP Balance Transfer Contact		Mr.	Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	07/30/2020	2026	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	Backup User Access Contact	Senior IT Security and Data Governance Coordinator		Hobbs	Richard		7132952313					richard.hobbs@communityhealthchoice.org	4888 Loop Central Drive		Houston	TX	77054	10/07/2024	2026	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		7132952324				7132957041	evelyn.olatunbosun@communityhealthchoice.org	4888 Loop Central Drive		Houston	TX	77054	10/07/2024	2026	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	Bid Audit Contact	CFO	Ms.	Mateja	Anna		7132954733					anna.mateja@communityhealthchoice.org	4888 Loop Central West	Suite 600	Houston	TX	77081	03/26/2024	2026	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	Bid Audit Site Contact	Accounting Manger	Ms.	Gulley	Bridget		7138486697					bridget.gulley@communityhealthchoice.org	4888 Lopp Central Drive		Houston	TX	77051	12/04/2024	2026	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	Bid Primary Contact	Chief Growth Officer		Kharytonova	Nataliya		7132952225					nataliya.kharytonova@communityhealthchoice.org	4888 Loop West	Suite 600	Houston	TX	77054	12/04/2024	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central West	Suite 600	Houston	TX	77081	12/04/2024	2026	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	CEO - CMS Administrator Contact	President and CEO	Mrs.	Wright	Lisa		7132952410					lisa.wright@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	03/26/2024	2026	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	CEO - Senior Official for Contracting	President and CEO	Mrs.	Wright	Lisa		7132952410					lisa.wright@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	03/26/2024	2026	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		7132952238					Anna.Mateja@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77054	03/26/2024	2026	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 Operating Officer	Chief Operations Officer	Mr.	Johnson	Darrin		7132956795					Darrin.Johnson@CommunityHealthChoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	03/17/2025	2026	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 Information Officer	Chief Information Officer	Mrs.	Levermann	Laurie		7132955015					laurie.levermann@communityhealthchoice.org	4888 Loop Central Drive	Suite 125	Houston	TX	77081	10/07/2024	2026	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 Information Security Officer	Information/HIPPA Security Officer	Mr.	Hobbs	Richard		7132952226					richard.hobbs@communityhealthchoice.org	4888 Loop Central Drive	Suite 125	Houston	TX	77054	03/26/2024	2026	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	Chief Compliance Officer		Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Ste 600		Houston	TX	77081	01/10/2025	2026	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	Complaints Tracking Contact	Chief Compliance Officer		Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Ste 600	Suite 125	Houston	TX	77081	01/10/2025	2026	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	Contact for Fraud Investigations	Manager, Special Investigations Unit		Turner	Ramona		7132952363					Ramona.Turner@communityhealthchoice.org	4888 Loop Central Drive	Suite 125	Houston	TX	77081	10/07/2024	2026	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	Sr. Director, Contact Center		Ziegler	Tonie		7132952384					tonie.ziegler@communityhealthchoice.org	4888 Loop Central Drive		Houston	TX	77054	10/07/2024	2026	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	Corporate Mailing						7132952350					compliance@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	12/04/2024	2026	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		7132952235					tonie.ziegler@communityhealthchoice.org	4888 Loop Central Drive	Suite 125	Houston	TX	77081	10/07/2024	2026	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	DIR Contact	Accounting Manager	Ms.	Gulley	Bridget		7132952238					bridget.gulleya@communityhealthchoice.org	4888 Loop Central Drive	Suite 125	Houston	TX	77054	10/07/2024	2026	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	DIR Contact (Secondary)	Vice President and Controller		Cutner	Sonja		7133145650					sonja.cutner@communityhealthchoice.org	4888 Loop Central Drive		Houston	TX	77051	01/17/2025	2026	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	Discount Program Payment Contact	Chief Financial Officer	Mrs.	Mateja	Anna		7132952238					Anna.Mateja@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Emergency Part D Contact	Pharmacy Director	Dr.	Tran-Tan	Khang		7132956791					Khang.Tran-Tan@CommunityHealthChoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Risk Adjustment		Purnell	Lisa		7132952358					Lisa.Purnell@CommunityHealthChoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	12/04/2024	2026	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	Enrollment Contact	Enrollment Manager		Byrd	Maria		7133145667					maria.byrd@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	EOB Transfer Contact	Sr. Director - Contact Center		Ziegler	Tonie		7132952384				7132957023	tonie.ziegler@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	03/26/2024	2026	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	Financial Audit Contact	Accounting Manager	Mrs.	Gulley	Bridget		7132952238					Bridget.Gulley@communityhealthchoice.org	4888 Loop Central Drive		Houston	TX	77054	10/07/2024	2026	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	Financial Reporting Contact	Accounting Manager	Mrs.	Gulley	Bridget		7138486691					bridget.gulley@communityhealthchoice.org	4888 Loop Drive		Houston	TX	77054	08/29/2024	2026	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	Formulary Contact	Pharmacy Director	Dr.	Tran-Tan	Khang		7132956791					Khang.Tran-Tan@CommunityHealthChoice.org	4888 Loop Central Drive		Houston	TX	77081	10/07/2024	2026	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	Formulary Contact (Secondary)	Formualry Team Lead		Paddock	Deanna		6087291628				6087292628	deanna.paddock@navitus.com	361 Integrity Dr.		Madison	WI	53717	05/06/2020	2026	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	General Contact	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					compliance@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/18/2025	2026	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	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	12/05/2024	2026	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	HIPAA Privacy Officer	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77054	12/05/2024	2026	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	HIPAA Security Officer	Information/HIPPA Security Officer	Mr.	Hobbs	Richard		7132952226					richard.hobbs@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Sr. VP, Health Services	Ms.	Richardson	DeiLaSheun		7132956791					deilasheun.richardson@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77054	12/04/2024	2026	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	Interoperability Contact	VP, Information Technology	Mr.	Anand	Amit		7132955015					amit.anand@CommunityHealthChoice.org	4888 Loop Central Drive		Houston	TX	77054	12/04/2024	2026	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	MA Appeals/Grievances Contact	Sr. Manager of Appeals & Complaints		Point	Beth		7132952350					beth.point@communityhealthchoice.org	4888 Loop Central Drive		Houston	TX	77081	10/07/2024	2026	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	MA Claims Processing Contact for Public Website	Sr. Director, Call Center	Ms.	Ziegler	Tonie		7132952384					tonie.ziegler@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77054	12/04/2024	2026	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	Marketing Contact	Sr. Communication Specialist		Bledsoe	Sandra		7132952391					sandra.bledsoe@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Morris	Charles		7132955193					charles.morris@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77054	12/04/2024	2026	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	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	12/05/2024	2026	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 Coordinator	Director of Complance	Ms.	Smither	Shantelle		7132954763					shantelle.smither@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/18/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy Director	Dr.	Tran-Tan	Khang		7132956791					Khang.Tran-Tan@CommunityHealthChoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy Director	Dr.	Tran Tan	Khang		7132956791					Khang.tran-tan@communityhealthchoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Eligibility Supervisor		Bryd	Maria		7132954772					maria.bryd@communityhealthchoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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	Online Enrollment Center Contact (Optional)			Bryd	Maria		7132954772					maria.bryd@communityhealthchoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Enrollment Manager		Byrd	Maria		7133145667					maria.byrd@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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 C Application Contact	Chief Growth Officer	Ms.	Kharytonova	Nataliya		7132952225					nataliya.kharytonova@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77054	12/05/2024	2026	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 C Reporting Contact	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					Compliance@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/18/2025	2026	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 Appeals	Sr. Manager Appeals and Complaints	Mrs.	Point	Beth						7132957033	beth.point@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active	7132952350				HMO - Health Maintenance Organization		C	Dallas
H9826	Part D Appeals Contact (Secondary)			Tran-Tan	Khang							khang.tran-tan@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active	7132956791				HMO - Health Maintenance Organization		C	Dallas
H9826	Part D Application Contact	Chief Growth Officer	Mrs.	Kharytonova	Nataliya		7133144735					nataliya.kharytonova@communityhealthchoice.org	4888 Loop Central, Ste. 600		Houston	TX	77081	01/27/2025	2026	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 Benefits Contact	Pharmacy Director		Tran-Tan	Khang		7132956791					Khang.Tran-Tan@CommunityHealthChoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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 Claims Submission Contact			Derks	Bob		9202214404				9202214904	pde@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	02/02/2019	2026	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						9202214676	christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	07/30/2020	2026	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Dallas
H9826	Part D Price File Contact (Back-up)			Plan Finder	Navitus		6087291578				6087292578	plan.finder@navitus.com	2601 West Beltline Highway	Suite 600	Madison	WI	53713	02/02/2019	2026	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 Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	plan.finder@navitus.com	361 Integrity Drive		Madison	WI	53717	07/30/2020	2026	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 Quality Assurance Contact	Pharmacy Director		Tran-Tan	Khang		7132956791					Khang.Tran-Tan@CommunityHealthChoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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 Reporting Contact	Pharmacy Director		Tran Tan	Khang		7132956791					Khang.Tran-Tan@CommunityHealthChoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Patient Safety Contact	Sr. Vice President, Health Services	Ms.	Richardson	DeiLaSheun		7132952306					deilasheun.richardson@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Payment Contact	Chief Financial Officer	Mrs.	Mateja	Anna		7132952238					Anna.Mateja@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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 Director	Pharmacy Director		Tran-Tan	Khang		7132956791					Khang.Tran-Tan@CommunityHealthChoice.org	4888 Loop Central Drive	Ste 600	Houston	TX	77081	02/20/2025	2026	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 Network Management Contact	VP, Pharmacy Network Management		Santos	Christina	~	6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	05/13/2025	2026	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						9202214724	danielle.nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/16/2022	2026	COMMUNITY HEALTH CHOICE TEXAS, INC.	Local CCP	Community Health Choice	HMO/HMOPOS		Harris County Hospital District	724	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Dallas
H9826	Plan Directory Contact for Public Website	Sr. Director - Network Management	Mr.	Banda	Michael		7133145667					michael.banda@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting Manager	Mrs.	Gulley	Bridget		7132952238					Bridget.Gulley@CommunityHealthChoice.org	4888 Loop Central Drive	Suite 125	Houston	TX	77081	02/20/2025	2026	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	Processor Contact	Chief Compliance Officer	Ms.	Miller	Terrica		7132954735					terrica.miller@CommunityHealthChoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Quality Contact	Director of Quality		Otto	Melanye		7132955677					melanye.otto@CommunityHealthChoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Reconciliation Contact	Accounting Manager	Mrs.	Gulley	Bridget		7132952330					bridget.gulley@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Recovery Audit Contact	Sr. Director, Internal Audit	Ms.	Johnson	Bridget		7132956733					bridget.johnson@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	SNP Application Contact	Product Development Manager	Mr.	Vo	Huy		7133145669					terrica.miller@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	SNP State Contact	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Drive	Suite 125	Houston	TX	77054	12/04/2024	2026	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	System Contact			Levermann	Laurie		7132955015					laurie.levermann@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Sr Manager, Accounting and Finance	Ms.	Gulley	Bridget		7138486697					Bridget.Gulley@CommunityHealthChoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	07/09/2025	2026	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	User Access Contact	Chief Compliance Officer	Ms.	Miller	Terrica		7133145610					terrica.miller@communityhealthchoice.org	4888 Loop Central Drive	Suitge 600	Houston	TX	77081	02/20/2025	2026	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	Utilization Management Contact	Director of Utilization Management	Mrs.	DeJean	Karen		7132952444					karen.dejean@communityhealthchoice.org	4888 Loop Central Drive	Suite 600	Houston	TX	77081	02/20/2025	2026	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	Utilization Review Contact	Director of Utilization Management	Mrs.	DeJean	Karen		7132952444					karen.dejean@communityhealthchoice.org	4888 Loop Central Drive		Houston	TX	77081	10/07/2024	2026	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	Agent/Broker Compensation Data Contact	Director of Sales		Dues	Travis		6145463157				6145463131	Travis.Dues@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Automated TrOOP Balance Transfer Contact	Part D Analyst		Houk	Kim		6145463183				6145463131	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Backup User Access Contact	Sr. Application Specialist		Crawford	Carl		6145463215				6145463144	ccrawford@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Best Available Evidence Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Bid Audit Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463211	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Bid Audit Site Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Bid Primary Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	CAP Report Contact for Public Website	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	CEO - CMS Administrator Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	Jack.Randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/06/2025	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	CEO - Senior Official for Contracting	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Chief Financial Officer	Chief Financial Officer	Mr	Vis	David		6145463211				6145463131	david.vis@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Chief Operating Officer	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Chief Information Officer	VP Service Optimization	Mr.	Trimmer	Matt		3017547190					matt.trimmer@trinity-health.org	3100 Easton Square Place		Columbus	OH	43219	07/17/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Chief Information Security Officer	Sr Security Manager, Enterprise Information Securi	Mr.	Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	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	6147068474				6142348372	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Complaints Tracking Contact	Compliance Specialist	Mr	Jordan	David	A	6147068474					djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Contact for Fraud Investigations	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Coordination of Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Corporate Mailing						4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	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		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	DIR Contact	CEO		Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square  Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	DIR Contact (Secondary)	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Discount Program Payment Contact	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Electronic Health Record Contact	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Emergency Part D Contact	Chief Compliance Officer		Suffern	Patricia		4124780244				6145463132	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/23/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Emergency Part D Contact (Secondary)	Pharmacy Director	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	12/17/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Employer Waiver Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Encounter Data & Risk Adjustment Operations Contact	Risk Adjustment Reconciliation Analyst		Sloan	Mike		6145463134					mike.sloan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Enrollment Contact	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	EOB Transfer Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Financial Audit Contact	Chief Compliance Officer	Ms.	Suffern	Patricia	A	4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/24/2025	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Financial Reporting Contact	CEO	Mr.	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Formulary Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Formulary Contact (Secondary)	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	General Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Government Relations Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	HIPAA Privacy Officer	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	HIPAA Security Officer	Sr Security Manager, Enterprise Information Securi		Enneking	Tom		6145463668					tenneking@mchs.com	3100 Easton Square Place		Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Hospice Contact	Senior Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Interoperability Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	MA Appeals/Grievances Contact	Senior Director, Member and Provider Services		Schlabach	Marilyn		6145463180				6145463132	mschlabach@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	MA Claims Processing Contact for Public Website	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Marketing Contact	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Medical Director	MD	Dr.	Wise	Greg		6145463151				6145463131	gwise@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Medicare Compliance Officer	Chief Compliance Officer	Ms	Suffern	Patricia		4124780244					patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Medicare Coordinator	Chief Administrative Officer	Mr	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Medicare Part D Opioid Overutilization Contact	Pharmacy Data Analyst	Ms.	Houk	Kimberly		6145463183					kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/03/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Medication Therapy Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	OffShore Subcontractor Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Online Enrollment Center Contact (Back-up)	Supervisor, Enrollment	Ms	Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Online Enrollment Center Contact (Optional)	Director, Enrollment and Premium Billing		Caudle	Jeff		6145463224				6145463148	jcaudle@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Online Enrollment Center Contact (Primary)	Manager, Enrollment & Reconciliation		Buddell	Natasha		6145463222				6145463148	nbuddell@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part C Application Contact	Director, Product Management and Business Devlpt		Mauck	Brandon		6145955681					brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part C Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Appeals	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Appeals Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Application Contact	Director, Product Management and Business Dvlpt		Mauck	Brandon		6145955681				6145463131	brandon.mauck@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	03/29/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Benefits Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Claims Submission Contact	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Exceptions Contact	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Exceptions Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim						6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Price File Contact (Back-up)	Formulary Consultant		Scott	Sarah		4803109219					sarah.scott@CVSHealth.com	9501 E. Shea		Scottsdale	AZ	85260	05/02/2025	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Price File Contact (Primary)	Pharmacy Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Quality Assurance Contact	Director of Pharmacy, Health Plans	Ms.	McGhee	Anna		2165345375				6142346481	anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Part D Reporting Contact	Compliance Specialist		Jordan	David		6145463431				6145463131	djordan@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Patient Safety Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Payment Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Pharmacy Director	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Pharmacy Network Management Contact	Director, Pharmacy	Ms.	McGhee	Anna		2165345375					anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Pharmacy Network Management Contact (Secondary)	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Pharmacy Technical Help Desk Contact	Director, Pharmacy	Ms.	McGhee	Anna							anna.mcghee@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H9827	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Data Analyst	Mrs	Miller	Kim							kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Chicago
H9827	PHR Beneficiary Contact																	01/29/2021	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS	MediGold	Trinity Health Corporation	234	Yes	Active	8002403851				HMO - Health Maintenance Organization		C	Chicago
H9827	Physician Incentive Contact	Interim VP, Health Services	Ms	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Plan Directory Contact for Public Website	Medicare Compliance Officer		Suffern	Patricia		4124780244				6145463131	patricia.suffern@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Plan to Plan Reconciliation Contact	Pharmacy Data Analyst		Houk	Kim		6145463183				6145463132	kulrich@Medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Processor Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794					chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	01/21/2024	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Quality Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Reconciliation Contact	CEO	Mr	Randolph	John	C	6145463152				6145463131	jack.randolph@MediGold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Reconciliation Contact (Secondary)	Controller		Ndoye	Fatou		6145463707					fatou.ndoye@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Recovery Audit Contact	Chief Administrative Officer	Mr.	Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Surveillance Contact	Chief Administration Officer		Alvarado	Chuck		6145463794					Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	System Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	Chuck.Alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Third Party Administrator (TPA) Liaison	Sr Finance Analyst		Fountain	Lisa		6145463220					lfountain@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	09/14/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	User Access Contact	Chief Administration Officer		Alvarado	Chuck		6145463794				6145463131	chuck.alvarado@mchs.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	10/27/2022	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Utilization Management Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	Angela.Thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9827	Utilization Review Contact	Interim VP, Health Services	Ms.	Thomas	Angela	C	6145969891				6142348838	angela.thomas@medigold.com	3100 Easton Square Place	Suite 300-Health Plan	Columbus	OH	43219	04/07/2023	2026	MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.	Local CCP	Trinity Health Plan New York	HMO/HMOPOS		Trinity Health Corporation	234	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9830	Automated TrOOP Balance Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Backup User Access Contact	Chief Information Officer	Ms.	Babachicos	Cara		7209746739				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Bid Primary Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	CAP Report Contact for Public Website	VP of Compliance		Teter	Lezlie		7203929719				3039961600	lteter@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	CEO - CMS Administrator Contact	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	CEO - Senior Official for Contracting	CEO	Mr.	Blair	Patrick		7209746704				3039961600	pblair@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Chief Operating Officer	Market President	Ms.	Stevenson	Kristine		2672862173				3039961600	kstevenson@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Chief Information Officer	CIO	Ms.	Babachicos	Cara		3037202994					cbabachicos@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Chief Information Security Officer	SVP of Information Technology	Mr.	Naus	Cole		7209210443				3039961600	MNaus@innovage.com	InnovAge	8950 East Lowry Blvd	Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Complaints Tracking Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Contact for Fraud Investigations	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Corporate Mailing						3038694664				3039961600	cbabachicos@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	DIR Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	DIR Contact (Secondary)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Discount Program Payment Contact	Director of Finance	Ms.	Hewitt	Jessica		7209476767					jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Emergency Part D Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Emergency Part D Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Encounter Data & Risk Adjustment Operations Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Enrollment Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	EOB Transfer Contact	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Financial Audit Contact	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Financial Reporting Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Formulary Contact	SVP of Clinical Strategic Partnerships	Mr.	Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Formulary Contact (Secondary)	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	JHewitt@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	General Contact	VP Strategy & Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP, External Affairs		Nelson	Don		6082175110					dnelson3@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	HIPAA Privacy Officer	Privacy Officer		Moxon	Jeff		7206613727				3039961600	jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	HIPAA Security Officer	Privacy Officer		Moxon	Jeff		7207896084					jmoxon@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Interoperability Contact	SVP of Applications		Zierolf	Kris		7209742380					kzierolf@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	07/28/2023	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	MA Appeals/Grievances Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	MA Claims Processing Contact for Public Website	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Marketing Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Medical Director	National Medical Director	Dr.	Learned	Mark		7207896028					mlearned@innovage.com	8950 East Lowry Blvd.		Denver	CO	80230	12/05/2025	2026	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	Chief Compliance Officer	Mrs.	Patton	Olivia		7206702472				3039961600	opatton@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Medicare Coordinator	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Medicare Part D Opioid Overutilization Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 E. Lowry Blvd		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Medication Therapy Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Online Enrollment Center Contact (Back-up)	Finance and Compliance Analyst		Kizewski	Alex		3038694664				3039961600	akizewski@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Online Enrollment Center Contact (Primary)	Medicare Compliance Manager		Brown	Lauren		7209746031				3039961600	lbrown2@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Part C Application Contact	VP,  Strategy and Corporate Development		Thomason	Olivia		3033458617					othomason@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/03/2025	2026	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 Appeals	Director of Compliance		Licht	Hannah						3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H9830	Part D Appeals Contact (Secondary)	Director of Compliance		Licht	Hannah						3039961600	hlicht@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active	7208796016				PACE - Nat		C	Philadelphia
H9830	Part D Application Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Benefits Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Claims Submission Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H9830	Part D Exceptions Contact (Secondary)	Director of Pharmacy Services		Pham	Mary						3039961600	mpham@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active	7207896083				PACE - Nat		C	Philadelphia
H9830	Part D Price File Contact (Back-up)	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	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 Price File Contact (Optional)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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 Price File Contact (Primary)	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	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 Quality Assurance Contact	SVP, Clinical Strategic Partnerships Clinical Oper		Cinque	Michael		7207444048				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	07/28/2023	2026	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 Reporting Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Patient Safety Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Payment Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Personal Health Record Contact	Privacy Officer		Moxon	Jeff		3033006944				3039961600	jmoxon@myinnovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Pharmacy Director	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Pharmacy Network Management Contact	SVP of Clinical Strategic Partnerships		Cinque	Michael		7206663817				3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Pharmacy Network Management Contact (Secondary)	Director of Pharmacy Services		Pham	Mary		7207896083					mpham@myinnovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/19/2025	2026	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	SVP of Clinical Strategic Partnerships		Cinque	Michael						3039961600	mcinque@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active	7206663817				PACE - Nat		C	Philadelphia
H9830	PHR Beneficiary Contact																	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE	Total Longterm Care, Inc.	Total Community Options, Inc.	230	Yes	Active	8772776163	732			PACE - Nat		C	Philadelphia
H9830	Plan Directory Contact for Public Website	Director of Marketing		Bravo	Sandra		7203875733					sbravo@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	04/03/2024	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Plan to Plan Reconciliation Contact	Finance and Compliance Analyst		Kizewski	Alex		7207896171				7209173390	akizewski@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	07/28/2023	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Processor Contact	CFO	Mr.	Adams	Ben		9178423099				3039961600	badams@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Quality Contact	Senior Director of Quality		Stamps	Jennifer		7207896011					Jstamps@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Reconciliation Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Reconciliation Contact (Secondary)	Financial and Compliance Analyst		Kizewski	Alex		7207896171					akizewski@innovage.com	8950 E. Lowry Boulevard		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Recovery Audit Contact	Director of Finance	Mrs.	Hewitt	Jessica		7209746767					jhewitt@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Surveillance Contact	Director of Marketing		Bravo	Sandra		5627600842				3039961600	sbravo@innovage.com	8950 E. Lowry Blvd.		Denver	CO	80230	02/14/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	System Contact	Director of PACE Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Third Party Administrator (TPA) Liaison	Director of Finance	Ms.	Hewitt	Jessica		7209746767				3039961600	jhewitt@innovage.com	8950 East Lowry Blvd		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	User Access Contact	Director of Compliance		Licht	Hannah		7203844161				3039961600	hlicht@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	05/19/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Utilization Management Contact	Senior Medical Director		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9830	Utilization Review Contact	Senior Director of Quality		Stamps	Jennifer		7207896011				3039961600	jstamps@innovage.com	8950 East Lowry Boulevard		Denver	CO	80230	12/05/2025	2026	INNOVAGE PENNSYLVANIA LIFE, LLC	National PACE	InnovAge Pennsylvania LIFE	National PACE		Total Community Options, Inc.	230	Yes	Active					PACE - Nat		C	Philadelphia
H9834	Agent/Broker Compensation Data Contact	Manager, Individual Market Sales		Schiro	Rick		6084714891					rick.schiro@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Automated TrOOP Balance Transfer Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Backup User Access Contact	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Best Available Evidence Contact	Director, Enrollment, Billing & Collections		Jones	Jenny		6084714695					jenny.jones@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Bid Audit Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Bid Audit Site Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Bid Primary Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	CAP Report Contact for Public Website	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	CEO - CMS Administrator Contact	President and CEO	Ms	Senty, J.D.	Christine		6084714802					christine.senty@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	CEO - Senior Official for Contracting	President and CEO	Ms	Senty, J.D.	Christine		6084714802					christine.senty@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Chief Financial Officer	Senior Vice President, CFO, Treasurer	Mr.	Butcher	Jeff		6084714771					jeffrey.butcher@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Chief Operating Officer	Vice President, Operations	Ms.	Schiffman	Debra		6086431408					debra.schiffman@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Chief Information Officer	Sr. VP, Chief Information & Digital Officer	Mr	Balu	Siva		6084714830					siva.balu@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Chief Information Security Officer	Senior Director, Information Security	Mr	Olson	Jeff		6084714662					jeff.olson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	CMS Casework Communication Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Complaints Tracking Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Contact for Fraud Investigations	Chief Compliance Officer	Ms.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Coordination of Benefits Contact	Director, Enrollment, Billing & Collections		Jones	Jenny		6084714695					jenny.jones@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Corporate Mailing						6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	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		6086441433					lori.greubel@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	DIR Contact	Director, Actuarial Services		Heuer	Troy		6084714817					troy.heuer@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	DIR Contact (Secondary)	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Discount Program Payment Contact	Lead Financial Analyst		Cheung	Sheila		6088818082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Emergency Part D Contact	Pharmacy Manager		Suhr	Anessa		6083178565				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Emergency Part D Contact (Secondary)	Director of Clinical Pharmacy		Fejfar	Jeremy		6083851887				6088818308	jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Encounter Data & Risk Adjustment Operations Contact	Lead Healthcare Informatics Analyst		Gault	Angie		6086048299					angie.gault@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Enrollment Contact	Director, Enrollment, Billing & Collections		Jones	Jenny		6084714695					jenny.jones@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	EOB Transfer Contact	Vice President, Operations		Schiffman	Debra		6086431408				6088818307	debra.schiffman@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Financial Audit Contact	Manager, Actuarial Services	Mrs.	Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Financial Reporting Contact	Senior Vice President, CFO, Treasurer	Mr.	Butcher	Jeff		6084714771					jeffrey.butcher@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Formulary Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Formulary Contact (Secondary)	Pharmacy Director of Government & Quality Programs		Fejfar	Jeremy		6088818603					jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	General Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Government Relations Contact	Chief Compliance Officer	Mrs.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	HIPAA Privacy Officer	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	HIPAA Security Officer	Senior Director, Information Security		Olson	Jeff		6084714662					jeff.olson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	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		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Interoperability Contact	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	MA Appeals/Grievances Contact	Manager, Appeals and Grievances		Salveson	Kate		6086431527					kathryn.salveson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	MA Claims Processing Contact for Public Website			Service	Customer		8003945566					customerservice@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Marketing Contact	Director, Product Marketing		Alexander	Cari		6084714864					cari.alexander@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Medical Director	SVP, Chief Clinical Officer	Ms	Berger	Jami		6084714806					jami.berger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Skifton	Kelly	N	6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Medicare Coordinator	Medicare Product Director		Scholze	Amanda		6088818094					amanda.scholze@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Medicare Part D Opioid Overutilization Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Medication Therapy Management Contact	Pharmacy Director of Clinical Pharmacy	Mr	Fejfar	Jeremy		6088818603				6088818308	jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Online Enrollment Center Contact (Back-up)	Member Enrollment Analyst		Petersen	Gerri		6088818197					geraldine.petersen@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Online Enrollment Center Contact (Primary)	Member Enrollment Analyst		Petersen	Gerri		6088818197					geraldine.petersen@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part C Application Contact	Medicare Product Manager		Griffin	Jessica		6088818199					jessica.griffin@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part C Reporting Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefis.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Appeals	Manager, Appeal & Grievances		Salveson	Kate							kathryn.salveson@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	6086431527				HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Appeals Contact (Secondary)	Appeals Specialist		Specialists	Appeals						6086443500	appeals.specialists@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	8003945566	308284			HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Application Contact	Medicare Product Manager		Griffin	Jessica		6088818199					jessica.griffin@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Benefits Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Claims Submission Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	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						6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	8003945566				HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Price File Contact (Back-up)	Director of Pharmacy Government Programs		Fejfar	Jeremy		6088818603					jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Price File Contact (Optional)	Sr. Business Analyst, OptumRx		Kim	Kevin		6265334804					kevin.kim@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Price File Contact (Primary)	Sr. Business Analyst, OptumRx		Kim	Kevin		6265334804					kevin.kim@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Quality Assurance Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Part D Reporting Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Patient Safety Contact	Director of Pharmacy Government Programs	Mr	Fejfar	Jeremy		6088818603					jeremy.fejfar@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Payment Contact	Senior Vice President, CFO, Treasurer	Mr.	Butcher	Jeff		6084714771					jeffrey.butcher@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Pharmacy Director	Director, Pharmacy Medicare Operations		Lojkovic	Kathy		8475020855					kathy.lojkovic@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Pharmacy Network Management Contact	Pharmacy Manager		Suhr	Anessa		6088818616				6088818307	anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Pharmacy Technical Help Desk Contact	OptumRx Senior Manager, PhD		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active	8005064614				HMO - Health Maintenance Organization		C	Chicago
H9834	Plan Directory Contact for Public Website			Service	Customer		8003945566					customerservice@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Plan to Plan Reconciliation Contact	Lead Financial Analyst		Cheung	Sheila		6088818082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Processor Contact	Pharmacy Manager		Suhr	Anessa		6088818616					anessa.suhr@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Quality Contact	Manager, Consulting Analytics		Traastad	Maggie		6088818609					maggie.traastad@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Reconciliation Contact	Manager, Actuarial Services		Mueller	Shannan		2623910110					shannan.mueller@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Recovery Audit Contact	Chief Compliance Officer	Ms.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	SNP Application Contact	Medicare Product Manager		Griffin	Jessica		6088818199					jessica.griffin@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	SNP State Contact	Medicaid Products & Government Affairs Director		Moody	Jonathan		6084714756					jonathan.moody@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Surveillance Contact	Chief Compliance Officer	Ms.	Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	System Contact	Senior Compliance Analyst		Stanton	Jessica		6088818157					jessica.stanton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Third Party Administrator (TPA) Liaison	Lead Financial Analyst		Cheung	Sheila		6088818082					sheila.cheung@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	User Access Contact	Chief Compliance Officer		Skifton	Kelly		6088818151					kelly.skifton@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Utilization Management Contact	Senior Vice President, Chief Clinical Officer	Ms	Berger	Jami		6084714806					jami.berger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	HMO/HMOPOS		University of Wisconsin Hospitals and Clincs Autho	677	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9834	Utilization Review Contact	Senior Vice President, Chief Clinical Officer	Ms	Berger	Jami		6084714806					jami.berger@quartzbenefits.com	2650 Novation Pkwy		Fitchburg	WI	53713	08/06/2025	2026	QUARTZ HEALTH PLAN MN CORPORATION	Local CCP	Quartz Medicare Advantage (HMO)	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 Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Backup User Access Contact	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	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 Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Bid Primary Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	CAP Report Contact for Public Website	Executive Director		Huegel	Lori Anne		5742478763					Lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	CEO - CMS Administrator Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	CEO - Senior Official for Contracting	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Chief Financial Officer	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46546	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Chief Operating Officer	COO	Ms.	Lewis	Anne		4066472980					anne.lewis@trinity-health.org	20255 Victor Pkwy  MS-E3C		Livonia	MI	48152	09/22/2020	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Chief Information Officer	Director Enterprise IT Operations	Mr	Gillespie	Jeff		6142348636					gillespj@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	09/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Chief Information Security Officer	VP Information Security	Mr	Jennings	Preston		6105503083					Preston.Jennings@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	09/15/2023	2026	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	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Complaints Tracking Contact	Director Quality & Compliance	Ms.	Moody	Meagan		2674750133					MMoody@Trinity-Health.org	250 E. Day Rd		Mishawaka	IN	46545	01/22/2024	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Contact for Fraud Investigations	Director Quality & Compliance	Ms.	Moody	Meagan		2674750133					MMoody@Trinity-Health.org	250 E. Day Rd		Mishawaka	IN	46545	01/22/2024	2026	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 Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Corporate Mailing						5742478700					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	09/15/2023	2026	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		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	DIR Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Discount Program Payment Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Emergency Part D Contact	Executive Director	Ms	Huegel	Lori Anne		5742478700					Lorianne.huegel@trinity-health.org	250 E. Day		Mishawaka	IN	46545	09/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Encounter Data & Risk Adjustment Operations Contact	Director of Coding and Documentation		Creaney	Emy		7343431939					creaneye@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Enrollment Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	EOB Transfer Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763				5743350674	Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.	Suite 1	Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Financial Audit Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Financial Reporting Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Formulary Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2679917601				2679917618	joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	General Contact	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Government Relations Contact	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	HIPAA Privacy Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	HIPAA Security Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Interoperability Contact	Director Enterprise IT Operations		Gillespie	Jeff		7343433079					gillespj@trinity-health.org	20555 Victor Parkway	TH PACE	Livonia	MI	48152	09/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	MA Appeals/Grievances Contact	Director Quality & Compliance	Ms.	Moody	Meagan		2674750133					MMoody@Trinity-Health.org	250 E. Day Rd		Mishawaka	IN	46545	01/22/2024	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	MA Claims Processing Contact for Public Website	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Marketing Contact	Director Marketing & Communications	Ms.	Lark	Azia		9735182754					azia.lark@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	02/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Medical Director	Medical Director		Quinn	Christophe		5742478700					christopher.quinn@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	02/24/2017	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Medicare Compliance Officer	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Medicare Coordinator	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/04/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Medicare Part D Opioid Overutilization Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/27/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Medication Therapy Management Contact	Manager Part D Compliance	Mr	Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	Mercy LIFE	1001 Baltimore Pike	Springfield	PA	19064	07/27/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part C Application Contact	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part D Appeals	Manager Part D Compliance		Garbarino	Joseph							Joseph.Garbarino@mercyhealth.org	1930 South Broad St	Unit 3	philadelphia	PA	19145	01/04/2021	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Chicago
H9842	Part D Application Contact	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part D Benefits Contact	Regional Finance Director		Fuhrmeister	Nicole		2157788707					nicole.fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part D Claims Submission Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	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	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Chicago
H9842	Part D Price File Contact (Back-up)	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part D Price File Contact (Primary)	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part D Quality Assurance Contact	Director Quality & Compliance	Ms.	Moody	Meagan		2674750133					MMoody@Trinity-Health.org	250 E. Day Rd		Mishawaka	IN	46545	01/22/2024	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Part D Reporting Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Patient Safety Contact	Director Quality & Compliance	Ms.	Moody	Meagan		2674750133					MMoody@Trinity-Health.org	250 E. Day Rd		Mishawaka	IN	46545	01/22/2024	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Payment Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Pharmacy Director	Manager Pharmacy, Part D Compliance		Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	10/03/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Pharmacy Network Management Contact	Manager Pharmacy, Part D Compliance		Garbarino	Joseph		2153394362					joseph.garbarino@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	10/03/2022	2026	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	Manager Part D Compliance		Garbarino	Joseph							joseph.garbarino@trinity-health.org	2500 Northgate Road		Trevose	PA	19053	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active	2153394362				PACE - Nat		C	Chicago
H9842	Plan Directory Contact for Public Website	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Plan to Plan Reconciliation Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Processor Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Quality Contact	Director Quality & Compliance	Ms.	Moody	Meagan		2674750133					MMoody@Trinity-Health.org	250 E. Day Rd		Mishawaka	IN	46545	01/22/2024	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Reconciliation Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Recovery Audit Contact	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Surveillance Contact	Executive Director	Ms	Huegel	Lori Anne		5742478763					lorianne.huegel@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/17/2022	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	System Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Third Party Administrator (TPA) Liaison	Regional Director, Finance	Ms	Fuhrmeister	Nicole		5742478763					Nicole.Fuhrmeister@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	11/24/2025	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	User Access Contact	National Director QI/Compliance	Ms	Watts	Christina		2484206065					wattscl@trinity-health.org	20555 Victor Parkway		Livonia	MI	48152	08/15/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Utilization Management Contact	Medical Director		Quinn	Christophe		5742478700					christopher.quinn@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9842	Utilization Review Contact	Medical Director		Quinn	Christophe		5742478700					christopher.quinn@trinity-health.org	250 E. Day Rd.		Mishawaka	IN	46545	08/03/2023	2026	SAINT JOSEPH PACE	National PACE	Saint Joseph PACE	National PACE		Trinity Health Corporation	234	Yes	Active					PACE - Nat		C	Chicago
H9884	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Kansas City
H9884	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	Kansas City
H9884	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	Kansas City
H9884	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Kansas City
H9884	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	Kansas City
H9884	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	Kansas City
H9884	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	Kansas City
H9884	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9884	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	Kansas City
H9888	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H9888	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	7742193868				PPO - BBA		C	New York
H9888	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072990251				PPO - BBA		C	New York
H9888	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H9888	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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 Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	8666934620				PPO - BBA		C	New York
H9888	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active	2072398200				PPO - BBA		C	New York
H9888	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				PPO - BBA		C	New York
H9888	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	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	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC	Local CCP	Devoted Health	Local PPO		Devoted Health, Inc.	690	Yes	Active					PPO - BBA		C	New York
H9904	Agent/Broker Compensation Data Contact	Director of Sales Operations	Ms.	LaPlant	Brandi		7747011604					brandi.laplant@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Automated TrOOP Balance Transfer Contact	Sr. Manager, Medicare Pharmacy Program	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Backup User Access Contact	CFO	Ms.	Natarajan	Gayatri		7747011731					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Best Available Evidence Contact	Chief Compliance Officer for COO	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Bid Audit Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Bid Audit Site Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Bid Primary Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	CAP Report Contact for Public Website	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	CEO - CMS Administrator Contact	CEO	Ms.	Latorre	Sarah		5087698977					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	CEO - Senior Official for Contracting	CEO	Ms.	Latorre	Sarah		5087698977					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Chief Financial Officer	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Chief Operating Officer	Chief Executive Officer (for VP Ops)	Ms.	Latorre	Sarah		5087935401					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Chief Information Officer	IT Director	Mr.	Carey	Cameron		7747011604					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Chief Information Security Officer	IT Director	Mr.	Carey	Cameron		7747011604					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	CMMI Model Point of Contact	CEO	Ms.	Latorre	Sarah		5087698977					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	07/02/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	CMS Casework Communication Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Complaints Tracking Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Contact for Fraud Investigations	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Coordination of Benefits Contact	Claims Manager (for VP Ops)	Ms.	Green	Rose		7747011176					rose.green@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Corporate Mailing						5087935401					sarah.latorre@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Customer Service Operations Contact	Vice President	Mr.	Velten	Steve		8164357408					svelten@dsthealth.com	210 W 10th St		Kansas	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	DIR Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.nataraja@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	DIR Contact (Secondary)	Chief Financial Officer	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Discount Program Payment Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Emergency Part D Contact	Sr. Manager Medicare Pharmacy Program	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Emergency Part D Contact (Secondary)	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					Susan.Jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Encounter Data & Risk Adjustment Operations Contact	Director, Business Systems Analysis	Ms.	Pedigo	Anne		6157723229					anne.pedigo@sscinc.com	210 W. 10th Street		Kansas CIty	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Enrollment Contact	Operations Manager	Ms.	Wheeler	Jackelin		7747011160					jackelin.wheeler@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	EOB Transfer Contact	Vice President	Mr.	Velten	Steve		8164357408				3607211381	svelten@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Financial Audit Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Financial Reporting Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Formulary Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Formulary Contact (Secondary)	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	General Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Government Relations Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	HIPAA Privacy Officer	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	HIPAA Security Officer	IT Director	Mr.	Carey	Cameron		9789356216					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Hospice Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Interoperability Contact	IT Director	Mr.	Carey	Cameron		9789356216					cam.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	MA Appeals/Grievances Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	MA Claims Processing Contact for Public Website	Vice President	Mr.	Velten	Steve		8164357408					svelten@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Marketing Contact	Marketing Director	Ms.	Grier	Maureen		7814929832					maureen.grier@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Medical Director	Chief Medical Officer	Dr.	Gelman	Gennady		9179683146					gennady.gelman@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Medicare Compliance Officer	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Milbrook St		Worcester	MA	01605	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Medicare Coordinator	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Medicare Part D Opioid Overutilization Contact	Sr. Manager Medicare Pharmacy Program	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Medication Therapy Management Contact	Sr. Manager Medicare Pharmacy Program	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	OffShore Subcontractor Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Online Enrollment Center Contact (Primary)	Operations Manager	Ms.	Wheeler	Jackelin		7747011160					jackelin.wheeler@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part C Application Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part C Reporting Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Appeals	Sr Manager of Pharmacy Part D	Ms.	Jones	Susan							susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	7747011720				PPO - BBA		C	Boston
H9904	Part D Appeals Contact (Secondary)	Chief Compliance Officer	Mr.	Arnott	Drew							drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	7747011423				PPO - BBA		C	Boston
H9904	Part D Application Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Benefits Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Claims Submission Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Exceptions Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan							erica.hursey@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	7747011720				PPO - BBA		C	Boston
H9904	Part D Exceptions Contact (Secondary)	Sr Manager of Pharmacy Part D	Ms.	Jones	Susan							susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	7747011720				PPO - BBA		C	Boston
H9904	Part D Price File Contact (Back-up)	Vice President, Compliance & Contracting	Mr.	Cone	Mark		8168436461					mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Price File Contact (Optional)	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Price File Contact (Primary)	Vice President, Compliance & Contracting	Mr.	Cone	Mark		8168436461					mark.cone@sscinc.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Quality Assurance Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Part D Reporting Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Patient Safety Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Payment Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Pharmacy Director	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Milbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Pharmacy Network Management Contact	VP Account Management II	Mr.	Nagy	Don		6123186111					don.nagy@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Pharmacy Network Management Contact (Secondary)	Sr Director Pharmacy Network Analytics and Pricing	Mr.	Huffman	Gregg		8164352471					ghuffman@dsthealth.com	210 W 10th St		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Pharmacy Technical Help Desk Contact	Sr. Manager, CDAG, Medicare Part D	Mr.	DiBiase	Joe							joe.dibiase@primetherapeutics.com	P.O. Box 64806		St. Paul	MN	551640811	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	8778654624				PPO - BBA		C	Boston
H9904	Pharmacy Technical Help Desk Contact (Secondary)	Account Manager Health Plans		Muhammad	Atiyya							atiyya.muhammad@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active	8778654624				PPO - BBA		C	Boston
H9904	Plan Directory Contact for Public Website	Marketing Director	Ms.	Greer	Maureen		7747011213					maureen.greer@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Plan to Plan Reconciliation Contact	Sr. Manager Medicare Pharmacy	Ms.	Jones	Susan		7747011720					susan.jones@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Processor Contact	Vice President	Mr.	Velten	Steve		8164357408					svelten@dsthealth.com	210 W. 10th Street		Kansas City	MO	64105	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Quality Contact	Director of Quality	Ms.	Botello	Grace		7747011727					grace.botello@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Reconciliation Contact	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Reconciliation Contact (Secondary)	Comptroller	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Recovery Audit Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	SNP Application Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Surveillance Contact	Chief Compliance Officer	Mr.	Arnott	Drew		7747011423					drew.arnott@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	System Contact	IT Director	Mr.	Carey	Cameron		9789356216					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Third Party Administrator (TPA) Liaison	CFO	Ms.	Natarajan	Gayatri		7745700390					gayatri.natarajan@massadvantage.com	67 Millbrook Street		Worchester	MA	01606	06/13/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	User Access Contact	IT Director	Mr.	Carey	Cameron		9789356216					cameron.carey@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	02/20/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Utilization Management Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9904	Utilization Review Contact	Operations Support Specialist	Ms.	Bochtler	Kimberly		2075764136					kimberly.bochtler@massadvantage.com	67 Millbrook Street		Worcester	MA	01606	12/05/2025	2026	CENTRAL MASS HEALTH, LLC	Local CCP	Mass Advantage	Local PPO		Central Mass Health Holding LLC	773	Yes	Active					PPO - BBA		C	Boston
H9907	Agent/Broker Compensation Data Contact	Manager, Sales Operations		Chowdhury	Nahar		6179729400	60926				Nahar.Chowdury@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Automated TrOOP Balance Transfer Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Backup User Access Contact	Lead Govt Prgms Compliance Manager		Foster	Amber		7816128333					Amber.Foster@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	3152780				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Bid Audit Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Bid Audit Site Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Bid Primary Contact	Director, Pricing - Senior Products		Hummel	Matthew		7816122128	86887				matthew.hummel@point32health.org	1 Wellness Way		Canton	MA	02021	10/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	CAP Report Contact for Public Website	Director, Government Programs Compliance Officer		Geroski	Tami		7816121000	86892				Tami.Geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Gilligan	Patrick		7816126840	86300				Patrick.Gilligan@point32health.org	1 Wellness Way		Canton	MA	02021	06/16/2025	2026	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	Chief Financial Officer	Mr.	MacFarlane	Glenn		7816126840	86287				glenn.macfarlane@point32health.org	1 Wellness Way		Canton	MA	02021	08/05/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Chief Operating Officer	Chief Operating Officer	Ms.	Catlender	Kathryn		7816126840	84588				Katie.Catlender@point32health.org	1 Wellness Way		Canton	MA	02021	07/14/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Chief Information Officer	SVP and Chief Information Officer	Ms.	Ferhatbegovic	Selma		7816121000	84633				Selma.Ferhatbegovic@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Complaints Tracking Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				Sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Contact for Fraud Investigations	VP,  Privacy, Fraud Prevention & Recovery		Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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			COB Inquiries	Medicare		7816121000					Medicare_COB_Inquiries@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Corporate Mailing						7816121000					R.Scott.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Villatoro	Yesly		7816121000	54152				yesly.villatoro@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	DIR Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	DIR Contact (Secondary)	Pharmacy Analyst Senior		Santino	Cristina		7816121000	82560				cristina.santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Discount Program Payment Contact	Sr. Manager, Accounting		Parikh	Roshni		7816121000	84512				roshni.parikh@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Electronic Health Record Contact	Director, Core Administration System Application		Pavao	Joseph		7816121000	83289				Joseph.Pavao@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Emergency Part D Contact	Director, Pharmacy Operations		Bonica	Joseph		7816123342					joseph.bonica@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Emergency Part D Contact (Secondary)	Senior Manager, Pharmacy Operations		MacAuley	Jacqueline		6176123059					jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/04/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Employer Waiver Contact	Manager, Client Services		Bartkiewicz	Mary		7816121000	83937				Mary.Bartkiewicz@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Encounter Data & Risk Adjustment Operations Contact	Manager, Risk Adjustment Data & Reporting		Quinlan	Judith		7816121000	83377				judith.quinlan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Enrollment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897	83156				thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	EOB Transfer Contact	Manager, Business Implementation		Nesmith	Tanisha		7816124861				6176730286	tanisha.nesmith@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Financial Audit Contact	Senior Vice President and Chief Financial Officer	Mr.	Walker	R. Scott		7816126840	86840				R.Scott.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Financial Reporting Contact	Assistant Corporate Controller		Jaiswal	Ruchi		6179729400	84518				Ruchi.Jaiswal@point32health.org	1 Wellness Way		Canton	MA	02021	08/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Formulary Contact	Clinical Pharmacist Senior		Kowalski	Alec		7816121000	82045				alec.kowalski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Formulary Contact (Secondary)	Clinical Pharmacist Senior		Shafir	Frances		7816122897					frances.shafir@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	General Contact	Medicare Compliance Officer	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		Lewis	Kristin		7816121000	83621				kristin.lewis@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	HIPAA Privacy Officer	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	10/06/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	HIPAA Security Officer	VP Chief  Information Security Officer	Mr.	Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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		MacAuley	Jacqueline		7816121000	83059				jacqueline.macauley@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Interoperability Contact	VP, Information Security Officer		Faria	Tony		7816121000	88611				Tony.Faria@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	MA Appeals/Grievances Contact	Director, Appeals & Grievances		Gonzalez	Michelle		6179729400	83114				michelle.gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	MA Claims Processing Contact for Public Website	Director, Claims		Patel	Monal		7816121000	88187				Monal.Patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Marketing Contact	Director, Marketing		Walsh	Tim		7816121000	87541				Tim.Walsh@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Medical Director	Medical Director	Dr.	Courtemanche	Abbie		7816121000	67024				Abbie.Courtemanche@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	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	Ms.	Geroski	Tami	A	7816121000	86892				tami.geroski@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Medicare Coordinator	Vice President, Medicare		Walker	Eddie		7816121000	84471				Edward.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Medicare Part D Opioid Overutilization Contact	Medical Director	Dr.	Dohan	David		7816121000	82615				David.Dohan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Medication Therapy Management Contact	Sr Pharmacy Program Manager		Burns	Ashlyn		7816122239					ashlyn.burns@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Online Enrollment Center Contact (Back-up)	Manager, Enrollment		Ben-Ezra	Daniel		7816121000	54054				Daniel.Ben-Ezra@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Online Enrollment Center Contact (Optional)	Supervisor, Enrollment		Maloney	Kimberly		7816121000	83576				Kimberly.Maloney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Online Enrollment Center Contact (Primary)	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part C Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part C Reporting Contact	Sr. Program Manager, Appeals & Grievances		Mello	Sheri		7816121000	84682				sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Appeals	Director, Appeals & Grievances		Gonzalez	Michelle							Michelle.Gonzalez@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	83114			PPO - BBA		C	Boston
H9907	Part D Appeals Contact (Secondary)	Sr. Program Manager, Appeals & Grievances		Mello	Sheri							sheri.mello@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	84862			PPO - BBA		C	Boston
H9907	Part D Application Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Benefits Contact	Director, Business Implementation		Chukwu	Matthew		7816121000	83967				matthew.chukwu@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Claims Submission Contact	Senior Manager, Pharmacy Operations		Alves	Heather		7816121000	82988				heather.alves@point32health.org	1 Wellness Way		Canton	MA	02021	10/09/2025	2026	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		Chan	Bryan							bryan.chan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	82370			PPO - BBA		C	Boston
H9907	Part D Exceptions Contact (Secondary)	Supervisor, Pharmacy Utilization Management		Bannan	Philip							Philip.Bannan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	7816121000	60178			PPO - BBA		C	Boston
H9907	Part D Price File Contact (Back-up)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					Tim.Sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Price File Contact (Optional)	Sr. Pharmacy Implementation Specialist		Sullivan	Tim		7816124922					tim.sullivan@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Price File Contact (Primary)	Sr Business Analyst		Moore-Elliott	Shalandria		7637974305					shalandria.moore-elliott@optum.com	1600 McConnor Pwy.		Schaumburg	IL	60173	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Quality Assurance Contact	Vice President, Pharmacy		Fenton	Karen		7186121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Part D Reporting Contact	Sr. Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Patient Safety Contact	Sr Pharmacy Implementation Specialist		von Fritzinger	Lisa		7816123778					lisa.vonfritzinger@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Payment Contact	Director, Public Plans Enrollment & Revenue Rec		Mahoney	Thomas		7816124897					thomas.mahoney@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Pharmacy Director	Vice President, Pharmacy		Fenton	Karen		7816121000	83431				Karen.Fenton@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Pharmacy Network Management Contact	Manager, Retail Network Operations		Hagan	Kyle		3039895828					Kyle.Hagan@optum.com	7120 W Iowa Ave		Lakewood	CO	80232	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Ashby	JoLynn		7637326364					JAshby@CastiaRx.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	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	Sr. Manager		Villaneuva	Juan							Juan.Villanueva@optum.com	3515 S Harbor Blvd.		Costa Mesa	CA	92626	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	8556792639				PPO - BBA		C	Boston
H9907	Pharmacy Technical Help Desk Contact (Secondary)	Associate Director, Pharmacy Help Desk		Betten	Brad							bradley.betten@optum.com	1600 McConnor Parkway		Schaumburg	IL	601736801	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active	8556792639				PPO - BBA		C	Boston
H9907	Plan Directory Contact for Public Website	Marketing Materials Production Manager		Kayser	Kenneth		7816121000	83518				kenneth.kayser@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Plan to Plan Reconciliation Contact	Manager, Finance Operations Compliance		Schumaker	Tyler		6179729400	87394				Tyler.Schumaker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Processor Contact	Director, Claims		Patel	Monal		7816121000	88187				monal.patel@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Quality Contact	Director, HEDIS Quality Informatics		McCoy	Kelly		7816121000	83515				kelly.mccoy@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Reconciliation Contact	Senior Manager, Pharmacy Reporting & Analysis		Keating	Melissa		7816121000	84020				Melissa.Keating@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Reconciliation Contact (Secondary)	Pharmacy Analyst Sr.		Santino	Cristina		7816121000	82560				Cristino.Santino@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Recovery Audit Contact	VP,  Privacy, Fraud Prevention & Recovery	Mr.	Orr	Joshua		6175848328					Joshua.Orr@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Surveillance Contact	Director, Sales Operations		Tollefsen	John		7816122266					John.Tollefsen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	System Contact	Senior Manager, Business Account Management		Allen	Jeffrey		7816121000	83167			6179729008	Jeffrey.Allen@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Third Party Administrator (TPA) Liaison	Manager, Accounting		Gatzen	Kelly	A	8609896689					kelly.gatzen@point32health.org	1 Wellness Way		Canton	MA	02021	07/01/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	User Access Contact	Director Medicare Compliance Officer		Geroski	Tami	A	5708142999	0				Tami.Geroski@Point32health.org	1 Wellness Way		Canton	MA	02021	10/21/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Utilization Management Contact	Director, Utilization Management		Walker	Karen		7816121000					Karen.Walker@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9907	Utilization Review Contact	Lead Medical Director, Clinical Reviews	Dr.	Slota	Janet		6179729400	87527				Janet.Slota@point32health.org	1 Wellness Way		Canton	MA	02021	04/03/2025	2026	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	Local CCP	Tufts Health Plan	Local PPO		Point32Health, Inc.	398	Yes	Active					PPO - BBA		C	Boston
H9909	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	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	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8449170642				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	DIR Contact	VP Formulary & Rebate Economics		Ellermeir	Nicole		9133875120					nellermeir@ElixirSolutions.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4056014429				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	01/18/2021	2026	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	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	10/09/2023	2026	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	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	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	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Ms	Brimm	Angie		8449170642				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8449170642				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/17/2022	2026	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		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Coordinator	Executive Director	Ms.	Voigtmann	Kari		6156036996				8442805360	kvoigtmann@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	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	Medication Therapy Management Contact	Director of Clinical Product Development and Strat	Ms.	Miller	Holly		3304866457				3304058094	hrmiller@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	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	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2024	2026	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	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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 C Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H9909	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Mr	Binegar	Sam						3304058081	appeals@ElixirSolutions.com	2181 E Aurora Road	Building B, Suite 201	Twinsburg	OH	44087	02/16/2022	2026	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8003997524				HMO - Health Maintenance Organization		C	Dallas
H9909	Part D Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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 Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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						3304864801	alavignette@EnvisionRx.com	2181 East Aurora Road	Suite 201	Twinsburg	OH	44087	01/18/2021	2026	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	3308886079				HMO - Health Maintenance Organization		C	Dallas
H9909	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/16/2022	2026	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H9909	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Chris		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	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 Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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 Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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 Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/16/2022	2026	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 Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	2026	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8336611993				HMO - Health Maintenance Organization		C	Dallas
H9909	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Technician		Sanchez	Lynn						6157610920	lsanchez@amhealthplans.com	909 S Meridian Avenue	Ste 425	Oklahoma City	OK	73108	06/25/2021	2026	AMERICAN HEALTH PLAN OF MS, INC.	Local CCP	American Health Advantage of MS	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8449170642				HMO - Health Maintenance Organization		C	Dallas
H9909	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8449170642				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	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	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/30/2023	2026	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	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	06/25/2021	2026	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	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/16/2022	2026	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	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	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	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	SNP State Contact	Executive Director	Ms.	Voigtmann	Kari		6156036996				8442805360	kvoigtmann@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	01/18/2021	2026	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	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	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	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/25/2021	2026	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
H9916	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3143493212					PartD_FIR@centene.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Backup User Access Contact	Compliance Analyst		Coleman	Jordan		3146145493					jordan.coleman@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Best Available Evidence Contact	Director, Business Operations		McKenzie	Shakira		8182061838					Shakira.Mckenzie@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Bid Audit Site Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33436	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Chief Financial Officer	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Chief Information Officer	Executive Vice President Chief Information Officer	Mr.	LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Contact for Fraud Investigations	Senior Director, Special Investigations Unit		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Corporate Mailing						8662464358					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	DIR Contact	Senior Director, Predictive Analytics	Mr.	Lamour	David		8132067536					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	DIR Contact (Secondary)	Vice President, Finance	Mr.	Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Electronic Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132061838				HMO - Health Maintenance Organization		C	Dallas
H9916	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775					Robert.Champagne@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Employer Waiver Contact	Director, Product Management, G&A Product Growth		Pulido	Griselda		8133566423					griselda.pulido@centene.com	21281 Burbank Blvd		Woodland Hills	CA	91367	07/30/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Encounter Data & Risk Adjustment Operations Contact	Senior Director, Risk Adjustment Program Oversight		Herceg	Vanessa		8132067388					Encounters_Raps_Ops@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Enrollment Contact	Director, Business Operations		McKenzie	Shakira		8132061838					lisovr@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	08/04/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.R.Johnson@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	HIPAA Security Officer	Regional Vice President, CISO		Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Hospice Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	MA Appeals/Grievances Contact	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	MA Claims Processing Contact for Public Website	Staff Vice President, Operations		Porter	Sarah		5027738174					sarah.porter@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/10/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.R.Johnson@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Online Enrollment Center Contact (Primary)	Operations Analyst III		Pham	Chinh		7133491726					chinh.pham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part C Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part C Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Appeals	Senior Manager, Pharmacy Operations		Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132063350				HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132066534				HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Benefits Contact	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8132067152				HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	6023080218				HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Payment Contact	Vice President, Medicare CFO		Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra							ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33634	12/12/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Dallas
H9916	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	12/12/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active	8337500408				HMO - Health Maintenance Organization		C	Dallas
H9916	PHR Beneficiary Contact																	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS	Centene Corporation	Centene Corporation	351	Yes	Active	8334449088				HMO - Health Maintenance Organization		C	Dallas
H9916	Physician Incentive Contact	Head of Value-Based Programs		Chervitz	Charles		3145190321					Charles.D.Chervitz@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Plan Directory Contact for Public Website			Services	Provider		8662968731					CorporateMedicareComplianceDept@Centene.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Quality Contact	Senior Compliance Analyst		Schofield	Angela		8053048031					angela.m.schofield@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	SNP Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/27/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	SNP State Contact	Senior Manager, Compliance		Hilton	Jason		3146067780					jason.c.hilton@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Utilization Management Contact	Vice President, EPHCO Utilization Management		McKeehan	Mandy	N	9174546902					mmckeehan@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	12/16/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9916	Utilization Review Contact	Sr Vice President, Medical Management Operations		Henrichsen	Kim		3143202716					kimberlee.henrichsen@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	02/07/2025	2026	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	Local CCP	Wellcare	HMO/HMOPOS		Centene Corporation	351	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9917	Agent/Broker Compensation Data Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					katie.bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	relay.health@navitus.com	Navitus Health Solutions, LLC	1025 West Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Backup User Access Contact	Medicare Compliance Officer, Plan Partner Support	Ms.	Bouyer	Valorie		6159161254					valorie.bouyer@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Best Available Evidence Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Bid Audit Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Bid Audit Site Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Bid Primary Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	CEO - CMS Administrator Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	CEO - Senior Official for Contracting	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Chief Financial Officer	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Chief Operating Officer	Chief Operating Officer/General Manager	Mr.	Emami	John		7038837508					john.emami@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Chief Information Officer	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Chief Information Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	CMS Casework Communication Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Complaints Tracking Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Contact for Fraud Investigations	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Coordination of Benefits Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Corporate Mailing						8558550489					customerservice@alignseniorcare.com	PO BOX 4440		Glen Allen	VA	23058	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Customer Service Operations Contact			Davis	Damon		8043325134					damon.davis@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	DIR Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	DIR Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Discount Program Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Emergency Part D Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Emergency Part D Contact (Secondary)	Manager, Part D Pharmacy Services	Ms.	Shamis	Julia		5167260010					julia.shamis@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Encounter Data & Risk Adjustment Operations Contact	VP of Risk Adjustment	Mr.	Hassenstab	Mark		5072697711					Mark.Hassenstab@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Enrollment Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797					stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	EOB Transfer Contact	Enrollment Manager	Ms	Beringer	Stephanie		2066977797				8336102390	stephanie.beringer@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	02/25/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Financial Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Financial Reporting Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Formulary Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Formulary Contact (Secondary)	Formulary Team Lead		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@Navitus.com	361 Integrity Drive		Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	General Contact	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Government Relations Contact			Landahl	Darryl		8323845949					darryl.landahl@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	HIPAA Privacy Officer	Chief Compliance Officer and HIPAA Privacy Officer	Ms.	Crowe	Melanie		4049330409					melanie.crowe@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rubin	Jacob		7578285813					jacob.rubin@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Hospice Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Interoperability Contact	Director of Data Operations and Architecture	Mr.	Karunakaran	Sukumaran		8043966384					sukumaran.karunakaran@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	MA Appeals/Grievances Contact	Director - Grievance/Appeals & CTMs		Fernandez	Erik		7862398513					Erik.Fernandez@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	MA Claims Processing Contact for Public Website	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Marketing Contact	Marketing Director	Mrs	Kibler	Kierstin		4196055687					kierstin.kibler@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Medical Director	VP Medical Affairs		Dahlgren	Andrew		8042968288					Andrew.Dahlgren@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Medicare Coordinator	CEO/President	Mr.	Dressen	Jeremy		6127474241					jeremy.dressen@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Medicare Part D Opioid Overutilization Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	02/10/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Medication Therapy Management Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	OffShore Subcontractor Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part C Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part C Reporting Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/09/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214372				HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Appeals Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Application Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Benefits Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Claims Submission Contact	Manager,Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	Navitus Health Solutions, LLC 1025 W. Navitus Drive	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Exceptions Contact			LeClair	Christophe						9202214676	christopher.leclair@Navitus.com	Navitus Health Solutions	361 Integrity Dr	Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	9202214176				HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Exceptions Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Price File Contact (Back-up)			Buie	Megan		5122313140				6087292584	megan.buie@Navitus.com	Navitus Health Solutions, LLC 2601 W. Beltline Hwy.	361 Integrity Drive	Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Price File Contact (Optional)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	Plan.Finder@Navitus.com	361 Integrity Dr.		Madison	WI	53717	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Quality Assurance Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Part D Reporting Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Patient Safety Contact	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Payment Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road, Suite 110		Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Pharmacy Director	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Pharmacy Network Management Contact	VP Network Management		Santos	Christina		6088204408					christina.santos@navitus.com	361 Integrity Drive		Madison	WI	53717	06/06/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Pharmacy Network Management Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor		3476835717					victor.sone@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Pharmacy Technical Help Desk Contact	Manager, Customer Care Accounts		Nett	Danielle						9202214724	danielle.nett@navitus.com	Navitus Health Solutions, LLC	1025 W. Navitus Drive	Appleton	WI	54913	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	8662703877	4224			HMO - Health Maintenance Organization		C	Chicago
H9917	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director Part D Operations	Mr.	Sone	Victor							victor.sone@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active	3476835717				HMO - Health Maintenance Organization		C	Chicago
H9917	Physician Incentive Contact	Executive Director	Mr.	Quintero	Arturo	M	7865869550					Artie.Quintero@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Plan Directory Contact for Public Website			Sindlinger	Rocio		8558550489					rocio.sindlinger@curanahealth.com	PO BOX 4440		Glen Allen	VA	23058	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Plan to Plan Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					p2padministration@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Processor Contact	VP Business Service Operations	Ms	Rushman	Patty		6129138671					Patty.Rushman@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	12/09/2025	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Quality Contact	VP of Quality		Ferguson	Laura		8042206174					laura.ferguson@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Reconciliation Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Reconciliation Contact (Secondary)	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Recovery Audit Contact	CFO/VP of Finance	Ms.	Martin	Rachel		7755448314					Rachel.Martin@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	SNP Application Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	AllyAlign Health, Inc. 10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	SNP State Contact			Mayhew	Kaitlin		8046908271					kaitlin.mayhew@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Surveillance Contact	SVP Sales and Marketing Strategy	Ms	Bonner	Katie		5157459076					Katie.Bonner@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	System Contact	Chief Information Officer	Mr.	Tyler	Todd		5037205641					todd.tyler@curanahealth.com	10900 Nuckols Rd.	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Third Party Administrator (TPA) Liaison	Manager of Regulatory Accounting	Ms.	Weis	Katelyn		6073294042					kate.weis@curanahealth.com	10900 Nuckols Rd	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	User Access Contact	Medicare Compliance Officer	Ms.	Kotun	Gillian		6154811897					gillian.kotun@curanahealth.com	10900 Nuckols Road	Suite 110	Glen Allen	VA	23060	10/08/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Utilization Management Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9917	Utilization Review Contact	VP Clinical Programs	Ms	Murray	Maureen		5074611197					Maureen.Murray@curanahealth.com	10900 Nuckols Road		Glen Allen	VA	23060	12/17/2024	2026	ALIGN SENIOR CARE FLORIDA, INC.	Local CCP	Align Senior Care	HMO/HMOPOS		Curana Health Holdings, LLC	733	Yes	Active					HMO - Health Maintenance Organization		C	Chicago
H9942	Agent/Broker Compensation Data Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Automated TrOOP Balance Transfer Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Backup User Access Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Best Available Evidence Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Bid Audit Contact			Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Bid Audit Site Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Bid Primary Contact		Mr.	Granow	Les		5614440709					Les.Granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	CAP Report Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	CEO - CMS Administrator Contact		Mr.	Lerer	Ben		5614440780					Ben.lerer@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H9942	CEO - Senior Official for Contracting		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Chief Financial Officer		Mr.	Granow	Les		5614440709					les.granow@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Chief Operating Officer		Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Chief Information Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Chief Information Security Officer	CIO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	CMS Casework Communication Contact			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Complaints Tracking Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Contact for Fraud Investigations			Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Coordination of Benefits Contact		Ms.	Crowl	Lacey		7657921412					Lacey.crowl@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Corporate Mailing						5616901134					compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Customer Service Operations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	DIR Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H9942	DIR Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Discount Program Payment Contact		Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	Longevity Health Plan	485 Madison Avenue Suite 202	New York	NY	10022	05/30/2025	2026	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	Seattle
H9942	Electronic Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Emergency Part D Contact		Ms.	Lennox	Melyssa		2032008037					Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Emergency Part D Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Encounter Data & Risk Adjustment Operations Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Enrollment Contact	COO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	EOB Transfer Contact		Ms.	Socoski	Beth		5616901134				5616901134	Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Financial Audit Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Financial Reporting Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Formulary Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Formulary Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	General Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Government Relations Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	HIPAA Privacy Officer	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	HIPAA Security Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Hospice Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Interoperability Contact	CIO		Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	MA Appeals/Grievances Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	MA Claims Processing Contact for Public Website	Medicare Compliance Director		Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Marketing Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Medical Director		Mr.	Orgain	Javette		3127206656					javette.orgain@longevityhealthplan.com	Longevity Health Plan	1611 Church Street	Evanston	IL	60201	05/30/2025	2026	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	Seattle
H9942	Medicare Compliance Officer		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Medicare Coordinator	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Medicare Part D Opioid Overutilization Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Medication Therapy Management Contact		Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	OffShore Subcontractor Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part C Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part C Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part D Appeals	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	8002040016				PPO - BBA		C	Seattle
H9942	Part D Appeals Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	8002040016				PPO - BBA		C	Seattle
H9942	Part D Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part D Benefits Contact		Mr.	Latko	Jeff		6363352997					JLatko@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	09/25/2025	2026	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	Seattle
H9942	Part D Claims Submission Contact	Director   Regulated Markets Medicare Solutions	Ms.	Dovico	Rosario		8002040016					Rosario_dovico@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part D Exceptions Contact	Sr. Pharmacy Manager	Mr.	Schumm	Brian						8882358551	Brian_Schumm@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	8002040016				PPO - BBA		C	Seattle
H9942	Part D Exceptions Contact (Secondary)	Medicare Compliance Director	Ms.	Socoski	Beth							beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	8002040016				PPO - BBA		C	Seattle
H9942	Part D Price File Contact (Back-up)	Product Manager Advisor	Ms.	Williams	Stephanie		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part D Price File Contact (Optional)	Medicare Compliance Director	Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part D Price File Contact (Primary)	sr mgr, Government Programs		Dolfi	Amanda		8002040016				8882358551	medicarewebsitefiles@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part D Quality Assurance Contact	Chief Clinical Officer	Ms	Lusk	Lyanna		5616963207					lyanna.lusk@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Part D Reporting Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Patient Safety Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Payment Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Personal Health Record Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Pharmacy Director	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Pharmacy Network Management Contact	Network Account Director, Retail Strategy & Contra	Ms.	Kelly	Heather		8002040016					hakelly@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Pharmacy Network Management Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Pharmacy Technical Help Desk Contact	Director, Customer Service	Ms.	Moore	LaTasha						8882358551	LaTasha_Monroe@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	8009221557				PPO - BBA		C	Seattle
H9942	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Account Manager	Ms.	Lennox	Melyssa							Melyssa.Lennox@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP	Local CCP	Longevity Health Plan	Local PPO		Longevity Health Founders, LLC	697	Yes	Active	8009221557				PPO - BBA		C	Seattle
H9942	Physician Incentive Contact		Ms.	Socoski	Beth		5616901134					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Plan Directory Contact for Public Website	Medicare Compliance Director	Ms.	Socoski	Beth		8883133609					Compliance@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Plan to Plan Reconciliation Contact		Ms.	Ajayi	Bisi		5616328915					bisi.ajayi@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Processor Contact		Mr.	Steffen	Jeff		6363351729					JHSteffen@express-scripts.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Quality Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Reconciliation Contact	Controller	Ms.	Zhai	Vicky		5616328915					vicky.zhai@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Reconciliation Contact (Secondary)	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Recovery Audit Contact	VP Compliance	Ms.	Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	SNP Application Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	SNP State Contact		Ms.	Socoski	Beth		4122601207					Beth.Socoski@longevityhealthplan.com	Longevity Health Plan	11780 U.S. Highway 1 Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Surveillance Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	System Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Third Party Administrator (TPA) Liaison	COO	Mr.	Bharadwaj	Sri		9494390333					sri.bharadwaj@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	User Access Contact	VP Compliance		Socoski	Beth		4122601207					beth.socoski@longevityhealthplan.com	11780 U.S. Highway 1	Suite N107	Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Utilization Management Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9942	Utilization Review Contact	Chief Clinical Officer	Ms.	Markowitz	Sheryl		7037271313					Sheryl.Markowitz@longevityhealthplan.com	11780 U.S. Highway 1 Suite N107		Palm Beach Gardens	FL	33408	05/30/2025	2026	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	Seattle
H9955	Agent/Broker Compensation Data Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Automated TrOOP Balance Transfer Contact	AVP, Pharmacy		Vu	John		8012525706					an.vu@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Backup User Access Contact	AVP, Medicare Compliance		McDaniel	Heather	M	2036857419					Heather.McDaniel@molinahealthcare.com	2 Osprey Drive		Seymour	CT	06483	05/21/2025	2026	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	Director, Medicare PEnrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Contact	MHI- Senior Vice President, Chief Actuary		Lynam	Ben		5625194904					benjamin.lynam@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Audit Site Contact	MHI- Vice President, Compliance	Mr.	Gupta	Rohit		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Bid Primary Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CAP Report Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Ocean Gate		Long Beach	CA	90802	05/21/2025	2026	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	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Operating Officer	MHI- COO Medicare	Mrs.	Sapra	Bhawna		5629011029					bhawna.sapra@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Officer	MHI - Chief Information Officer	Mr.	Desai	Amir		5625170801					amir.desai@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate Ave	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Dir, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood Street		Oak Park	MI	48237	05/21/2025	2026	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	Complaints Tracking Contact	Director, Medicare A&G		Bennett	Kimberly		2488549474					Kimberly.Bennett@molinahealthcare.com	24121 Rosewood St		Oak Park	MI	48237	05/21/2025	2026	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	Contact for Fraud Investigations	MHI- Director, FWA Vendor Oversight		Tiernan	Shane		3852352159					shane.tiernan@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		4842691480					Jake.Hartberger@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Corporate Mailing						6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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, Call Center		Faroughi	Cheryl		6145476829					cheryl.faroughi@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	DIR Contact (Secondary)	Director, Financial Plng & Analysis		Cook	Keith		5625422024					keith.cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Discount Program Payment Contact	Senior Financial Analyst		Chun	Sooyeon		8042157387					Sooyeon.Chun@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Emergency Part D Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Emergency Part D Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director, Encounters		Aryal	Sabina		5625069069					sabina.aryal@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Enrollment Contact	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	EOB Transfer Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706				8013162770	an.vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Financial Audit Contact	MHI - VP, Operating Finance	Mr.	Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Financial Reporting Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Formulary Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Formulary Contact (Secondary)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E.Shea Blvd.		Scottsdale	AZ	85260	05/21/2025	2026	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	General Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Privacy Officer	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	HIPAA Security Officer	Chief Information Security Officer		Wilson	Michael		5627063968					michael.wilson1@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Interoperability Contact	VP, Enterprise Architecture		Haines	George		5625170210					George.Haines@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	MA Appeals/Grievances Contact	COO, Medicare	Mrs.	Sapra	Bhawna		5629011029					Bhawna.sapra@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	MA Claims Processing Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Marketing Contact	CEO, Medicare		Akotia	Dennis		6302033902					medicaremarketingoversight@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	06/04/2025	2026	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	Medical Director	Chief Medical Officer	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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		5629511594					MedicareComplianceOfficer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Coordinator	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Part D Opioid Overutilization Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	06/04/2025	2026	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	Medication Therapy Management Contact	Director, Clinical Pharmacy/MTM		Osborn	Stefen		8019870041					Stefen.Osborn@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	OffShore Subcontractor Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Online Enrollment Center Contact (Primary)	Director, Medicare Enrollment		LeJeune	Ryan		5625494527					ryan.lejeune@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 C Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Appeals	Director, Medicare Pharmacy Services		Knowles	Chris							Christopher.Knowles@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5625170246				HMO - Health Maintenance Organization		C	New York
H9955	Part D Appeals Contact (Secondary)	Director, Pharmacy Services		Ramirez	Danielle							Danielle.Ramirez@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8018580400	172067			HMO - Health Maintenance Organization		C	New York
H9955	Part D Application Contact	CEO, Medicare	Mr.	Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Benefits Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Claims Submission Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H9955	Part D Exceptions Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin							Erin.Gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	5708612665				HMO - Health Maintenance Organization		C	New York
H9955	Part D Price File Contact (Back-up)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					Erin.Gordon@molinahealthcare.com	7050 South Union Park Center Suite 200		Midvale	UT	84047	05/21/2025	2026	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 Price File Contact (Optional)	Senior Consultant, CVS Health		Loveland	Chet		4806064873					chet.loveland@cvshealth.com	9501 E. Shea Blvd,		Scottsdale	AZ	85260	05/21/2025	2026	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 Price File Contact (Primary)	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Quality Assurance Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Reporting Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Patient Safety Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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	Payment Contact	Associate Vice President, Data Analytics		Sancheti	Alok		5629011054					alok.sancheti@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Personal Health Record Contact	MHI - Vice President, Compliance		Zevnik	Timothy		9493151837					timothy.zevnik@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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 Director	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact	AVP, Medicare Pharmacy Services		Vu	John		8012525706					An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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 Network Management Contact (Secondary)	Vice President, Medicare Pharmacy Services		Gordon	Erin		5708612665					erin.gordon@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	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						4803146077	dayoubj@cvshealth.com	445 Great Circle Road		Nashville	TN	37228	05/21/2025	2026	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	New York
H9955	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Medicare Pharmacy Services		Vu	John							An.Vu@molinahealthcare.com	7050 South Union Park Center	Suite 200	Midvale	UT	84047	05/21/2025	2026	MOLINA HEALTHCARE OF OHIO, INC.	Local CCP	Molina Healthcare of Ohio	HMO/HMOPOS		Molina Healthcare, Inc.	165	Yes	Active	8012525706				HMO - Health Maintenance Organization		C	New York
H9955	Physician Incentive Contact	MHI - VP, Operating Finance		Parthasarathy	Vijay		6303818563					vijay.parthasarathy@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan Directory Contact for Public Website			Services	Member		8006650898					CentralizedOps.Medicare@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Plan to Plan Reconciliation Contact	Director, Finance		Cook	Keith		5625422024					P2P.molina@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Processor Contact	MHI- Senior Vice President, Corporate Operations		Bell	Del		8885625442	116712				del.bell@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Quality Contact	Vice President, Quality & Star Performance		Cash	Gerrilin		2485149333					gerrilin.cash@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact	AVP, Actuarial Services		Hanna	Maxwell		5625285586					maxwell.hanna@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Gutzmer	Josh		5625061257					Josh.Gutzmer@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Recovery Audit Contact	MHI - Mgr, Compliance	Mr.	Arellano	Flavio		5625421598					Compliance.ExternalAudit@MolinaHealthCare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	SNP Application Contact	CEO, Medicare		Akotia	Dennis		6302033902					MedicareProductDevelopment@molinahealthcare.com	200 Oceangate	Suite 100	Longbeach	CA	90802	05/21/2025	2026	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	SNP State Contact	CEO, Medicare		Akotia	Dennis		6302033902					dennis.akotia@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Surveillance Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	System Contact	AVP, IT Product Line Support		Carrera	Michele		5625170372					Michele.Carrera@molinahealthcare.com	650 Pine Ave		Long Beach	CA	90802	05/21/2025	2026	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	Third Party Administrator (TPA) Liaison	Dir, Fin Plan & Analysis		Cook	Keith		5625422024					Keith.Cook@molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	User Access Contact	MHI- Vice President, Compliance		Gupta	Rohit		5629511594					MedicareComplianceOfficer@Molinahealthcare.com	200 Oceangate	Suite 100	Long Beach	CA	90802	05/21/2025	2026	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	Utilization Management Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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	Utilization Review Contact	CMO, Medicare	Dr.	Donigian	David		2483206713					david.donigian@molinahealthcare.com	200 Oceangate		Long Beach	CA	90802	05/21/2025	2026	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
H9968	Agent/Broker Compensation Data Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Automated TrOOP Balance Transfer Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Backup User Access Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Best Available Evidence Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Bid Audit Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Bid Audit Site Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Bid Primary Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6152602183				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/02/2025	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	CEO - CMS Administrator Contact	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	CEO - Senior Official for Contracting	CEO	Mr.	Bailey	Michael	D	6157518131				8442805360	mbailey@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Chief Financial Officer	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Chief Operating Officer	Chief Operating Officer	Ms.	Bradley	Robin		6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Chief Information Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Chief Information Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	CMMI Model Point of Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	CMS Casework Communication Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Complaints Tracking Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Contact for Fraud Investigations	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Coordination of Benefits Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Corporate Mailing						6156148404				8442805360	rbradley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Customer Service Operations Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8443211763				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	DIR Contact	Manager, Health Plans Finance		Parkin	Frank		2038148504					fparkin@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	DIR Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Discount Program Payment Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Electronic Health Record Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Emergency Part D Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Emergency Part D Contact (Secondary)	Pharmacy Operations	Mrs.	Sanchez	Lynn		4057066535				8442805360	lsanchez@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Encounter Data & Risk Adjustment Operations Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Enrollment Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	EOB Transfer Contact	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Financial Audit Contact	Health Plan Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Financial Reporting Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Formulary Contact	Clinical Formulary Pharmacist	Mr.	Wong	Tim		8582915420					FAS@medimpact.com	10181 Scripps Gateway		San Diego	CA	92131	07/25/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Formulary Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	General Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Government Relations Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	HIPAA Privacy Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	HIPAA Security Officer	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Hospice Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Interoperability Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	MA Appeals/Grievances Contact	Sr Director, Health Plan Administration	Mrs.	Brimm	Angie		8443211763				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	MA Claims Processing Contact for Public Website	Director, Health Plan Administration Claims	Mr.	Demick	Chris		8443211763				8442805360	CDemick@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Marketing Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Medical Director	Medical Director	Dr.	Misra	Sumathi		6156365478					SMisra@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Medicare Compliance Officer	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Medicare Coordinator	Executive Director	Ms.	Voigtmann	Kari		6156036996				8442805360	kvoigtmann@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Medicare Part D Opioid Overutilization Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/13/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Medication Therapy Management Contact	Director of Clinical Programs	Mr	Poore	Richard		6036285133					rpoore@healthdialog.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	OffShore Subcontractor Contact	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		6153900555				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Online Enrollment Center Contact (Back-up)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Mohning	Kathleen		6154650182				8442805360	kmohning@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part C Application Contact			Foote	Denise		6152602183					dfoote@amhealthplans.com	201 Jordan		Franklin	TN	37067	11/13/2023	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part C Reporting Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Appeals	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Appeals Contact (Secondary)	Appeals Supervisor, Clinical Operations	Ms	McCauley	Angela						3304058081	appeals@ElixirSolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8448211763				HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Application Contact			Foote	Denise		6152602183					dfoote@amhealthplans.com	201 Jordan		Franklin	TN	37067	11/13/2023	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Benefits Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Claims Submission Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Exceptions Contact	Appeals Supervisor Clinical Operations	Ms.	McCauley	Angela						3304058081	Appeals@Elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Exceptions Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa						8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8443211763				HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Price File Contact (Back-up)	Director, Reporting & Analytics	Mr	Campbell	Tim		9547672633					tcampbell@ElixirSolutions.com	10181 Scripps Gateway		San	CA	92131	06/17/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Price File Contact (Optional)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Price File Contact (Primary)	Manager, Reporting & Analytics	Mr.	Wentz	Christophe		3304864910					cwentz@ElixirSolutions.com	10181 Scripps Gateway		San Diego	CA	92131	06/18/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Quality Assurance Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Part D Reporting Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Patient Safety Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Payment Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Pharmacy Director	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Pharmacy Network Management Contact	Director of Pharmacy Network Development and Ops	Ms	Profio	Lauren		3304864864				3304058094	lprofio@EnvisionRx.com	2181 East Aurora Rd	Suite 201	Twinsburg	OH	44087	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Pharmacy Network Management Contact (Secondary)	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4056012482				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Pharmacy Technical Help Desk Contact	Vice President Operations	Mr.	Conn	Todd							tconn@Elixirsolutions.com	7835 Freedom Avenue NW North		Canton	OH	44720	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active	8335026757				HMO - Health Maintenance Organization		C	Dallas
H9968	Plan Directory Contact for Public Website	Sr Director, Health Plan Administration	Ms.	Brimm	Angie		8443211763				8442805360	abrimm@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/14/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Plan to Plan Reconciliation Contact	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499					stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Processor Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	909 South Meridian Avenue	Suite 425	Oklahoma City	OK	73108	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Quality Contact	R.Ph, Vice President, Health Services	Ms.	Roper	Lisa		4058262110				8442805360	lroper@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Reconciliation Contact	Chief Financial Officer	Mr.	Bogle	Jeff		6157518134				8442805360	MACFO@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	08/15/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Reconciliation Contact (Secondary)	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Recovery Audit Contact	Vice President, Finance	Mr.	Harris	Richard		7135575987				8442805360	rharris@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	SNP Application Contact	VP Health Plan Administration & Analytics	Ms.	Foote	Denise		6156568049				8442805360	dfoote@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	SNP State Contact	Executive Director	Ms.	Voigtmann	Kari		6156036996				8442805360	kvoigtmann@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Surveillance Contact	Compliance Officer	Mrs.	Ward	Debbie		4054046691				8442805360	dward@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	System Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Third Party Administrator (TPA) Liaison	Sr. Manager,  Financial Accounting	Ms.	Tilley	Stephanie		9312420499				8442805360	stilley@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	06/07/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	User Access Contact	Chief Information Officer	Mr.	Shermer	Barry		6156967173				8442805360	bshermer@AmHealthPartners.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Utilization Management Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9968	Utilization Review Contact	Director, Health Services	Ms.	Nelson	Susie		6156365478				8442805360	snelson@AmHealthPlans.com	201 Jordan Road	Suite 200	Franklin	TN	37067	02/12/2024	2026	AMERICAN HEALTH PLAN OF PENNSYLVANIA INC	Local CCP	American Health Advantage of Pennsylvania	HMO/HMOPOS		Mitchell Family Office	795	Yes	Active					HMO - Health Maintenance Organization		C	Dallas
H9977	Agent/Broker Compensation Data Contact	Sales Operations		Shah	Rishi		2488422231					rshah@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Automated TrOOP Balance Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Backup User Access Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Best Available Evidence Contact	Membership Operations		Mangat	Sunny		6178589484					enrollment@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Bid Audit Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Bid Audit Site Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Bid Primary Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productbids@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	CAP Report Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	CEO - CMS Administrator Contact	Chief Executive  Officer	Mr.	Park	Ed		7812272122					Epark@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	CEO - Senior Official for Contracting	Chief of Medicare Markets	Mr.	Quintana	Dariel		7812272123					dquintana@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Chief Financial Officer	Chief Financial Officer	Mr.	Yale	W. Bradley		7812272124					byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Chief Operating Officer	Chief Operating Officer	Mr.	Henry	Larry		7812272127					lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Chief Information Officer	Chief Technology Officer	Mr.	Nye	Jack		6172304584					jnye@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Chief Information Security Officer	Chief Information Officer	Mr.	Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	CMMI Model Point of Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	CMS Casework Communication Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Complaints Tracking Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					JCagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Contact for Fraud Investigations	SIU		Bowman	John		3144732898					john.bowman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Coordination of Benefits Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Corporate Mailing						8003386833					kathryn.lafargue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Customer Service Operations Contact	Chief Operating Officer		Nanavati	Monna		3392037312					mnanavati@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	DIR Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	DIR Contact (Secondary)	Medicare Advantage Programs		Stearns	David		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Discount Program Payment Contact	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Electronic Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Emergency Part D Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Emergency Part D Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Employer Waiver Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Encounter Data & Risk Adjustment Operations Contact	Provider Operations		Sherman	Rachel		6175197086					Rsherman@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Enrollment Contact	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	EOB Transfer Contact	Medicare Part D		McDaniel	Jody		2072990251				6177024316	jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Financial Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Financial Reporting Contact	Statutory Reporting		Alfano	Joseph		8609169120					Joseph.Alfano@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Formulary Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Formulary Contact (Secondary)	Pharmacy		Mendez	Kristen		6179702549					kristen.mendez@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	General Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Government Relations Contact	Chief Legal and External Affairs Officer		Cowan	Mo		7812272122					mcowan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	HIPAA Privacy Officer	Privacy Officer		Reilly	Emily		4043049090					Emily.reilly@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	HIPAA Security Officer	Chief Information Officer		Careless	Jason		6025764139					Jason.careless@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Hospice Contact	Membership Operations		Mangat	Sunny		6178589484					smangat@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Interoperability Contact	Product		Erawan	Henky		6176698288					herawan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	MA Appeals/Grievances Contact	Appeals, Grievances and Medicare Complaints		Cagot	Janette		3049146913					jcagot@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	MA Claims Processing Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Marketing Contact	Marketing		Lord	Austin		5085964196					Austin.lord@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Medical Director	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Medicare Compliance Officer	Chief Compliance Officer	Ms.	O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Medicare Coordinator	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Medicare Part D Opioid Overutilization Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Medication Therapy Management Contact	Pharmacy		Bioc	Justin		2405810317					jbioc@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	OffShore Subcontractor Contact	Delegated Operations		Woodward	Sarah		8003386833					swoodward@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Online Enrollment Center Contact (Back-up)	Membership Operations		Lepsevich	Katie		5084047626					klepsevich@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Online Enrollment Center Contact (Optional)	Membership Operations		Lippmann	Laura		6319013336					laura.lippmann@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Online Enrollment Center Contact (Primary)	Membership Operations		Strain	Emily		8022995105					emily.berk@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part C Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part C Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Appeals	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Appeals Contact (Secondary)	Medicare Part D		Tripp	Ginger							gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	7742193868				HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Benefits Contact	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Claims Submission Contact	Medicare Advantage Programs		Stearns	David		2072398200					Dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Exceptions Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072990251				HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Exceptions Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Price File Contact (Back-up)	Medicare Advantage Programs		Stearns	Dave		2072398200					dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Price File Contact (Optional)	Medicare Part D		Tripp	Ginger		7442193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Price File Contact (Primary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Quality Assurance Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Part D Reporting Contact	Compliance		Anderson	Abra		6074351005					aanderson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Patient Safety Contact	Pharmacy		Cue	Anlly		9546102501					pharmacy@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Payment Contact	Chief Financial Officer		Yale	W. Bradley		7812272124					Byale@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Personal Health Record Contact	Stars Program		Rosenbaum	Julia		2153137556					jrosenbaum@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Pharmacy Director	Pharmacy		Cue	Anlly		9546102501					angie.cue@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Pharmacy Network Management Contact	Medicare Advantage Programs		Stearns	David		2072398200					DStearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Pharmacy Network Management Contact (Secondary)	Medicare Part D		McDaniel	Jody		2072990251					jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Pharmacy Technical Help Desk Contact	Medicare Part D		McDaniel	Jody							jody.mcdaniel@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Atlanta
H9977	Pharmacy Technical Help Desk Contact (Secondary)	Medicare Advantage Programs		Stearns	Dave							dstearns@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active	2072398200				HMO - Health Maintenance Organization		C	Atlanta
H9977	PHR Beneficiary Contact																	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS	Devoted Health	Devoted Health, Inc.	690	Yes	Active	8552927485				HMO - Health Maintenance Organization		C	Atlanta
H9977	Physician Incentive Contact	Provider Performance		Grijalba	Dunia		9545796191					dgrijalba@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Plan Directory Contact for Public Website	Chief Compliance Officer		O'Kane	Shannon		8003386833					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Plan to Plan Reconciliation Contact	Accounting		Aucoin	Craig		7817263460					p2padmin@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Processor Contact	Chief Operating Officer		Henry	Larry		7812272127					Lhenry@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Quality Contact	Quality		Keegan	Christie		8003386833	6			8772643872	christie.keegan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Reconciliation Contact	Chief Actuary		Quinn	Daniel		9788692163					dquinn@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Reconciliation Contact (Secondary)	Actuary		Baumstein	Michael		2016747341					michael.baumstein@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Recovery Audit Contact	Chief Accounting Officer	Mr.	Donovan	Glen		3139193837					glen.donovan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	SNP Application Contact	Medicare Product Strategy		Holway	Jonathan		5087357313					productapplications@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	SNP State Contact	Compliance		Buchanan	Christy		2057182483					Christy.Buchanan@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Surveillance Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	System Contact	Enterprise Technology		Gallant	David		6033205421					Dgallant@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Third Party Administrator (TPA) Liaison	Medicare Part D		Tripp	Ginger		7742193868					gtripp@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	User Access Contact	Chief Compliance Officer		O'Kane	Shannon		7812272132					sokane@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Utilization Management Contact	Utilization Management		Parks	Regina		2542203062					regina.parks@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9977	Utilization Review Contact	Medical Director	Dr.	Johnson	David		3612449130					David.Johnson@devoted.com	221 Crescent Street	Suite 202	Waltham	MA	02453	11/20/2025	2026	DEVOTED HEALTH PLAN OF NEW MEXICO, INC.	Local CCP	Devoted Health	HMO/HMOPOS		Devoted Health, Inc.	690	Yes	Active					HMO - Health Maintenance Organization		C	Atlanta
H9986	Agent/Broker Compensation Data Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Automated TrOOP Balance Transfer Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Backup User Access Contact	Compliance Consultant		Sharpe	April		7865261284					asharpe@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	11/12/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Best Available Evidence Contact	Sr. VP of Operations		Gutwald	David		6318812404	801304				dgutwald@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	02/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Bid Audit Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Bid Audit Site Contact	Chief Compliance Officer		Santamaria	Cary		7867594387					csantamaria@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	11/12/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Bid Primary Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	CAP Report Contact for Public Website	Compliance Officer		Santamaria	Cary		7867594387					csantamaria@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/16/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	CEO - CMS Administrator Contact	CEO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	CEO - Senior Official for Contracting	CEO	Mr.	Plana	Nestor		3057888158					nplana@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/18/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Chief Financial Officer	CFO	Mr	Thomas	Tarlton		7866824979					tthomas@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/20/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Chief Operating Officer	COO	Ms.	Prince	Holly	G	7867494387					hprince@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	09/20/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Chief Information Officer	Chief Information Officer	Mr.	Paseltiner	Michael		3052621292					MPaseltiner@ilshealth.com	4601 NW 77 Avenue		Miami	FL	33166	02/27/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Chief Information Security Officer	Director of Information Security	Mr.	Quinoa	Alex		3052621292	103813				AQuinoa@ilshealth.com	4601 NW 77 Avenue		Miami	FL	33166	02/27/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	CMMI Model Point of Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	CMS Casework Communication Contact	Senior Director of Medicare Operations		Fagundo	Jenny		7865435229					JFagundo@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	12/02/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Complaints Tracking Contact	Senior Director of Medicare Operations		Fagundo	Jenny		7865435229					JFagundo@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	12/02/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Contact for Fraud Investigations	Special Investigations Unit Director		Benett	Jill		7867423391					JBennett@ilshealth.com	201 East Park Avenue	Suite 400B	Tallahassee	FL	32301	02/21/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Coordination of Benefits Contact	Sr. VP of Operations		Gutwald	David		6318812404	801304				dgutwald@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	04/12/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Corporate Mailing						8882621292					ariddle@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	02/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Customer Service Operations Contact	National Director of Call Center Operations		Perez	Lizette	T	8333227526					ltperez@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	05/05/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	DIR Contact	AVP & Controller		Rankin	Krystal		6467750693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	DIR Contact (Secondary)		Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	03/04/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Discount Program Payment Contact	AVP & Controller		Rankin	Krystal		6467750693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Electronic Health Record Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Emergency Part D Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Emergency Part D Contact (Secondary)	Medical Director	Dr.	Barrial	Rafael		7862391451					rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/15/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Encounter Data & Risk Adjustment Operations Contact	Sr. VP of Operations		Gutwald	David		6318812404	801304				dgutwald@ilshealth.com	1 Computer Associates Plaza		Islandia	NY	11749	02/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Enrollment Contact	Director of Enrollment		Caulfield	Anne		9176547790					acaulfield@ilshealth.com	1377 Motor Parkway		Islandia	NY	11749	12/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	EOB Transfer Contact	Vice President, Claims & Call Center		Chacon	Pela		3052621292				3053057005	pchacon@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	02/10/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Financial Audit Contact	AVP & Controller	Ms.	Rankin	Krystal		6467750693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/10/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Financial Reporting Contact	AVP & Controller	Ms.	Rankin	Krystal		6467750693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/10/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Formulary Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Formulary Contact (Secondary)	Medical Director	Dr.	Barrial	Rafael		7862391451					rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/15/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	General Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Government Relations Contact	VP, Government Affairs		Gormley	Carol		3052257266					cgormley@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee,	FL	32301	02/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	HIPAA Privacy Officer	Director, Compliance & Asst. General Counsel		Blanton	Amy		8882621292					ablanton@ilshealth.com	201 E Park Ave	Ste 400B	Tallahassee	FL	32301	05/01/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	HIPAA Security Officer	Director of Information Security	Mr.	Quinoa	Alex		3052621292	103813				AQuinoa@ilshealth.com	4601 NW 77 Avenue		Miami	FL	33166	02/27/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Hospice Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Interoperability Contact	Chief Information Officer	Mr.	Paseltiner	Michael		3052621292					MPaseltiner@ilshealth.com	4601 NW 77 Avenue		Miami	FL	33166	02/27/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	MA Appeals/Grievances Contact	Senior Director of Medicare Operations	Ms	Fagundo	Jenny		7868773149					jfagundo@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	04/27/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	MA Claims Processing Contact for Public Website	Sr. VP of Operations		Gutwald	David		8333227526					dgutwald@ilshealth.com	1 Computer Associates Plaza		Islandia	NY	11749	01/06/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Marketing Contact	Compliance Consultant		Sharpe	April		7865261284					asharpee@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	10/01/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Medical Director	Medical Director	Dr.	Barrial	Rafael		7862391451					rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/15/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Medicare Compliance Officer	Chief Compliance Officer	Ms	Santamaria	Cary		7867594387					csantamaria@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	11/12/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Medicare Coordinator	Director of Delegation Oversight		Diaz	Emma		5616961749					EDiaz01@ilshealth.com	4601 N.W. 77th Avenue		Miami	FL	33166	06/14/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Medicare Part D Opioid Overutilization Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	05/06/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Medication Therapy Management Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part C Application Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part C Reporting Contact	Director, Regulatory & Operational Reporting	Mr.	Green	Robert		6313588280					rgreen@ilshealth.com	1377 Motor Parkway	Suite 307	Islandia	NY	11749	01/26/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Appeals	Part D Prescription Drug Appeals		IRE Contact Group	ALJ and						7326914838	_ALJandIREContactGroup@CVSHealth.com	620 Epsilon Dr		Pittsburgh	PA	15238	09/19/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active	4219672300	71910			HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Appeals Contact (Secondary)	Medical Director	Dr.	Barrial	Rafael							rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/15/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active	7862391451				HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Application Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Benefits Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Claims Submission Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Exceptions Contact	Director of Pharmacy Benefits	Dr	Prados	Yesenia						7866796899	yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	01/10/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active	8553440930				HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Exceptions Contact (Secondary)	Corporate Chief Medical Officer	Dr.	Barrial	Rafael							rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/15/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active	7862391451	103501			HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Price File Contact (Back-up)	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Price File Contact (Optional)	Corporate Chief Medical Officer	Dr.	Barrial	Rafael		7862391451					rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/15/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Price File Contact (Primary)	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Quality Assurance Contact	Corporate Chief Medical Officer	Dr.	Barrial	Rafael		7862391451					rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/15/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Part D Reporting Contact	Director, Regulatory & Operational Reporting	Mr.	Green	Robert		6313588280					rgreen@ilshealth.com	1377 Motor Parkway	Suite 307	Islandia	NY	11749	01/26/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Patient Safety Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Payment Contact	CFO	Mr	Thomas	Tarlton		3052621292	106643				tthomas@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	01/04/2023	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Personal Health Record Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Pharmacy Director	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Pharmacy Network Management Contact	Director of Pharmacy Benefits	Dr.	Prados	Yesenia		7866796899					yprados@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	03/31/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Pharmacy Technical Help Desk Contact	Pharmacy Helpdesk		Helpdesk	Pharmacy						3054027827	cara.cox@cvshealth.com	2401 Cherahala Blvd.		Knoxville	TN	37932	05/16/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active	8666934620				HMO - Health Maintenance Organization		C	Kansas City
H9986	PHR Beneficiary Contact																	02/12/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS	HPMP of Florida Inc dba Florida Complete Care	Independent Living Systems, LLC	695	Yes	Active	8885261292				HMO - Health Maintenance Organization		C	Kansas City
H9986	Physician Incentive Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Plan Directory Contact for Public Website	President and COO	Mrs.	Riddle	Abby		8333227526					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Plan to Plan Reconciliation Contact	AVP & Controller		Rankin	Krystal		6467750693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Processor Contact	Sr. VP of Operations		Gutwald	David		6318812404	801304				dgutwald@ilshealth.com	1 Computer Associates Plaza		Islandia	NY	11749	02/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Quality Contact	VP of Quality Improvement		Sub Laban	Grace	M	3052621292	103504				gsublaban@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	01/13/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Reconciliation Contact	AVP & Controller	Ms.	Rankin	Krystal		6467750693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/10/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Reconciliation Contact (Secondary)	CFO	Mr	Thomas	Tarlton		8882621292					tthomas@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	05/06/2022	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Recovery Audit Contact	AVP & Controller	Ms.	Rankin	Krystal		6467750693					KRankin@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	12/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	SNP Application Contact	President and COO	Mrs.	Riddle	Abby		8505095998					ariddle@ilshealth.com	201 East Park Ave	Suite 400B	Tallahassee	FL	32301	05/05/2025	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Surveillance Contact	Chief Compliance Officer		Santamaria	Cary		7867594387					csantamaria@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	11/12/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	System Contact	Chief Information Officer	Mr.	Paseltiner	Michael		3052621292					MPaseltiner@ilshealth.com	4601 NW 77 Avenue		Miami	FL	33166	02/27/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Third Party Administrator (TPA) Liaison	Sr. VP of Operations		Gutwald	David		6318812404	801304				dgutwald@ilshealth.com	4601 NW 77 Avenue  FL		Miami,	FL	33166	08/09/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	User Access Contact	Compliance Consultant		Sharpe	April		7865261284					asharpe@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	11/12/2021	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Utilization Management Contact	Medical Director	Dr.	Barrial	Rafael		7862391451					rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	01/10/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9986	Utilization Review Contact	Medical Director	Dr.	Barrial	Rafael		7862391451					rbarrial@ilshealth.com	4601 NW 77th Ave		Miami	FL	33166	01/10/2024	2026	HPMP OF FLORIDA, INC.	Local CCP	Florida Complete Care	HMO/HMOPOS		Independent Living Systems, LLC	695	Yes	Active					HMO - Health Maintenance Organization		C	Kansas City
H9998	Automated TrOOP Balance Transfer Contact	Director of Data Management		Shell	Brian	C	8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Backup User Access Contact	System Adminstrator		Smith	Daniel		8067660230				8067660250	dasmith@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	04/07/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Best Available Evidence Contact	Director of Data Management		Shell	Brian	C	8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Bid Primary Contact	Director of Data Management		Shell	Brian	C	8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	CAP Report Contact for Public Website	Director of Data Management		Shell	Brian	C	8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	CEO - CMS Administrator Contact	CEO	MRS	Lawson	Beth		8067671648					starcare@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	12/04/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	CEO - Senior Official for Contracting	CEO	MRS	Lawson	Beth		8067671648					starcare@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	12/04/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Chief Financial Officer	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	tfhastings@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Chief Operating Officer	CEO	MRS	Lawson	Beth		8067671648					starcare@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	10/23/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Chief Information Officer	CHIEF INFORMATION OFFICER	MS	Potitadkul	Wendy		8067660272				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Chief Information Security Officer	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/25/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	CMS Casework Communication Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Complaints Tracking Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Contact for Fraud Investigations	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/25/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Coordination of Benefits Contact	Director of Data Management	Mr	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	04/07/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Corporate Mailing						8067737857				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Customer Service Operations Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	DIR Contact	Director of Data Management	Mr	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	DIR Contact (Secondary)	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	tfhastings@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Discount Program Payment Contact	Director of Data Management	Mr	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Emergency Part D Contact	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/25/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Emergency Part D Contact (Secondary)	Director of Data Management	Mr	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Encounter Data & Risk Adjustment Operations Contact	Director of Data Management	Mr	Shell	Brian		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	10/24/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Enrollment Contact	Enrollment Coordinator	Mrs	Ewing	Cheryl		8067671736				8067910578	chewing@silverstar.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	EOB Transfer Contact	Director of Data Management	Mr	Shell	Brian		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Financial Audit Contact	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Financial Reporting Contact	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Formulary Contact	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	tfhastings@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Formulary Contact (Secondary)	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/25/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	General Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Government Relations Contact	CEO	MRS	Lawson	Beth		8067671648					starcare@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	12/04/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	HIPAA Privacy Officer	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/25/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	HIPAA Security Officer	CHIEF INFORMATION OFFICER	MS	Potitadkul	Wendy		8067660272				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Interoperability Contact	Director of Data Management		Shell	Brian	C	8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	06/01/2022	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	MA Appeals/Grievances Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	MA Claims Processing Contact for Public Website	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Marketing Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Medical Director	Medical Director	Dr.	Rodriguez	Enrique		8067671718					erodrigu@silverstar.org	P.O. Box 2828		Lubbock	TX	79408	04/03/2013	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Medicare Compliance Officer	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	Kharris@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/28/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Medicare Coordinator	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Medicare Part D Opioid Overutilization Contact	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	06/01/2022	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Medication Therapy Management Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Online Enrollment Center Contact (Back-up)	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Online Enrollment Center Contact (Primary)	Director of Data Management	Mr	Shell	Brian		8067671726					PACEdatateam@starcarelubbock.org	PO Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part C Application Contact	Director of Data Management	Mr	Shell	Brian		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part D Appeals	CFO	MRS.	HASTINGS	TANYA						8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active	8067660223				PACE - Nat		C	New York
H9998	Part D Appeals Contact (Secondary)	Part D Compliance Officer	Mrs	HARRIS	KAREN						8067660250	PACEdatateam@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	08/25/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active	8067401407				PACE - Nat		C	New York
H9998	Part D Application Contact	Director of Data Management	Mr	Shell	Brian		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part D Benefits Contact	Director of Data Management	Mr	Shell	Brian		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part D Claims Submission Contact	Director of Data Management	MR	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part D Exceptions Contact	CFO	MRS.	HASTINGS	TANYA						8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active	8067660223				PACE - Nat		C	New York
H9998	Part D Exceptions Contact (Secondary)	Director of Data Management	Mr	SHELL	BRIAN						8067910578	bshell@silverstar.org	P.O. Box 2828		Lubbock	TX	79408	04/03/2013	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active	8067671726				PACE - Nat		C	New York
H9998	Part D Price File Contact (Back-up)	Director of Data Management		Shell	Brian		8067671726				8067910578	bshell@silverstar.org	P.O. Box 2828		Lubbock	TX	79408	12/30/2013	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part D Price File Contact (Primary)	Director of Data Management	Mr	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part D Quality Assurance Contact	Part D Compliance Officer	MS.	HARRIS	KAREN		8067401407				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	08/25/2020	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Part D Reporting Contact	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Patient Safety Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Payment Contact	Director of Data Management	MR	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Personal Health Record Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Pharmacy Director	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Pharmacy Network Management Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Pharmacy Technical Help Desk Contact	CFO	MRS.	HASTINGS	TANYA						8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active	8067660223				PACE - Nat		C	New York
H9998	PHR Beneficiary Contact																	04/03/2013	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE	Silver Star Health Network	Lubbock Regional Mental Health	356	Yes	Active	8067401500				PACE - Nat		C	New York
H9998	Plan Directory Contact for Public Website	Director of Data Management	MR	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Plan to Plan Reconciliation Contact	Director of Data Management	MR	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Processor Contact	Director of Data Management		SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Quality Contact	Silver Star PACE Program Director	MS.	FORD	MARCELLA		8067874824				8067671726	mford@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	09/20/2023	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Reconciliation Contact	Director of Data Management	MR.	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Reconciliation Contact (Secondary)	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Recovery Audit Contact	CFO	MRS.	HASTINGS	TANYA		8067660223				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	02/18/2025	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Surveillance Contact	Plant Operation Director	MR.	HARWOOD	CHRIS		8065436421				8067660250	charwood@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	04/03/2013	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	System Contact	CHIEF INFORMATION OFFICER	MS	Potitadkul	Wendy		8067660272				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Third Party Administrator (TPA) Liaison	SeniorScript Account Manager		Bautista	Anna		6304453500					anna.bautista@optum.com	1600 McConnor Parkway		Schaumberg	IL	60173	05/27/2016	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	User Access Contact	CHIEF INFORMATION OFFICER	MS	Potitadkul	Wendy		8067660272				8067660250	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Utilization Management Contact	Director of Data Management	Mr	Shell	Brian		8067671726				8067660250	PACEdatateam@starcarelubbock.org	PO BOX 2828		LUBBOCK	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
H9998	Utilization Review Contact	Director of Data Management	MR	SHELL	BRIAN		8067671726				8067910578	PACEdatateam@starcarelubbock.org	P.O. Box 2828		Lubbock	TX	79408	01/18/2019	2026	LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION	National PACE	Silver Star	National PACE		Lubbock Regional Mental Health	356	Yes	Active					PACE - Nat		C	New York
R0110	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R0110	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024989871				Regional PPO		C	Kansas City
R0110	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R0110	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024682494				Regional PPO		C	Kansas City
R0110	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8008658715				Regional PPO		C	Kansas City
R0110	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5025800475				Regional PPO		C	Kansas City
R0110	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0110	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R0759	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Regional PPO		C	Boston
R0759	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R0759	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R0759	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Regional PPO		C	Boston
R0759	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R0759	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R1532	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R1532	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024989871				Regional PPO		C	Kansas City
R1532	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R1532	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024682494				Regional PPO		C	Kansas City
R1532	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8008658715				Regional PPO		C	Kansas City
R1532	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5025800475				Regional PPO		C	Kansas City
R1532	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R1532	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R2604	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Regional PPO		C	Boston
R2604	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R2604	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R2604	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Regional PPO		C	Boston
R2604	Plan Directory Contact for Public Website			Customer Service	UHC		8773704892					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R2604	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3175	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Discount Program Payment Contact	Sr. Accountant		Omar	Zack		9524862771					zack_omar@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/21/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	HIPAA Security Officer	CISO UHC and EIS Optum Tech		Archer	Mark		6125784628					mark.archer@optum.com	11020 Optum Circle		Eden Prairie	MN	55344	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Medicare Part D Opioid Overutilization Contact	Senior Clinical Pharmacist		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Online Enrollment Center Contact (Primary)	Associate Director, Business Process		Weingarten	Heather		7158520479					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	10 Little Moose Lane		Saugerties	NY	12477	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8889037587				Regional PPO		C	Boston
R3175	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8005959532				Regional PPO		C	Boston
R3175	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	680 Blair Mill Road		Horsham	PA	19044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8005959532				Regional PPO		C	Boston
R3175	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Patient Safety Contact	Director, Clinical Pharmacy		Milne	Erika		9529315293					erika_milne@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8778896510				Regional PPO		C	Boston
R3175	Plan Directory Contact for Public Website			Customer Service	UHC		8004578506					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Processor Contact	VP, Claims		Barber	Joseph		3128030121					joseph_barber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	680 Blair Mill Road		Horsham	PA	19044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	680 Blair Mill Road		Horsham	PA	19044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	680 Blair Mill Road		Horsham	PA	19044	01/02/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3175	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R3444	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Regional PPO		C	Boston
R3444	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R3444	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R3444	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Regional PPO		C	Boston
R3444	Plan Directory Contact for Public Website			Customer Service	UHC		8773703207					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R3444	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R4182	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R4182	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024989871				Regional PPO		C	Kansas City
R4182	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R4182	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024682494				Regional PPO		C	Kansas City
R4182	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8008658715				Regional PPO		C	Kansas City
R4182	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5025800475				Regional PPO		C	Kansas City
R4182	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R4182	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5342	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Discount Program Payment Contact	Sr. Accountant		Omar	Zack		9524862771					zack_omar@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	02/21/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	HIPAA Security Officer	CISO UHC and EIS Optum Tech		Archer	Mark		6125784628					mark.archer@optum.com	11020 Optum Circle		Eden Prairie	MN	55344	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Medicare Part D Opioid Overutilization Contact	Senior Clinical Pharmacist		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Online Enrollment Center Contact (Primary)	Associate Director, Business Process		Weingarten	Heather		7158520479					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	10 Little Moose Lane		Saugerties	NY	12477	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8889037587				Regional PPO		C	Boston
R5342	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8005959532				Regional PPO		C	Boston
R5342	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	680 Blair Mill Road		Horsham	PA	19044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8005959532				Regional PPO		C	Boston
R5342	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Patient Safety Contact	Director, Clinical Pharmacy		Milne	Erika		9529315293					erika_milne@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active	8778896510				Regional PPO		C	Boston
R5342	Plan Directory Contact for Public Website			Customer Service	UHC		8004578506					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/11/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Processor Contact	VP, Claims		Barber	Joseph		3128030121					joseph_barber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	680 Blair Mill Road		Horsham	PA	19044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	680 Blair Mill Road		Horsham	PA	19044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	680 Blair Mill Road		Horsham	PA	19044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5342	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	No	Active					Regional PPO		C	Boston
R5361	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R5361	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024989871				Regional PPO		C	Kansas City
R5361	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R5361	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024682494				Regional PPO		C	Kansas City
R5361	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8008658715				Regional PPO		C	Kansas City
R5361	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5025800475				Regional PPO		C	Kansas City
R5361	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5361	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R5826	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024989871				Regional PPO		C	Kansas City
R5826	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R5826	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024682494				Regional PPO		C	Kansas City
R5826	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8008658715				Regional PPO		C	Kansas City
R5826	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5025800475				Regional PPO		C	Kansas City
R5826	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5826	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R5941	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	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	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	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	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Bid Audit Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Audit Site Contact	Director & Actuary III		Scherer	Kyle		6466565264					Kyle.Scherer@elevancehealth.com	One Penn Plaza		New York	NY	10001	02/02/2024	2026	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	Bid Primary Contact	Product Management Director		Gray	Heather		9043474771					Heather.McKee@anthem.com	5211 Pine Rockland Ave.		Lithia	FL	33547	06/28/2024	2026	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	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	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	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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 Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	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 Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	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 Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	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	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	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	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	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	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	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	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	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	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	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	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	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	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	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	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	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	Encounter Data & Risk Adjustment Operations Contact	Director Systems Support & Programs,GBD Encounters		Cotter	Len		4103709774					len.cotter@anthem.com	5800 Northampton Blvd.	Maildrop VA28	Norfolk	VA	23502	11/04/2021	2026	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	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	EOB Transfer Contact	QM Acred/Reg Review Analyst Sr		Pollack	Kristy		9204103749				9209237572	kristy.pollack@bcbswi.com	4361 Irwin Simpson Road	Bldg I	Mason	OH	45040	10/05/2021	2026	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	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	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	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	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	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	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	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	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	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	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 II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	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	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	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	MA Appeals/Grievances Contact	VP Gov't Hlth Ben Grievns & Appeals		Kerry Winston	LeAnne	D	7573190130				8884581406	leanne.kerry-winston@elevancehealth.com	500 Northampton Blvd.		Norfolk	VA	23502	10/10/2024	2026	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	MA Claims Processing Contact for Public Website			Service	Customer		8882307338					MedicareAdvantageAssistance@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	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	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	02/12/2025	2026	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	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	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	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	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	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	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	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	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 C Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 C Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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 Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				Regional PPO		C	Chicago
R5941	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				Regional PPO		C	Chicago
R5941	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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 Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	5133167654				Regional PPO		C	Chicago
R5941	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	7577562058				Regional PPO		C	Chicago
R5941	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	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 Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	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 Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	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 Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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 Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	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	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	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 Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	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 Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	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 Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	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	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				Regional PPO		C	Chicago
R5941	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO		Elevance Health, Inc.	1	Yes	Active	8333774266				Regional PPO		C	Chicago
R5941	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM INSURANCE COMPANIES, INC.	Regional CCP	Anthem Blue Cross and Blue Shield	Regional PPO	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				Regional PPO		C	Chicago
R5941	Physician Incentive Contact	Compliance Director		Jansante	Amanda		7273167407					amanda.jansante@elevancehealth.com	293 Kinross Cir. Pelham		Pelham	AL	35124	05/16/2025	2026	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	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	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	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	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	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	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	Quality Contact	Dir Strategic Initiatives		Ramos	Hilary		6095695625					hilary.ramos@elevancehealth.com	1001 Pennsylvania Ave		Washington	DC	20004	07/15/2024	2026	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	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	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	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	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	SNP Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	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	SNP State Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	02/07/2024	2026	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	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	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	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	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	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	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	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	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	Utilization Management Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Utilization Review Contact	Initiative Project Leader, Medicare Enterprise		Heapes	Mary		7322152000					mary.heapes@elevancehealth.com	17 Cornell Drive		East Brunswick	NJ	08816	06/28/2024	2026	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	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/30/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Best Available Evidence Contact	Manager, Plan Sponsor Support		Kinsey, Jr.	Wayne		8002386279				8886656296	BAE/LISMailbox@aetna.com	Attn: BAE	P.O. Box 14076	Lexington	KY	40512	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Bid Audit Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Bid Audit Site Contact	Lead Director, Actuarial		Foster	Mikaela		9132025086					fosterm1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Bid Primary Contact	AVP, Product Mgmt. & Dev, Medicare Product		Goble	Kelly		7346797784					GobleK@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	CAP Report Contact for Public Website	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	01/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Chief Operating Officer	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	12/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Complaints Tracking Contact	Executive Director Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	Lorraine.Diamond@Aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	09/16/2021	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Coordination of Benefits Contact	Manager, Client Operations		Maples	Zaneta		2145528104					MedicareCOBPharmacy@AETNA.com	1405 Xenium Lane North	Suite 140	Plymouth	MN	55441	05/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Corporate Mailing						4806612030				8554548052	MedicareCO@aetna.com	151 Farmington Avenue	Mail Code RC61	Hartford	CT	06156	07/08/2019	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Customer Service Operations Contact	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Discount Program Payment Contact	Financial Planning & Analysis Consultant		Griswold	Magdalena		7175262949					GriswoldM2@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Encounter Data & Risk Adjustment Operations Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Formulary Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/05/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	MA Appeals/Grievances Contact	AVP, Deputy CMO	Dr.	Lin	Thomas		2816373197				8607541320	LinT@aetna.com	14955 Heathrow Forest Parkway		Houston	TX	77032	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	MA Claims Processing Contact for Public Website	AVP, Medicare Service Operations		Knight	Meg		8002825366					MKnight@aetna.com	14955 Heathrow Forest Pkwy		Houston	TX	77032	06/24/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Medical Director	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Online Enrollment Center Contact (Back-up)	Sr. Analyst Business Analytics		Stank	Tom		7176492572				2157754150	StankT@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Online Enrollment Center Contact (Primary)	Manager, Business Consultant		Killen	Melissa		4803914600					melissa.killen@cvshealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	07/11/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part C Application Contact	AVP, Product Mgt. & Dev., Medicare Product		Goble	Kelly		7346797784					mapdapp@aetna.com	28588 Northwestern Highway		Southfield	MI	48034	07/09/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part C Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active	2244768116				Regional PPO		C	Atlanta
R6694	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active	7132085765				Regional PPO		C	Atlanta
R6694	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active	4692435213				Regional PPO		C	Atlanta
R6694	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active	4125803128				Regional PPO		C	Atlanta
R6694	Part D Price File Contact (Back-up)	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part D Price File Contact (Primary)	Senior Consultant		Smith	Jonathan		4129524541					SmithJ335F51@aetna.com	730 Holiday Drive, Bldg 8	Mail Code: F219	Pittsburg	PA	15220	11/30/2020	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Part D Reporting Contact	Lead Dir., Bus. Compliance, Medicare Ops. Int.		Blankley	Barbara		2067018041					blankleyb@aetna.com	600 University Street		Seattle	WA	98101	11/18/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	12/29/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Personal Health Record Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active	8002386279				Regional PPO		C	Atlanta
R6694	PHR Beneficiary Contact																	02/10/2015	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO	Aetna Medicare Customer Service	CVS Health Corporation	49	Yes	Active	8002825366				Regional PPO		C	Atlanta
R6694	Physician Incentive Contact	Lead Director, Compliance		Benitez	Bernadette		2105253588				8554548052	BLBenitez@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Plan Directory Contact for Public Website			Customer Service	Aetna		8006240756					CustomerService@aetna.com	151 Farmington Avenue		Hartford	CT	06156	08/12/2015	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Quality Contact	Lead Director, Quality Management		Flores	Kimberly	N	6149335605					FloresK2@aetna.com	3200 Highland Ave., MCF661		Downers Grove	IL	60515	12/19/2022	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Reconciliation Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	System Contact	Executive Director, Application Development		Hepner	Mark		4123279231					mahepner@aetna.com	2222 Ewing Road		Moon Township	PA	15108	01/03/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Third Party Administrator (TPA) Liaison	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Utilization Management Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6694	Utilization Review Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	AETNA LIFE INSURANCE COMPANY	Regional CCP	Aetna Medicare	Regional PPO		CVS Health Corporation	49	Yes	Active					Regional PPO		C	Atlanta
R6801	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Regional PPO		C	Boston
R6801	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R6801	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R6801	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Regional PPO		C	Boston
R6801	Plan Directory Contact for Public Website			Customer Service	UHC		8006434845					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R6801	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7220	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Encounter Data & Risk Adjustment Operations Contact	Director, Health Info Management		Lenfert	Matthew		5024766717					mlenfert1@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	MA Appeals/Grievances Contact	Risk Management Lead		Mammone	Danielle		5025804190					dmammone@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	MA Claims Processing Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part C Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East  Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part C Reporting Contact	Sr Compliance Professional		Troxell	Christie		5025807177					ctroxell@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R7220	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024989871				Regional PPO		C	Kansas City
R7220	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	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	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8593219075				Regional PPO		C	Kansas City
R7220	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5024682494				Regional PPO		C	Kansas City
R7220	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	8008658715				Regional PPO		C	Kansas City
R7220	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active	5025800475				Regional PPO		C	Kansas City
R7220	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Quality Contact	Director		Shephard	Angela		7088297767					ashephard@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	SNP Application Contact	Director, Insurance Product Compliance		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	SNP State Contact	Director, Insurance Product Management		Rose	Lauressa		5025808272					lrose1@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Utilization Management Contact	Associate Director, Compliance		Blythe	Mathew		5025802765					mblythe@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7220	Utilization Review Contact	Market Vice President		Sauder	Haley		5853199156					hsauder@humana.com	500 West Main Street	c/o Joni Votaw	Louisville	KY	40202	08/13/2025	2026	HUMANA INSURANCE COMPANY	Regional CCP	Humana	Regional PPO		Humana Inc.	128	Yes	Active					Regional PPO		C	Kansas City
R7444	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Encounter Data & Risk Adjustment Operations Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	MA Appeals/Grievances Contact	Claims Bus Process Tech		Depczynski	Lisa		7163192359					lisa_depczynski@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	MA Claims Processing Contact for Public Website	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part C Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part C Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Regional PPO		C	Boston
R7444	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R7444	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Regional PPO		C	Boston
R7444	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Regional PPO		C	Boston
R7444	Plan Directory Contact for Public Website			Customer Service	UHC		8007110646					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Quality Contact	SVP Quality & Performance Improvement		Brady	Will		9529126655					will.brady@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	SNP Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Utilization Management Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	55440	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
R7444	Utilization Review Contact	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	Regional CCP	UnitedHealthcare	Regional PPO		UnitedHealth Group, Inc.	239	Yes	Active					Regional PPO		C	Boston
S0262	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	12/19/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Backup User Access Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Bid Primary Contact	Actuary		Van Hise	Dennis		4047344706					KPMedicareBids@kp.org	300 Lakeside Drive, 28th Floor		Oakland	CA	94612	06/27/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	CAP Report Contact for Public Website	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/31/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Chief Financial Officer	SVP, CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					mark.c1.stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/18/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/18/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Goddard	Jim		9252065125					bill.d.vourthis@kp.org	6560 Greenwood Plaza Blvd.		Greenwood Village	CO	80111	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	CMS Casework Communication Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Complaints Tracking Contact	Medicare Compliance Lead	Ms	Piper	Kimberly	C	2064739504				2068770645	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	980579055	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Corporate Mailing						8004430815					mscc@kp.org	P.O. Box 12916		Oakland	CA	946042916	02/09/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Customer Service Operations Contact			Services	Member		8004430815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John		5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Formulary Contact	Pharmacy Project Manager		Kim	Jung		5624459129					jung.x3.kim@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Formulary Contact (Secondary)	PHARMACY PROJECT MGR I		Lin	Clement	J	5624459129					Clement.J.Lin@kp.org	12254 Bellflower Blvd		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	General Contact	Compliance Director		Tiratsuyan	Luiza		6263442906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	HIPAA Security Officer	Senior Director	Mr.	Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					Cathy.P.Plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Marketing Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Medicare Compliance Officer	Compliance Director	Ms.	Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Medicare Coordinator	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Medication Therapy Management Contact	Medication Therapy Management		Bentley	Elizabeth		5034889240					elizabeth.d.bentley@kp.org	500 NE Multnomah #100		Portland	OR	97232	12/04/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					jovan.robinson@kp.org	10740 Fourth Street	2nd Floor, Cubicle 023W02	Rancho Cucamonga	CA	91730	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Appeals	Executive Director, Member Relations		Osborne	Susan							Susan.A.Osborne@kp.org	500 NE Multnomah St., Suite 100		Portland	OR	97232	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8774083496				Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Application Contact			Kaplan	Andrew		5105073252					andrew.s.kaplan@kp.org	81 Clarewood Ln.		Oakland	CA	94618	11/15/2023	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Benefits Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Claims Submission Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Exceptions Contact	Supervisor Program Management		Ramos	Blanca							blanca.a.ramos@kp.org	12254 Bellflower Blvd		Downey	CA	90242	12/06/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	5623703382				Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/11/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Part D Reporting Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/11/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Pharmacy Director	National Pharmacy Benefits, Vice President		Miller	Wayne		5626583674					wayne.i.miller@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Pharmacy Network Management Contact	National Pharmacy Benefits, Project Manager II		Munoz	Vanessa		5624477739					Vanessa.L.Munoz@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Pharmacy Network Management Contact (Secondary)	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	01/24/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8776451282				Medicare Prescription Drug Plan		5	Dallas
S0262	Plan Directory Contact for Public Website	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	01/10/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Surveillance Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/11/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0262	User Access Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER PERMANENTE INSURANCE COMPANY	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S0375	Agent/Broker Compensation Data Contact	Director, Medicare Sales	Mr.	Trahan	Donald		4109987538					donald.trahan@carefirst.com	10455 Mill Run Circle	Mailstop OWML1	Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Automated TrOOP Balance Transfer Contact	Manager, Specialty Business	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Backup User Access Contact	Sr. Regulatory Medicare Compliance Analyst	Ms.	Incorvati	Laura		4106052405					Laura.Incorvati@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Best Available Evidence Contact	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	06/25/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Bid Audit Contact	Product Manager	Ms.	Franklin	Lisa		4109985647					Lisa.Franklin@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Bid Audit Site Contact	Product Manager	Ms.	Franklin	Lisa		4109985647					Lisa.Franklin@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Bid Primary Contact	Product Manager	Ms.	Franklin	Lisa		4109985647					Lisa.Franklin@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	CAP Report Contact for Public Website	Health Plan CEO	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Johnson	Ricardo		4105285789					ricardo.johnson@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	11/05/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Johnson	Ricardo		4105285789					ricardo.johnson@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	11/05/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Chief Financial Officer	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Chief Operating Officer	COO and SVP Government Programs	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/20/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Chief Information Officer	VP, IT Ops and Infrastructure	Ms.	Henderson	Dori		4109985656					Dori.Henderson@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Chief Information Security Officer	Chief Information Security Officer	Mr.	Suarez	Roberto		4109985716					Roberto.Suarez@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	CMMI Model Point of Contact	Health Plan CEO	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	CMS Casework Communication Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Complaints Tracking Contact	Manager, Appeals	Ms.	Muth	Angela		4105282226					Angela.Muth@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Contact for Fraud Investigations	Director, SIU	Ms.	Kennedy	Elizabeth		4105287067					elizabeth.kennedy@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Coordination of Benefits Contact	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	06/25/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Corporate Mailing						4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Customer Service Operations Contact	Manager, Operations	Ms.	Boer	Kelsey		4109985353					Kelsey.Boer@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	DIR Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	DIR Contact (Secondary)	Manager, Specialty Services	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Discount Program Payment Contact	Senior Business Analyst	Ms.	Harris	Amanda		4105287839					Amanda.Harris@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	08/29/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Emergency Part D Contact	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Emergency Part D Contact (Secondary)	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Employer Waiver Contact	Director of Operations	Ms.	Gonce	Angie		4109987561					angie.gonce@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Enrollment Contact	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	EOB Transfer Contact	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107				4109987534	Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Financial Audit Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Financial Reporting Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Formulary Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Formulary Contact (Secondary)	Clinical Pharmacist	Ms.	Atueyi	Ifeoma		4109986386					Ifeoma.Atueyi@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	06/25/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	General Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Government Relations Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	HIPAA Privacy Officer	Dir, Privacy & Compliance	Ms.	Gregory	Lauren		4105285066					lauren.gregory@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	HIPAA Security Officer	Chief Information Security Officer	Mr.	Suarez	Roberto		4109985716					Roberto.Suarez@carefirst.com	1501 S. Clinton Street		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Hospice Contact	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	10455 Mill Run Circle		Owing Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Interoperability Contact	VP, Enterprise Arch. & Integr.	Mr.	Heyl	Bob		2026806682					Bob.Heyl@carefirst.com	840 First Street, NE		Washington	DC	20065	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Marketing Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Medical Director	Lead Medical Director	Dr.	Granger	David		4105282284					David.Granger@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	1501 South Clinton Street		Baltimore	MD	21224	12/07/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Medicare Coordinator	Sr. Regulatory Compliance Analyst	Ms.	Incorvati	Laura		4106052405					laura.incorvati@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Medication Therapy Management Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Online Enrollment Center Contact (Back-up)	Health Plan Chief Ops Officer	Ms.	Toland	Cheryl		4109985107					Cheryl.Toland@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Online Enrollment Center Contact (Primary)	Manager, Enrollment	Ms.	Knox	Dorothea		4109985599					CFGroupMA@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	09/26/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Appeals	Manager, Clinical Operations	Ms.	Beyda	Trista						7326914838	_REReconsideration@cvscaremark.com	3424 William Penn Hwy,		Pittsburg	PA	15235	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active	8889700917				Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Appeals Contact (Secondary)	Medicare Appeals Analyst	Ms.	Gabor-Lyon	Pam						7326914838	Trista.Beyda@cvshealth.com	3424 William Penn Hwy		Pittsburgh	PA	15235	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active	8889700917				Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Application Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Benefits Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Claims Submission Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Exceptions Contact	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi							Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active	4105285053				Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Exceptions Contact (Secondary)	Clinical Pharmacist	Ms	Lee	Catherine							Catherine.Lee@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active	4105287033				Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Price File Contact (Back-up)	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Price File Contact (Optional)		Mr.	Loveland	Chet		4806064823					Chet.Loveland@cvshealth.com	9501 E. Shea Blvd.  MC 121		Scottsdale	AZ	85260	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Price File Contact (Primary)	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Quality Assurance Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Part D Reporting Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					mary-paul.snapp-borleis@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Patient Safety Contact	Clinical Pharmacist	Ms	Lee	Catherine		4105287033					Catherine.Lee@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Payment Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Personal Health Record Contact	CEO, Medicare-Medicaid		Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle	Mailstop OWML1 18192	Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Pharmacy Director	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi		4105285053					Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Pharmacy Network Management Contact	Director Pharmacy Government Programs	Mr.	Nardone	Mark		4109985675					Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Pharmacy Network Management Contact (Secondary)	Sr. Dir., Pharm Eval & Oversight	Ms.	Poplawski	Mandi		4105285303					Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Pharmacy Technical Help Desk Contact	Director Pharmacy Government Programs	Mr.	Nardone	Mark							Mark.Nardone@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active	8666934620				Medicare Prescription Drug Plan		5	Chicago
S0375	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Dir. , Pharm Eval & Oversight	Ms.	Poplawski	Mandi							Mandi.Poplawski@carefirst.com	1501 S Clinton St		Baltimore	MD	21224	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active	8666934620				Medicare Prescription Drug Plan		5	Chicago
S0375	PHR Beneficiary Contact																	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan	CareFirst BlueCross Blue Shield Medicare Advantage	CareFirst, Inc.	45	Yes	Active	8552905744				Medicare Prescription Drug Plan		5	Chicago
S0375	Plan Directory Contact for Public Website			Services	Member		8552905744					Cheryl.Toland@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Plan to Plan Reconciliation Contact	Financial Analyst	Mr.	Murry	Kyle		4106052401					Kyle.Murry@Carefirst.com	P.O. Box 782085		Philadelphia	PA	191781637	08/21/2025	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Processor Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Reconciliation Contact	VP Financial Planning/CFO	Mr.	Phillips	Christophe		4109987213					Christopher.Phillips@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Reconciliation Contact (Secondary)	Director, Pharmacy Services	Mr.	Nardone	Mark		4109985675					Mark.Nardone@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Surveillance Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	System Contact	CEO of Health Plan	Mr.	Rapach	Mike		4109984601					mike.rapach@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	Third Party Administrator (TPA) Liaison	Senior Accountant	Ms.	Mitchell	Patrice	R	4109985273					patrice.mitchell@carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0375	User Access Contact	Medicare Compliance Officer	Ms.	Snapp-Borleis	Mary-Paul		4106052579					Mary-Paul.Snapp-Borleis@Carefirst.com	10455 Mill Run Circle		Owings Mills	MD	21117	10/12/2024	2026	CAREFIRST ADVANTAGE PPO, INC	PDP	CareFirst BlueCross BlueShield Group Prescription Drug Plan	Medicare Prescription Drug Plan		CareFirst, Inc.	45	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S0586	Agent/Broker Compensation Data Contact	Director, Sales Administration		Sheehy	Cathryn		5189913973					csheehy@mvphealthcare.com	625 State Street		Schenectady	NY	12305	04/15/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Backup User Access Contact	Compliance Coordinator		Carter	Marlo		5189913814					mcarter@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Best Available Evidence Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	RMoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Bid Audit Contact	Sr. Director, Internal Audit		Hillerman	Stephen		5189913995					shillerman@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Bid Audit Site Contact	VP, Acting Chief Actuary		Lombardo	Matt		5189913845				5183882311	mlombardo@mvphealthcare.com	625 State Street		Schenectady	NY	12305	07/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Bid Primary Contact	Leader, Product Benefits	Mr	Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	CAP Report Contact for Public Website	Corporate Compliance Officer		Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	CEO - CMS Administrator Contact	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	CEO - Senior Official for Contracting	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Chief Financial Officer	Chief Financial Officer	Ms.	Austen	Karla		5183882357					kausten@mvphealthcare.com	625 State Street		Schenectady	NY	12305	06/26/2014	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Chief Operating Officer	President and CEO	Mr.	Delvecchio	Chris		5189010624				5853272319	cdelvecchio@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Chief Information Officer	Chief Digital & Information Officer	Mr.	Della Villa	Michael		5183882626					mdellavilla@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Chief Information Security Officer	VP, Office of the CDIO & CISO	Mr.	Swits	David		5189913694					dswits@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/11/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	CMS Casework Communication Contact	Leader, Medicare Appeals		Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Complaints Tracking Contact	Leader, Medicare Appeals	Ms	Allen	Amy		5852588096				5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Contact for Fraud Investigations	Leader, Special Investigations Unit		Cordato	Rocco		5189010613					rcordato@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Coordination of Benefits Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Corporate Mailing						8006657924					memberservices@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Customer Service Operations Contact	Sr. Leader, Customer Care & Support Services		Greenberg	Melissa		5189913731					mgreenberg@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	DIR Contact	Leader, State & Federal Plan BIlling		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	DIR Contact (Secondary)	Sr. Director, Actuarial		Jaiman	Rajshree		5189913834					rjaiman@mvphealthcare.com	625 State St.		Schenectady	NY	12305	02/28/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Discount Program Payment Contact	Analyst	`	Bates	Marcus		5853272286					mbates@mvphealthcare.com	625 State St		Schenectady	NY	12305	11/10/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Emergency Part D Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Emergency Part D Contact (Secondary)	Professional, Compliance Coordinator		Dunham	Kristina		5857208250					kdunham@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Enrollment Contact	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	rmoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	EOB Transfer Contact	Director, Pharmacy Management		Colin	Wendy		5858852435				8004010915	wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Financial Audit Contact	Sr. Director, Internal Audit	Mr.	Hillerman	Stephen		5189913995				5188363202	shillerman@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Financial Reporting Contact	Sr. Leader, Accounting & Assistant Controller		Cenzano	Jennifer		5189010623					jcenzano@mvphealthcare.com	625 State Street		Schenectady	NY	12305	01/18/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Formulary Contact	Professional, Pharmacy Program Management		Berube	Leah		5183851264					lberube@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/17/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Formulary Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	General Contact	Medicare Compliance Officer		Borges	Linda		5189913308					mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/15/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Government Relations Contact	Medicare Compliance Officer		Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	HIPAA Privacy Officer	Corporate Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	HIPAA Security Officer	Corporate Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Hospice Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					WColin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Interoperability Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State St		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Marketing Contact	Sr. Director, Medicare Marketing & Strategic Partn		Regan	Jennifer		5189010772					jregan@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/06/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Medical Director	Vice President Medical Affairs &Medical Direction		Merola	Jason		5853272208					jmerola@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	12/12/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	03/29/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Medicare Coordinator	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy Management		Colin	Wendy		5858852435				8004010915	wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Medication Therapy Management Contact	Leader, Pharmacy Clinical Operations		MacArthur	Carly		5183867483					cmacarthur@mvphealthcare.com	625 State St.		Schenectady	NY	12305	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	OffShore Subcontractor Contact	Sr. Director, Cyber Security and Cyber GRC		Rich	John		5189913674					jrich@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/11/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Online Enrollment Center Contact (Primary)	Leader, Medicare Enrollment Operations		Moxley	Radija		5858852361				5853272227	rmoxley@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Appeals	Leader, Medicare Appeals		Allen	Amy						5853275724	aallen@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	5852588096				Medicare Prescription Drug Plan		5	Boston
S0586	Part D Appeals Contact (Secondary)	Compliance Coordinator, Medicare Appeals		Stepnowski	Ashley							astepnowski@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	5857208126				Medicare Prescription Drug Plan		5	Boston
S0586	Part D Application Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Benefits Contact	Leader, Product Benefits		Hart	Andrew		5858852391					ahart@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Claims Submission Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Exceptions Contact	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	5858852435				Medicare Prescription Drug Plan		5	Boston
S0586	Part D Exceptions Contact (Secondary)	Leader, Pharmacy Clinical Operations		MacArthur	Carly							cmacarthur@mvphealthcare.com	625 State St		Schenectady	NY	12305	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	5183867483				Medicare Prescription Drug Plan		5	Boston
S0586	Part D Price File Contact (Back-up)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Price File Contact (Optional)	Professional, Pharmacy Compliance Coordinator		Dunham	Kristina		5857208250					KDunham@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Price File Contact (Primary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Quality Assurance Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Part D Reporting Contact	Professional, Pharmacy Compliance Coordinator		Dunham	Kristina		5857208250					Kdunham@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Patient Safety Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Payment Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Pharmacy Director	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Pharmacy Network Management Contact	Director Network Operations		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd. MC 080		Scottsdale	AZ	85260	02/27/2019	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
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	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	8666934620				Medicare Prescription Drug Plan		5	Boston
S0586	Pharmacy Technical Help Desk Contact (Secondary)	Director, Pharmacy Management		Colin	Wendy							wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active	5858852435				Medicare Prescription Drug Plan		5	Boston
S0586	Plan Directory Contact for Public Website	Director, Provider Data Management		Santilli	Richard		5189913775					rsantilli@mvphealthcare.com	625 State St		Schenectady	NY	12305	04/10/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Plan to Plan Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State Street		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Processor Contact	Director, Pharmacy Management		Colin	Wendy		5858852435					wcolin@mvphealthcare.com	20 South Clinton Avenue		Rochester	NY	14604	02/13/2024	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Reconciliation Contact	Leader, State & Federal Plan Billing		Marcus	Yael		9144298496					ymarcus@mvphealthcare.com	625 State St		Schenectady	NY	12305	10/04/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Reconciliation Contact (Secondary)	Sr. Director, Actuarial		Jaiman	Rajshree		5189913834					rjaiman@mvphealthcare.com	625 State St.		Schenectady	NY	12305	02/28/2023	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Borges	Linda		5189913803				5188363202	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Surveillance Contact	Medicare Compliance Officer		Borges	Linda		5189913803				5183882311	mco@mvphealthcare.com	625 State Street		Schenectady	NY	12305	08/23/2022	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	System Contact	VP, Office of the CDIO & CISO		Swits	David		5189913694					dswits@mvphealthcare.com	625 State Street		Schenectady	NY	12305	02/13/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	Third Party Administrator (TPA) Liaison	Analyst		Bates	Marcus		5853272286					mbates@mvphealthcare.com	625 State St		Schenectady	NY	12305	11/10/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S0586	User Access Contact	Leader, Compliance Audits		Barile	Diana		5189913587					dbarile@mvphealthcare.com	625 State Street		Schenectady	NY	12305	09/18/2025	2026	MVP HEALTH PLAN, INC.	PDP	MVP Health Care	Medicare Prescription Drug Plan		MVP Health Care, Inc.	197	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1030	Agent/Broker Compensation Data Contact	Consumer Sales Manager		Carter	Brent		2052207681					bcarter@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	Automated TrOOP Balance Transfer Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/23/2023	2026	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	New York
S1030	Backup User Access Contact	Compliance Analyst I		Blevins	Dominique		2052206984					dominique.blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/30/2025	2026	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	New York
S1030	Best Available Evidence Contact	Sr. Business Analyst		Hurst	Terri		2052202695					Terri.Hurst@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/01/2023	2026	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	New York
S1030	Bid Audit Contact	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	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	New York
S1030	Bid Audit Site Contact	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	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	New York
S1030	Bid Primary Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
S1030	CAP Report Contact for Public Website	Dept Manager Internal Audit		Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	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	New York
S1030	CEO - CMS Administrator Contact	President and Chief Executive Officer	Mr	Vines	Tim		2052206363					TVines@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	07/14/2020	2026	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	New York
S1030	CEO - Senior Official for Contracting	Executive Vice President	Mr.	Briggs III	Dick	D	2052206952					dbriggs@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	07/01/2020	2026	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	New York
S1030	Chief Financial Officer	SVP & Chief Financial Officer	Mr.	Carden	Noel		2052207741					ncarden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2022	2026	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	New York
S1030	Chief Operating Officer	SVP Business Operations	Mr.	Hill	James	S	2052202196					Jim.Hill@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/24/2020	2026	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	New York
S1030	Chief Information Officer	SVP and CIO	Mr.	Dunsmore	Joe		2052202441					jdunsmore@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	04/08/2025	2026	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	New York
S1030	Chief Information Security Officer	Chief Info Security Officer	Mr.	Parton	Chris		2052207421					cparton@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	02/26/2016	2026	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	New York
S1030	CMMI Model Point of Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
S1030	CMS Casework Communication Contact	Compliance Analyst		Stoudemire	Danielle		2052205678					Danielle.Stoudemire@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/14/2024	2026	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	New York
S1030	Complaints Tracking Contact	Compliance Analyst		Stoudemire	Danielle		2052205678					Danielle.Stoudemire@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/14/2024	2026	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	New York
S1030	Contact for Fraud Investigations	Special Investigations Manager		Ellison	Amy		2052202573					AELLISON@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	07/16/2025	2026	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	New York
S1030	Coordination of Benefits Contact	Manager Claims Processing		Cole	Jason		2052202490					Jason.Cole@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/02/2023	2026	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	New York
S1030	Corporate Mailing						2052206655					Laney.ODell@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/28/2025	2026	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	New York
S1030	Customer Service Operations Contact	Dept Manager Customer Service		Pearson	Latreta		2052202601					llpearson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2026	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	New York
S1030	DIR Contact	VP Controller		DeLawrence	Jennifer		2052207282				2052202795	JDeLawrence@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/12/2020	2026	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	New York
S1030	DIR Contact (Secondary)	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/04/2022	2026	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	New York
S1030	Discount Program Payment Contact	Sr. Accountant		Lambert	Christophe		2052206593					CLambert@bcbsal.org	450 Riverchase Pkwy East		Birmingham	AL	35244	04/19/2016	2026	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	New York
S1030	Emergency Part D Contact	Pharmacy Operations Coordinator		Sevens	Andrew		2052202593					WStevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/23/2023	2026	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	New York
S1030	Emergency Part D Contact (Secondary)	Pharmacy Services Manager		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Employer Waiver Contact	Manager Enrollment Service		Sexton	Missy		2052206589					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/02/2023	2026	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	New York
S1030	Enrollment Contact	Manager Enrollment Service		Sexton	Missy		2052206589					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2023	2026	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	New York
S1030	EOB Transfer Contact	Pharmacy Services Manager		Matthews	Ginny		2052206558				2052200803	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Financial Audit Contact	Dept Manager Internal Audit	Ms.	Bradley	Mallory		2052207259					mallory.bradley@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/26/2024	2026	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	New York
S1030	Financial Reporting Contact	Dept Mgr Accounting/Reporting		O'Neal	Keith		2052206202					Keith.ONeal@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	01/13/2021	2026	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	New York
S1030	Formulary Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/13/2018	2026	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	New York
S1030	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/17/2024	2026	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	New York
S1030	General Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					RGregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	Government Relations Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
S1030	HIPAA Privacy Officer	Manager Corporate Compliance		Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	HIPAA Security Officer	Manager Corporate Compliance		Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	Hospice Contact	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					WStevens@bcbsal.org	450 Riverchase Pkwy East		Hoover	AL	35244	04/17/2019	2026	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	New York
S1030	Interoperability Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					rgregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	Marketing Contact	Sr. Compliance Analyst		Parham	Andrea	M	2052207206					AParham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/24/2024	2026	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	New York
S1030	Medical Director	Associate Medical Director	Dr.	Darden	Barry		2052206605					James.Darden@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/11/2018	2026	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	New York
S1030	Medicare Compliance Officer	Manager Corporate Compliance	Mr.	Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	Medicare Coordinator	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
S1030	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacist		Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	01/13/2025	2026	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	New York
S1030	Medication Therapy Management Contact	VP Pharmacy Services		Cale	Dorinda		2052202655					dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	OffShore Subcontractor Contact	Compliance Analyst II		Blevins	Dominique		2052207984					dominique.blevins@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/30/2025	2026	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	New York
S1030	Online Enrollment Center Contact (Back-up)	Sr. Business Analyst		Johnson	Geraldine		2052206077					gejohnson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/08/2021	2026	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	New York
S1030	Online Enrollment Center Contact (Optional)	Manager Enrollment Service		Sexton	Missy		2052207276					Melissa.Sexton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	04/18/2023	2026	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	New York
S1030	Online Enrollment Center Contact (Primary)	Sr Business Analyst		Hurst	Terri		2052202695					Terri.Hurst@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	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	New York
S1030	Part D Appeals	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	New York
S1030	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/18/2024	2026	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	New York
S1030	Part D Application Contact	Manager Product Management		Staton	Shelley		2052202329					Shelley.Staton@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	05/06/2025	2026	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	New York
S1030	Part D Benefits Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Part D Claims Submission Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558					Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Part D Exceptions Contact	Regulatory Pharmacist Sr.		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Mendota Heights	MN	55120	12/18/2024	2026	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	New York
S1030	Part D Exceptions Contact (Secondary)	Pharmacy Services Manager		Matthews	Ginny							Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	2052206558				Medicare Prescription Drug Plan		5	New York
S1030	Part D Price File Contact (Back-up)	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593				2052202939	Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/13/2018	2026	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	New York
S1030	Part D Price File Contact (Optional)	Price File Analyst Sr		Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	2900 Ames Crossing Road		Mendota Heights	MN	55120	04/08/2021	2026	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	New York
S1030	Part D Price File Contact (Primary)	Pharmacy Services Mgr		Matthew	Ginny		2052206558				2057337486	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Part D Quality Assurance Contact	Clinical Program Manager		Hamid	Samer		2055639884					samer.hamid@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/13/2024	2026	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	New York
S1030	Part D Reporting Contact	Senior Compliance Analyst		Parham	Andrea		2052207206					aparham@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	11/10/2022	2026	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	New York
S1030	Patient Safety Contact	VP Pharmacy Services		Cale	Dorinda		2052202655				2052208739	dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Payment Contact	VP Controller		DeLawrence	Jennifer		2052207282					JDeLawrence@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	02/12/2020	2026	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	New York
S1030	Pharmacy Director	VP Pharmacy Services		Cale	Dorinda		2052202655					dcale@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Pharmacy Network Management Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2054034052	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Pharmacy Network Management Contact (Secondary)	AVP Network Relations		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55122	12/18/2024	2026	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	New York
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	2026	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	8778788668				Medicare Prescription Drug Plan		5	New York
S1030	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Member Services		Scott	Shane							shane.scott@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	01/13/2025	2026	BCBS OF ALABAMA & UTIC INSURANCE COMPANY	PDP	BlueRx (PDP)	Medicare Prescription Drug Plan		BlueCross BlueShield of Alabama	32	Yes	Active	8778788668				Medicare Prescription Drug Plan		5	New York
S1030	Plan Directory Contact for Public Website	Manager Claims Operations		Corley	Jeff		8005176425					OpsCompliance@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	09/10/2013	2026	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	New York
S1030	Plan to Plan Reconciliation Contact	In-charge Analyst Cash Mgmt		Prince	Jonathan		2052207723					jonathan.prince@bcbsal.org	450 Riverchase Parkway		Birmingham	AL	35244	03/18/2024	2026	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	New York
S1030	Processor Contact	Pharmacy Services Mgr		Matthews	Ginny		2052206558				2052208739	Ginny.Matthews@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	10/13/2020	2026	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	New York
S1030	Reconciliation Contact	Manager Financial Accounting		Williamson	Amanda		2052207289					Amanda.Williamson@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	03/20/2018	2026	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	New York
S1030	Reconciliation Contact (Secondary)	Sr. Accountant		Lambert	Christophe		2052206593				2052202795	CLambert@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/15/2021	2026	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	New York
S1030	Recovery Audit Contact	Manager Corporate Compliance	Mr.	Gregg	Roger		2052207480					RGREGG@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	Surveillance Contact	Consumer Sales Manager		Carter	Brent		2052207681					bcarter@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	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	New York
S1030	System Contact	Manager Corporate Compliance		Gregg	Roger		2052207480					RGregg@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	12/16/2024	2026	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	New York
S1030	Third Party Administrator (TPA) Liaison	Pharmacy Operations Coordinator		Stevens	Andrew		2052202593					Wstevens@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	08/13/2018	2026	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	New York
S1030	User Access Contact	Regulatory Compliance Manager		O'Dell	Laney		2052206655					laney.odell@bcbsal.org	450 Riverchase Parkway East		Birmingham	AL	35244	06/03/2022	2026	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	New York
S1140	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/18/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/21/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/03/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/10/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	09/25/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/22/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	03/21/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	06/03/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Corporate Mailing						7168877169				7168877911	amy.mcdonald@highmarkhealth.org	257 West Genesee Street		Buffalo	NY	14202	03/07/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/23/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5184232294					rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/02/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Enrollment Contact	Manager, Government Business Enrollment		Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	EOB Transfer Contact	Manager, Claims	Ms.	Johannes	Karin		7168876875				7168876875	karin.johannes@highmark.com	257 West Genesee St.		Buffalo	NY	14202	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156				4125447156	kathleen.carl@highmark.com	120 5th Avenue Pittsburgh		Pittsburgh	PA	15222	07/31/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	10/06/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/29/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					Justine.Patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	11/09/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Interoperability Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	06/23/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Medical Director	VP, Executive Medical Director	Dr,	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	07/28/2021	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing		Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	4125444579				Medicare Prescription Drug Plan		5	Boston
S1140	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	4125441596				Medicare Prescription Drug Plan		5	Boston
S1140	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	11/08/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite SPECARE	Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	8006002227				Medicare Prescription Drug Plan		5	Boston
S1140	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	9013817109				Medicare Prescription Drug Plan		5	Boston
S1140	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets	Ms	Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	11/09/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	08/04/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Payment Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	03/12/2024	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		Buffalo	NY	14203	02/14/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Pharmacy Network Management Contact	Network Account Director, Retail Strategy&Contract		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/09/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	11/09/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
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	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	Boston
S1140	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	5705783579				Medicare Prescription Drug Plan		5	Boston
S1140	PHR Beneficiary Contact																	10/28/2021	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan	Highmark Western and Northeastern New York Inc	Highmark Health	123	Yes	Active	8003292792				Medicare Prescription Drug Plan		5	Boston
S1140	Plan Directory Contact for Public Website			Service	Customer		8773271395					customerservice@bcbswny.com	PO Box 13599		Albany	NY	12212	02/21/2020	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Plan to Plan Reconciliation Contact	Manager, Operational Accounting		Stehr	Brett		7173022748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 898820	Camp Hill	PA	17089	06/28/2023	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	01/29/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	02/23/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/29/2025	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1140	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/28/2022	2026	Highmark Western and Northeastern New York Inc.	PDP	Highmark Blue Cross Blue Shield or Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S1822	Agent/Broker Compensation Data Contact	VP Government Programs		Clelland	Jennifer	J	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	11/04/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Automated TrOOP Balance Transfer Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Backup User Access Contact	Coordinator Government Programs		Yu	Chao		9528837240					chao.x.yu@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Best Available Evidence Contact	Sr. Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Bid Audit Contact	Director, Integrity and Compliance		Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	11/17/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Bid Audit Site Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS:  21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Bid Primary Contact	Vice President, Actuary		Stewart	Sara	M	9528835049					sara.m.stewart@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21105H	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	CAP Report Contact for Public Website	Senior Manager Medicare Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/05/2014	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	CEO - CMS Administrator Contact	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/06/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	CEO - Senior Official for Contracting	President and CEO	Ms.	Walsh	Andrea	M	9528835343				9528835350	wendy.r.kobe@healthpartners.com	8170 33rd Avenue South	MS: 21110A	Minneapolis	MN	55425	01/04/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Chief Financial Officer	SVP & Chief Financial Officer	Ms.	Johnson	Kathleen	A	9528836531					kathy.a.johnson1@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110T	Minneapolis	MN	554401309	03/29/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Chief Operating Officer	EVP, Health Engagement and Informatics Officer	Ms.	Knudson	Susan	M	9528835573					susan.m.knudson@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110A	Minneapolis	MN	554401309	02/04/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Chief Information Officer	Senior Vice President and CTO	Mr.	Thull	Tim	D	9528837636					timothy.d.thull@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	01/16/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Chief Information Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	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	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Complaints Tracking Contact	Manager Member Rights and Benefits		Kruse	Morgan	L	9529677679					Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS: 21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Contact for Fraud Investigations	Senior Manager Claims		Dahlberg	Kara	A	9529675640					kara.a.dahlberg@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  25510F	Minneapolis	MN	55101	07/09/2024	2026	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	9529677335					RVSCCOBTECHS@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	04/20/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Corporate Mailing						9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/05/2014	2026	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		9529677668					alison.m.renneke@healthpartners.com	8170 33rd Avenue South, PO Box 9463	MS:  21103R	Minneapolis	MN	554409463	01/29/2020	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	DIR Contact	Sr. Pharmacy Plan Contract Manager		Reinhardt	Sandra	L	9528836739					sandra.l.reinhardt@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	DIR Contact (Secondary)	Consultant, Data Analysis		Binsfeld	David	T	9529675950					david.t.binsfeld@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS 21108Q	Minneapolis	MN	554401309	01/09/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Discount Program Payment Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Emergency Part D Contact	Sr. Director Pharmacy Services		Strahl	Christine	L	9528835022				9529676667	christine.l.strahl@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Emergency Part D Contact (Secondary)	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Employer Waiver Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Enrollment Contact	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	EOB Transfer Contact	Sr. Manager Claims Production		Huseby	Pam	J	9529675530				9528837666	pam.j.huseby@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103R	Minneapolis	MN	554401309	08/30/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Financial Audit Contact	Director Monitoring and Compliance	Ms.	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Financial Reporting Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21109A	Minneapolis	MN	554401309	07/24/2019	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Formulary Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Formulary Contact (Secondary)	Formulary Administration Pharmacist		Savage	Robert		8587906426					robert.savage@medimpact.com	MedImpact Healthcare Systems, Inc.	10181 Scripps Gateway Ct.	San Diego	CA	92131	07/24/2019	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	General Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	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	9529675119					jennifer.j.clelland@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	08/30/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	HIPAA Privacy Officer	Sr. Director Integrity Compliance Privacy Officer		Wells	Prasanta	K	9528837325					prasanta.k.wells@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103K	Minneapolis	MN	554401309	05/27/2015	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	HIPAA Security Officer	VP Technology Infrastructure & Security	Mr.	Muller	Frank	J	9529676070					frank.j.muller@healthpartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	09/10/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Hospice Contact	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Interoperability Contact	Program Manager, IT		Geisler	Chris	J	6122479067					Chris.J.Geisler@HealthPartners.Com	8170 33rd Ave S		Bloomington	MN	55425	01/09/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Marketing Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Medical Director	Health Plan Chief Medical Officer	Dr.	Kakacek	Virginia	L	9528837120					virginia.l.kakacek@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21110Q	Minneapolis	MN	554401309	09/21/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Medicare Compliance Officer	Director, Integrity and Compliance	Ms.	Moscetti	Stephanie	M	9528837330				9528835522	stephanie.m.moscetti@healthpartners.com	8170 33rd Avenue South		Bloomington	MN	55425	11/17/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Medicare Coordinator	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Medicare Part D Opioid Overutilization Contact	Pharmacy UM Systems and Data Analyst		Hamm	Sarah	K	9529677652					sarah.k.hamm@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Medication Therapy Management Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Online Enrollment Center Contact (Back-up)	Director Membership Accounting		McWell	Carrie	J	9529675487					carrie.j.mcwell@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/30/2017	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Online Enrollment Center Contact (Optional)	Admin Product Implementation Manager		Wessel	Sara	C	9529677623					sara.c.wessel@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	11/29/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Online Enrollment Center Contact (Primary)	Manager Membership Accounting		Marty	Amanda	E	9529677685					amanda.e.marty@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103R	Minneapolis	MN	554401309	01/09/2018	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Appeals	Manager Member Rights and Benefits		Kruse	Morgan	L						Morgan.L.Kruse@HealthPartners.Com	P.O. Box 9463	MS:  21103R	Minneapolis	MN	554409463	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active	8007963806				Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Appeals Contact (Secondary)	Supervisor, Member Rights and Benefits		Dress	Samantha							Samantha.L.Dress@HealthPartners.com	8170 33rd Avenue South	MS: 21103R	Bloomington	MN	55425	12/06/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active	8007963806				Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Application Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Benefits Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Claims Submission Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina	P	9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/03/2021	2026	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					8888835434	hillary.a.whelan@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	11/23/2020	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active	8004927259				Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Price File Contact (Primary)	Sr Pharmacy UM Comp and Ops Analyst		Riggs	Ben	H	6513230244					benjamin.h.riggs@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	12/12/2023	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Quality Assurance Contact	Director Quality and Compliance		Book	Anne	M	9528835128					anne.m.book@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21108T	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Part D Reporting Contact	Director of Medicare and Government Programs		Schultz	Amy	L	9529675117					amy.l.schultz@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21103C	Minneapolis	MN	554401309	12/02/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Patient Safety Contact	MTM Program Manager		Groen	Sarah		9528835396					segroen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	01/06/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Payment Contact	Director Corporate Financial Reporting and Tax		Brandt	Kevin	J	9528836584					kevin.j.brandt@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	05/09/2013	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Pharmacy Director	VP Pharmacy		Busch	David	L	9529675049					david.l.busch@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21111B	Minneapolis	MN	554401309	06/25/2020	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Pharmacy Network Management Contact	Supervisor Pharmacy Configuration Services		Heinen	Keeley		9528835279					keeley.m.heinen@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Pharmacy Network Management Contact (Secondary)	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/03/2025	2026	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					8888835434	Hillary.A.Whelan@HealthPartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	12/19/2022	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active	8004927259				Medicare Prescription Drug Plan		5	Chicago
S1822	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Director, Customer Service		Sahs	Dale							dale.sahs@express-scripts.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	11/03/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	Chicago
S1822	Plan Directory Contact for Public Website			Services	Provider		9528837699					RVSCProviderInquiry@HealthPartners.com	8170 33rd Avenue South, PO Box 1309		Minneapolis	MN	554401309	06/10/2013	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Plan to Plan Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Processor Contact	Manager, Regulated Products & Configuration Servic		Spassova	Dina		9528836536					dina.p.spassova@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21111B	Minneapolis	MN	554401309	04/08/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Reconciliation Contact	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd  Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/04/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Recovery Audit Contact	Director Monitoring and Compliance	Ms.	Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Surveillance Contact	Director Monitoring and Compliance		Lockner	Laurena	S	9529677650					laurena.s.lockner@healthpartners.com	8170 33rd Avenue South	MS: 21103C	Minneapolis	MN	55425	08/24/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	System Contact	Senior Manager Operational Integrity		Smith	Robert	C	9529677663					robert.c.smith@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21193J	Minneapolis	MN	554401309	02/19/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	Third Party Administrator (TPA) Liaison	Senior Accountant		Lee	Sheng		7155715521					sheng.x.lee@healthpartners.com	8170 33rd Avenue South, P.O. Box 1309	MS: 21109A	Minneapolis	MN	554401309	03/11/2025	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S1822	User Access Contact	Mgr Govt Prog Materials & Regulatory Comm		Her-Vang	Xong		9529675061					xong.x.hervang@healthpartners.com	8170 33rd Avenue South, PO Box 1309	MS:  21103C	Minneapolis	MN	554401309	11/16/2021	2026	HEALTHPARTNERS, INC.	PDP	HealthPartners	Medicare Prescription Drug Plan		HealthPartners, Inc.	117	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Agent/Broker Compensation Data Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Automated TrOOP Balance Transfer Contact	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten		2026391689					keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Backup User Access Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Best Available Evidence Contact	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten		2026391689					keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Bid Audit Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Bid Audit Site Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Bid Primary Contact	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/29/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	CAP Report Contact for Public Website	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten		2026391689					keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	CEO - CMS Administrator Contact	President & CEO	Ms	Keck	Kim		3122976050					kkeck@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	10/30/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	CEO - Senior Official for Contracting	President & CEO	Ms	Keck	Kim		3122976050					kkeck@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	10/30/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Chief Financial Officer	EVP and CFO	Ms	Fisher	Christina		3122975760					cfisher@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	10/30/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Chief Operating Officer	SVP Federal Employee Program	Mr	Yoder	David		2029421206					david.yoder@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Chief Information Officer	Sr VP & CIO	Mr	Tidmarsh	Lachlan		3122975671					lachlan.tidmarsh@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	03/20/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Chief Information Security Officer	VP and Chief Info Sec Ofcr	Mr	Lugo	Christophe		3122976580					christopher.lugo@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	03/20/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	CMS Casework Communication Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Complaints Tracking Contact	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten		2026391689					keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Contact for Fraud Investigations	ED BCBSA Anti-Fraud	Mr	Nottingham	Junius		2029421235					junius.nottingham@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Coordination of Benefits Contact	Dir OPL Fed Hlth Prg Reim	Ms	Torrico	Yoonji		2029421124					yoonji.torrico@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Corporate Mailing						3122976000					cristiam.rodriguez@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	03/20/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Customer Service Operations Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	DIR Contact	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	DIR Contact (Secondary)	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Discount Program Payment Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Emergency Part D Contact	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Emergency Part D Contact (Secondary)	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2023447372					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Enrollment Contact	MD Business Solutions	Ms	Padgett	Brenda		2029421287					brenda.padgett@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	EOB Transfer Contact	MD Business Solutions	Ms	Padgett	Brenda		2029421287				2029421065	brenda.padgett@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Financial Audit Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Financial Reporting Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Formulary Contact	Director Pharmacy Policy	Mr	Seneviratne	Viran		2029421175					Viran.Seneviratne@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Formulary Contact (Secondary)	Clinical Pharmacist, EGWP	Ms.	Gray	Brittany		2029421073					brittany.gray@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	06/03/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	General Contact	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/29/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Government Relations Contact	SVP Federal Employee Program	Mr	Yoder	David		2029421206					david.yoder@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	HIPAA Privacy Officer	Dep Gen Couns Litig and Regulatory	Ms	Sanders	Robin		2029421168					robin.sanders@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	HIPAA Security Officer	VP Litigation and Risk Legal and Governance	Ms	Sanders	Robin		2029421168					Robin.Sanders@bcbsa.com	750 9th St. NW, Suite 900		Washington	DC	20001	10/02/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Hospice Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Interoperability Contact	MD Business Solutions	Ms	Padgett	Brenda		2029421287					brenda.padgett@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Marketing Contact	ED FEP Member Experience	Ms	Spruill	Karen		2029421187					karen.spruill@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Medical Director	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	02/20/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Medicare Compliance Officer	VP Litigation and Risk Legal and Governance	Ms	Sanders	Robin		2029421168					Robin.Sanders@bcbsa.com	750 9th St. NW, Suite 900		Washington	DC	20001	10/02/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Medicare Coordinator	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/29/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Medicare Part D Opioid Overutilization Contact	Dir Pharmacy Policy	Mr	Seneviratne	Viran		2029421175					Viran.Seneviratne@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Medication Therapy Management Contact	Dir MTM Pgms	Ms	McNair	Michelle		2029421203					michelle.mcnair@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	OffShore Subcontractor Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Online Enrollment Center Contact (Back-up)	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Online Enrollment Center Contact (Optional)	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten		2026391689					keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Online Enrollment Center Contact (Primary)	MD Business Solutions	Ms	Padgett	Brenda		2029421287					brenda.padgett@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Appeals	Dir Pharmacy Policy	Mr	Seneviratne	Viran							Viran.Seneviratne@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active	2029421175				Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Appeals Contact (Secondary)	Mgr Member Services	Ms	Silva	Angela							angela.silva@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active	2029421068				Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Application Contact	Dep Gen Coun Bus Ops Chief Wash Couns	Ms	Klein	Jill		2029421171					jill.klein@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Benefits Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Claims Submission Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Exceptions Contact	Dir Pharmacy Policy	Mr	Seneviratne	Viran							Viran.Seneviratne@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active	2029421175				Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Exceptions Contact (Secondary)	Clinical Pharmacist, EGWP	Ms.	Gray	Brittany							brittany.gray@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	06/03/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active	2029421073				Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Price File Contact (Back-up)	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Price File Contact (Optional)	Cons, Pharmacy Operations	Mr	Charitable	Moise		8003455413					moise.charitable@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Price File Contact (Primary)	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten		2026391689					keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Quality Assurance Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Part D Reporting Contact	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten		2026391689					keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Patient Safety Contact	Dir Pharmacy Policy	Mr	Seneviratne	Viran		2029421175					Viran.Seneviratne@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Payment Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Personal Health Record Contact	Dir Pharmacy Policy	Mr	Seneviratne	Viran		2029421175					Viran.Seneviratne@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Pharmacy Director	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Pharmacy Network Management Contact	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Pharmacy Network Management Contact (Secondary)	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Pharmacy Technical Help Desk Contact	Mgr, Pharmacy Operations	Ms	Woodson	Keirsten							keirsten.woodson@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active	8666934620				Medicare Prescription Drug Plan		5	Chicago
S2135	Pharmacy Technical Help Desk Contact (Secondary)	Cons, Pharmacy Operations	Mr	Charitable	Moise							moise.charitable@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active	8666934620				Medicare Prescription Drug Plan		5	Chicago
S2135	PHR Beneficiary Contact																	02/22/2023	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan	Blue Cross Blue Shield Association	BlueCross BlueShield Association, Federal Employee	807	Yes	Active	4402418186				Medicare Prescription Drug Plan		5	Chicago
S2135	Plan Directory Contact for Public Website	MD Member Engagement	Ms	Colon-Padilla	Marieli		2029421270					Marieli.ColonPadilla@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Plan to Plan Reconciliation Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	200 E. Randolph St., Suite 1800	Attn Treasury Operations	Chicago	IL	60601	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Processor Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Reconciliation Contact	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Reconciliation Contact (Secondary)	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Recovery Audit Contact	Compliance Lead Consultant	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	200 E. Randolph St., Suite 1800		Chicago	IL	60601	10/07/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Surveillance Contact	ED FEP Pharmacy Programs	Ms	Borja	Asuncion		2029421286					asuncion.borja@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	02/20/2025	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	System Contact	Dir Pharmacy Operations	Ms	Shuler	Julianna		2029421046					julianna.shuler@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	Third Party Administrator (TPA) Liaison	Dir Pharmacy Compliance	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2135	User Access Contact	Dir Pharmacy Compliance	Mr	Rodriguez	Cristiam		2029421199					cristiam.rodriguez@bcbsa.com	750 9th St NW,  Suite 900		Washington	DC	20001	08/08/2024	2026	BLUE CROSS BLUE SHIELD ASSOCIATION	PDP	Blue Cross Blue Shield Association	Medicare Prescription Drug Plan		BlueCross BlueShield Association, Federal Employee	807	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S2468	Agent/Broker Compensation Data Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Automated TrOOP Balance Transfer Contact	Senior Manager, Medicare Operations		Halley	Derek		8182286374					Derek.Halley@blueshieldca.com	6300 Canoga Ave,		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Backup User Access Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Best Available Evidence Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Bid Audit Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Bid Audit Site Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Bid Primary Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	CAP Report Contact for Public Website	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	5625806482				Medicare Prescription Drug Plan		5	Dallas
S2468	CEO - CMS Administrator Contact	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	CEO - Senior Official for Contracting	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Chief Financial Officer	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Chief Operating Officer	Vice President, Medicare	Mr.	Uhm	Alexander		7148145698					Alexander.Uhm@blueshieldca.com	3840 Kilroy Airport Rd.		Long Beach	CA	90806	11/29/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Chief Information Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Chief Information Security Officer	Chief Information Officer	Ms.	Davis	Lisa		5106073600					Lisa.Davis@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	CMS Casework Communication Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Complaints Tracking Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Contact for Fraud Investigations	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Coordination of Benefits Contact	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Corporate Mailing						5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Customer Service Operations Contact	Director		Mathews	Carolyn		5626135004					Carolyn.Mathews@blueshieldca.com	3021 Reynolds Ranch Pkwy		Lodi	CA	95240	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	DIR Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	DIR Contact (Secondary)	Director, Actuary	Ms.	Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Discount Program Payment Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Emergency Part D Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Emergency Part D Contact (Secondary)	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Employer Waiver Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland HIlls	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Enrollment Contact	Senior Manager, Installation & Billing		Wilson	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	EOB Transfer Contact	Medicare Project & Program Manager		Zuehlke	Erica		2093713036				8558953519	zuehlke@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Financial Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Financial Reporting Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Formulary Contact	Director, Formulary Strategy and P&T		Nguyen	Nhi		9168410342					Nhi.Nguyen@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Formulary Contact (Secondary)	Principal Pharmacist, Formulary Management		Trinh	Andy		3238276322					Andy.Trinh@blueshieldca.com	601 Potrero Grande Drive		Monterey Park	CA	91755	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	General Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Government Relations Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	HIPAA Privacy Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	HIPAA Security Officer	Chief Privacy Officer		Keystone	David		5103013363					david.keystone@blueshieldca.com	601 12th Street		Oakland	CA	94607	09/27/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Hospice Contact	Senior Program Manager		Fields	Torrie		4152295839					Torrie.Fields@blueshieldca.com	50 Beale St.		San Francisco	CA	94105	02/02/2018	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Interoperability Contact	VP Enterprise Digital Growth		Grimm	David		6196864233					david.grimm@blueshieldca.com	2275 Rio Bonito Way	Suite 250	San Diego	CA	92108	02/15/2022	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Marketing Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Medical Director	Medicare Medical Director	Dr.	Siddiq	Khaliq		5627137953					Khaliq.Siddiq@blueshieldca.com	555 Anton Boulevard	Suite 800	Costa Mesa	CA	92626	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Medicare Compliance Officer	Senior Director, Medicare Compliance	Mr.	Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Medicare Coordinator	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					Sheri.Lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Medicare Part D Opioid Overutilization Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					OpioidDUR@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/13/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Medication Therapy Management Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					Dawn.Becker-Ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	OffShore Subcontractor Contact	Senior Director, Medicare Compliance		Robinson	Richard		5625806482					MedicareComplOfficer@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/16/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Online Enrollment Center Contact (Back-up)	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Ave		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Online Enrollment Center Contact (Optional)	IT Product Manager, Consultant		Skuta	Paul		9168660922					Paul.Skuta2@blueshieldca.com	601 12th Street		Oakland	CA	94607	10/02/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Online Enrollment Center Contact (Primary)	Senior Manager, Installation & Billing		White	Cheri		9163503262					cheri.white@blueshieldca.com	4207 Town Center Blvd, Building B		El Dorado Hills	CA	95762	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Appeals	Supervisor, Medicare Appeals and Grievances		Lopez	Celina						9163506593	celina.lopez@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/18/2016	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	8007764466				Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Appeals Contact (Secondary)	Senior Manager, Operations		Salam	Shahid							Shahid.Salam@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	8007764466				Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Application Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Benefits Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Claims Submission Contact	Lead Medicare Rx Benefits & Claims Specialist		Campbell	Leslie		5306263838					leslie.campbell@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/18/2016	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
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	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	8007764466				Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Exceptions Contact (Secondary)	Senior Manager, Medicare Compliance		Mata	Marcos							Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	8007764466				Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Price File Contact (Back-up)	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Price File Contact (Optional)	Business Analyst, Rx Benefit/Claims Implementation		Ng	Alvin		5106072964					alvin.ng@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/14/2020	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Price File Contact (Primary)	Business Analyst, Pharmacy Strategy and Operations		Ellen	Brian		9166591606					brian.ellen@blueshieldca.com	4700 Bechelli Lane		Redding	CA	96002	11/04/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Quality Assurance Contact	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Part D Reporting Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					marcos.mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Patient Safety Contact	Sr. Pharmacist, Medicare Rx Program Manager		Becker-Ellison	Dawn		9168410330					dawn.becker-ellison@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	01/18/2016	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Payment Contact	Senior Director, Medicare Finance		Ballou	Taylor		8182286697					Taylor.Ballou@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Pharmacy Director	Senior Director, Phamacy Markets		Yang	Winnie		8182282873					winnie.yang@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	06/25/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Pharmacy Network Management Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106072901					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Pharmacy Network Management Contact (Secondary)	Senior Program Manager, Medicare Rx Compliance		Nelson	Kimberly	C	5106073281					Kim.Nelson@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Pharmacy Technical Help Desk Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik							Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	12/20/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	8003757924				Medicare Prescription Drug Plan		5	Dallas
S2468	Pharmacy Technical Help Desk Contact (Secondary)	Sr. Manager		Nordby	Christina							cnordb01@blueshieldca.com	3300 Zinfandel Drive		Rancho Cordova	CA	95670	12/30/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active	5626135252				Medicare Prescription Drug Plan		5	Dallas
S2468	Plan Directory Contact for Public Website			Services	Member		8007764466					membersvcs@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Plan to Plan Reconciliation Contact	Supervisor Accounts Payable/Receivable		Perez	Cheryl		9167024442					BSCP2PRecon@blueshieldca.com	3021 Reynolds Ranch Parkway		Lodi	CA	95240	02/22/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Processor Contact	Senior Manager, Rx Benefit & Claims Operations		Hartley	Erik		5106073281					Erik.Hartley@blueshieldca.com	601 12th Street		Oakland	CA	94607	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Reconciliation Contact	Director, Actuary		Shah	Dimple		5106072597					Dimple.Shah@blueshieldca.com	601 12th Street		Oakland	CA	94607	05/29/2025	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Reconciliation Contact (Secondary)	Senior Director, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/11/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Recovery Audit Contact	Senior Manager, Medicare Compliance	Mr.	Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Surveillance Contact	Senior Manager, Medicare Compliance		Mata	Marcos		8182286048					Marcos.Mata@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	01/04/2021	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	System Contact	Sr. Director, IT Product Management		Chambers	Shelley		1916866073					Shelley.Chambers@blueshieldca.com	4203 Town Center Boulevard		El Dorado Hills	CA	95762	09/07/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	Third Party Administrator (TPA) Liaison	Director, Actuary		Shah	Dimple		5109068189					dimple.shah@blueshieldca.com	50 Beale Street		Oakland	CA	94105	12/04/2024	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2468	User Access Contact	Senior Manager, Medicare Compliance		Lester	Sheri		5623641860					sheri.lester@blueshieldca.com	6300 Canoga Avenue		Woodland Hills	CA	91367	03/22/2023	2026	CALIFORNIA PHYSICIANS' SERVICE	PDP	Blue Shield of California	Medicare Prescription Drug Plan		California Physicians' Service	30	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S2893	Agent/Broker Compensation Data Contact	Director, Broker and Sales Commissions		Newcomb	Stephen		6172469980					Stephen.Newcomb@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	12/07/2018	2026	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	Automated TrOOP Balance Transfer Contact	Manager Strategic Accounts		Pityou	Sean		6022458871					JEAccountManagement@CVSCaremark.com	9501 E. Shea BLVD		Scottsdale	AZ	85260	06/16/2022	2026	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	Backup User Access Contact	Sr Manager		Donovan	Gerard		6172468466					Gerard.Donovan@bcbsma.com	25 Technology Place		Hingham	MA	020434359	01/30/2024	2026	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		4806147228					Tiffany.Mondhink@CVSHealth.com	9501 E. Shea Blvd, MC125		Scottsdale	AZ	85260	11/14/2019	2026	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	Bid Audit Contact	Actuarial Analyst		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	02/17/2021	2026	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	Bid Audit Site Contact	Actuarial Analyst		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	02/17/2021	2026	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	Bid Primary Contact	Actuarial Analyst		West	Gregory		6172465077					Gregory.West@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	02/17/2021	2026	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	CAP Report Contact for Public Website	Director, Medicare Compliance		Sullivan	Christina		7816038012					Medicarecompliance@bcbsma.com	25 Technology Place		Hingham	MA	020434359	01/30/2024	2026	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	CEO - CMS Administrator Contact	Chief Executive Officer	Ms.	Iselin	Sarah		6172463805					sarah.iselin@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	12/21/2022	2026	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	CEO - Senior Official for Contracting	Chief Executive Officer	Ms.	Iselin	Sarah		6172463805					sarah.iselin@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	12/21/2022	2026	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.	Kam	Ruby		6172463600					Ruby.Kam@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	10/03/2023	2026	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 Operating Officer	Executive Vice President, Chief Operating Officer	Mr.	Lynch	Richard		6172465000					Richard.Lynch@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	12/16/2019	2026	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 Information Officer	Chief Information Officer	Ms.	Hildebrand	Victoria		6172465000					victoria.hildebrand@bcbsma.com	101 Huntington Ave	Suite 1300	Boston	MA	021997611	02/01/2021	2026	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 Information Security Officer	Chief Information Security Officer	Mr.	Di Bassinga	Nsiona		6172463988					nsiona.dibassinga@bcbsma.com	101 Huntington Avenue, Suite 1300		Boston	MA	021997611	09/24/2025	2026	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		4803927135					Lori.Rocco@CVSHealth.com	9501 E. Shea BLVD, MC121		Scottsdale	AZ	85260	01/27/2023	2026	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	Complaints Tracking Contact	Sr. PDP Analyst, Customer Service, CTM, Group,		White	Stephen		6172467670					Stephen.White@BCBSMA.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	11/14/2019	2026	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	Contact for Fraud Investigations	Associate General Counsel		Stewart	Jennifer		6172463527					Jennifer.Stewart@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	06/25/2018	2026	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		4802980166					Silvia.Viana@cvshealth.com	9501 E.Shea BLVD,	MC121	Scottsdale	AZ	85260	06/08/2020	2026	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	Corporate Mailing						8002004255					placeholder@cms.hhs.gov	P. O. Box 55007		Boston	MA	022055007	06/16/2010	2026	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		4128757137					dayoubj@cvshealth.com	315 Cloisterbane Drive		St. Johns	FL	32259	10/11/2022	2026	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	DIR Contact	Reporting Sr. Analyst		Kovalski	Robin		6172468586				6172468506	Robin.Kovalski@BCBSMA.com	25 Technology Place		Hingham	MA	02043	08/05/2021	2026	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	DIR Contact (Secondary)	Sr. Accounting Consultant	Mr	Setzer	Bryan		6172466261					Bryan.Setzer@BCBSMA.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	11/14/2019	2026	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	Discount Program Payment Contact	Manager, Accounting		Chau	Joyce		4017709055					Joyce.Chau@CVSHealth.com	200 Highland Corporate Drive	Mail Code 2260	Cumberland	RI	02864	05/21/2025	2026	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	Emergency Part D Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place	Mailstop 03-04	Hingham	MA	020434359	01/30/2024	2026	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	Employer Waiver Contact	Senior Product Manager		Hasan	Sayeema		6172466307					Sayeema.Hasan@BCBSMA.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	06/16/2022	2026	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	Enrollment Contact	Med D Ops Enrollment		Mondhink	Tiffany		4806147228					Tiffany.Mondhink@CVSHealth.com	9501 E. Shea Blvd	MC125	Scottsdale	AZ	85260	11/14/2019	2026	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	EOB Transfer Contact	Director, Member Communications, PDP Plan Ops		Weingardt	Alesa		3309574321				4803582668	Alesa.Weingardt@CVSHealth.com	9501 E. Shea BLVD	MC 146	Scottsdale	AZ	85260	01/27/2023	2026	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	Financial Audit Contact	Audit and Risk Management	Mr	Bulman	Tim		6172468038					Timothy.Bulman@bcbsma.com	101 Huntington Avenue	Suite 1300	Boston	MA	021997611	09/20/2019	2026	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	Financial Reporting Contact	Financial Reporting Manager		Goveia	Ross		6172465000					Ross.Goveia@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	12/07/2021	2026	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	Formulary Contact	Clinical Pharmacy Manager		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	03/29/2022	2026	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	Formulary Contact (Secondary)	Clinical Pharmacist		Schraut	David		6172465762					David.Schraut@bcbsma.com	25 Technology Place		Hingham	MA	02043	11/04/2019	2026	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	General Contact	Director, Medicare Compliance		Sullivan	Christina		7816038012				6172468506	Medicarecompliance@bcbsma.com	25 Technology Place		Hingham	MA	02043	01/30/2024	2026	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	Vice President, Government and Regulatory ffairs		Caljouw	Michael		6172463499					Michael.Caljouw@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	01/30/2024	2026	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	HIPAA Privacy Officer	Privacy Officer		Abdel-Samed	Jennifer		4042424614					Jennifer.Abdel-Samed@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	06/16/2022	2026	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	HIPAA Security Officer	Vice President and Chief Information Security Offi		Baggett	Sean		6172465824					Sean.Baggett@bcbsma.com	101 Huntington Ave, Suite 1300		Boston	MA	021997611	11/16/2020	2026	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		6022458871					JEAccountManagement@CVSHealth.com	9501 E.Shea BLVD		Scottsdale	AZ	85260	06/16/2022	2026	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	Interoperability Contact			Sullivan	Christina		6172462507					christina.sullivan@bcbsma.com	25 Technology Place		Hingham	MA	02043	04/13/2022	2026	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	Marketing Contact	Director, Medicare Product		Hasan	Sayeema		6172466307					Sayeema.Hasan@BCBSMA.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	01/30/2024	2026	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	Medical Director	Sr. Medical Director, Clinical Support Svc		Catero	Martin		4803163732					Martin.Catero@CVSHealth.com	4755 South 44th Place	MC 145	Phoenix	AZ	85040	11/09/2021	2026	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		7816038012					NEJECompliance@bcbsma.com	25 Technology Place	Mail stop 03/04	Hingham	MA	020434359	04/28/2022	2026	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 Coordinator	Director Operations		Bentley	Melanie		6172468403					melanie.bentley@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	02/25/2020	2026	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 Part D Opioid Overutilization Contact	Clinical Pharmacist, Pharmacy Operations		Schraut	David		6172465762					David.Schraut@bcbsma.com	25 Technology Place		Hingham	MA	02043	10/24/2018	2026	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	Medication Therapy Management Contact	Clinical Manager		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	101 Huntington Avenue		Boston	MA	02199	05/30/2024	2026	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	Online Enrollment Center Contact (Back-up)	Sr. Analyst		Lisy	Derrick		2165704911					Derrick.Lisy@CVSHealth.com	29100 Aurora RD		Solon	OH	44139	07/27/2021	2026	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	Online Enrollment Center Contact (Optional)	Sr. Analyst		Lisy	Derrick		2165704911					Derrick.Lisy@CVSHealth.com	29100 Aurora Rd		Solon	OH	44139	07/27/2021	2026	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	Online Enrollment Center Contact (Primary)	Application Development Manager		Braxter	Sarah		2162157288					Sarah.Braxter@CVSHealth.com	29100 Aurora RD		Solon	OH	44139	07/27/2021	2026	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 Appeals	Manager RPh, Medicare Part D CD&A Client Support		Moran	Vickie							Vickie.Moran@CVSHealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/09/2021	2026	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active	4125263320				Medicare Prescription Drug Plan		5	Boston
S2893	Part D Appeals Contact (Secondary)	Director, Medicare Part D CD&A Client Support		Christensen	Ann							Ann.Christensen@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	11/09/2021	2026	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active	6023883829				Medicare Prescription Drug Plan		5	Boston
S2893	Part D Application Contact	Senior Product Manager		Hasan	Sayeema		6172466307					Sayeema.Hasan@BCBSMA.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	11/18/2019	2026	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 Benefits Contact	Senior Product Manager		Hasan	Sayeema		6172466307					Sayeema.Hasan@BCBSMA.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	06/16/2022	2026	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 Claims Submission Contact	Director, Medicare Ops		Steinke	Sydney		6024057057					Sydney.Steinke@CVSHealth.com	8801 E. Raintree Drive	MC 121	Scottsdale	AZ	85260	01/27/2023	2026	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	2026	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active	4125263320				Medicare Prescription Drug Plan		5	Boston
S2893	Part D Exceptions Contact (Secondary)	Director, Medicare Part D CD&A Client Support		Christensen	Ann							Ann.Christensen@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	11/09/2021	2026	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active	6023883829				Medicare Prescription Drug Plan		5	Boston
S2893	Part D Price File Contact (Back-up)	Clinical Pharmacy Manager		Wong	Timothy		6172466927					Timothy.Wong@bcbsma.com	25 Technology Place		Hingham	MA	02043	03/29/2022	2026	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 Price File Contact (Optional)	Clinical Pharmacist		Schraut	David		6172465762					David.Schraut@BCBSMA.com	25 Technology Place		Hingham	MA	02043	07/10/2020	2026	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 Price File Contact (Primary)	Director, Medicare Operations		Steinke	Sydney		6024057057				4013357984	Sydney.Steinke@CVSHealth.com	8801 E. Raintree Drive	MC 121	Scottsdale	AZ	85260	06/16/2022	2026	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 Quality Assurance Contact	Lead Director, Medicare Quality/Audit		Brauner	Lyle		6026183945					Lyle.Brauner@CVSHealth.com	9501 E. Shea Blvd.		Scottsdale	AZ	85260	06/16/2022	2026	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 Reporting Contact	Program Manager		MacDougall	Erin		6172469714					Erin.MacDougall@bcbsma.com	25 Technology Place	Mail Stop 03-04	Hingham	MA	020434359	11/14/2019	2026	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	Patient Safety Contact	Clinical Advisor		Reed	Monica		2817025942					Monica.Reed@CVSHealth.com	750 W John Carpenter Fwy #1200		Irving	TX	75039	06/16/2022	2026	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	Payment Contact	Manager, Accounting		Chau	Joyce		4017709055					Joyce.Chau@CVSHealth.com	200 Highland Corporate Drive	Mail Code 2260	Cumberland	RI	02864	05/21/2025	2026	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 Director	Director, Pharmacy Operations		Nelhuebel	Melinda		6172464407					Melinda.Nelhuebel@bcbsma.com	25 Technology Place		Hingham	MA	02043	05/29/2018	2026	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 Network Management Contact	Director, Network Operations		Smith	Shawn		4806529980					Shawn.Smith@CVSHealth.com	9501 E. Shea BLVD		Scottsdale	AZ	85260	12/16/2020	2026	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 Network Management Contact (Secondary)	Senior Director, Pharmacy Services		Erwin	Mary Beth		6172463276					MaryBeth.Erwin@bcbsma.com	One Enterprise Dr		N. Quincy	MA	02171	10/24/2019	2026	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	2026	ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT	PDP	Blue MedicareRx	Medicare Prescription Drug Plan		Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	386	Yes	Active	8666934620				Medicare Prescription Drug Plan		5	Boston
S2893	Plan Directory Contact for Public Website	Blue MedicareRx (PDP)		Care	Customer		8885434917					JEAccountManagement@CVSCaremark.com	Blue MedicareRx (PDP)	PO Box 280200	Nashville	TN	37228	11/14/2019	2026	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	Plan to Plan Reconciliation Contact	Sr. Consultant, Finance Med D		Spradlin	Eun-Jung		6022997668					eun-jung.spradlin@cvshealth.com	PO Box 842237		Dallas	TX	752842237	02/03/2023	2026	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	Processor Contact	Director Network Systems & Standards		Graham	Heather		2145370421					Heather.Graham@cvshealth.com	750 W John Carpenter Freeway, Suite 1200		Irving	TX	75039	11/09/2021	2026	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	Reconciliation Contact	Manager, Accounting		Chau	Joyce		4017709055					joyce.chau@cvshealth.com	200 Highland Corporate Drive	Mail Code 2260	Cumberland	RI	02864	05/21/2025	2026	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	Reconciliation Contact (Secondary)	Sr. Accounting Consultant		Setzer	Bryan		6172466261					Bryan.Setzer@bcbsma.com	101 Huntington Avenue Suite 1300		Boston	MA	021997611	10/24/2019	2026	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	Recovery Audit Contact	Sr. Accounting Consultant	Mr	Setzer	Bryan		6172466261					Bryan.Setzer@BCBSMA.com	101 Huntington Avenue	Suite 1300	Boston	MA	02199	11/14/2019	2026	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	Surveillance Contact	Medicare Compliance Manager		Sullivan	Christina		7816038012				6172468506	medicarecompliance@bcbsma.com	25 Technology Place	Mailstop 03-03	Hingham	MA	020434359	04/15/2022	2026	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	System Contact	Manager Strategic Accounts		Pityou	Sean		6022458871					JEAccountManagement@cvshealth.com	9501 E.Shea BLVD		Scottsdale	AZ	85260	06/16/2022	2026	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	Third Party Administrator (TPA) Liaison	Manager, Accounting		Chau	Joyce		4017709055					Joyce.Chau@CVSHealth.com	200 Highland Corporate Drive	Mail Code 2260	Cumberland	RI	02864	05/21/2025	2026	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	User Access Contact	Manager		Sullivan	Christina		6172462507					Christina.Sullivan@bcbsma.com	25 Technology Place		Hingham	MA	020434359	08/05/2021	2026	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
S3285	Agent/Broker Compensation Data Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	05/26/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Automated TrOOP Balance Transfer Contact	Medicare Operations Supervisor	Mr.	Distel	Chris		8587906376					PartDCAT@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/23/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Backup User Access Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Best Available Evidence Contact	Program Associate	Ms.	Mays	Dara		8587905710					dara.mays@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Bid Audit Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Bid Audit Site Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Bid Primary Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	CAP Report Contact for Public Website	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	CEO - CMS Administrator Contact	President, MG Insurance Company	Mr.	Barr	Damien		8587906330					damien.barr@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/25/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	CEO - Senior Official for Contracting	President, MG Insurance Company	Mr.	Barr	Damien		8587906330					damien.barr@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/25/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Chief Financial Officer	President, MG Insurance Company	Mr.	Barr	Damien		8587906330					damien.barr@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/25/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Chief Operating Officer	President, MG Insurance Company	Mr.	Barr	Damien		8587906330					damien.barr@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/25/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Chief Information Officer	Software Engineer IV	Mr.	Cuarto	Jojo		8587907184					jojo.cuarto@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/23/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Chief Information Security Officer	Software Engineer IV	Mr.	Cuarto	Jojo		8587907184					jojo.cuarto@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/23/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	CMS Casework Communication Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Complaints Tracking Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Contact for Fraud Investigations	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Coordination of Benefits Contact	Program Associate	Ms.	Mays	Dara		8587905710					dara.mays@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Corporate Mailing						8587906294					niejadd.evans@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/20/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Customer Service Operations Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	DIR Contact	Financial Data Recon Analyst	Mr.	Hallman	Blake		8587907493					blake.hallman@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/20/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	DIR Contact (Secondary)	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	05/26/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Discount Program Payment Contact	Blake Hallman	Mr.	Hallman	Blake		8587907493					blake.hallman@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/20/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Emergency Part D Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Emergency Part D Contact (Secondary)	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Employer Waiver Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Enrollment Contact	Program Manager	Ms.	Stokes	Janelle		6199806944					janelle.stokes@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	EOB Transfer Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323				8583572494	michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	07/01/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Financial Audit Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Financial Reporting Contact	Financial Data Recon Analyst	Mr.	Hallman	Blake		8587907493					blake.hallman@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/27/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Formulary Contact	Mgr Formulary Admin & Maintenance	Ms.	Nyawablia	Christina		8587906279					FMT@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Formulary Contact (Secondary)	Pharmacy Director	Ms.	Benson	Tara		8587907069					tara.benson@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	01/31/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	General Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Government Relations Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	HIPAA Privacy Officer	Privacy Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	HIPAA Security Officer	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Hospice Contact	Program Associate	Ms.	Mays	Dara		8587905710					dara.mays@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Interoperability Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Ct		SAN DIEGO	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Marketing Contact	Program Manager	Ms.	Stokes	Janelle		6199806944					janelle.stokes@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	09/26/2024	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Medical Director	Medical Director	Dr.	Jimenez	Rick		8582915360					rick.jimenez@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/20/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Medicare Compliance Officer	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Medicare Coordinator	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Medicare Part D Opioid Overutilization Contact	Pharmacy Director	Ms.	Benson	Tara		8587907069					tara.benson@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	10/17/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Medication Therapy Management Contact	Clinical Solutions Manager III	Ms.	Nguyen	Linh		8587906627					MTMP@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/02/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	OffShore Subcontractor Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Online Enrollment Center Contact (Back-up)	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Appeals	Compliance Officer	Mrs.	Koja-Volk	Jordana							jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active	8587905653				Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Appeals Contact (Secondary)	Manager, Appeals & Grievances	Ms.	Martin	Dawn						8587906118	dawn.martin@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/23/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active	8587905653				Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Application Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	05/26/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Benefits Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Claims Submission Contact	Medicare Part D Program Manager	Ms.	Stockes	Janelle		8587906682					janelle.stokes@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	09/26/2024	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Exceptions Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana							jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active	8587905653				Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Exceptions Contact (Secondary)	Director, PA & UM Programs	Ms.	Emoto	Julianne						8587905846	julianne.emoto@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/23/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active	8587905846				Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Price File Contact (Back-up)	Medicare Part D Program Manager	Ms.	Niemi	Kirstin		8587906455					PlanFinderCommunications@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/02/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Price File Contact (Optional)	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Price File Contact (Primary)	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	07/01/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Quality Assurance Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	07/01/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Part D Reporting Contact	PDP Program Manager I	Ms.	Williams	Valencia		8587903028					valencia.williams@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	02/15/2022	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Patient Safety Contact	Pharmacy Director	Ms.	Benson	Tara		8587907069					tara.benson@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	01/24/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Payment Contact	Financial Data Recon Analyst	Mr.	Hallman	Blake		8587907493					blake.hallman@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/20/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Personal Health Record Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Pharmacy Director	Pharmacy Director	Ms.	Benson	Tara		8587907069					tara.benson@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	01/24/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Pharmacy Network Management Contact	Director, Pharmacy Network Administration	Mr.	Hunt	Brian		8587907092					brian.hunt@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/23/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Pharmacy Network Management Contact (Secondary)	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
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	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active	8448263451				Medicare Prescription Drug Plan		5	Chicago
S3285	Plan Directory Contact for Public Website			Service	Customer		8448263451					karina.lewis@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	10/25/2019	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Plan to Plan Reconciliation Contact	Financial Data Recon Analyst	Mr.	Hallman	Blake		8587907493					blake.hallman@medimpact.com	PO Box 78606		Milwaukee	WI	532788606	07/11/2019	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Processor Contact	Senior Vice President,  Government Programs	Mr.	Helmus	Scott		8584373471					Scott.Helmus@MedImpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/15/2025	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Reconciliation Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Reconciliation Contact (Secondary)	Financial Data Recon Analyst	Mr.	Hallman	Blake		8587907493					blake.hallman@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	01/24/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Recovery Audit Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Surveillance Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	System Contact	Director, PDP Operations	Ms.	Bossert	Michele		8587906323					michele.bossert@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	12/30/2020	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	Third Party Administrator (TPA) Liaison	Financial Data Recon Analyst	Mr.	Hallman	Blake		8587907493					blake.hallman@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	11/20/2018	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3285	User Access Contact	Compliance Officer	Mrs.	Koja-Volk	Jordana		8587905653					jordana.koja-volk@medimpact.com	10181 Scripps Gateway Court		San Diego	CA	92131	08/01/2023	2026	MG INSURANCE COMPANY	PDP	MG Insurance Company	Medicare Prescription Drug Plan		MedImpact Holdings, Inc.	698	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3389	Agent/Broker Compensation Data Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Automated TrOOP Balance Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2021	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Backup User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Best Available Evidence Contact	Customer Service		Health Plan	UPMC		8775393080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Bid Audit Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Bid Audit Site Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Bid Primary Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	CAP Report Contact for Public Website	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	CEO - CMS Administrator Contact	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	CEO - Senior Official for Contracting	President	Ms.	Jenkins	Mary Beth		4124547764				4124547750	jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	01/06/2025	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Chief Financial Officer	Chief Financial Officer	Mr.	Gebbens	Gordon		4124545559					gebbgx@UPMC.EDU	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	07/18/2016	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Chief Operating Officer	Chief Operating Officer	Ms.	Jenkins	Mary Beth	L	4124547764					jenkinsml@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	12/09/2015	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Chief Information Officer	Chief Information Officer	Mr.	McCallister	Ed		4124547711					mccallisterew@upmc.edu	USX Tower, 60th Floor	600 Grant Street	Pittsburgh	PA	15219	03/14/2016	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Chief Information Security Officer	Vice President, ISD	Mr	Haas	Scott		4124546162					haassm@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/14/2016	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	CMS Casework Communication Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Complaints Tracking Contact	Sr. Administrator, Medicare Compliance	Ms.	McGough	Amber		4124545250					russellal@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Contact for Fraud Investigations	Sr. Director Fraud & Abuse		Workman	Craig		4124545524					workmanc@upmc.edu	USX Tower, 47th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Coordination of Benefits Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Corporate Mailing						4124547500					upmchp@upmc.edu	USX Tower, 55th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Customer Service Operations Contact	Customer Service		Health Plan	UPMC		8775393080					upmchp@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	DIR Contact	Director, Pharmacy Finance		Bovier	Jacqueline		4124547584					bovierjd@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/18/2015	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	DIR Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Discount Program Payment Contact	Business Analyst III		Michalski	Jeff	K	4124545715				4124542110	michalskij@upmc.edu	USX Tower, 21st Floor	600 Grant Street	Pittsburgh	PA	15219	11/18/2024	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Emergency Part D Contact	Vice President, Customer Engagement & Enrollment		Palmerine	Anne		4129777828					palmerineac3@upmc.edu	USX Tower, 23rd Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Emergency Part D Contact (Secondary)	AVP, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	12/27/2023	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Enrollment Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	EOB Transfer Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Financial Audit Contact	Sr. Director, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Financial Reporting Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Formulary Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Formulary Contact (Secondary)	Manager, Clinical Pharmacy Medicare	Ms.	Ryan	Maggie		4124547086					ryanm7@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	05/13/2025	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	General Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Government Relations Contact	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	HIPAA Security Officer	Chief Privacy Officer	Ms.	Grumbine	Megan		7034021772					grumbinem@upmc.edu	USX Tower, 41st Floor	600 Grant St.	Pittsburgh	PA	15219	11/03/2020	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Hospice Contact	Pharmacy Coordinator	Ms.	Lindemuth	Nicole		4124548589					lindemuthnl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	06/24/2020	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Interoperability Contact	Sr. Director, Medicare Operations		Cain	John		4124545539					cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	02/16/2022	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Marketing Contact	Director, Medicare Marketing		McVey	Alicia		4124545525					mcveyal@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	08/03/2017	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Medical Director	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Vybiral	Erin		4124545247				4124542110	mccomplianceofficer@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	12/15/2021	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Medicare Coordinator	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Medicare Part D Opioid Overutilization Contact	Sr. Manager, Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Medication Therapy Management Contact	Sr. Manager Clinical Pharmacy		Zandier	Lauren		4124542950				4124545295	craigl@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	10/23/2018	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Online Enrollment Center Contact (Back-up)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Online Enrollment Center Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Online Enrollment Center Contact (Primary)	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Appeals	Manager, C&G		Richards	Rebecca						4124547920	richardsr3@upmc.edu	USX Tower, 42nd Floor	600 Grant Street	Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active	4124540116				Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Appeals Contact (Secondary)	Manager, Pharmacy Compliance		Chaussinand	Matt							chaussinandm@upmc.edu	600 Grant St., USX, 12th Floor		Pittsburgh	PA	15219	02/25/2021	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active	4124545914				Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Application Contact	Project Manager		Clawson	Jeff		4124545192				4124542110	clawsonjw@upmc.edu	US Steel Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	11/01/2017	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Benefits Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Claims Submission Contact	Director, Regulated Markets Medicare Solutions		Dovico	Rosario		2012696398					rosario_dovico@express-scripts.com	100 Parsons Pond Drive		Franklin Lakes	NJ	07417	04/23/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Exceptions Contact			Services	Pharmacy							upmchp@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	08/29/2012	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active	8003964139				Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Price File Contact (Back-up)	Sr. Manager, Government Programs		Dolfi	Amanda		6147613606					medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	01/12/2018	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Price File Contact (Optional)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Price File Contact (Primary)	Director, Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107 St. #11202		Overland	KS	66207	07/28/2020	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Quality Assurance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Part D Reporting Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Patient Safety Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Payment Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Personal Health Record Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Pharmacy Director	Sr. Director, Pharmacy Operations		Kienzle	Paul		7242070388					kienzlepa@upmc.edu	USX Tower, 12th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Pharmacy Network Management Contact	Network Account Director		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	10/31/2016	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
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	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	Dallas
S3389	PHR Beneficiary Contact																	12/21/2007	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan	MyHealth	UPMC Health System	249	Yes	Active	4128032065				Medicare Prescription Drug Plan		5	Dallas
S3389	Plan Directory Contact for Public Website			Marketing	Medicare		8773813765					upmchp@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/23/2012	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Plan to Plan Reconciliation Contact	Business Analyst		Michalski	Jeff		4124545715				4124542110	medicarereporting@upmc.edu	US Steel Tower, 600 Grant Street, 9th Floor	c/o UPMC Health Plan Attn: Aunika Hall P2P - 09-257	Pittsburgh	PA	15219	08/11/2025	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Processor Contact	Sr Director - Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Reconciliation Contact	Chief Actuary		Wisniewski	John		4124545180					wisniewskijc@upmc.edu	USX Tower, 14th Floor	600 Grant Street	Pittsburgh	PA	15219	02/28/2017	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Reconciliation Contact (Secondary)	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Recovery Audit Contact	Sr. Director, Medicare Operations	Mr.	Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Surveillance Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	System Contact	Director, Enrollment & COB		Aber	Kelly		4124547664					aberkn@upmc.edu	USX Tower, 5th Floor	600 Grant Street	Pittsburgh	PA	15219	05/20/2015	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	Third Party Administrator (TPA) Liaison	Business Analyst III		Michalski	Jeff	K	4124545715				4124542110	michalskij@upmc.edu	c/o UPMC Health Plan Attn: Dave Soltesz P2P	US Steel Tower, 600 Grant Street, 21st Floor	Pittsburgh	PA	15219	11/18/2024	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3389	User Access Contact	Sr. Director, Medicare Operations		Cain	John		4124545539				4124542110	cainjo@upmc.edu	USX Tower, 9th Floor	600 Grant Street	Pittsburgh	PA	15219	03/12/2019	2026	UPMC HEALTH BENEFITS, INC.	PDP	UPMC Health Plan	Medicare Prescription Drug Plan		UPMC Health System	249	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3521	Agent/Broker Compensation Data Contact	Manager, Broker Administration and Operations		McBride	Kelly		5857396683					Kelly.McBride@Excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Automated TrOOP Balance Transfer Contact	Supervisor, Medicare Operations		Matecki	Lisa		7166145722					Lisa.Matecki@excellus.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Backup User Access Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Best Available Evidence Contact	Supervisor Medicare Operations		Piershalski	Dana		7168574435				7168576160	medicare.reconciliation.unit@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Bid Audit Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Bid Audit Site Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Bid Primary Contact	Actuarial Director, Government Programs		Meyers	Angela		5857942328					angela.meyers@excellus.com	165 Court Street		Rochester	NY	14647	05/29/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	CAP Report Contact for Public Website	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	CEO - CMS Administrator Contact	Executive Vice President & Chief Financial Officer	Mr	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	CEO - Senior Official for Contracting	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Chief Financial Officer	Executive Vice President & Chief Financial Officer	Mr.	Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Chief Operating Officer	President and Chief Executive Officer	Mr.	Reed	Jim		3156716406					Jim.Reed@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Chief Information Officer	SVP & Chief Info Data Digital Officer	Ms	Langston	Cindy		5853276529					Cindy.Langston@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Chief Information Security Officer	Vice President, Chief Information Security Officer	Mr.	Pickup	Jason		5853397620	25511				Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	CMS Casework Communication Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Complaints Tracking Contact	Medicare Compliance Program Administrator		Gomez	Rafael		7168576226					Advocacy.Department@excellus.com	205 Park Club Lane		Buffalo	NY	14221	04/07/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Contact for Fraud Investigations	Corporate Director of Special Investigations		Paris	Meg		5852384425				5854536346	Meg.Paris@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Coordination of Benefits Contact	Manager, Analysis and Recovery		May	Mary		3157928873					Mary.May@excellus.com	301 Woods Park Drive	Suite 201	Clinton	NY	13323	05/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Corporate Mailing						5852384505					CCiardi@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Customer Service Operations Contact	Vice President, Customer Care		Levi	Alexander		5853996683					Alexander.Levi@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	DIR Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	DIR Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Discount Program Payment Contact	Director Financial Operations		McCullough	Shandell		5852787839					Shandell.McCullough@excellus.com	165 Court Street		Rochester	NY	14647	06/06/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Emergency Part D Contact	Executive Vice President & Chief Financial Officer		Gorecki	Christophe	M	4809935254					Christopher.Gorecki@excellus.com	165 Court St		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Emergency Part D Contact (Secondary)	Director, Pharmacy Operations		Rocco	Darlene		5852613857				8778125306	Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Enrollment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	EOB Transfer Contact	Strategic Pharmacy Change Manager		Ammons	Andrea		5853397986				8778125306	Andrea.Ammons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Financial Audit Contact	Director, Regulatory Auditing & Medicare Oversight	Mrs	Knappen	Heather		5857390661					heather.knappen@excellus.com	165 Court Street		Rochester	NY	14647	11/11/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Financial Reporting Contact	Manager, Medicare and SN Finance		Stalzer	Virginia		5852384428					Virginia.Stalzer@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Formulary Contact	Medicare Part D Formulary Manager		Woodruff	Eric		7167832740					Eric.Woodruff@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Formulary Contact (Secondary)	Medicare Part D Formulary Manager		Banaszak	Danielle		7166145704					Danielle.Banaszak@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	General Contact	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Government Relations Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	HIPAA Privacy Officer	VP, Ethics & Privacy Officer		Hill	Timothy	J	3158771234					Timothy.Hill@excellus.com	333 Butternut Drive		Dewitt	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	HIPAA Security Officer	Vice President, Chief Information Security Officer		Pickup	Jason		5853397620					Jason.Pickup@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Hospice Contact	Director, Pharmacy Utilization Management		Khan	Joe		7168437881					Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Interoperability Contact	Strategic Porfolio Management		Meek	Shauna		5852384570					Shauna.Meek@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Marketing Contact	Marketing Manager		Reardon	Elizabeth		5853276504					Elizabeth.Reardon@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Medical Director	Senior VP and Corporate Medical Director		Cohen	Stephen		5854536366					Stephen.Cohen@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Medicare Compliance Officer	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Medicare Coordinator	VP, Medicare		Bodley	Karen		5854559038					Karen.Bodley@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Medicare Part D Opioid Overutilization Contact	Quality Improvement Clinical Pharmacist		Morano	Melissa		7166145705					melissa.morano@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	06/20/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Medication Therapy Management Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Online Enrollment Center Contact (Back-up)	Enrollment Operation Project Manager II		Abiusi	Amy		7164408638					Amy.Abiusi@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Online Enrollment Center Contact (Optional)	Manager, EDI & Enrollment Governance		Field	Eric		3154360215					Eric.Field@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Online Enrollment Center Contact (Primary)	Enrollment Operations Analyst II		Conway	Michael		7165738029					Michael.Conway@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Appeals	Compliance Program Administrator III		Gomez	Rafael							Rafael.Gomez@excellus.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	7168576226				Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Appeals Contact (Secondary)	Manager of Advocacy and Compliance Ops		Casillo	Lynda							Lynda.Casillo@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	7168576146				Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Application Contact	Product Implementation and Operations Project Mgr		McParlane	Kelli		7164910233					Kelli.McParlane@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Benefits Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Claims Submission Contact	Pharmacy Product Ops Specialist		Kohlmeier	Charity		5852384504					Charity.Kohlmeier@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Exceptions Contact	Director, Pharmacy Utiization Management		Khan	Joe							Joe.Khan@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	7168437881				Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Exceptions Contact (Secondary)	Clinical Pharmacist		Brayer	Hayden							Hayden.Brayer@excellus.Com	165 Court Street		Rochester	NY	14647	04/01/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	5854536416				Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Price File Contact (Back-up)	Pharmacy Product Ops Specialist		DuVall	Amanda		7168576177					Amanda.DuVall@univerahealthcare.com	205 Park Club Lane		Buffalo	NY	14221	12/04/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Price File Contact (Optional)	Director of Government Programs		Westrum	Josh		4807363132	433132				medicarewebsitefiles@express-scripts.com	4225 W. 107th St.	#11202	Overland Park	KS	66207	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Price File Contact (Primary)	Pharmacy Product Ops Specialist		Ciaramaglia	Shannon		5852384506					shannon.ciaramaglia@excellus.com	165 Court Street		Rocheser	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Quality Assurance Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Part D Reporting Contact	Medicare Compliance Program Administrator		Dewa	Renate		3155732791					Renate.Dewa@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Patient Safety Contact	Manager, Clinical Pharmacy Programs		Diehl	Christophe		5855305648					Christopher.Diehl@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Payment Contact	Director, Medicare Enrollment and Reconciliation		Della Rocco	Kimberly		5853393876					Kimberly.DellaRocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Pharmacy Director	Director, Pharmacy Operations		Rocco	Darlene		5853277544					Darlene.Rocco@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Pharmacy Network Management Contact	Pharmacy Operations Support		Brown	Burt		5853277530				5853396640	Burt.Brown@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Pharmacy Network Management Contact (Secondary)	Network Account Directory Retail Strategy and Cont		Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		ST Louis	MO	63121	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
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	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	Chicago
S3521	Pharmacy Technical Help Desk Contact (Secondary)	SR Director Goverment Programs, Medicare		Gibson	Sharon							SGGibson@Express-scripts.Com	One Express Way		St Louis	MO	63121	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	Chicago
S3521	Plan Directory Contact for Public Website	Manager, Medicare Compliance		Spitler	Tracy		5852383644					Tracy.Spitler@Excellus.com	165 Court Street		Rochester	NY	14647	08/28/2025	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Plan to Plan Reconciliation Contact	Manager, Finance Operations		Simmons	Jennifer		5856492768					Jennifer.Simmons@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Processor Contact	SR Directory Government Programs, Medicare		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St Louis	MO	63121	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Reconciliation Contact	Actuarial Analyst		LaMantia	John		8726007942					John.LaMantia@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Reconciliation Contact (Secondary)	Manager, Actuarial Services		Khaper	Susan		3156716451					Susan.Khaper@excellus.com	333 Butternut Drive		Syracuse	NY	13214	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Recovery Audit Contact	Manager Financial Compliance	Mr.	Mau	Ahren		5854785535					Ahren.Mau@excellus.com	165 Court St		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Surveillance Contact	Medicare Compliance Officer	Mrs.	Dibble	Laura		5853397745					Laura.Dibble@excellus.com	165 Court St.		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	System Contact	VP and Chief Apps Officer		Kay	Carolanne		5854142258					Carolanne.Kaye@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	Third Party Administrator (TPA) Liaison	Financial Analyst		McManus	Michael		5853397789					Michael.Mcmanus@excellus.com	165 Court Street		Rochester	NY	14647	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3521	User Access Contact	Medicare Compliance Program Administrator		Conte	Elva		7168437805					Elva.Conte@univerahealthcare.com	205 Park Club Lane		Williamsville	NY	14221	01/22/2024	2026	EXCELLUS HEALTH PLAN, INC.	PDP	Excellus Health Plan, Inc	Medicare Prescription Drug Plan		Lifetime Healthcare, Inc.	87	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S3875	Agent/Broker Compensation Data Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117					sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Automated TrOOP Balance Transfer Contact	Dir, Project and Program Management		Arinsberg	Valerie		8555862573				8886568099	valerie.arinsberg@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	02/09/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Backup User Access Contact	Compliance Analyst		Jones	Donna		6123293510					donna.jones@primetherapeutic.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Best Available Evidence Contact	Product Director		Valdivia	Luguer		8555862573				8886568099	slcenrollment@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Bid Audit Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Bid Primary Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	CAP Report Contact for Public Website	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	08/27/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	CEO - CMS Administrator Contact	President & CEO	Mr.	Kamal	Mostafa		9735157011				8886568099	mostafa.kamal@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	02/09/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	CEO - Senior Official for Contracting	President & CEO	Mr.	Kamal	Mostafa		9735157011					mostafa.kamal@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	02/09/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Chief Financial Officer	Chief Financial Officer	Mr.	Bodmer	Ken		6127773873					ken.bodmer@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	03/19/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Chief Operating Officer	Chief Operations and Technology Officer	Mr.	Mertel	Matthew		4806249222					matthew.mertel@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	02/09/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Chief Information Officer	Chief Operations and Technology Officer	Mr.	Mertel	Matthew		4806249222					matthew.mertel@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	02/09/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Chief Information Security Officer	Chief Information Security Officer	Mr.	Kracke	Cam		6127774109					ckracke@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	02/09/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	CMS Casework Communication Contact	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	08/27/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Complaints Tracking Contact	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	08/27/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Contact for Fraud Investigations	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Coordination of Benefits Contact	Product Director		Valdivia	Luguer		8015030117				8886568099	slcenrollment@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Corporate Mailing						8555862573				8886568099	slcenrollment@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	02/20/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Customer Service Operations Contact	Sr Director Operations		DiBiase	Joseph		4013441059				8886568099	joe.dibiase@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	DIR Contact	AVP Financial Planning & Analysis		Harries	Brian		6127775862					brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	DIR Contact (Secondary)	AVP, Financial Planning & Analysis		Harris	Brian		6127775862					brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Discount Program Payment Contact	Financial Analyst Sr		Yan	Kwok Cheun		4806249271					alex.yan@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Emergency Part D Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Emergency Part D Contact (Secondary)	VP Market Growth & Strategy		Magness	Jon		8019410008					jon.magness@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Employer Waiver Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Enrollment Contact	Product Director		Valdivia	Luguer		8015030118				8886568099	slcenrollment@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	EOB Transfer Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Financial Audit Contact	AVP, Financial Planning & Analysis	Mr.	Harris	Brian		6127775862					brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	07/19/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Financial Reporting Contact	AVP, Financial Planning & Analysis		Harris	Brian		6127775862				8886568099	brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Formulary Contact	AVP GP Pharmacy & Clinical Services		Nunnally	Jilliann		8045434280					jill.nunnally@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Formulary Contact (Secondary)	Mgr Clinical Pharmacist Review		Miller	Steven		4806249491					steven.miller@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	General Contact	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	08/27/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Government Relations Contact	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	08/27/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	HIPAA Privacy Officer	Director Privacy Officer		Ward	Stacy		6127775697				8664708807	sward@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	HIPAA Security Officer	Chief Information Security Officer	Mr.	Kracke	Cam		6127774109					Ckracke@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Hospice Contact	Functional Business Consultant Sr		Ibenskis	Sara	N	8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Interoperability Contact	Director Analytics		Stark	Sean		8555862573					slcenrollment@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Marketing Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Medical Director	VP Medical Director	Dr.	Chodroff	Marci		8015030117				8886568099	marci.chodroff@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Medicare Compliance Officer	Compliance Officer	Ms	Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Medicare Coordinator	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Medicare Part D Opioid Overutilization Contact	VP Market Growth & Strategy		Magness	Jon		8019410008				8886568099	jon.magness@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Medication Therapy Management Contact	Clinical Program Development Director Sr		Ferro	Christina		4013441063				8886562207	christina.ferro@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Appeals	Sr Director Operations		DiBiase	Joseph						8886567791	joe.dibiase@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active	4013441059				Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Appeals Contact (Secondary)	Supervisor Clinical Pharmacy Operations		Tunstall	Aaliyah						8555862573	aaliyah.tunstall@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active	8015030117				Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Application Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Benefits Contact	Functional Business Consultant Sr		Ibenskis	Sara		8015030117				8886568099	sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Claims Submission Contact	Director Project & Program Management		Arinsberg	Valerie		8555862573				8886568099	valerie.arinsberg@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Exceptions Contact	Sr Director Operations		DiBiase	Joseph						8886568099	joe.dibiase@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active	4013441059				Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Exceptions Contact (Secondary)	Supervisor Clinical Pharmacy Operations		Tunstall	Aaliyah						8886568099	aaliyah.tunstall@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active	8555862573				Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Price File Contact (Back-up)	AVP Network		Gimm	Joy		6026153241					joy.gimm@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Price File Contact (Primary)	VP Market Growth & Strategy		Magness	Jon		8019410008					jon.magness@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Quality Assurance Contact	VP Quality & Accreditation		Jaco	Tame		3143874922					tame.jaco@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Part D Reporting Contact	VP Market Growth & Strategy		Magness	Jon		8019410008					jon.magness@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Patient Safety Contact	VP Market Growth & Strategy		Magness	Jon		8019410008				8886568099	jon.magness@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Payment Contact	AVP, Financial Planning & Analysis		Harris	Brian		6127775862				8886568099	brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Pharmacy Director	VP Market Growth & Strategy		Magness	Jon		8019410008				8886568099	jon.magness@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Pharmacy Network Management Contact	AVP Network		Gimm	Joy		6026153241					joy.gimm@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Pharmacy Network Management Contact (Secondary)	Functional Business Consultant Sr		Ibenskis	Sara		8015030117					sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Pharmacy Technical Help Desk Contact	Sr Director Operations		DiBiase	Joseph								2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active	8045480494				Medicare Prescription Drug Plan		5	Dallas
S3875	Pharmacy Technical Help Desk Contact (Secondary)	Supervisor Clinical Pharmacy Operations		Mendoza	Samantha							slcenrollment@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active	8555862573				Medicare Prescription Drug Plan		5	Dallas
S3875	Plan Directory Contact for Public Website	Functional Business Consultant Sr		Ibenskis	Sara		8015030117					sara.ibenskis@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Plan to Plan Reconciliation Contact	AVP Financial Planning & Analysis		Harris	Brian		6127775862					brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Processor Contact	Dir, Project & Program Management		Arinsberg	Valerie		4806249424					valerie.arinsberg@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Reconciliation Contact	AVP Financial Planning & Analysis		Harris	Brian		6127775862					brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Reconciliation Contact (Secondary)	Financial Analyst Sr		Yan	Kwok Cheun		4806249271					alex.yan@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Recovery Audit Contact	AVP, Financial Planning & Analysis	Mr.	Harris	Brian		6127775862				8886568099	brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Surveillance Contact	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	08/27/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	System Contact	Manager, Compliance		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	Third Party Administrator (TPA) Liaison	AVP, Financial Planning & Analysis		Harris	Brian		6127775862					brian.harris@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	09/03/2025	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3875	User Access Contact	Compliance Officer		Crosby	Bridget		7633503497					bridget.crosby@primetherapeutics.com	2900 Ames Crossing Road	Suite 200	Eagan	MN	55121	08/27/2024	2026	GRANITE ALLIANCE INSURANCE COMPANY	PDP	Granite Alliance	Medicare Prescription Drug Plan		Prime Therapeutics, LLC.	803	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S3994	Agent/Broker Compensation Data Contact	Supervisor, Medicare Sales		Guzman	Tati		8089485463				8089486585	tati_guzman@hmsa.com	P.O. Box 860	8 AMS	Honolulu	HI	96808	04/26/2023	2026	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	Boston
S3994	Automated TrOOP Balance Transfer Contact	Senior Business Analyst		Kalino	Karen		8089486262				8089486585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	11/27/2020	2026	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	Boston
S3994	Backup User Access Contact	VP, Chief Compliance Officer		Nakamura	Carrie		8089485369					carrie_nakamura@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Best Available Evidence Contact	Enrollment Specialist, IO Liaison		Jose	Angelica		8089485705				8089486285	Angelica_Jose@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	02/13/2025	2026	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	Boston
S3994	Bid Audit Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	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	Boston
S3994	Bid Audit Site Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Bid Primary Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Rivad	Maila		8089485767				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	01/23/2020	2026	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	Boston
S3994	CEO - CMS Administrator Contact	CEO	Mr.	Mugiishi	Mark		8089485021				8089485999	mark_mugiishi@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	11/06/2025	2026	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	Boston
S3994	CEO - Senior Official for Contracting	CEO	Mr.	Mugiishi	Mark		8089485021				8089485999	mark_mugiishi@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	11/06/2025	2026	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	Boston
S3994	Chief Financial Officer	EVP, Chief Financial Officer	Ms.	Smith	Xuejun		8089486621					jenny_smith@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808	11/27/2024	2026	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	Boston
S3994	Chief Operating Officer	President and COO	Ms.	Smith	Jenny		8089486621				8089485999	Jenny_smith@hmsa.com	P.O. Box 860	11 - EXEC	Honolulu	HI	96808	11/06/2025	2026	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	Boston
S3994	Chief Information Officer	EVP and Chief Information Officer	Mr.	Hopfer	Rick		8089486025				8089485999	rick_hopfer@hmsa.com	P.O. Box 860	11-EXEC	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Chief Information Security Officer	CISO	Mr.	Gummadi	Sudhakar		8087434389				8089527580	sudhakar_gummadi@hmsa.com	P.O. Box 860	10 - IPP	Honolulu	HI	96808	11/12/2025	2026	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	Boston
S3994	CMMI Model Point of Contact	Manager, Medicare Programs		Lyons	Malia		8089485191				8089486887	malia_lyons@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/11/2024	2026	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	Boston
S3994	CMS Casework Communication Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		8089485347				8089527546	Renee_Hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	12/29/2021	2026	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	Boston
S3994	Complaints Tracking Contact	Medicare Grievance & Appeal Coordinator		Hartenstein	Renee		8089485347				8089527546	renee_hartenstein@hmsa.com	P.O. Box 860	KB-MAA	Honolulu	HI	96808	11/24/2021	2026	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	Boston
S3994	Contact for Fraud Investigations	Director, Special Investigations Unit		Aronson	Virginya		8089528548					virginya_aronson@hmsa.com	P.O. Box 860	10 SIU	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Coordination of Benefits Contact	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	11/27/2024	2026	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	Boston
S3994	Corporate Mailing						8089486000					!MedicarePrograms@hmsa.com	P.O. Box 860	9 - MP	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Customer Service Operations Contact	Senior Manager, Customer Relations		Forsyth	Clarice		8089485224				8089485567	Customer-service@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	11/06/2025	2026	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	Boston
S3994	DIR Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	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	Boston
S3994	DIR Contact (Secondary)	Sr Business Analyst		Smith	Nicolette		8089485631					nicolette_smith@hmsa.com	P.O. Box 860	6 - FA	Honolulu	HI	96808	11/27/2024	2026	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	Boston
S3994	Discount Program Payment Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Emergency Part D Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Emergency Part D Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus		8089527772				8089485618	medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	02/07/2025	2026	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	Boston
S3994	Enrollment Contact	Enrollment Specialist, IO Liaison		Jose	Angelica		8089485705				8089486285	Angelica_Jose@hmsa.com	P.O. Box 860	7 - MS	Honolulu	HI	96808	02/13/2025	2026	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	Boston
S3994	EOB Transfer Contact	Senior Business Analyst, Medicare Programs		Refuerzo	Marilou		8084970295				8089486585	marilou_refuerzo@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Financial Audit Contact	Director, Government Accounting and Reporting	Ms.	Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Financial Reporting Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Formulary Contact	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	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	Boston
S3994	Formulary Contact (Secondary)	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	12/04/2020	2026	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	Boston
S3994	General Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Government Relations Contact	SVP, Government		Diesman	Jennifer		8085616397				8089486860	jennifer_diesman@hmsa.com	P.O. Box 860	11 EXEC	Honolulu	HI	96808	11/16/2023	2026	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	Boston
S3994	HIPAA Privacy Officer	AVP, Compliance & Prv Officer		Borje-Bonkowski	Maria		8089486205					maria_borje-bonkowski@hmsa.com	P.O. Box 860	10 - C&E	Honolulu	HI	96808	12/02/2024	2026	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	Boston
S3994	HIPAA Security Officer	CISO	Mr.	Gummadi	Sudhakar		8087434389				8089527580	sudhakar_gummadi@hmsa.com	P.O. Box 860	10 - IPP	Honolulu	HI	96808	11/12/2025	2026	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	Boston
S3994	Hospice Contact	Business Analyst - Medicare Part D		Kanda	Jordan		8089527749				8089485611	jordan_kanda@hmsa.com	P.O. Box 860	10 - KB-PM	Honolulu	HI	96808	12/03/2024	2026	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	Boston
S3994	Interoperability Contact	VP, Health Data Integ & Analytic		Dobbs	David	C	8089486030					david_dobbs@hmsa.com	P.O. Box 860	6 CORP	Honolulu	HI	96808	04/08/2022	2026	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	Boston
S3994	Marketing Contact	Sr. Business Analyst		Peters	Kristen	A	8089481180					Kristen_Peters@HMSA.com	PO Box 860	8 - MP	Honolulu	HI	96808	07/01/2025	2026	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	Boston
S3994	Medical Director	Medicare Medical Director		Percy	David		8089486252				8089486340	david_percy@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Medicare Compliance Officer	AVP, Regulatory Compliance and SIU	Ms.	Aronson	Virginya		8089528548				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Medicare Coordinator	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	04/08/2022	2026	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	Boston
S3994	Medication Therapy Management Contact	BH Business Analyst		Francis	Teesha		8089527564					teesha_francis@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	12/13/2023	2026	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	Boston
S3994	OffShore Subcontractor Contact	Manager, Medicare Programs		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	02/13/2025	2026	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	Boston
S3994	Online Enrollment Center Contact (Back-up)	Manager, Medicare Programs		Hishinuma	Nathan		8089527823				8089486887	nathan_hishinuma@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	02/13/2025	2026	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	Boston
S3994	Online Enrollment Center Contact (Optional)	Sr. Business Analyst		Peters	Kristen	A	8089481180					Kristen_Peters@HMSA.com	PO Box 860	8 - MP	Honolulu	HI	96808	07/01/2025	2026	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	Boston
S3994	Online Enrollment Center Contact (Primary)	Enrollment Specialist, IO Liaison		Jose	Angelica		8089485705				8089486285	Angelica_Jose@hmsa.com	P.O. Box 860	7 MS	Honolulu	HI	96808	02/13/2025	2026	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	Boston
S3994	Part D Appeals	Senior Manager, Member Advocacy and Appeals		Inouye	Marissa						8089527546	marissa_inouye@hmsa.com	P.O. Box 860		Honolulu	HI	96808	10/17/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	8089527792				Medicare Prescription Drug Plan		5	Boston
S3994	Part D Appeals Contact (Secondary)	Senior Business Analyst		Kalino	Karen						8089486585	karen_apiki_kalino@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	11/27/2020	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	8089486262				Medicare Prescription Drug Plan		5	Boston
S3994	Part D Application Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Part D Benefits Contact	VP, Medicare Programs		Takata Endo	Kimberly		8089528522				8089486887	kim_takata@hmsa.com	P.O. Box 860	8 - MP	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Part D Claims Submission Contact	Manager, Financial Services - HMO & Govt Reporting		Nakashima	Mark		8089486594				8089485063	mark_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	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	Boston
S3994	Part D Exceptions Contact	Clinical Pharmacist, Government Programs		Iwaishi	Brandon							Brandon_Iwaishi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	8089485618				Medicare Prescription Drug Plan		5	Boston
S3994	Part D Exceptions Contact (Secondary)	Manager, Clinical Pharmacy		Kuniyoshi	Derek							derek_kuniyoshi@hmsa.com	P.O. Box 860	10-KB-PM	Honolulu	HI	96808	11/12/2025	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	8004622085				Medicare Prescription Drug Plan		5	Boston
S3994	Part D Price File Contact (Back-up)	Manager of Financial Operations		Albert	Sebastian		4802519123					Sebastian.Albert2@cvshealth.com	9501 E Shea Blvd	CVS Caremark	Scottsdale	AZ	85260	10/10/2025	2026	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	Boston
S3994	Part D Price File Contact (Optional)	Program Manager   PBM Finance Operations		Pertgen	Richard		8045258502					Richard.Pertgen@cvshealth.com	9501 E. Shea Blvd. MC080	CVS Caremark	Scottsdale	AZ	85260	12/29/2021	2026	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	Boston
S3994	Part D Price File Contact (Primary)	Sr. Analyst		Scott	Sara		4803109219					sarah.scott@cvshealth.com	9501 E. Shea Blvd.	CVS Caremark	Scottsdale	AZ	85260	11/03/2023	2026	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	Boston
S3994	Part D Quality Assurance Contact	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	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	Boston
S3994	Part D Reporting Contact	Manager, Medicare Program		Hishinuma	Nathan		8089527823				8089466887	nathan_hishinuma@hmsa.com	P.O. Box 860	8-MP	Honolulu	HI	96808	11/06/2025	2026	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	Boston
S3994	Patient Safety Contact	Manager, Clinical Pharmacy		Kuniyoshi	Derek		8089486723				8089488298	derek_kuniyoshi@hmsa.com	1601 Kapiolani Blvd.	10-KB-PM	Honolulu	HI	96814	12/04/2020	2026	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	Boston
S3994	Payment Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Pharmacy Director	Director, Pharmacy Operations		Goo	Roy		8082225910					roy_goo@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	12/13/2023	2026	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	Boston
S3994	Pharmacy Network Management Contact	Director		Smith	Shawn		4803914844					shawn.smith@cvshealth.com	9501 E. Shea Blvd., MC080	CVS Caremark	Scottsdale	AZ	85260	12/20/2019	2026	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	Boston
S3994	Pharmacy Network Management Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus		8089527772					medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	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	Boston
S3994	Pharmacy Technical Help Desk Contact	Sr. Manager		Stauffer	Grace							grace.stauffer@cvshealth.com	9501 E. Shea Blvd		Scottsdale	AZ	85260	12/06/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	8666934620				Medicare Prescription Drug Plan		5	Boston
S3994	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Solutions Manager		Oi	Marcus							medicarepartd@hmsa.com	P.O. Box 860	10-KB-MM	Honolulu	HI	96808	08/13/2024	2026	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	PDP	HMSAs Medicare Rx Plan	Medicare Prescription Drug Plan		Hawaii Medical Service Association	107	Yes	Active	8089527772				Medicare Prescription Drug Plan		5	Boston
S3994	Plan Directory Contact for Public Website	Manager, Medicare Program		Hishinuma	Nathan		8089527823				8089527823	nathan_hishinuma@hmsa.com	P.O. Box 860	7 CR	Honolulu	HI	96808	12/15/2025	2026	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	Boston
S3994	Plan to Plan Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Processor Contact	Manager, Internal Operations Liaison, Claims		Mariboho	Darla		8089485760					Darla_Mariboho@hmsa.com	P.O. Box 860	7 - CA	Honolulu	HI	96808	12/09/2024	2026	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	Boston
S3994	Reconciliation Contact	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	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	Boston
S3994	Reconciliation Contact (Secondary)	Sr Business Analyst		Smith	Nicolette		8089485631					nicolette_smith@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	12/09/2024	2026	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	Boston
S3994	Recovery Audit Contact	Director, Government Accounting and Reporting	Ms.	Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	07/19/2024	2026	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	Boston
S3994	Surveillance Contact	Supervisor, Medicare Sales		Guzman	Tati		8089485463				8089486585	tati_guzman@hmsa.com	P.O. Box 860	8 AMS	Honolulu	HI	96808	12/04/2020	2026	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	Boston
S3994	System Contact	Solution Delivery Advisor		Ng	Philip		8089486688				8089486799	philip_ng@hmsa.com	P.O. Box 860	5 - IS	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	Third Party Administrator (TPA) Liaison	Director, Government Accounting and Reporting		Nakashima	Marla		8089486020				8089485063	marla_nakashima@hmsa.com	P.O. Box 860	6 FA	Honolulu	HI	96808	10/27/2022	2026	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	Boston
S3994	User Access Contact	Medicare Compliance Officer	Ms.	Rivad	Maila		8089485767				8089486585	MCO@hmsa.com	P.O. Box 860	10-CE	Honolulu	HI	96808	06/08/2021	2026	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	Boston
S4501	Agent/Broker Compensation Data Contact	Director Government Sales		Aquino	Cathy		7166354948				7166318857	cathy.aquino@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/29/2022	2026	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	Dallas
S4501	Automated TrOOP Balance Transfer Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Backup User Access Contact	Risk Operations Analyst		Carr	Sarah Jane		7166313001					SarahJane.Carr@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/19/2022	2026	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	Dallas
S4501	Best Available Evidence Contact	Manager - Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	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	Dallas
S4501	Bid Audit Contact	Director - Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2022	2026	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	Dallas
S4501	Bid Audit Site Contact	Chief Compliance Officer		Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	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	Dallas
S4501	Bid Primary Contact	Director - Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2022	2026	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	Dallas
S4501	CAP Report Contact for Public Website	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	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	Dallas
S4501	CEO - CMS Administrator Contact	President and CEO	Dr.	Cropp, MD	Michael		7166353995				7162507135	Michael.Cropp@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	08/18/2025	2026	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	Dallas
S4501	CEO - Senior Official for Contracting	President and CEO	Dr.	Cropp, MD	Michael		7166353995				7162507135	Michael.Cropp@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	08/18/2025	2026	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	Dallas
S4501	Chief Financial Officer	Executive Vice President - Chief Financial Officer	Mr.	Gross	Jared		7166353516					Jared.Gross@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/11/2024	2026	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	Dallas
S4501	Chief Operating Officer	Exec Vice President and Chief Operating Officer	Mr.	Rodgers	John		7166353630					john.rodgers@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/12/2014	2026	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	Dallas
S4501	Chief Information Officer	Chief Information Security Officer	Mr.	Jabrucki	Peter		7162507383					Peter.Jabrucki@Independenthealth.com	511 Farber lakes		Buffalo	NY	14221	01/14/2019	2026	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	Dallas
S4501	Chief Information Security Officer	Chief Information Security Officer	Mr.	Jabrucki	Peter		7162507383					Peter.Jabrucki@Independenthealth.com	511 Farber lakes		Buffalo	NY	14221	01/14/2019	2026	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	Dallas
S4501	CMS Casework Communication Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	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	Dallas
S4501	Complaints Tracking Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	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	Dallas
S4501	Contact for Fraud Investigations	Director-Corporate Recoveries		Caulfield	Sheila		7166353783					Sheila.Caulfield@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/11/2024	2026	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	Dallas
S4501	Coordination of Benefits Contact	Manager - Corporate Recoveries		Abou-Said	Kelly		7166353758					Kelly.Abou-Said@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/07/2022	2026	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	Dallas
S4501	Corporate Mailing						7166313001					Dawn.Odrzywolski@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	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	Dallas
S4501	Customer Service Operations Contact	Manager - Provider & Member Services		Bogacz	Lindsay		7166353973					Lindsay.Bogacz@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/08/2020	2026	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	Dallas
S4501	DIR Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	DIR Contact (Secondary)	Supervisor-Rebates Analytics		Ketch	Jamie		7166312485					Jamie.Ketch@pbdrx.com	10 Earhart Dr.		Williamsville	NY	14221	02/20/2024	2026	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	Dallas
S4501	Discount Program Payment Contact	Manager - Treasury Services		Fisher	Dave		7166353561					Dave.Fisher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/28/2018	2026	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	Dallas
S4501	Emergency Part D Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Emergency Part D Contact (Secondary)	Manager - Pharmacy Services		Jahn	Heather		7166354890					Heather.Jahn@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	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	Dallas
S4501	Employer Waiver Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Enrollment Contact	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	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	Dallas
S4501	EOB Transfer Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885				7166319636	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Financial Audit Contact	VP-Pricing & Underwriting	Ms.	Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	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	Dallas
S4501	Financial Reporting Contact	Accountant Regulatory Reporting		Coder	Sara		7162507123					Sara.Coder@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	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	Dallas
S4501	Formulary Contact	Clinical Pharmacist		Waite	Rebecca		7166353825				7162507163	Rebecca.Waite@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/06/2022	2026	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	Dallas
S4501	Formulary Contact (Secondary)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/21/2019	2026	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	Dallas
S4501	General Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Government Relations Contact	SVP Government Programs		Tracy	Robert		7166354904					Robert.Tracy@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	02/27/2018	2026	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	Dallas
S4501	HIPAA Privacy Officer	Chief Information Security Officer		Jabrucki	Peter		7162507383				7162507115	peter.jabrucki@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	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	Dallas
S4501	HIPAA Security Officer	Chief Information Security Officer		Jabrucki	Peter		7162507383				7162507115	peter.jabrucki@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	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	Dallas
S4501	Hospice Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Interoperability Contact	VP-IT Application Delivery		Haak	Lesley		7162504443					Lesley.Haak@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2022	2026	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	Dallas
S4501	Marketing Contact	Director Government Sales		Aquino	Cathy		7166354948				7166318857	cathy.aquino@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/14/2019	2026	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	Dallas
S4501	Medical Director	EVP - Chief Medical Officer	Dr.	Billittier, MD	Anthony		7166353635					Anthony.Billittier@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	06/19/2019	2026	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	Dallas
S4501	Medicare Compliance Officer	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/20/2018	2026	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	Dallas
S4501	Medicare Coordinator	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Medicare Part D Opioid Overutilization Contact	Manager-MTM & Pharmacy Quality		Hathaway	Natalie		7166357877					Natalie.Hathaway@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	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	Dallas
S4501	Medication Therapy Management Contact	Manager-MTM & Pharmacy Quality		Hathaway	Natalie		7166357877					Natalie.Hathaway@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	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	Dallas
S4501	OffShore Subcontractor Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Online Enrollment Center Contact (Back-up)	Operations and System Analyst-Mbrs Operations		Cleary	Jennifer		7166313001	2274				Jennifer.Cleary@independenthealth.com	511 Farber Lakes Drive		Williamsville	NY	14221	08/21/2025	2026	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	Dallas
S4501	Online Enrollment Center Contact (Primary)	Manager Enrollment Operations		Sell	Melanie		7162507321				7162507162	melanie.sell@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	11/09/2017	2026	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	Dallas
S4501	Part D Appeals	Director - Benefit Administration and Compliance		Kieser	Michelle							michelle.kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/13/2015	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	8006651502				Medicare Prescription Drug Plan		5	Dallas
S4501	Part D Appeals Contact (Secondary)	Director, Benefit Administration and Compliance		Kieser	Michelle							Michelle.Kieser@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/13/2017	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	8007365771				Medicare Prescription Drug Plan		5	Dallas
S4501	Part D Application Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Part D Benefits Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Part D Claims Submission Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Part D Exceptions Contact	Vice President - Pharmacy		Verrall	Kelly						7166310149	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			Medicare Prescription Drug Plan		5	Dallas
S4501	Part D Exceptions Contact (Secondary)	Manager - Pharmacy Services		Jahn	Heather						7166310149	Heather.Jahn@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			Medicare Prescription Drug Plan		5	Dallas
S4501	Part D Price File Contact (Back-up)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/21/2019	2026	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	Dallas
S4501	Part D Price File Contact (Optional)	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	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	Dallas
S4501	Part D Price File Contact (Primary)	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Part D Quality Assurance Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Part D Reporting Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	jeremy.laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	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	Dallas
S4501	Patient Safety Contact	Director, Pharmacy, Quality and MTM		Verrall	Kelly		7166354885				7162507121	kelly.verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	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	Dallas
S4501	Payment Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Pharmacy Director	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Pharmacy Network Management Contact	Vice President - Pharmacy		Verrall	Kelly		7166354885					Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	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	Dallas
S4501	Pharmacy Network Management Contact (Secondary)	Pharmacy Services Compliance & Product Specialist		Basher	Lindsay		7166353547					Lindsay.Basher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	07/03/2024	2026	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	Dallas
S4501	Pharmacy Technical Help Desk Contact	Manager, Provider and Member Services		Dandridge	Tinika							script@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/02/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	8009939898				Medicare Prescription Drug Plan		5	Dallas
S4501	Pharmacy Technical Help Desk Contact (Secondary)	Vice President - Pharmacy		Verrall	Kelly						7166310149	Kelly.Verrall@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	01/31/2025	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan		Independent Health Association, Inc.	131	Yes	Active	8002471466	5311			Medicare Prescription Drug Plan		5	Dallas
S4501	PHR Beneficiary Contact																	02/10/2014	2026	INDEPENDENT HEALTH BENEFITS CORPORATION	PDP	Pharmacy Benefit Dimensions PDP	Medicare Prescription Drug Plan	Independent Health - Member Services	Independent Health Association, Inc.	131	Yes	Active	8006651502				Medicare Prescription Drug Plan		5	Dallas
S4501	Plan Directory Contact for Public Website			Services	Member		8006651502					wnyms@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/10/2014	2026	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	Dallas
S4501	Plan to Plan Reconciliation Contact	Pharmacy Systems Gov. Programs Manager		Miszuk	Jane		7166357857					Jane.Miszuk@pbdrx.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/11/2019	2026	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	Dallas
S4501	Processor Contact	Director-Claims Operations		Taggart	David		7166357837					David.Taggart@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	12/11/2024	2026	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	Dallas
S4501	Reconciliation Contact	VP-Pricing & Underwriting		Pasieka	Andrea		7166353672					Andrea.Pasieka@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/04/2025	2026	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	Dallas
S4501	Reconciliation Contact (Secondary)	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Recovery Audit Contact	Director - Medicare Programs	Mr.	Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Surveillance Contact	Chief Compliance Officer	Mrs.	Britton	Nicole		7166354874					Nicole.Britton@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	02/27/2018	2026	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	Dallas
S4501	System Contact	Director - Medicare Programs		Morgan	Evan		7166353740					Evan.Morgan@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	05/22/2024	2026	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	Dallas
S4501	Third Party Administrator (TPA) Liaison	Manager - Treasury Services		Fisher	Dave		7166353561					Dave.Fisher@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	03/28/2018	2026	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	Dallas
S4501	User Access Contact	Medicare Programs Implementation Manager		Laubacker	Jeremy		7166354994				7162507197	Jeremy.Laubacker@independenthealth.com	511 Farber Lakes Drive		Buffalo	NY	14221	04/06/2020	2026	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	Dallas
S4802	Agent/Broker Compensation Data Contact	Director, Broker Commission		Wooddell	Gregory		8132066381					Gregory.Wooddell@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	01/24/2024	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Automated TrOOP Balance Transfer Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3143493212					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Backup User Access Contact	Senior Compliance Analyst		Smith	Robert		3143493085					Robert.K.Smith@CENTENE.COM	7676 Forsyth Blvd.		St. Louis	MO	63105	11/09/2021	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Best Available Evidence Contact	Supervisor, Operations		Steadman	Denethia		8132067131					Denethia.L.Steadman@centene.com	8725 Henderson Road		Tampa	FL	33634	07/17/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Bid Audit Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Road		Tampa	FL	33436	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Bid Audit Site Contact	Senior Manager, Ethics and Compliance		Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/15/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Bid Primary Contact	Vice President, Actuarial Services		Yannick	Michael		8132064988					Michael.D.Yannick@CENTENE.COM	8725 Henderson Road		Tampa	FL	33436	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	CAP Report Contact for Public Website	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	11/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	CEO - CMS Administrator Contact	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	01/08/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	CEO - Senior Official for Contracting	CEO, Medicare	Mr.	Carson	Michael		3149140750					michael.carson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	05/12/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Chief Financial Officer	Vice President, Finance	Mr.	Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	04/18/2024	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Chief Operating Officer	Chief Operating Officer	Mr.	Clark	Dan		4243027799					william.d.clark@wellcare.com	7700 Forsyth Blvd		Clayton	MO	63105	10/18/2024	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Chief Information Officer	Executive VP, Chief Information Officer	Mr.	Brooks	Mark		3145056076					Mark.Brooks@centene.com	7700 Forsyth Boulevard		Clayton	MO	63105	02/03/2021	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Chief Information Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	07/17/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	CMS Casework Communication Contact	Manager, Complaints and Issues		Grant	Takiyah	L	4803771856					Takiyah.L.Brown@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	07/18/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Complaints Tracking Contact	Senior Director, Contact Center Operations		Langan	Grant		8132067417					grant.langan@wellcare.com	5519 W. Idlewild Avenue		Tampa	FL	33634	07/25/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Contact for Fraud Investigations	Sr. Director, Special Investigations Unit (SIU)		Peters	Lori		8132063624					Lori.Peters@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Coordination of Benefits Contact	Director, Pharmacy Operations		Borowiecki	Jeff		3144055784					jeffrey.a.borowiecki@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/29/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Corporate Mailing						3147254477					CorporateMedicareComplianceDept@CENTENE.COM	7700 Forsyth  Blvd		Clayton	MO	63105	11/05/2021	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Customer Service Operations Contact	Vice President Contact Centers		Bollent	Jason		8132063857					jason.t.bollent@centene.com	8725 Henderson Road		Tampa	FL	33634	09/19/2024	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	DIR Contact	Senior Director, Predictive Analytics		Lamour	David		8132067536					David.Lamour@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	01/15/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	DIR Contact (Secondary)	Vice President, Finance		Palmer	Clint		5592443873					Clinton.J.Palmer@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	01/15/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Discount Program Payment Contact	Business Analyst III		Gaskin-Rivera	Dahira		8132065620					dahira.gaskin-rivera@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/05/2022	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Emergency Part D Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	07/30/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Emergency Part D Contact (Secondary)	Senior Director, Pharmacy Program Management		Nichols	Michele		9162368536					Michele.M.Nichols@CENTENE.COM	4201 E Commerce Way		Sacramento	CA	95834	07/30/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Employer Waiver Contact	Senior Director, Product Owner		Henao	Angela		8132063757					product_SNP@wellcare.com	8725 Henderson Road	Ren 1	Tampa	FL	33634	07/30/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Enrollment Contact	Director, Business Operations		Demirchyan	Ovsanna		8186766079					Ovsanna.Demirchyan@CENTENE.COM	7700 Forsyth Blvd.		Clayton	MO	63105	08/04/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	EOB Transfer Contact	Manager, Business Operations Overnight		Means	Tabatha		8132064647				0000000000	tabatha.a.means@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/11/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Financial Audit Contact	Senior Manager,  Ethics and Compliance	Ms.	Liebnau	Susan		3146047254					SLIEBNAU@CENTENE.COM	7676 Forsyth Blvd		Clayton	MO	63105	08/16/2021	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Financial Reporting Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Formulary Contact	Director, Pharmacy		Lee	Emily		9194795312					emily.k.lee@centene.com	7625 N Palm Ave #101		Fresno	CA	93711	08/04/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Formulary Contact (Secondary)	Director, Pharmacy		Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Drive		Houston	TX	77027	08/04/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	General Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Government Relations Contact	Staff Vice President, Public Policy		Fairman	Brittney		2022537949	47759				Brittney.Fairman@wellcare.com	1150 Connecticut Ave NW Suite 100		Washingtom	DC	20036	08/05/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	HIPAA Privacy Officer	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	HIPAA Security Officer	Regional Vice President, CISO	Mr.	Berry	Alan		3145190574					alan.r.berry@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	08/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Hospice Contact	Director, Pharmacy Operations	Mr.	Borowiecki	Jeff		3143493212					jeffrey.borowiecki@envolvehealth.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Interoperability Contact	Vice President, Information Technology		Siddanati	Mahesh		3145191936					mahesh.siddanati@centene.com	7700 Forsyth Blvd.		Clayton	MO	63105	08/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Marketing Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Medical Director	Senior Medical Director	Dr.	Ludwig	Lauren		3143042502					LAULEE@CENTENE.COM	7700 Forsyth Blvd		St. Louis	MO	63105	11/17/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Medicare Coordinator	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Medicare Part D Opioid Overutilization Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		8663392787					RxCaseManagement@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/25/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Medication Therapy Management Contact	Senior Director, Clinical Pharmacy Services		Smith	Jill		6028833209					Jill.L.Smith@Centene.com	8725 Henderson Road		Tampa	FL	33634	08/07/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	OffShore Subcontractor Contact	Manager, Compliance		Johnson	Lisa		8132061756					Lisa.Johnson@wellcare.com	8725 Henderson Road		Tampa	FL	33436	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Online Enrollment Center Contact (Back-up)	Director, Business Operations		McKenzie	Shakira		8132061838					shakira.mckenzie@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/12/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Online Enrollment Center Contact (Optional)	Sr Director, Application Development Engineering		Jain	Sidhartha		8132066783					sidhartha.jain@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/22/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Online Enrollment Center Contact (Primary)	Compliance Analyst		Arteaga	Veronica		8132063198					Veronica.Arteaga@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/25/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Appeals	Senior Manager, Pharmacy Operations	Ms.	Hatchman	Erika						8132061716	erika.hatchman@wellcare.com	8725 Henderson Rd		Tampa	FL	33634	08/08/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	8132063350				Medicare Prescription Drug Plan		5	Denver
S4802	Part D Appeals Contact (Secondary)	Manager, Contact Center Operations		Moore	Ashley							Ashley.Moore5@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/09/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	8132066534				Medicare Prescription Drug Plan		5	Denver
S4802	Part D Application Contact	Director, Medicare Strategy		Brougham	Kaitlin		5138337894					Kaitlin.m.brougham@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/25/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Benefits Contact	Director, Pharmacy	Mr.	Patel	Rushil		7133492605					rushil.patel@wellcare.com	4888 Loop Central Dr		h	TX	77027	09/29/2022	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Claims Submission Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.Champagne@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/22/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Exceptions Contact	Vice President, Pharmacy Operations		Patel	Ronak							ronak.patel@wellcare.com	8725 Henderson Road		Tampa	FL	33634	09/03/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	8132067152				Medicare Prescription Drug Plan		5	Denver
S4802	Part D Exceptions Contact (Secondary)	Senior Director, Pharmacy Operations	Ms.	Barnes	Lauren							Lauren.J.Barnes@CENTENE.COM	1870 W Rio Salado Pkwy		Tempe	AZ	85281	09/04/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	6023080218				Medicare Prescription Drug Plan		5	Denver
S4802	Part D Price File Contact (Back-up)	Business Analyst III		Sliwinski	Sarah		3134636882					Sarah.A.Zalewski@CENTENE.COM	8725 Henderson Rd		Tampa	FL	33634	09/04/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Price File Contact (Optional)	Director, Pharmacy Network Operations		Taylor	Pamela	J	9169265529					Pamela.J.Taylor@CENTENE.COM	4151 E. Commerce Way		Sacramento	CA	95834	09/05/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Price File Contact (Primary)	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/11/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Quality Assurance Contact	Vice President, Pharmacy UM Quality & Process Impr	Mr.	Nimtz	Ryan		8132065165					ryan.r.nimtz@centene.com	8725 Henderson Rd		Tampa	FL	33634	09/18/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Part D Reporting Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Patient Safety Contact	Manager, Ethics and Compliance		Roberts	Jennifer	E	8137353607					Jennifer.e.roberts@centene.com	8725 Henderson Rd		Tampa	FL	33634	07/14/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Payment Contact	Vice President, Medicare CFO	Mr.	Schindler	Michael		3104821083					michael.j.schindler@centene.com	4801 W 122nd Terr		Overland Park	KS	66209	04/05/2024	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Personal Health Record Contact	Senior Director, Ethics and Compliance		Deutschmann	Brian		3145056711					bdeutschmann@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	09/18/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Pharmacy Director	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/19/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Pharmacy Network Management Contact	Senior Director, Pharmacy Program Management		Swartz	Adam		8132063708					Adam.W.Swartz@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	09/22/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Pharmacy Network Management Contact (Secondary)	Director, Pharmacy Network Operations		Taylor	Pamela		9162419635					pamela.j.taylor@centene.com	2868 Prospect Park Drive, Suite 230	Mailstop: CA-162-02-01	Rancho Cordova	CA	95670	10/01/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Pharmacy Technical Help Desk Contact	Vice President, Contact Centers		Easley	Ezra	M						ezra.m.easley@centene.com	8725 Henderson Road		Tampa	FL	33646	12/18/2024	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	8337500408				Medicare Prescription Drug Plan		5	Denver
S4802	Pharmacy Technical Help Desk Contact (Secondary)	Vice President, Operations		Makram	Katy							Katherine.J.Makram3@CENTENE.COM	8725 Henderson Road		Tampa	FL	33646	10/09/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active	8337500408				Medicare Prescription Drug Plan		5	Denver
S4802	Plan Directory Contact for Public Website			Inquiries	Website		8888889355					contactus@wellcare.com	8725 Henderson Road		Tampa	FL	33634	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Plan to Plan Reconciliation Contact	Senior Manager, Revenue Reconciliation		Rosado	Frank		8132066231				8132833302	P2P-CASH@wellcare.com	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	08/18/2023	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Processor Contact	Vice President Pharmacy Benefit&Network Operations		Champagne	Robert		8132267775				8138656701	Robert.A.Champagne@CENTENE.COM	8725 Henderson Road		Tampa	FL	33634	10/07/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Reconciliation Contact	Senior Director, Actuarial Services		Liu	Mandy		8132064578					Mandy.Liu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	10/09/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Reconciliation Contact (Secondary)	Vice President, Actuarial Services		Lu	Di		8132067328					Di.Lu@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	11/04/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Recovery Audit Contact	Manager, Ethics and Compliance	Mrs.	Roberts	Jennifer		8137353607					Jennifer.E.Roberts@CENTENE.COM	7700 Forsyth Blvd		Clayton	MO	63105	12/05/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Surveillance Contact	Medicare Compliance Officer		Crognale III	Louis		8322651505					louis.crognale@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/06/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	System Contact	Executive Vice President Chief Information Officer		LeClaire	Brian		3142368400					brian.leclaire@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	11/05/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	Third Party Administrator (TPA) Liaison	Business Analyst II		Patel	Chandni		8132065179					Chandni.M.Patel@CENTENE.COM	8725 Henderson Road	Attn: P2P Department	Tampa	FL	33634	10/22/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4802	User Access Contact	Senior Manager, Compliance		Wilson	Ashley		3145056491					ashley.l.wilson@centene.com	7700 Forsyth Blvd		Clayton	MO	63105	10/15/2025	2026	WELLCARE PRESCRIPTION INSURANCE, INC.	PDP	Wellcare	Medicare Prescription Drug Plan		Centene Corporation	351	Yes	Active					Medicare Prescription Drug Plan		5	Denver
S4983	Agent/Broker Compensation Data Contact	Manager, Medicare Compliance		Lawrence	Winston		5105070510					winston.d.lawrence@kp.org	1 Kaiser Plaza, 12th Floor		Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Automated TrOOP Balance Transfer Contact	Project Manager III, Pharmacy Benefit Mgmt		Perez	Elizabeth	R	5623670592					Elizabeth.R.Perez@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Backup User Access Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Best Available Evidence Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Bid Audit Contact	Executive Director, Actuarial Services		Davis	Joel		6786972258					joel.e.davis@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/17/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Bid Audit Site Contact	Compliance Consultant		Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Bid Primary Contact	Actuary		Van Hise	Dennis		4047344706					KPMedicareBids@kp.org	300 Lakeside Drive, 28th Floor		Oakland	CA	94612	06/27/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	CAP Report Contact for Public Website	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	CEO - CMS Administrator Contact	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	12/31/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	CEO - Senior Official for Contracting	VP, Medicare Products	Mr.	Underwood	Jeffrey		5037242466					jeff.d.underwood@kp.org	One Kaiser Plaza		Oakland	CA	94612	06/19/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Chief Financial Officer	SVP & CFO National Medicare Finance	Mr.	Stewart	Mark		4012848679					mark.c1.stewart@kp.org	1 Kaiser Plaza	c/o Kaiser Foundation Health Plan	Oakland	CA	94612	12/18/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Chief Operating Officer	Executive Director, Medicare Market Strategy & Ops	Mr.	Miller	Paul		5033410073					paul.a.miller@kp.org	500 NE Multnomah St., Ste. 100		Portland	OR	97232	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Chief Information Officer	EVP, Enterprise Business Services	Mr.	Bagli	Yazdi		5102209190					Yazdi.F.Bagli@kp.org	One Kaiser Plaza		Oakland	CA	94612	12/18/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Chief Information Security Officer	VP, Chief Information Security Officer	Mr.	Goddard	Jim		9252065125					bill.d.vourthis@kp.org	6560 Greenwood Plaza Blvd.		Greenwood Village	CO	80111	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	CMS Casework Communication Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Complaints Tracking Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Contact for Fraud Investigations	Vice President, Investigations		Neiman	Tamara		5105063820					tamara.neiman@kp.org	One Kaiser Plaza	Ordway Building, 12th Floor	Oakland	CA	94612	10/16/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Coordination of Benefits Contact	Senior Director		Chung	Clarence		5623909293				5626583866	clarence.j.chung@kp.org	12254 Bellflower Blvd - Suite 106, 1st Floor		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Corporate Mailing						6263443906					luiza.x.tiratsuyan@kp.org	PO Box 9813, Bldg RCB, Mail Stop RCB-C3W-08	PO Box 9813, Bldg RCB, Mail Stop RCB-C3W-08	Renton	WA	980579055	02/09/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Customer Service Operations Contact			Services	Member		8004430815					mscc@kp.org	1800 Harrison St., 23rd Floor		Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	DIR Contact	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	DIR Contact (Secondary)	Sr. Financial Analyst		San	Kei		5626583445					Kei.San@kp.org	12254 Bellflower Blvd. Fl. 2		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Discount Program Payment Contact			Ballesteros	Mayra		6262525164					mayra.x.lujano@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Emergency Part D Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Enrollment Contact	Operations Manager, Medicare Membership Admin		Duda	Arlet		8586143377					arlet.b.duda@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	EOB Transfer Contact	Pharmacy Medicare Operations, Project Manager II		Bonoan	John		5624180564				5626583848	john.b.bonoan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Financial Audit Contact	Compliance Consultant	Ms.	Tadevosyan	Syuzi		8182992300					syuzi.x.tadevosyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Financial Reporting Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Formulary Contact	Formulary Coordinator		Martinez	Melina		2066307900					Melina.X1.Martinez@kp.org	PO BOX 9009, Bldg RCA, Mail Stop-RCA-B2N-02	2921 Naches Ave, SW, Bldg RCA	Renton	WA	98057	11/13/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Formulary Contact (Secondary)	Sr Manager		Toyoda	Yayoi		2066307900					Yayoi.Toyoda@kp.org	PO Box 9009, Bldg RCA, Mail Stop-RCA-B2N-O2	2921 Naches Ave, W, Bldg RCA	Renton	WA	98057	04/07/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	General Contact	Compliance Director		Tiratsuyan	Luiza		6263442906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Government Relations Contact	Senior Vice President, Government Relations		Barrueta	Anthony	A	5102716835					Anthony.Barrueta@kp.org	One Kaiser Plaza		Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	HIPAA Privacy Officer	Compliance Director		Anderson	Angela		5104353413					Angela.B.Anderson@kp.org	1800 Harrison Street	16th Floor	Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	HIPAA Security Officer	Senior Director	Mr.	Vourthis	Bill		9252065125					bill.d.vourthis@kp.org	5820 Owens Drive	Building E	Pleasanton	CA	94588	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Hospice Contact	Senior Team Manager, Medicare Membership Admin.		Salcido	Adam		8588293521					CSC-SD-Hospice-BAE@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Interoperability Contact	National EDI Business Operations		Plattner	Cathy		6268336526					Cathy.P.Plattner@kp.org	75 N Fair Oaks Ave.		Pasadena	CA	91103	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Marketing Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Medical Director	Executive Vice President, Chief Medical Officer	Dr.	Bindman	Andrew	B	5102716624					Andrew.B.Bindman@kp.org	One Kaiser Plaza	26th floor	Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Medicare Compliance Officer	Compliance Director	Ms.	Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Medicare Coordinator	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Medicare Part D Opioid Overutilization Contact	Dir, Pharmacy Operations, Medication Safety		Matias	Jennifer	E	5624191676					jennifer.e.matias@kp.org	200 15th Ave., E		Seattle	WA	98112	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Medication Therapy Management Contact	Pharmacy Care Delivery Specialist	Ms.	Thieman	Ingrid	L	3603252667					ingrid.l.thieman@kp.org	189 Telegraph Rd.		Bellingham	WA	98226	02/18/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	OffShore Subcontractor Contact	Compliance Consultant - Privacy and Security		Glenn	Jovan		9092512010					jovan.robinson@kp.org	10740 Fourth Street	2nd Floor, Cubicle 023W02	Rancho Cucamonga	CA	91730	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Appeals	Senior Director, Grievance Operations	Ms.	Flynn	Kristine	P						Kristine.Flynn@kp.org	10740 Fourth Street		Rancho Cucamonga	CA	91730	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	9093677399				Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Application Contact			Kaplan	Andrew		5105073252					andrew.s.kaplan@kp.org	81 Clarewood Ln.		Oakland	CA	94618	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Benefits Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Claims Submission Contact	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Exceptions Contact	Manager, Pharmacy Ancillary Services	Ms.	Maktabi	Noushin						2069014410	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	980579009	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8007291174				Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Price File Contact (Back-up)	Financial Analyst		Kamikawa	Emely		5622998753				5626583712	emely.a.kamikawa@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Price File Contact (Optional)	Associate Consultant		Quan	Mariclare		5623850395					mariclare.a.quan@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Price File Contact (Primary)	Pharmacy Pricing		Bullard	Myra		5623195747				5626583712	myra.c.bullard@kp.org	12254 Bellflower Blvd., 2nd Floor		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Quality Assurance Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Part D Reporting Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Patient Safety Contact	Vice President, Clinical Pharmacy Services		Le	Kim		5622997015					Kim.N1.Le@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Payment Contact	Controller National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza, Suite 2552		Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Pharmacy Director	National Pharmacy Benefits, Vice President		Miller	Wayne		5626583674					wayne.i.miller@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Pharmacy Network Management Contact	National Pharmacy Benefits, Project Manager II		Munoz	Vanessa		5624477739					Vanessa.L.Munoz@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Pharmacy Network Management Contact (Secondary)	Pharmacy Medicare Business Line Manager		Bonvie	Claudette		5623199392					claudette.r.bonvie@kp.org	12254 Bellflower Blvd.		Downey	CA	90242	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Pharmacy Technical Help Desk Contact	Customer Care Center		OptumRx	PBM								755 Research Parkway Suite 160		Oklahoma City	OK	73104	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active	8776451282				Medicare Prescription Drug Plan		5	Dallas
S4983	Plan Directory Contact for Public Website	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Plan to Plan Reconciliation Contact	Interim Director, Medicare Accounting		Wright	Mark	A	9253239443					mark.a.wright@kp.org	1 Kaiser Plaza, 25th Floor		Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Processor Contact	Medicare Compliance Consultant	Mr.	Carver	Jon	R	4257578659					jonathan.r.carver@kp.org	1300 SW 27th St.		Renton	WA	98057	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Reconciliation Contact	Controller, National Medicare Finance	Ms.	Gaeta	Ines		9517433423					ines.gaeta@kp.org	1 Kaiser Plaza		Oakland	CA	94612	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Reconciliation Contact (Secondary)	Senior Business Process Manager		Hsiue	Tony		5626583836					tony.x.hsiue@kp.org	12254 Bellflower Blvd.  Flr. 2		Downey	CA	90242	01/14/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Recovery Audit Contact	Manager, Revenue Mgmt Compliance	Ms	Gonzalez	Heidy	G	6263723181					heidy.gonzalez@kp.org	74 S Fair Oaks Avenue		Pasadena	CA	91103	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Surveillance Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	System Contact	Director, Membership Administration Systems & S.S.		Putman	Anthony		8586506364					anthony.m.putman@kp.org	3840 Murphy Canyon Rd.		San Diego	CA	92123	01/24/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	Third Party Administrator (TPA) Liaison	Manager, Accounting		Hsu	Michael		6262715838					Michael.Hsu@kp.org	393 E Walnut St., 4th floor		Pasadena	CA	91188	12/12/2024	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S4983	User Access Contact	Compliance Director		Tiratsuyan	Luiza		6263443906					luiza.x.tiratsuyan@kp.org	74 N. Pasadena Ave.		Pasadena	CA	91103	08/26/2025	2026	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC	PDP	Kaiser Permanente	Medicare Prescription Drug Plan		Kaiser Foundation Health Plan, Inc.	138	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5540	Agent/Broker Compensation Data Contact	Director, Financial Systems		Lazar	Lisa		9197653359					Lisa.Lazar@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	09/28/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Automated TrOOP Balance Transfer Contact	Manager, PBM Operations		Hanson	Michelle		6127776706					eobp2p@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Backup User Access Contact	EDI Analyst		Umstead	Kamala		9197654363					kamala.umstead@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	09/26/2019	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Best Available Evidence Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Bid Audit Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Bid Audit Site Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/15/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Bid Primary Contact	Director, Actuarial Services		Vander Berg	Lucas		9842193485					Lucas.VanderBerg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	CAP Report Contact for Public Website	Manager, Internal Communications		Stinneford	Mark		9197653005					media.inquiry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/20/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	CEO - CMS Administrator Contact	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	CEO - Senior Official for Contracting	President and CEO	Mr.	Sotunde	Tunde		9199098201					Tunde.Sotunde@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/19/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Chief Financial Officer	SVP, Chief Financial Officer and Treasurer	Mr.	Perry	Mitchell	W	9197653923					mitch.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/21/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Chief Operating Officer	SVP, Chief Operations & Member Experience Officer	Ms.	Mizelle	Karla		9849603787					karla.mizelle@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	03/22/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Chief Information Officer	AVP, IT Solution Delivery	Mrs.	Moum	Aldara		9196160924					Aldara.Moum@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	08/19/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Chief Information Security Officer	Chief Information Security Officer	Mr.	Chilton	Richard		9197652021					Rick.Chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	277022291	01/15/2016	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	CMS Casework Communication Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Complaints Tracking Contact	Manager, Contact Center		Rambert	Alex		9197657299					Caseworker@bcbsnc.com	4613 University Drive		Durham	NC	27707	05/21/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Contact for Fraud Investigations	Manager, Special Investigations Unit		Meyer	John		9842752360					John.Meyer@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	07/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Coordination of Benefits Contact	Team Lead, Operations		Pridgen	David		3362014141					David. Pridgen@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Corporate Mailing						3362014460				3366592969	deborah.washington-mcneill@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Customer Service Operations Contact	Sr. Manager, Contact Center		Woods	Renita		9197657057					Renita.Woods@bcbsnc.com	4613 University Drive		Durham	NC	27707	03/26/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	DIR Contact	Director, Actuarial Services		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	03/15/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Discount Program Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	10/03/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Emergency Part D Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Emergency Part D Contact (Secondary)	Director, Government Markets CFO		Perry	Endya		9197775504					endya.perry@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Employer Waiver Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Enrollment Contact	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	EOB Transfer Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536				9197657291	Corporate.pharmacy@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Financial Audit Contact	Director, Audit	Ms.	Ferrell	Kim		3362014038					kim.ferrell@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Financial Reporting Contact	Director, Corporate Financial Reporting		Lindsey	Elizabeth		5022108328					Elizabeth.Lindsey@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/05/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Formulary Contact	Manager, Pharmacy Programs		Hiller	Debra		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics Inc	2900 Ames Crossing Road	Eagan	MN	55121	03/07/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	General Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Government Relations Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	HIPAA Privacy Officer	Director, Privacy, Ethics & Corp Policies		Hamlet	Lynne		9197657416					lynne.hamlet@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/18/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	HIPAA Security Officer	Chief Information Security Official		Chilton	Rick		9197652021					rick.chilton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/30/2014	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Hospice Contact	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Interoperability Contact	Director, Corporate Compliance Official		Haith	Elenor		9842125897					Elenor.Haith@bcbsnc.com	PO Box 2291		Durham	NC	27702	07/20/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Marketing Contact	Manager, Medicare Plan Administration		Brown	Alison		9196728994					alison.brown@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	12/28/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Medical Director	VP, Chief Medical Officer	Dr.	Wallace	Marcus		9843891622					Marcus.Wallace@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	06/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Medicare Compliance Officer	Director, Corporate Compliance	Mrs.	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/09/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Medicare Coordinator	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Medicare Part D Opioid Overutilization Contact	Sr Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Medication Therapy Management Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	OffShore Subcontractor Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Online Enrollment Center Contact (Back-up)	Manager, Membership Services		Brackett	Latrese		3362019770					latrese.brackett@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	04/16/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Online Enrollment Center Contact (Primary)	Director, Member Enrollment & Operations		Clayton	Beth		9197652438					Beth.Clayton@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/19/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Appeals	Director, Commercial and Medicare Appeals & Griev		McFall	Adonna							Adonna.McFall@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	05/08/2018	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active	8882987520				Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Appeals Contact (Secondary)	Mgr, MA and PDP Appeals and Grievances		Lanier	Paige						8883758836	paige.lanier@bcbsnc.com	P.O. Box 2291		Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active	8774947647				Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Application Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3366923556				3366592969	deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Benefits Contact	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Claims Submission Contact	Functional Business Consultant - Govt Prgms		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	Prime Therapeutics LLC	2900  Ames Crossing Road	Eagan	MN	55121	03/22/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Exceptions Contact	Director, Pharmacy		Moore	Jim							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	4613 University Drive	Durham	NC	27707	04/18/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active	8882969790				Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Exceptions Contact (Secondary)	Team Leader, Clinical Pharmacy Reviews - Medicare		Parikh	Swati							PartDExceptions@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	01/04/2022	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active	8882969790				Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Price File Contact (Back-up)	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Price File Contact (Optional)	Price File Analyst Sr		Trudeau	Ashley		6127771338					ashley.trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Price File Contact (Primary)	Sr. Pharmacy Operations Analyst		Edwards	Chrissie		9197653536					chrissie.edwards@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Quality Assurance Contact	Manager, Pharmacy Quality		Naples	Anna		9843000718					Anna.Naples@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Part D Reporting Contact	Director, CIG Compliance		Washington-McNeill	Deborah		3362014460					deborah.washington-mcneill@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/10/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Patient Safety Contact	Manager, Pharmacy		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Payment Contact	Principal Financial Accounting & Reporting Analyst		Onasanya	Tola		2248050506					tola.onasanya@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	10/03/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Pharmacy Director	VP, Pharmacy Services		Trautman	Suzanne		7045988684					Suzanne.Trautman@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	10/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Pharmacy Network Management Contact	AVP, Corporate Pharmacy		Rooker	Todd		6024181702					Todd.Rooker@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	08/27/2025	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Programs		Hiller	Debbie		9197651931					debra.hiller@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Pharmacy Technical Help Desk Contact			Helpdesk	Pharmacy							bret.schultz@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active	8772777893				Medicare Prescription Drug Plan		5	Atlanta
S5540	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops		Bunch	Jon							jonathan.bunch@primetherapeutics.com	Prime Therapeutics, LLC 2900 Ames Crossing Road		Eagan	MN	55121	12/14/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active	8772777893				Medicare Prescription Drug Plan		5	Atlanta
S5540	Plan Directory Contact for Public Website	Call Center support		Services	Member		8882969790					renita.woods@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	07/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Plan to Plan Reconciliation Contact	Sr Accountant		Taylor	Krystal		9849603607					krystal.taylor@bcbsnc.com	ATTN:  Sheila Adams or Yvonne Stancil (Medicare P2P)	PO Box 30060 Mailstop 700-1AP	Durham	NC	27702	02/28/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Processor Contact	Dir Govt Programs & Ops		Zeien	Daniel		6127776775					daniel.zeien@primetherapeutics.com	Prime Therapeutics, LLC	2655 Eagan Woods Drive	Eagan	MN	55122	05/31/2019	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Reconciliation Contact	Director, Actuarial Services		Pigg	Ryland		9196168313					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P. O. Box 2291	Durham	NC	27702	03/11/2021	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Recovery Audit Contact	Director, Corporate Compliance	Mrs	Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina,	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Surveillance Contact	Director, Corporate Compliance		Haith	Elenor		9842125897					elenor.haith@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27702	06/13/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	System Contact	Director, IT Solution Delivery		Keltner	Doug		9194607400					Doug.Keltner@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	08/02/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	Third Party Administrator (TPA) Liaison	AVP, Head of Actuarial Services & Valuation		Pigg Jr.	Ryland		9847776107					Ryland.Pigg@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	P.O. Box 2291	Durham	NC	27702	05/11/2023	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5540	User Access Contact	Electronic Data Interchange Analyst		Dunn	Lorrie		9197653669					lorrie.dunn@bcbsnc.com	Blue Cross and Blue Shield of North Carolina	PO Box 2291	Durham	NC	27707	07/12/2024	2026	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	PDP	Blue Cross and Blue Shield of North Carolina	Medicare Prescription Drug Plan		CuraCor Solutions Corp.	884	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5584	Agent/Broker Compensation Data Contact	Manager	Mr.	Delaney	Brandon		3134482712					bdelaney@bcbsm.com	600 East Lafayette Blvd.	MC 520J	Detroit	MI	48226	03/16/2022	2026	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	Automated TrOOP Balance Transfer Contact	Manager	Mr.	Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Backup User Access Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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		3132256662					BHall@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	06/17/2022	2026	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	Bid Audit Contact	Director		Weicker	Brian		3132259571					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	06/17/2022	2026	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	Bid Audit Site Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/16/2022	2026	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	Bid Primary Contact	Manager		Wilkins	Shannon		2486654009					swilkins@bcbsm.com	600 East Lafayette	MC 1501	Detroit	MI	48226	12/05/2024	2026	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	CAP Report Contact for Public Website	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	09/13/2021	2026	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	CEO - CMS Administrator Contact	President and CEO	Mrs.	Keith	Tricia		3132250452					tkeith@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	01/14/2025	2026	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	CEO - Senior Official for Contracting	President and CEO	Mrs.	Keith	Tricia		3132250452					tkeith@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	01/14/2025	2026	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	3132257939					pmozak@bcbsm.com	600 East Lafayette Blvd.	MC 2122	Detroit	MI	48226	01/11/2022	2026	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 Operating Officer	President and CEO	Ms.	Keith	Tricia		3132250452					TKeith@bcbsm.com	600 East Lafayette Blvd.	MC 2000	Detroit	MI	48226	01/14/2025	2026	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 Information Officer	Senior Vice President	Mr.	Fandrich	William		3132255800					Wfandrich@bcbsm.com	600 East Lafayette Blvd.	MC 2010	Detroit	MI	48226	11/15/2019	2026	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 Information Security Officer	Senior Vice President	Mr.	Fandrich	William		3132255800					Wfandrich@bcbsm.com	600 East Lafayette Blvd.	MC 2010	Detroit	MI	48226	11/15/2019	2026	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	Senior Analyst		Whitener	David		3136546885					DWhitener@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/04/2024	2026	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	Complaints Tracking Contact	Senior Analyst		Whitener	David		3136546885					DWhitener@bcbsm.com	600 East Lafayette		Detroit	MI	48226	12/04/2024	2026	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	Contact for Fraud Investigations	Manager		Zasadny	Brian		3132255956					bzasadny@bcbsm.com	600 East Lafayette		Detroit	MI	48226	07/03/2025	2026	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		Adams	Ronnie		2486654591					radams@bcbsm.com	600 East Lafayette Blvd.	TC 1515	Detroit	MI	48226	03/04/2024	2026	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	Corporate Mailing						2483955887					vpickens@bcbsm.com	600 East Lafayette Blvd.	MC TC1301	Detroit	MI	48226	03/14/2022	2026	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		3132255856					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2026	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	DIR Contact	Manager	Mr.	Nalamolu	Chandra		3132256810					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	MC 1705	Detroit	MI	48226	12/18/2012	2026	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	DIR Contact (Secondary)	Senior Health Care Analyst	Ms.	Desaraju	Vidhya		2486654514					vdesaraju@bcbsm.com	600 East Lafayette Blvd.	MC 1705	Detroit	MI	48226	11/18/2021	2026	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	Discount Program Payment Contact	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette		Detroit	MI	48226	04/21/2025	2026	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	Emergency Part D Contact	Manager	Mrs.	Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	12/27/2024	2026	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	Emergency Part D Contact (Secondary)	Director	Mrs.	Underhill	Molly		6163753398					MUnderhill@bcbsm.com	600 East Lafayette Blvd.	TC 1300	Detroit	MI	48226	12/28/2020	2026	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	Enrollment Contact	Manager		Carlisle-Brant	Terrie		3132256881					Tbrant@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	09/20/2023	2026	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	EOB Transfer Contact	Manager	Mrs.	Rawson	Lori		6169565796				8773459942	lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Financial Audit Contact	Director	Mr.	Weicker	Brian		3132259571					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	06/17/2022	2026	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	Financial Reporting Contact	Manager		Ellis	Carol		3132257492					cellis@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/17/2025	2026	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	Formulary Contact	Manager		Siess	Hac		3134480140					hsiess@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	Formulary Contact (Secondary)	Supervisor	Ms.	Lota	Amardeep		2486654537					Alota@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/17/2022	2026	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	General Contact	Compliance Consultant	Ms.	White	Jasmin		2486654235					jwhite4@bcbsm.com	600 East Lafayette	MC 1502	Detroit	MI	48226	12/04/2024	2026	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	Managing Director	Ms.	Pickens	Veronica		2483955887					vpickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	02/23/2024	2026	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	HIPAA Privacy Officer	VP, Enterprise Compliance and Privacy Official	Ms.	Lange	Kelly		3132258554					KLange@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	12/27/2021	2026	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	HIPAA Security Officer	VP, Enterprise Compliance and Privacy Official	Ms.	Lange	Kelly		3132258554					KLange@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	12/27/2021	2026	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		6169565796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Interoperability Contact	Director	Mr.	Kett	James		3132250224					jkett@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	02/11/2022	2026	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	Marketing Contact	Director		Parrish	Loralie		3135007876					lparrish1@bcbsm.com	600 East Lafayette Blvd.	MC 1401	Detroit	MI	48226	03/05/2024	2026	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	Medical Director	Senior Medical Director	Dr.	Yende	Namita		3132259513					nyende@bcbsm.com	600 East Lafayette Blvd.	MC 516D	Detroit	MI	48226	03/17/2025	2026	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		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/03/2022	2026	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 Coordinator	Managing Director	Ms.	Pickens	Veronica		2483955887					VPickens@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	09/13/2021	2026	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 Part D Opioid Overutilization Contact	Manager		Mates	Bianca		8002874163				8778958667	MedicarePartDOverutilizationMonitoring@bcbsm.com	600 East Lafayette Blvd.	512J	Detroit	MI	48226	12/11/2025	2026	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	Medication Therapy Management Contact	Manager		Pallisco	Amy		2486654777					Apallisco@bcbsm.com	600 East Lafayette	MC 512J	Detroit	MI	48226	07/14/2025	2026	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	OffShore Subcontractor Contact	Manager	Mrs.	Stretch	Kaitlin		2486654275					kstretch@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	10/16/2019	2026	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	Online Enrollment Center Contact (Back-up)	Manager		Carlisle-Brant	Terrie		3132256881					Tbrant@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	09/20/2023	2026	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	Online Enrollment Center Contact (Primary)	Business Systems Analyst Sr		Hall	Barbara		3132256662					BHall@bcbsm.com	600 East Lafayette Blvd.	MC 1602	Detroit	MI	48226	06/17/2022	2026	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 Appeals	Manager		Lewis	Letoretoys						8666014428	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1408	Detroit	MI	48226	03/04/2024	2026	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	8004373803				Medicare Prescription Drug Plan		5	Chicago
S5584	Part D Appeals Contact (Secondary)	Supervisor	Ms.	Agnew	Amber						8666014428	dramspriorauthmedicared@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	8004373803				Medicare Prescription Drug Plan		5	Chicago
S5584	Part D Application Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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 Benefits Contact	Manager	Mrs.	Rawson	Lori		6169565796					lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	11/15/2019	2026	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 Claims Submission Contact	Manager		Nalamolu	Chandra		2486654549					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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		Lewis	Letoretoys						8666014428	dramspriorauthmedicareD@bcbsm.com	600 East Lafayette Blvd.	TC 1408	Detroit	MI	48226	03/04/2024	2026	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	8004373803				Medicare Prescription Drug Plan		5	Chicago
S5584	Part D Exceptions Contact (Secondary)	Supervisor	Ms.	Agnew	Amber						8666014428	dramspriorauthmedicared@bcbsm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	03/04/2024	2026	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	8004373803				Medicare Prescription Drug Plan		5	Chicago
S5584	Part D Price File Contact (Back-up)	Senior Health Care Analyst		McGuire	Donald		2486654548					dmcguire2@bcbsm.com	500 Renaissance Center	512A	Detroit	MI	48243	02/26/2025	2026	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 Price File Contact (Primary)	Manager	Mr.	Nalamolu	Chandra		3132256810					hnalamolu@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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 Quality Assurance Contact	Director	Ms.	Underhill	Molly		2483955505					munderhill@bcbm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/16/2020	2026	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 Reporting Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Patient Safety Contact	Director		Connelly	Theresa		2483955529					Tconnelly@bcbsm.com	500 Renaissance Center	505A	Detroit	MI	48243	12/04/2024	2026	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	Payment Contact	Manager		Ellis	Carol		3132257492					cellis@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/17/2025	2026	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 Director	Director	Ms.	Underhill	Molly		6163753398					munderhill@bcbm.com	600 East Lafayette Blvd.	TC 1308	Detroit	MI	48226	11/18/2021	2026	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 Network Management Contact	Director		Underhill	Molly		2483955505					munderhill@bcbsm.com	600 East Lafayette Blvd.	TC1308	Detroit	MI	48226	03/04/2024	2026	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 Network Management Contact (Secondary)	Manager	Mrs.	Rawson	Lori		6169565796					Lrawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Manager	Mr.	Nalamolu	Chandra							hnalamolu@bcbsm.com	600 East Lafayette Blvd	MC 1309	Detroit	MI	48226	12/10/2025	2026	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	8558100007				Medicare Prescription Drug Plan		5	Chicago
S5584	Pharmacy Technical Help Desk Contact (Secondary)	Manager	Ms.	Rawson	Lori							lrawson@bcbsm.com	600 East Lafayette Blvd	TC 1309	Detroit	MI	48226	12/10/2025	2026	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	8558100007				Medicare Prescription Drug Plan		5	Chicago
S5584	Plan Directory Contact for Public Website	Director	Ms.	Judson	Johanna		8663091719					jjudson@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/16/2022	2026	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	Plan to Plan Reconciliation Contact	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette Blvd.	Attn: P2P Mail Code 0807 - G Dillard-Brown	Detroit	MI	48226	04/21/2025	2026	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	Processor Contact	Manager	Mrs.	Rawson	Lori		6169565796					LRawson@bcbsm.com	600 East Lafayette Blvd.	TC 1309	Detroit	MI	48226	10/16/2019	2026	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	Reconciliation Contact	Manager		Ellis	Carol		3132257492					cellis@bcbsm.com	600 East Lafayette Blvd.		Detroit	MI	48226	03/12/2025	2026	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	Reconciliation Contact (Secondary)	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette		Detroit	MI	48226	04/21/2025	2026	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	Recovery Audit Contact	Vice President, Enterprise Compliance	Ms.	Lange	Kelly		3132258554					medcomplianceofficer2@bcbsm.com	600 East Lafayette Blvd.	MC 1603	Detroit	MI	48226	03/14/2022	2026	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	Surveillance Contact	Director		Crawford	Constance		2486654231					ccrawford@bcbsm.com	600 East Lafayette Blvd.	TC 1301	Detroit	MI	48226	06/17/2022	2026	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	System Contact	Manager		Martell	Stacey		3138065905					smartell@bcbsm.com	600 East Lafayette Blvd.	MC 1502	Detroit	MI	48226	12/03/2024	2026	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	Third Party Administrator (TPA) Liaison	Financial Coordinator		Sempek	Lindora		2484179714					Lsempek@bcbsm.com	600 East Lafayette		Detroit	MI	48226	04/21/2025	2026	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	User Access Contact	Analyst	Mr.	Teklinski	Greg		2486654284					gteklinski@bcbsm.com	600 East Lafayette Blvd.	MC S140	Detroit	MI	48226	03/16/2022	2026	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
S5593	Agent/Broker Compensation Data Contact	Director Direct Pay Sales	Ms.	Mountain	Ashley		4125442178					ashley.richert@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	05/13/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Automated TrOOP Balance Transfer Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/16/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Backup User Access Contact	Sr. Risk and Regulatory Intelligence Analyst	Ms.	Hegedus	Emily		6078219034					emily.hegedus@highmarkhealth.org	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Best Available Evidence Contact	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					LISBAE@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/01/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Bid Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Bid Audit Site Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Bid Primary Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/13/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/05/2017	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	CEO - CMS Administrator Contact	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	01/06/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	CEO - Senior Official for Contracting	President, Highmark Health Plan	Mr.	Doran	Thomas		4125442221					Thomas.Doran@highmark.com	120 Fifth Avenue, Ste. 3032		Pittsburgh	PA	15222	02/10/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Chief Financial Officer	CFO Highmark Health Plan	Ms.	Musler	Kate		4125448653					katherine.musler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	02/25/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Chief Operating Officer	SVP, Government Business Segment President	Ms.	Miller	Alexis	A	4125447389					Alexis.Miller@Highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	02/10/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Chief Information Officer	Senior Vice President, Infrastructure & Architectu	Mr.	Krebs	Mark		7173026255					mark.krebs@goenGen.com	120 Fifth Avenue		Pittsbrugh	PA	15222	09/25/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Chief Information Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					Caleb.Merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/28/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	CMMI Model Point of Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	08/15/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	CMS Casework Communication Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne	M	4125444579				7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	01/06/2020	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Complaints Tracking Contact	Manager, Appeals and Grievances	Ms.	Walsh	Lynne		4125444579				7176354209	Lynne.Walsh@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	01/06/2020	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Contact for Fraud Investigations	VP Financial Investigation & Provider Review	Mr.	Spear	Kurt		4125447069					Kurt.Spear@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	12/05/2017	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Coordination of Benefits Contact	Sr. Process Analyst	Ms.	Cassidy	Christina		4125444417					Christina.Cassidy@highmark.com	120 Fifth Avenue	PAP P5111	Pittsburgh	PA	15222	12/26/2019	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Corporate Mailing						4125447031					Thomas.Boettler@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/26/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Customer Service Operations Contact	Director, Member & Provider Services		Scarnati	Chris		8148716712					Chris.Scarnati@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/09/2020	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	DIR Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	DIR Contact (Secondary)	Senior Risk & Compliance Case Manager		Stetson	Kelsey		4125445816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Discount Program Payment Contact	Manager, Financial Shared Services		Gaughan	Tammy		5702006379					Tammy.Gaughan@highmark.com	1800 Center Street		Camp Hill	PA	17011	05/28/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Emergency Part D Contact	Manager, Pharmacy Customer Service		Sheridan	Rebecca		5182205661				5184232294	rebecca.sheridan@highmark.com	40 Century Hill Drive		Latham	NY	12110	06/23/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Emergency Part D Contact (Secondary)	Director, Pharmacy Customer Service		Wilson	Gena		7163920294					Gena.Wilson@highmark.com	257 West Genesee St		Buffalo	NY	14202	06/23/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Employer Waiver Contact	Manager, Health Plan Product	Mr.	Zambino	Anthony		3024213122					Anthony.Zambino@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Enrollment Contact	Manager, Government Business Enrollment		Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	EOB Transfer Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	bob.opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	12/26/2019	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Financial Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Financial Reporting Contact	Vice President, Accounting & Reportin	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Formulary Contact	Senior Pharmacist, Clinical Pharmacy Services		Humphries	Jessica		4128884890					jessica.humphries@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	08/16/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Formulary Contact (Secondary)	Senior Pharmacist		Desai	Ravi		8142896191					ravi.desai@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	152223099	02/14/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	General Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Government Relations Contact	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/29/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	HIPAA Privacy Officer	Chief Privacy and Data Ethics Officer	Ms.	Patrick	Justine		4125444643					Justine.Patrick@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	HIPAA Security Officer	Chief Information Security Officer	Mr.	Merriman	Caleb		4125448000					caleb.merriman@goengen.com	120 Fifth Avenue		Pittsburgh	PA	15222	01/06/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Hospice Contact	Intake Coordinator		Welker	Jessica		7178883043					DrugHelp_Authorizations@highmark.com	120 5th Avenue Place		Pittsburgh	PA	15222	10/25/2019	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Interoperability Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/25/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Marketing Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					Jillian.Pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	10/14/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Medical Director	VP, Executive Medical Director	Dr,	Law	Timothy		4125446445					timothy.law@highmark.com	120 Fifth Ave.		Pittsburgh	PA	15222	12/20/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	Boettler	Thomas		4125447031					Thomas.Boettler@highmark.com	120 5th Avenue	Suite 1833	Pittsburgh	PA	15222	12/05/2017	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Medicare Coordinator	Director, Government Compliance	Ms.	Carl	Kathleen	A	4125447156					Kathleen.Carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Medicare Part D Opioid Overutilization Contact	Pharmacist		Ali	Dewaa		4129040214					Dewaa.Ali@highmark.com	120 5th Avenue	PAP P4207	Pittsburgh	PA	15222	11/14/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Medication Therapy Management Contact	Senior Pharmacist	Ms.	Adlesic	Meredith		4128883749					Meredith.Adlesic@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	OffShore Subcontractor Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Online Enrollment Center Contact (Back-up)	Director, Enrollment & Billing	Mr.	Marze	Michael		4125441502					Michael.Marze@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Online Enrollment Center Contact (Primary)	Manager, Government Business Enrollment	Mr.	Stanhoff	David		4125445689					David.Stanhoff@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/20/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Appeals	Manager, Member Appeals & Grievances	Ms.	Walsh	Lynne	M					7176354209	Lynne.Walsh@highmark.com	120 Fifth Avenue	Suite P5501	Pittsburgh	PA	15222	12/31/2020	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	4125444579				Medicare Prescription Drug Plan		5	Boston
S5593	Part D Appeals Contact (Secondary)	Supervisor, Appeals & Grievances	Ms.	Miller	Rachel	M					7176354209	Rachel.Miller@highmark.com	Fifth Ave Place	120 Fifth Avenue, Ste 5322	Pittsburgh	PA	15222	09/06/2018	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	4125441596				Medicare Prescription Drug Plan		5	Boston
S5593	Part D Application Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Benefits Contact	VP, Product Strategy & Portfolio Development	Mr.	Lightner	Timothy		4125440952					timothy.lightner@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Claims Submission Contact	Director Regulated Marketing Medicare Solutions		Dovico	Rosario		9145896300				8882822583	Rosario_dovico@express-scripts.com	One Express Way		St. Louis	MO	63121	11/09/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Exceptions Contact			Affairs	Pharmacy							drughelp@highmark.com	120 Fifth Avenue	Suite SPECARE	Pittsburgh	PA	15222	08/04/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	8006002227				Medicare Prescription Drug Plan		5	Boston
S5593	Part D Exceptions Contact (Secondary)	Senior Pharmacy Manager Prior Auth		Hollowell	Adam							Adam.Hollowell@evernorth.com	One Express Way	Mail Stop:S13NB	St. Louis	MO	63121	01/06/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	9013817109				Medicare Prescription Drug Plan		5	Boston
S5593	Part D Price File Contact (Back-up)	Sr. Manager, Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way -Bldg 1		St. Louis	MO	63121	10/21/2024	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Price File Contact (Optional)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	03/04/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Price File Contact (Primary)	Senior Pharmacy Analyst, Pharmacy Gov Operations		Bojkic	Nicole		8148716881					Nicole.Bojkic@highmark.com	301 Fifth Avenue Place		Pittsburgh	PA	15222	03/04/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Quality Assurance Contact	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Part D Reporting Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Patient Safety Contact	Director, Clinical Pharmacy Operations	Mr.	Causer	Derek		4125445835					Derek.Causer@highmark.com	120 Fifth Avenue Place		Pittsburgh	PA	15222	12/20/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Payment Contact	Vice President, Accounting and Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Pharmacy Director	Director Pharmacy Programs		Conjerti	Erica		7168878532					Erica.Conjerti@highmark.com	1 Seneca St		buff	NY	14203	02/14/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Pharmacy Network Management Contact	Network Account Director, Retail Strat & Contract	Ms.	Kelly	Heather		3146921866				8773875800	hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	01/12/2018	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Pharmacy Network Management Contact (Secondary)	Manager, Pharmacy Government Operations	Ms.	Lynn Schill	Jodie		5705783579					Jodie.LynnSchill@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
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	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	Boston
S5593	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Government Operations	Ms	Lynn Schill	Jodie							Jodie.LynnSchill@highmark.com	120 Fifth Avenue Pittsburgh, PA 15222		Pittsburgh	PA	15222	08/16/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active	5705783579				Medicare Prescription Drug Plan		5	Boston
S5593	PHR Beneficiary Contact																	07/23/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan	Highmark Inc	Highmark Health	123	Yes	Active	8665886967				Medicare Prescription Drug Plan		5	Boston
S5593	Plan Directory Contact for Public Website			Service	Provider		8665886967					resourcecenter@highmark.com	120 Fifth Ave		Pittsburgh	PA	15222	12/05/2017	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Plan to Plan Reconciliation Contact	Manager, Operational Accounting	Mr.	Stehr	Brett	J	7173022748					P2Precon@highmark.com	Highmark Inc. Attn: Cashier	PO Box 898820	Camp Hill	PA	170890407	06/28/2023	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Processor Contact	Manager, Claims	Mr.	Opal	Bob		4125445022				4125442111	Bob.Opal@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Reconciliation Contact	Vice President, Accounting & Reporting	Mr.	Bazzani	Matthew	B	4125448338					Matthew.Bazzani@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	09/06/2018	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Reconciliation Contact (Secondary)	Senior Risk * Compliance Case manager		Stetson	Kelsey		4125448816					kelsey.stetson@highmarkhealth.org	120 Fifth Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Recovery Audit Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Surveillance Contact	Senior Monitoring Analyst	Ms.	Pawlos	Jillian		4125445702					jillian.pawlos@highmarkhealth.org	120 5th Avenue		Pittsburgh	PA	15222	04/25/2022	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	System Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	Third Party Administrator (TPA) Liaison	Senior Accountant		Michael	Alexa		7175078387					Alexa.Michael@highmark.com	120 Fifth Avenue		Pittsburgh	PA	15222	08/28/2025	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5593	User Access Contact	Senior Risk Partner	Ms.	Carl	Kathleen		4125447156					kathleen.carl@highmark.com	120 5th Avenue		Pittsburgh	PA	15222	07/28/2021	2026	HM HEALTH INSURANCE COMPANY	PDP	Highmark Blue Shield	Medicare Prescription Drug Plan		Highmark Health	123	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5596	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Bid Audit Contact	Associate Actuary		Hoogerwerf	Brad		3374964137					bradley.hoogerwerf@elevancehealth.com	11000 Weston Parkway		Cary	NC	27514	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Bid Audit Site Contact	Associate Actuary		Hoogerwerf	Brad		3374964137					bradley.hoogerwerf@elevancehealth.com	11000 Weston Parkway		Cary	NC	27514	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Bid Primary Contact	Senior Product Manager		Hayes	Cheryl		5405883356					cheryl.hayes@elevancehealth.com	5115 Blackhawk Circle		Salem	VA	24153	05/14/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	EOB Transfer Contact	Compliance Director, Med Part D/Pharm Oversight		Doss	Jennifer		5137484736				8558419706	jennifer.doss@anthem.com	4361 Irwin Simpson Road		Mason	OH	45040	10/08/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	5133167654				Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	7577562058				Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	5133167654				Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	7577562058				Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Pharmacy Network Management Contact	Director, Pharmacy Oversight		Warner	Raymond		8054053246					raymond.warner@carelon.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/01/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	8333774266				Medicare Prescription Drug Plan		5	Chicago
S5596	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	8333774266				Medicare Prescription Drug Plan		5	Chicago
S5596	PHR Beneficiary Contact																	11/05/2015	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	1	Yes	Active	8004671199				Medicare Prescription Drug Plan		5	Chicago
S5596	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5596	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	ANTHEM INSURANCE COMPANIES, INC.	PDP	Anthem Insurance Companies, Inc.	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5601	Agent/Broker Compensation Data Contact	Lead Director, Service Ops		Philips	Elissa		4128653793					ebcolalella@aetna.com	141 County Line Road		New Galilee	PA	16141	12/30/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Automated TrOOP Balance Transfer Contact	Manager, Financial Planning and Analysis	Mr.	Hoffer	Jason		7175262745					jwhoffer@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Backup User Access Contact	Executive Director, Compliance		Johnson	Meegan		7634799853					JohnsonM8@AETNA.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	10/24/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Best Available Evidence Contact	Assoc. Manager,  Plan Sponsor Support		Randall	Octavia		7178292621				8665526205	oirandall@aetna.com	1425 Union Meeting Road		Blue Bell	PA	19422	07/08/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Bid Audit Contact	Lead Director, Part D Actuarial		Randall	James		5133497156					RandallJ@Aetna.com	4516 Willow View Court		Howell	MI	48843	07/16/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Bid Audit Site Contact	Sr. Manager, Part D Actuarial		Shipp	Micaela		7062064592					Micaela.Shipp@CVSHealth.com	151 Farmington Ave.		Hartford	CT	06156	07/16/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Bid Primary Contact	AVP, Actuarial-Cred		Schoening	Bradley		4022126350					BLSchoening@aetna.com	11415 S 173 Ave		Gretna	NE	68028	11/18/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	CAP Report Contact for Public Website	SilverScript, Chief Compliance Officer	Mr.	Jeswald	Patrick	J	4806612030				4803146974	Patrick.Jeswald@CVSHealth.com	9501 E. Shea Blvd, MC016		Scottsdale	AZ	85260	09/18/2014	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	CEO - CMS Administrator Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	CEO - Senior Official for Contracting	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Chief Financial Officer	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Chief Operating Officer	President and COO of Medicare	Ms.	Hennessy	Barbara		8602739559					hennessyb@aetna.com	151 Farmington Ave.		Hartford	CT	06156	04/30/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Chief Information Officer	SVP, HCB IT	Mr.	Frank	Nathan	C	6307372008					nathan.frank@cvshealth.com	3200 Highland Ave.		Downers Grove	IL	60515	09/28/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Chief Information Security Officer	Chief Information Security Officer & SVP TSS	Mr.	Rosa	Alan		6469433060					CISO@CVSHealth.com	223 Spring Street, 12th Floor		New York	NY	10013	08/29/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	CMS Casework Communication Contact	Executive Director, Medicare Complaints		Diamond	Lorraine		7247785042				8607545693	cmscasework@aetna.com	1 CVS Drive		Woonsocket	RI	02895	12/19/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Complaints Tracking Contact	Supervisor, Medicare Operations		Benage	Melissa		6194974262					Melissa.Benage@CVSHealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	07/08/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Contact for Fraud Investigations	Sr. Director Special Investigation		Statchen	Richard		8602738109				8609759719	statchenr1@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	12/28/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Coordination of Benefits Contact	Manager, MedD Financial Operations		Simon	Brittany		4805364772					brittany.davis@cvshealth.com	9501 Shea Blvd. MC 121		Scottsdale	AZ	85260	11/18/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Corporate Mailing						8602730793					MedicareCO@aetna.com	151 Farmington Ave.		Hartford	CT	06156	10/24/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Customer Service Operations Contact	Director Customer Care		Swanger	Rachel		4123286668					Rachel.Swanger@CVSHealth.com	105 Mall Blvd.		Pittsburgh	PA	15146	12/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	DIR Contact	Lead Director,FP&A	Mr	Sweeney	Timothy		4016036922					timothy.sweeney@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	DIR Contact (Secondary)	Executive Director, FP&A	Mr	Passuello	Clifford		7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Discount Program Payment Contact	Manager, Accounting		Chau	Joyce		4017709055					joyce.chau@cvshealth.com	200 Highland Corporate Drive, Mail Code 2260		Cumberland	RI	02864	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Emergency Part D Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Emergency Part D Contact (Secondary)	Manager, Prod & Strat Planning		Shucet	Esther		7246308748				8602738880	shucete@aetna.com	151 Farmington Avenue		Hartford	CT	06156	11/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Employer Waiver Contact	Senior Vice President, Medicare	Mr.	Fernandez	Jeffrey		5046099290					jeff.fernandez@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/22/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Enrollment Contact	Executive Director, Service Operations		Blakeman	Andrea		4124326200				4128653896	amblakeman@cvshealth.com	2222 Ewing Road	Mail Code F233	Moon Township	PA	15108	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	EOB Transfer Contact	Executive Director, FP&A		Passuello	Clifford		7178292378				8554548052	capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Financial Audit Contact	Senior Manager FP&A	Ms.	Phillips	Karrie	E	8602736236					PhillipsKE@aetna.com	151 Farmington Avenue	Mail Code AS32	Hartford	CT	06156	01/03/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Financial Reporting Contact	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Formulary Contact	Executive Director, Medical Affairs		Wilson	Laura		2168709760					Laura.Wilson@CVSHealth.com	377 Buffalo Run Road		Friendsville	MD	21531	12/28/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Formulary Contact (Secondary)	Medicare Operations Leader		Vanlandingham	Mary		8044366121					mcvanlanding@aetna.com	9881 Mayland Drive		Richmond	VA	23233	01/03/2020	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	General Contact	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	Patrick.Jeswald@CVSHealth.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	10/28/2019	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Government Relations Contact	AVP, Government Affairs, Public Policy		Jones	Greg	A	2022855320					JonesG2@CVSHealth.com	1275 Pennsylvania Ave. NW, Suite 700		Washington	DC	20004	11/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	HIPAA Privacy Officer	VP, Deputy Privacy Officer		Granberg	Mitchell		4014082333					mitchell.granberg@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	HIPAA Security Officer	Chief Information Security Officer	Mr.	Rosa	Alan		4017703111					CISO@CVSHealth.com	1 CVS Drive		Woonsocket	RI	02895	12/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Hospice Contact	Sr. Manager, ESRD/Hospice Financial Operations		Westerlund	Lynnette		7249940659				8442994547	HospiceProviderRelationsTeam@CVSCaremark.com	9501 E. Shea Blvd, MC 121		Scottsdale	AZ	85260	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Interoperability Contact	Executive Director, Strategic Programs		Wampler	Ronald		5206616814					rxwampler@cvshealth.com	7767 E. Windriver Drive		Tucson	AZ	85750	12/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Marketing Contact	Sr. Director of Operations Integrity		Hayes	Cheryl	R	5152043059					crbarkau@aetna.com	1 CVS Drive		Woonsocket	RI	02895	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Medical Director	Executive Medical Director - Medical Affairs	Dr.	Catero, MD	Martin		4803163732					Martin.Catero@CVSHealth.com	4755 South 44 Place  NC145		Phoenix	AZ	85040	12/16/2022	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Medicare Compliance Officer	Chief Medicare Compliance Officer	Mr	Jeswald	Patrick	J	4806612030				8554548052	MedicareCO@aetna.com	9501 E Shea Blvd.	MC-016	Scottsdale	AZ	85260	05/14/2019	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Medicare Coordinator	VP, Contact Center of Excellence		Ellison	Christine		4124326289					EllisonC1@aetna.com	300 Corporate Parkway #1005		Amherst	NY	14226	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Medicare Part D Opioid Overutilization Contact	Director Clinical Pharmacy		McCann	Herbert	G	7178292347					MedicareRDUR@Aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Medication Therapy Management Contact	Manager, Clinical Pharmacy		Haynes	Kathleen		8606875613					HaynesK@aetna.com	151 Farmington Avenue		Hartford	CT	06156	07/09/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	OffShore Subcontractor Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	09/21/2021	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Online Enrollment Center Contact (Primary)	Senior Manager, Systems and Process Support		VanKooten	Scott		4192760227					scott.vankooten@cvshealth.com	9501 E Shea Boulevard		Scottsdale	AZ	85260	07/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Appeals	Supervisor, Operations		Wyre	Jasmine						7326914838	jasmine.wyre@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active	2244768116				Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Appeals Contact (Secondary)	Manager, Pharmacy RPh		Vo	Binh						7326914838	binh.vo@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	12/20/2022	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active	7132085765				Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Application Contact	VP, Business Administration & Governance	Ms.	Snyder	Karen		7175415903					pdpapp@aetna.com	151 Farmington Ave.		Hartford	CT	06156	01/10/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Benefits Contact	Exec. Dir.,  Part D Product Development		Bohrer	Christophe		8609165704				8602738880	BohrerC@aetna.com	151 Farmington Avenue	Mail Code RW4A	Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Claims Submission Contact	Business Project Program Manager		Shoiock	Mitchell		2157750114					ShoiockM@AETNA.com	151 Farmington Avenue		Hartford	CT	06156	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Exceptions Contact	Executive Director, Quality & Audit		Bailey	Lori							lori.bailey@cvshealth.com	1300 E. Campbell Rd		Richardson	TX	75083	11/12/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active	4692435213				Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Exceptions Contact (Secondary)	Professional Clinical		Frank	Kaitlyn							kaitlyn.frank@cvshealth.com	620 Epsilon Drive		Pittsburgh	PA	15238	11/19/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active	4125803128				Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Price File Contact (Back-up)	Sr. Manager, Medicare Finance		Stauffer	Grace		4804798023					Grace.Stauffer@CVSHealth.com	9501 E. Shea Blvd., MC034		Scottsdale	AZ	85260	12/28/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Price File Contact (Optional)	Sr. Manager, Compliance		Wilson	Michael	L	4806124407					michael.wilson@cvshealth.com	9501 E Shea Blvd		Scottsdale	AZ	85260	07/08/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Price File Contact (Primary)	Manager, Medicare Finance		Pertgen	Richard		8045258502					richard.pertgen@cvshealth.com	7239 Walnut Road		Fair Oaks	CA	95628	07/08/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Quality Assurance Contact	AVP, Deputy CMO		Offenberger	Terence		9494663695					offenbergert@aetna.com	10516 Selkirk Lane		Los Angeles	CA	90077	01/03/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Part D Reporting Contact	Sr. Director, Operations Integrity		Gabbert	Tonya		8597790852					trgabbert@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Patient Safety Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Payment Contact	Ld Director- Business Analytics, Finance Reporting		Parikh	Amee	V	2679741882					parikha@aetna.com	151 Farmington Avenue		Hartford	CT	06156	06/26/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Pharmacy Director	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/30/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Pharmacy Network Management Contact	Executive Director, Clinical Pharmacy		McKenna	Erin		4125924308					EKMcKenna@aetna.com	151 Farmington Ave. MC-RT41		Hartford	CT	06156	12/24/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Pharmacy Network Management Contact (Secondary)	Executive Director, Strategic Planning		Phillips	Rachel		6194974216					rachel.phillips4@aetna.com	4310 East Cotton Center Blvd. Suite 110		Phoenix	AZ	85040	02/04/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Pharmacy Technical Help Desk Contact	Lead Dir.,Medicare Pharmacy Ops, Bus. Admin & Gov.		Madison	Ryan							madisonr@cvshealth.com	750 E. Park Drive		Harisburg	PA	17111	11/20/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active	8002386279				Medicare Prescription Drug Plan		5	Atlanta
S5601	Plan Directory Contact for Public Website	Advisor, Medicare Plan Management		Devine	Kelly		8662355660				8448021415	CVSCaremark.EmailManager@CVSHealth.com	SilverScript Insurance	P.O. Box 30001	Pittsburgh	PA	152220330	04/28/2020	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Plan to Plan Reconciliation Contact	Sr. Analyst, FP&A	Mr.	Banga	Sundeep		9164602733					P2P@aetna.com	JPMorgan Chase- Lockbox Processing,    ATTN: AHM - HC	Box 22429, 4 Chase Metrotech Center, 7th Floor East	Brooklyn	NY	11245	07/11/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Processor Contact	VP, Business Administration & Governance		Snyder	Karen		7175415903					snyderk3@cvshealth.com	151 Farmington Avenue		Hartford	CT	06156	11/13/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Reconciliation Contact	Manager, Accounting		Chau	Joyce		4017709055					joyce.chau@cvshealth.com	200 Highland Corporate Drive, Mail Code 2260		Cumberland	RI	02864	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Reconciliation Contact (Secondary)	VP, CFO, Medicare	Mr.	Mike	David		7248824938					david.mike@aetna.com	151 Farmington Ave.		Hartford	CT	06156	06/05/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Recovery Audit Contact	Executive Director, FP&A	Mr	Passuello	Clifford	A	7178292378					capassuello@cvshealth.com	151 Farmington Ave.		Hartford	CT	06156	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Surveillance Contact	Lead Director, Product Mgmt & Dev		Wallace	Latacha		8602737211					wallacel1@aetna.com	151 Farmington Ave.		Hartford	CT	06156	12/10/2024	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	System Contact	Director, Med D IT	Mr.	Bish	Charles		2169702881					charles.bish@cvshealth.com	29100 Aurora Road		Solon	OH	44139	11/29/2022	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	Third Party Administrator (TPA) Liaison	Manager, Accounting		Chau	Joyce		4017709055					joyce.chau@cvshealth.com	200 Highland Corporate Drive, Mail Code 2260		Cumberland	RI	02864	05/21/2025	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5601	User Access Contact	Executive Assistant		Yedgarlof	Mary	B	3015815862				8554548052	mbyedgarlof@aetna.com	9501 E. Shea Blvd. MC-016		Scottsdale	AZ	85260	12/30/2023	2026	SILVERSCRIPT INSURANCE COMPANY	PDP	Aetna Medicare	Medicare Prescription Drug Plan		CVS Health Corporation	49	Yes	Active					Medicare Prescription Drug Plan		5	Atlanta
S5609	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	5032254801				Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	8447656826				Medicare Prescription Drug Plan		5	Dallas
S5609	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active	8444571209				Medicare Prescription Drug Plan		5	Dallas
S5609	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5609	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	ASURIS NORTHWEST HEALTH	PDP	Asuris Northwest Health	Medicare Prescription Drug Plan		Cambia Health Solutions, Inc.	227	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5617	Agent/Broker Compensation Data Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Automated TrOOP Balance Transfer Contact	Operations Advisor	Ms.	Fertig	Nancy	J	8609024553					nancy.fertig@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Backup User Access Contact	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Best Available Evidence Contact	Enrollment/Billing Manager	Ms.	Rodrigue	Jacquelyn		0000000000					jacquelyn_p_rodrigue@hcsc.com	530 Great Cricle Rd		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Bid Audit Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Bid Audit Site Contact	Exec Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	04/25/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Bid Primary Contact	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	04/16/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	CAP Report Contact for Public Website	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417					tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/19/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/19/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/25/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	07/07/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Chief Information Officer	VP Information Techno	Mr.	Kopec	Christophe	D	8602263874					christopher_d_kopec@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	CMMI Model Point of Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	CMS Casework Communication Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Complaints Tracking Contact	Customer Service Manager	Ms.	McCarroll	Angie		8607877035					angie.mccarroll@cignahealthcare.com	3700 O'Donnell Street		Baltimore	MD	21224	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Coordination of Benefits Contact	Enrollment/Billing Manager	Ms.	Rodrigue	Jacquelyn		0000000000					jacquelyn_p_rodrigue@hcsc.com	530 Great Cricle Rd		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Corporate Mailing						6155658100					HCSC_Medicare_CEO@hcsc.net	300 East Randolph Street		Chicago	IL	60601	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Customer Service Operations Contact	Sr Mgr Operations	Mrs	Weber	Ashleigh		8609029968					ashleigh_weber@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	DIR Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	DIR Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Discount Program Payment Contact	Accounting Lead Analyst	Mr.	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Emergency Part D Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Emergency Part D Contact (Secondary)	Program Management Senior Manager	Mr.	Bellcour	Jason		4125057437					jason.bellcour@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Employer Waiver Contact	Client Account Support Senior Manager	Ms.	Tant	Shelly	D	8609024561					shelly.tant@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Enrollment Contact	Enrollment/Billing Manager	Ms.	Rodrigue	Jacquelyn		0000000000					jacquelyn_p_rodrigue@hcsc.com	530 Great Cricle Rd		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	EOB Transfer Contact	Program Management Advisor	Ms.	Porter	Deborah	A	8609024586				8602266000	deborah.porter@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Financial Audit Contact	Legal Compliance Manager	Ms.	Gutierrez	Genise		7865270265					genise.gutierrez@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Financial Reporting Contact	Analytics and Reporting	Mrs.	Dodd	Martha		2153601412					martha_dodd@hcsc.com	500 Great Circle Rd		Nashville	TN	37228	03/25/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Formulary Contact	Clinical Program Director	Mr.	Baldwin	Vincent		8609025498					vincent.baldwin@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Formulary Contact (Secondary)	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Government Relations Contact	DSVP Government Programs		Dugoff	Eva		2022497214					eva_dugoff@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	HIPAA Privacy Officer	Medicare Privacy Officer	Ms.	Duncan	Jennifer	L	8607876801					jennifer.duncan@evernorth.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/19/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Hospice Contact	Enrollment/Billing Manager	Ms.	Rodrigue	Jacquelyn		0000000000					jacquelyn_p_rodrigue@hcsc.com	530 Great Cricle Rd		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Interoperability Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Marketing Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488					jennifer_ziemianin@bcbsil.com	300 East Randolph St		Chicago	IL	60601	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Medicare Coordinator	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	04/16/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Medicare Part D Opioid Overutilization Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					OpioidDrugManagement@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Medication Therapy Management Contact	Clinical Program Senior Manager	Ms.	Patel	Shivani	R	8607877901					shivani.patel@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	OffShore Subcontractor Contact	Legal Compliance Advisor	Ms.	Kidd	Amanda		6292030688					amanda.kidd@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Online Enrollment Center Contact (Optional)	Legal Compliance Advisor	Ms.	Panich	Danielle		8049046922					danielle.panich@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Online Enrollment Center Contact (Primary)	Enrollment/Billing Manager	Ms.	Rodrigue	Jacquelyn		0000000000					jacquelyn_p_rodrigue@hcsc.com	530 Great Cricle Rd		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Appeals	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	4805480643				Medicare Prescription Drug Plan		5	New York
S5617	Part D Appeals Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8609024668				Medicare Prescription Drug Plan		5	New York
S5617	Part D Application Contact	Legal Compliance Senior Advisor	Ms.	Wilson	Tyra		8607877417				6152342154	tyra.wilson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Benefits Contact	Sr Director, Medicare Part D Product Strategy	Ms.	Turner	Kelle		6123941302					kelle.turner@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Claims Submission Contact	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Exceptions Contact	Operations Senior Manager	Mr.	Erkens	Ron							ron.erkens@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	4805480643				Medicare Prescription Drug Plan		5	New York
S5617	Part D Exceptions Contact (Secondary)	Operations Manager	Ms.	Johnson	Yarmeka							yarmeka.johnson@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8609024668				Medicare Prescription Drug Plan		5	New York
S5617	Part D Price File Contact (Back-up)	Network Operations Sr Advisor	Ms.	Ustach	Beth		8608404728					beth.ustach@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Price File Contact (Optional)	Legal Compliance Advisor	Ms.	Dwyer	Sherri	L	7244254657					sherri.dwyer@cignahealthcare.com	500 Great Circle Road		Nasvhille	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Price File Contact (Primary)	Product Management Senior Manager	Ms.	Dolfi	Amanda	K	6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	02/17/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Quality Assurance Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Part D Reporting Contact	Data Measurement & Reporting Manager	Ms.	Stokes	Tammy		4805781204					tammy.stokes@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Patient Safety Contact	Clinical Program Senior Director	Ms.	Schuster	Annie		6156951241					annie.schuster@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Payment Contact	Accounting Lead Analyst	Mr	Hourigan	Michael		2036418892					michael.hourigan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	03/25/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Personal Health Record Contact	Clinical Operations Senior Director	Ms.	McCoy	Cindy		8045462626					cindy.mccoy@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Pharmacy Director	VP Government Programs Pharmacy Operations	Mr.	Meadows	Russ	W	6232994317					russ.meadows@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Pharmacy Network Management Contact	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne		8603389867					maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Pharmacy Network Management Contact (Secondary)	Network Operations Sr Advisor	Ms.	Ruggiero	June	O	8608035631					june.ruggiero@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Pharmacy Technical Help Desk Contact			Scripts	Express								500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	New York
S5617	Pharmacy Technical Help Desk Contact (Secondary)	Provider Contracting Sr Manager	Ms.	Bourdier	Maryanne							maryanne.bourdier@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8603389867				Medicare Prescription Drug Plan		5	New York
S5617	Plan Directory Contact for Public Website	Sr Dir Customer service	Mr.	Robinson	Corey		4239546977					corey_robinson@hcsc.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Processor Contact	Claims Manager	Ms.	Cleere	Rebecca		7702613813					rebecca.cleere@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Reconciliation Contact	Financial Analysis Senior Advisor	Ms.	Wright	Kimberly	A	9145234965					kimberly.wright@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Reconciliation Contact (Secondary)	Business Finance Director	Mr.	Miller	Ian		6155643473					ian.miller@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Recovery Audit Contact	Legal Compliance Advisor	Mr.	Finn	Matt		8007115672					matt.finn@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Surveillance Contact	Legal Compliance Manager	Ms.	Hafstrom	Kim		6232771478					kim.hafstrom@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	System Contact	Sr Dir Application Delivery	Mrs.	Velasquez	Jen		7866701684					Jen_Velasquez@hcsc.com	500 Great Circle Road		Nashville	TN	37228	08/22/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	Third Party Administrator (TPA) Liaison	Accounting Senior Manager	Ms.	Kirkpatrick	Mercy		3053025896					mercy.kirkpatrick@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	12/20/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5617	User Access Contact	Operational Risk Principal	Ms.	Parker	Marcie	R	9318011761					marcie.parker@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	09/29/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	HealthSpring	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Agent/Broker Compensation Data Contact	Product Management Advisor		Douglas	Renee		3148478035					SRDouglas2@express-scripts.com	One Express Way		St. Louis	MO	63121	08/29/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Automated TrOOP Balance Transfer Contact	Director		Proper	Rob		6142144681					ESITroopTransfer@express-scripts.com	440 Polaris Parkway	Suite 300	Westerville	OH	43082	08/29/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Backup User Access Contact	Product Owner		Robertson	Char		8175285868					char_Robertson@express-scripts.com	6025 Saddle Bag Dr		Fort Worth	TX	76179	07/31/2020	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Best Available Evidence Contact	Product Management Advisor		Bhasin	Nazy		3148474572					Nazy_Bhasin@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/29/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Bid Audit Contact	DSVP & Pharmacy Finance & Actuarial		Ding	Xiaoping		3126534527					Xiaoping_Ding@bcbsil.com	300 East Randolph St		Chicago	IL	60601	07/10/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Bid Audit Site Contact	Exec Dir Internal Audit		Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph St	Chicago	IL	60601	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Bid Primary Contact	DSVP & Pharmacy Finance & Actuarial		Ding	Xiaoping		3126534527					Xiaoping_Ding@bcbsil.com	300 East Randolph St		Chicago	IL	60601	07/10/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	CAP Report Contact for Public Website	Medicare Compliance Officer		Cox	Courtney		8133349377					Courtney.Cox@cigna.com	500 Great Circle Road		Nashville	TN	37228	03/08/2023	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/27/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409					stephen_harris@hcsc.net	300 East Randolph Street		Chicago	IL	60601	03/27/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Chief Financial Officer	VP & Actuary	Mrs	Galka	Jennifer		3126534565					jennifer_galka@bcbsil.com	300 East Randolph St		Chicago	IL	60601	03/27/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Chief Operating Officer	DSVP Government Programs	Ms	Mott	Dana		2022497214					HCSC_Medicare_CEO@hcsc.net	1001 Pennsylvania W		Washington	DC	20004	04/25/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Chief Information Officer	VP Information Technology	Mr.	Sankaran	Vijay		9196234952				8455580265	Vijay.Sankaran@cignahealthcare.com	115 Tabor Road		Morris Plains	NJ	07950	05/28/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/01/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	CMS Casework Communication Contact	Manager		Anderson	Angela		9729156108					angela_anderson@express-scripts.com	1640 Dallas Parkway,		Plano	TX	75093	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Complaints Tracking Contact	Manager		Anderson	Angela		9729156108					angela_anderson@express-scripts.com	1640 Dallas Parkway,		Plano	TX	75093	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Contact for Fraud Investigations	Product Owner		Robertson	Char		8175285868					char_Robertson@express-scripts.com	6025 Saddle Bag Dr  TX		Fort Worth	TX	76179	05/19/2022	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Coordination of Benefits Contact	Director		Proper	Rob		6142144681					MedDCOBTeam@express-scripts.com	440 Polaris Parkway		Westerville	OH	43082	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Corporate Mailing						3146846701				8666852758	blake_simon@express-scripts.com	One Express Way		St. Louis	MO	63121	03/07/2023	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Customer Service Operations Contact	Manager		Rodriguez	Jaime		4078548005					JRordriguez3@express-scripts.com	One Express Way		St. Louis	MO	63121	01/15/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	DIR Contact	Senior Manager		Katzman	James		7326855436					James_Katzman@express-scripts.com	569 Sylvan Road		River Vale	NJ	07675	01/13/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	DIR Contact (Secondary)	Director		Woldt	Jennifer		2019706121					Jennifer_Woldt@express-scripts.com	One Express Way		St. Louis	MO	63121	01/13/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Discount Program Payment Contact	Accounting Advisor		Ten Eyck	Tyler		3148478104					Tyler.TenEyck@evernorth.com	One Express Way	Mailstop S12NA	St Louis	MO	63121	06/23/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Emergency Part D Contact	VP - Express Scripts PDP	Ms.	Leech	Laura		4042901745					Laura_Leech@express-scripts.com	10833 Brandie Meadow Lane		Huntersville	NC	28078	12/20/2019	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Emergency Part D Contact (Secondary)			McAfoos	Hannah		6188232375					HCMcAfoos@express-scripts.com	One Express Way		St. Louis	MO	63121	12/30/2021	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Employer Waiver Contact	Senior Manager		Farrell	Funda		3473343367					Funda_Farrell@express-scripts.com	One Express Way		St. Louis	MO	63121	05/19/2022	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Enrollment Contact	Director		Tierney	Dan		2018191561					daniel_tierney@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	EOB Transfer Contact	Senior Manager		Farrell	Funda		3473343367				8666287139	Funda_Farrell@express-scripts.com	One Express Way		St. Louis	MO	63121	08/22/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Financial Audit Contact	Senior Manager	Mrs.	Haley	Rhonda		9085834351					randerson3@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Financial Reporting Contact	Accounting Manager		Ansley	Connie		6155643480					Connie.Ansley@healthspring.com	500 Great Circle Road		Nashville	TN	37228	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Formulary Contact	Operations Manager		Patel	Hetshree		8323305057					hpatel5@express-scripts.com	115 Tabor Rd		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Formulary Contact (Secondary)	Operations Sr. Manager		Borra	Danielle		8457426680					Dborra@express-scripts.com	53 Maple Lane		Monroe	NY	10950	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	08/19/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Government Relations Contact	DSVP Government Programs		Mott-Bronson	Dana		2022497214					Dana_Mott-bronson@hcsc.net	1001 Pennsylvania NW		Washington	DC	20004	03/27/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	HIPAA Privacy Officer	Medicare Privacy Officer		Duncan	Jennifer	P	8607876801					jenn.duncan@cignahealthcare.com	500 Great Circle Road		Nashville	TN	37228	06/26/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Mrs	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	300 Randolph St		Chicago	IL	60601	03/27/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Hospice Contact	Product Management Manager		Holdren	Frank		6143909546					HP-HospiceBAE@express-scripts.com	440 Polaris Parkway	Suite 300	Westerville	OH	43082	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Interoperability Contact	Senior Manager		Haley	Rhonda		9085834351					randerson3@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Marketing Contact	Senior Manager		Haley	Rhonda		9085834351					randerson3@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Medical Director	Medical Director		Rower	Jeremy		5039277667					Jeremy.Rower@evernorth.com	6625 West 78th Street	BL0675	Bloomington	MN	55439	04/05/2022	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Medicare Coordinator	VP - Express Scripts PDP	Mrs.	Leech	Laura		4042901745					Laura_Leech@express-scripts.com	10833 Brandie Meadow Lane		Huntersville	NC	28078	07/27/2023	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Medicare Part D Opioid Overutilization Contact	Clinical Program Advisor		Plath	Brian		7326704655					BPlath@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Medication Therapy Management Contact	Director-Product Management		Muralidharan	Adrienne		3143131932					AMuralidharan@express-scripts.com	One Express Way		St. Louis	MO	63121	03/17/2020	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	OffShore Subcontractor Contact	Director		Simon	Blake		2146207186					blake_simon@express-scripts.com	1640 Dallas Parkway		Plano	TX	75093	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Online Enrollment Center Contact (Back-up)	Director		Simon	Blake		2146207186					blake_simon@express-scripts.com	1640 Dallas Parkway,		Plano	TX	75093	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Online Enrollment Center Contact (Primary)	Director		Tierney	Dan		2018191561					daniel_tierney@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Appeals	Sr. Manager   Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/13/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	5132920563				Medicare Prescription Drug Plan		5	New York
S5660	Part D Appeals Contact (Secondary)	Senior Manager		Duffy	Valerie							Valerie.Duffy@evernorth.com	One Express Way		St. Louis	MO	63121	06/10/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	4437973575				Medicare Prescription Drug Plan		5	New York
S5660	Part D Application Contact	Director		Simon	Blake		2146207186					blake_simon@express-scripts.com	1640 Dallas Parkway,	Mail Stop 3W03	Plano	TX	75093	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Benefits Contact	Senior Manager		Farrell	Funda		3473343367					Funda_Farrell@express-scripts.com	One Express Way		St. Louis	MO	63121	05/19/2022	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Claims Submission Contact	Director		Dovico	Rosario		9145896300					Rosario_Dovico@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Exceptions Contact	Sr. Manager   Pharmacy Prior Authorization		Herbert	Joshua							Joshua.Herbert@evernorth.com	One Express Way Mail Stop: S13NB		St. Louis	MO	63121	10/13/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	5132920563				Medicare Prescription Drug Plan		5	New York
S5660	Part D Price File Contact (Back-up)	Manager, Regulated  Markets Product		Williams	Stephanie		5135091549					medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	04/10/2023	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Price File Contact (Optional)			Robertson	Char		8175285868					Char_Robertson@express-scripts.com	6025 Saddle Bag Dr.		Fort Worth	TX	76179	06/21/2019	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Price File Contact (Primary)	Sr. Manager,  Regulated Markets		Dolfi	Amanda		6147349264					medicarewebsitefiles@express-scripts.com	900 Cottage Grove Rd.,		Bloomfield	CT	06002	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Quality Assurance Contact	Director		Simon	Blake		2146207186					blake_simon@express-scripts.com	1640 Dallas Parkway,		Plano	TX	75093	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Part D Reporting Contact	Senior Manager		Haley	Rhonda		9085834351					randerson3@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Patient Safety Contact	Director		Strednak	Suzanne		2016697462					suzanne_strednak@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Payment Contact	Director		Woldt	Jennifer		2019706121					Jennifer_Woldt@express-scripts.com	One Express Way		St. Louis	MO	63121	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Pharmacy Director	VP - Express Scripts PDP	Mrs.	Leech	Laura		4042901745					Laura_Leech@express-scripts.com	10833 Brandie Meadow Lane		Huntersville	NC	28078	07/27/2023	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Pharmacy Network Management Contact			Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	11/30/2016	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	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	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	New York
S5660	Plan Directory Contact for Public Website			Scripts-Medicare	Express		8665294917					LetEvernorthHelpU@Evernorth.com	115 Tabor Road		Morris Plains	NJ	07950	12/16/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Plan to Plan Reconciliation Contact		Ms.	Thomas	Andrea	F	8049046147				6152917025	P2P@CignaHealthcare.com	P.O. Box 11407	Dept#8277	Birmingham	AL	35246	05/06/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Processor Contact	Senior Director		Gibson	Sharon		8052361175					SGGibson@express-scripts.com	One Express Way		St Louis	MO	63121	10/17/2017	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Reconciliation Contact	Director		Woldt	Jennifer		2019706121					Jennifer_Woldt@express-scripts.com	One Express Way		St. Louis	MO	63121	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Recovery Audit Contact	Senior Manager	Mrs	Haley	Rhonda		9085834351					randerson3@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Surveillance Contact	Director		Simon	Blake		2146207186					blake_simon@express-scripts.com	1640 Dallas Parkway,		Plano	TX	75093	06/04/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	System Contact	Senior Manager		Haley	Rhonda		3473343367					randerson3@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	Third Party Administrator (TPA) Liaison	Accounting Advisor		Ten Eyck	Tyler		3148478104					Tyler.TenEyck@evernorth.com	One Express Way	Mailstop S12NA	St. Louis	MO	63121	06/23/2025	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5660	User Access Contact	Senior Manager		Haley	Rhonda		9085834351					randerson3@express-scripts.com	115 Tabor Road		Morris Plains	NJ	07950	08/27/2024	2026	MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY	PDP	Express Scripts Medicare	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5715	Agent/Broker Compensation Data Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590				0000000000	howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/26/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Backup User Access Contact	Sr. Business Consultant	Ms.	Davis	Kassandra		3126531351				0000000000	kassandra_davis@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/25/2023	2026	Health Care Service Corporation	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	Chicago
S5715	Best Available Evidence Contact	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Bid Audit Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	11/06/2020	2026	Health Care Service Corporation	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	Chicago
S5715	Bid Audit Site Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	Health Care Service Corporation	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	Chicago
S5715	Bid Primary Contact	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	11/06/2020	2026	Health Care Service Corporation	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	Chicago
S5715	CAP Report Contact for Public Website	DSVP Government Programs	Ms.	Mott	Dana		2022497214					hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	Health Care Service Corporation	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	Chicago
S5715	CEO - CMS Administrator Contact	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	Health Care Service Corporation	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	Chicago
S5715	CEO - Senior Official for Contracting	President Government Markets	Mr.	Harris	Stephen		3126536409				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Chief Financial Officer	Director & Actuary	Mr.	Eifler	Adam		3126535482				0000000000	Adam_Eifler@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	01/06/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Chief Operating Officer	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Chief Information Officer	Executive Director Portfolio Delivery	Ms.	Floyd	Kris		8606554505					Kris_Floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building B	Richardson	TX	75082	03/21/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Chief Information Security Officer	Chief Technology and Information Security Officer	Mr	Petrassi	Jim		3122868334					jim_petrassi@bcbsil.com	Health Care Service Corporation	300 E Randolph st	Chicago	IL	60601	10/03/2025	2026	Health Care Service Corporation	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	Chicago
S5715	CMMI Model Point of Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	Health Care Service Corporation	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	Chicago
S5715	CMS Casework Communication Contact	Manager Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Complaints Tracking Contact	Manager, Medicare Operations & Oversight	Ms.	Morris	Tawanna		6308245090				0000000000	Tawanna_Morris@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Contact for Fraud Investigations	Director, Special Investigations, Gov't Programs	Ms.	O'Dea	Lynn	M	3126533579				0000000000	Lynn_M_Odea@bcbsil.com	Blue Cross Blue Shield of Illinois	300 East Randolph Street	Chicago	IL	60601	11/27/2019	2026	Health Care Service Corporation	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	Chicago
S5715	Coordination of Benefits Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	COBMedD@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Corporate Mailing						3126535521				0000000000	Rebecca_Beasley@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	12/21/2021	2026	Health Care Service Corporation	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	Chicago
S5715	Customer Service Operations Contact	VP of Customer Service	Mr.	Akovenko	Josh		6156958916				0000000000	josh_akovenko@hcsc.com	Health Care Service Corporation	500 Great Circle Rd	Nashville	IL	60601	12/04/2025	2026	Health Care Service Corporation	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	Chicago
S5715	DIR Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	DIR Contact (Secondary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Discount Program Payment Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	Health Care Service Corporation	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	Chicago
S5715	Emergency Part D Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Employer Waiver Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Enrollment Contact	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	Health Care Service Corporation	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	Chicago
S5715	EOB Transfer Contact	Mgr Project & Program Management	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/14/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Financial Audit Contact	Executive Dir Internal Audit	Mr.	Kolodziej	Dave		3126532483					David_L_Kolodziej@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/30/2020	2026	Health Care Service Corporation	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	Chicago
S5715	Financial Reporting Contact	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/03/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Formulary Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5055508705				0000000000	mahmoud_el-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE, Suite 300	Albuquerque	NM	87109	07/15/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		7272077384				0000000000	cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/15/2025	2026	Health Care Service Corporation	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	Chicago
S5715	General Contact	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Government Relations Contact	Executive Director - Health Policy	Ms.	DuGoff	Eva		2022497208				0000000000	eva_dugoff@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	09/26/2025	2026	Health Care Service Corporation	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	Chicago
S5715	HIPAA Privacy Officer	Mgr Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	HIPAA Security Officer	Mgr. Medicare Oversight & Ops	Ms.	Robinson	Patrice		6306316683					Patrice_Robinson@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Hospice Contact	Govt Prog Clinical Ops Dvisional Vice President	Ms.	Thomas-Spaulding	Felicia	S	5058162717				0000000000	Felicia_Spaulding@bcbsnm.com	Blue Cross Blue Shield of New Mexico	4411 The 25 Way NE	Albuquerque	NM	87109	02/27/2019	2026	Health Care Service Corporation	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	Chicago
S5715	Interoperability Contact	Head of DAS Platform Ops	Mr.	Padiyar	Satish		9727668983					Satish_Padiyar@bcbstx.com	1001 East Lookout Drive	Building A	Richardson	TX	75082	02/14/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Marketing Contact	Dir Government Programs Marketing	Ms.	Beasley	Rebecca		3126535521				0000000000	CMSSubmissions@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	01/10/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Medical Director	CMO Government Programs	Dr.	Ziemianin	Jennifer		3126534488				0000000000	jennifer_ziemianin@bcbsil.com	Health Care Service Corporation	300 E. Randolph	Chicago	IL	60601	09/29/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Medicare Compliance Officer	VP, Government Programs Compliance Officer	Ms.	Green	Kim	A	3126535110				3128199474	hcsc_medicare_compliance_officer@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	09/05/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Medicare Coordinator	DSVP Government Programs	Ms.	Mott	Dana		2022497214				0000000000	hcsc_medicare_ceo@hcsc.net	Health Care Service Corporation	1001 Pennsylvania NW	Washington	DC	20004	04/04/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Medicare Part D Opioid Overutilization Contact	Manager, Clinical Pharmacists	Ms.	Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	06/17/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Medication Therapy Management Contact	Director, Clinical Effectiveness and Operations	Mr.	Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/14/2025	2026	Health Care Service Corporation	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	Chicago
S5715	OffShore Subcontractor Contact	Sr. Mgr. Program Oversight	Ms.	Searcy	Alicia		3126536999					Alicia_Searcy@bcbsil.com	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Online Enrollment Center Contact (Back-up)	Associate Director - Projects	Mr.	Roberts	Dan		7035684213					Daniel.Roberts@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Online Enrollment Center Contact (Optional)	Director Program Oversight	Ms.	Lester	Roberta		5058163070					Roberta_Lester@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way N.E.	Albuquerque	NM	87109	01/10/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Online Enrollment Center Contact (Primary)	Deputy General Manager, Digital Operations	Mr.	Davis	Tom		5703449237	73545			0000000000	Thomas.Davis@cognizant.com	Cognizant	25 Lakeview Drive	Jessup	PA	18434	01/04/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Appeals	Regulatory Pharmacist Sr	Mr	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	Health Care Service Corporation	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Chicago
S5715	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	Health Care Service Corporation	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Chicago
S5715	Part D Application Contact	Manager, Medicare Product Development	Ms	Bradley	Kelly		9727665146				0000000000	Kelly_Bradley@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	12/22/2021	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Benefits Contact	Senior Director, Benefit Operations	Ms	Icaza	Ashley		5073018360				0000000000	ashley.icaza@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	12/11/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Claims Submission Contact	Health Data Analyst Sr	Mr	Brooke	Lance		4026862603				0000000000	LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Drive	Eagan	MN	55122	09/19/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Exceptions Contact	Regulatory Pharmacist Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	09/22/2025	2026	Health Care Service Corporation	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Chicago
S5715	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist Sr		Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	09/19/2024	2026	Health Care Service Corporation	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Chicago
S5715	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699				0000000000	emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Price File Contact (Optional)	Business Solution Analyst Sr.	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	01/12/2023	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Price File Contact (Primary)	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Quality Assurance Contact	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Part D Reporting Contact	Unit Mgr Analytics & Reporting	Ms.	Fagaragan	Irine		3126539638				0000000000	Irine_Fagaragan@bcbsil.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Patient Safety Contact	Clinical Program Pharmacist Prin	Ms.	Leland	Ann		6127775221				0000000000	ALeland@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/27/2019	2026	Health Care Service Corporation	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	Chicago
S5715	Payment Contact	President Government Markets	Mr.	Harris	Stephen		3135980596				0000000000	stephen_harris@hcsc.net	Health Care Service Corporation	300 East Randolph Street	Chicago	IL	60601	03/19/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Personal Health Record Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505					kris_floyd@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive Richardson	Richardson	TX	75082	09/26/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Pharmacy Director	Director Pharmacy Medicare	Mr.	El-Emawy	Mahmoud		5058162913					Mahmoud_El-emawy@bcbsnm.com	Health Care Service Corporation	4411 The 25 Way NE	Albuquerque	NM	87109	01/06/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Pharmacy Network Management Contact	VP, Network Management	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2023	2026	Health Care Service Corporation	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	Chicago
S5715	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55122	03/12/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Pharmacy Technical Help Desk Contact	Director, Member Services	Mr.	Schultz	Bret						0000000000	bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2026	Health Care Service Corporation	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	8006936704				Medicare Prescription Drug Plan		5	Chicago
S5715	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Bunch	Jonathon						0000000000	jonathon.bunch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/22/2022	2026	Health Care Service Corporation	PDP	Blue Cross and Blue Shield of IL, NM, OK, TX	Medicare Prescription Drug Plan		Health Care Service Corporation	110	Yes	Active	0000000000				Medicare Prescription Drug Plan		5	Chicago
S5715	Plan Directory Contact for Public Website			Service	Customer		8778956448				0000000000	MedicareContractsOffice@bcbstx.com	P.O. Box 4109		Scranton	PA	18505	09/21/2018	2026	Health Care Service Corporation	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	Chicago
S5715	Plan to Plan Reconciliation Contact	Accountant	Ms.	Bowen	Niaya		9727661642					niaya_bowen@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/29/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/04/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Reconciliation Contact	Sr. Managing Actuary	Mr.	Lowe	Stephen		3126532067				0000000000	Stephen_Lowe@bcbstx.com	Health Care Service Corporation	300 E. Randolph Street	Chicago	IL	60601	08/06/2024	2026	Health Care Service Corporation	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	Chicago
S5715	Reconciliation Contact (Secondary)	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				0000000000	Mark_Larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	01/06/2022	2026	Health Care Service Corporation	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	Chicago
S5715	Recovery Audit Contact	Dir Medicaid Programs	Ms.	Fowler	Rosemary		9727665428					rosemary_fowler@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/29/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Surveillance Contact	Dir Telesales & Digital	Ms.	Howe	Kimberly		3126534590					howek@bcbsil.com	Health Care Service Corporation	300 East Randolph Street Chicago	Chicago	IL	60601	09/26/2025	2026	Health Care Service Corporation	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	Chicago
S5715	System Contact	Exec Dir Technology Delivery	Ms.	Floyd	Kris		8606554505				0000000000	kris_floyd@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive	Richardson	TX	75082	09/26/2025	2026	Health Care Service Corporation	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	Chicago
S5715	Third Party Administrator (TPA) Liaison	Director HMO Financial Reporting	Mr.	Larson	Mark		9727664350				9727664360	mark_larson@bcbstx.com	Health Care Service Corporation	1001 East Lookout Drive, Building A	Richardson	TX	75082	03/25/2019	2026	Health Care Service Corporation	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	Chicago
S5715	User Access Contact	Sr. Business Consultant	Ms.	Perry-Barker	Chandra		9727662120				0000000000	Chandra_Perry-barker@bcbstx.com	Health Care Service Corporation	1001 E. Lookout Drive	Richardson	TX	75082	12/21/2021	2026	Health Care Service Corporation	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	Chicago
S5726	Agent/Broker Compensation Data Contact	AVP Government Programs		Nolte	Erin		7852916589					erin.nolte@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Automated TrOOP Balance Transfer Contact	Director PBM Operations		Cain	Christina		6127771330					EOBP2P@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Backup User Access Contact	Compliance Analyst		Temple	Candi		7852916305					candi.temple@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	07/30/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Best Available Evidence Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Bid Audit Contact	Compliance Manager		Reeves	Johnathan		7852916811					jason.oller@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	07/13/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Bid Audit Site Contact	Compliance Manager		Reeves	Johnathan		7852916811					Johnathan.reeves@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Bid Primary Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	CAP Report Contact for Public Website	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	CEO - CMS Administrator Contact	President and CEO	Mr.	All	Matthew	D	7852917631					matt.all@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	01/04/2021	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	CEO - Senior Official for Contracting	President and CEO	Mr.	All	Matthew	D	7852917631				7852918997	matt.all@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	01/04/2021	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Chief Financial Officer	Chief Financial Officer	Mr.	Bergman	Jeff		7852917263					jeff.bergman@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/01/2022	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Chief Operating Officer		Mrs.	Graves	Holly		7852917953					holly.graves@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	09/26/2023	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Chief Information Officer	VP Information Teachnology/CIO	Mr	Langdon	Matt		7852918426					matt.langdon@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	02/28/2020	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Chief Information Security Officer	Chief Information Security Officer	Mr	Pourmirza	Payam		7852918198					payam.pourmirza@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	CMS Casework Communication Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Complaints Tracking Contact	Supervisor CSC		Wisdom	Raven		7852914144					raven.wisdom@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	09/02/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Contact for Fraud Investigations	Manager Special Investigations Unit		Zimmerman	Tina		7852917693					tina.zimmerman@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	11/16/2020	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Coordination of Benefits Contact	Manager PBM Operations		Cain	Christina		6127771330					COBmedd@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/31/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Corporate Mailing						7852916589					erin.nolte@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/31/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Customer Service Operations Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	DIR Contact	Staff Accountant		Smith	Jennifer		7852917991					Jennifer.Smith@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	05/14/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	DIR Contact (Secondary)	Manager Financial Accounting		Wright	Stephanie		7852917404					stephanie.wright@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	04/28/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Discount Program Payment Contact	Supervisor, Cost Accounting		Smith	Jennifer		7852917991					jennifer.smith@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	07/14/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Emergency Part D Contact	Compliance Officer		Reeves	Johnathan		7852916305					johnathan.reeves@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	06/23/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Emergency Part D Contact (Secondary)	Compliance Analyst		Temple	Candi		7852916811					Compliance@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	06/23/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Employer Waiver Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Enrollment Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	EOB Transfer Contact	Director PBM Operations		Cain	Christina		6127771330				6127771330	COBmedd@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Financial Audit Contact	AVP Finance Strategy and Operation	Ms.	Okunoren	Margaret		7852917792					margaret.okunoren@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	10/07/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Financial Reporting Contact	Chief Financial Officer		Bergman	Jeff		7852917263				7852918465	jeff.bergman@bcbsks.com	1133 SW Topeka Blvd		Topeka	KS	666290001	06/01/2022	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Formulary Contact	Pharmacist		Trinh	Chau		7852918569					chau.trinh@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/31/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		7272077384					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	General Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Government Relations Contact	AVP Government Programs		Nolte	Erin		7852916589					erin.nolte@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	HIPAA Privacy Officer	Privacy Officer		Hoopes	Lisa		7852916940					lisa.hoopes@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	HIPAA Security Officer	Chief Information Security Officer	Mr.	Pourmirza	Payam		7852918198					payam.pourmirza@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Hospice Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Interoperability Contact	Manager Information Security		Carver	Brian		7852918148					brian.carver@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Marketing Contact	Manager Strategic Marketing		Thimmesch	Madi		7852917119					madi.thimmesch@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	05/23/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Medical Director	Medical Director	Dr	Broomes	Stephen		7852917947					stephen.broomes@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	11/07/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Medicare Compliance Officer	Compliance Officer	Mr.	Reeves	Johnathan		7852916305				7852900701	johnathan.reeves@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	07/13/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Medicare Coordinator	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Medicare Part D Opioid Overutilization Contact	Pharmacist		Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/31/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Medication Therapy Management Contact	Manager MTM Care Management	Mr.	Helbling	Matthew		8666862223					MTM.leadership@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55120	05/29/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	OffShore Subcontractor Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Online Enrollment Center Contact (Back-up)	AVP Government Programs		Nolte	Erin		7852916589					erin.nolte@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Online Enrollment Center Contact (Optional)	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Online Enrollment Center Contact (Primary)	AVP Government Programs		Nolte	Erin		7852916589					erin.nolte@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Appeals	Director Regulatory and Audit Response		Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road	Mailstop OH0205-A537	Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	8006936703				Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	8006936703				Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Application Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Benefits Contact	Manager PBM Operations		McCambridge	Danielle		6127772978					danielle.mccambridge@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Claims Submission Contact	Consultant Government Programs		Brooke	Lance		4026862603					lbrooke@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Exceptions Contact	Director Regulatory and Audit Response		Davis	Megan							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	8006936703				Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly							clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	8006936703				Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Price File Contact (Back-up)	File Price Analyst		Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Price File Contact (Optional)	QA Analyst		Ly	Martin		6127776931					martin.ly@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Price File Contact (Primary)	Pharmacist		Trinh	Chau		7852918569					chau.trinh@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Quality Assurance Contact	Pharmacist		Trinh	Chau		7852918569					chau.trinh@bcbsks.com	1133 SW Topeka Blvd.		Topeka	KS	666290001	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Part D Reporting Contact	Pharmacist		Trinh	Chau		7852918569					chau.trinh@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Patient Safety Contact	Senior Director		Puckett	Reese		6127775037					rpuckett@primetherapeutics.com	8400 Normandale Lake Blvd		Bloomington	MN	55437	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Payment Contact	Manager Financial Accounting		Wright	Stephanie		7852917404					stephanie.wright@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	04/28/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Pharmacy Director	Chief Pharmacist		Liesmann	Tiffany		7852918296					tiffany.liesmann@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Pharmacy Network Management Contact	AVP Network Management		Conlin	Marci		6127772837					mconlin@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Pharmacy Network Management Contact (Secondary)	Sr Director Network Management		Hanley	Megan		6127773969					megan.hanley@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Pharmacy Technical Help Desk Contact	Director Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	8663255231				Medicare Prescription Drug Plan		5	Chicago
S5726	Pharmacy Technical Help Desk Contact (Secondary)	Director Member Services		Bunch	Jonathon							jonathon.bunch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active	8663255231				Medicare Prescription Drug Plan		5	Chicago
S5726	PHR Beneficiary Contact																	07/28/2009	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan	Blue Cross Blue Shield of Kansas	Blue Cross Blue Shield of Kansas	310	Yes	Active	8667552776				Medicare Prescription Drug Plan		5	Chicago
S5726	Plan Directory Contact for Public Website	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Plan to Plan Reconciliation Contact	Supervisor Cost Accounting		Smith	Jennifer		7852917991					jennifer.smith@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/16/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Processor Contact	Director Government Programs		Allie	Cindy		6127776722					medicareclaimresearch@primetherapeutics.com	1133 Topeka Blvd		Eagan	MN	55121	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Reconciliation Contact	Supervisor Cost Accounting		Smith	Jennifer		7852917991					jennifer.smith@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/16/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Reconciliation Contact (Secondary)	Manager Financial Accounting		Wright	Stephanie		7852917404					stephanie.wright@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	04/28/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Recovery Audit Contact	Compliance Manager	Mr	Reeves	Johnathan		7852917855					johnatha.reeves@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/17/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Surveillance Contact	Manager Government Programs	Mr	Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	System Contact	Manager Government Programs		Gilmer-Gentry	Janice		7852918592					janice.gilmer-gentry@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	12/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	Third Party Administrator (TPA) Liaison	Manager Financial Accounting	Mr	Wright	Stephanie		7852917404					stephanie.wright@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	04/28/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5726	User Access Contact	Compliance Officer		Reeves	Johnathan		7852916305					johnathan.reeves@bcbsks.com	1133 Topeka Blvd		Topeka	KS	66629	06/23/2025	2026	BLUE CROSS AND BLUE SHIELD OF KANSAS	PDP	Blue Cross and Blue Shield of Kansas	Medicare Prescription Drug Plan		Blue Cross Blue Shield of Kansas	310	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5743	Agent/Broker Compensation Data Contact			Happe	Paul		6516621234					paul.happe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	11/24/2020	2026	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	Chicago
S5743	Automated TrOOP Balance Transfer Contact			Pharmacy Operations	ClearStone		6516627412					clearstone.pharmacy.operations@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	Backup User Access Contact			Nordwall	Darlene		6516628745					darlene.nordwall@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/30/2024	2026	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	Chicago
S5743	Best Available Evidence Contact	Director of Enrollment and Billing		Seidlik	Thomas		8776548810					CST-enrollment@ramtechinc.com	PO Box 31049		Tampa	FL	336313049	09/04/2025	2026	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	Chicago
S5743	Bid Audit Contact	Part D Managing Actuary		Santa	Tyler		6516628362					tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/01/2023	2026	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	Chicago
S5743	Bid Audit Site Contact	Part D Managing Actuary		Santa	Tyler		6516628362					tyler.santa@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/01/2023	2026	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	Chicago
S5743	Bid Primary Contact	HealthCare Analyst Pr, Actuarial		Kieffer	Ryan		6516624405					ryan.kieffer@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	CAP Report Contact for Public Website	Compliance Officer		Happe	Paul		6516621234				6516620648	paul.happe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	CEO - CMS Administrator Contact	CMS Administrator Contact	Ms	Mitchell	Angela		6516623607					Angela.Mitchell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	05/30/2024	2026	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	Chicago
S5743	CEO - Senior Official for Contracting	Senior Official for Contracting	Ms	Mitchell	Angela		6516623607					Angela.Mitchell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	05/30/2024	2026	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	Chicago
S5743	Chief Financial Officer		Ms	Ferlita	Carrie		6516629037					carrie.ferlita@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Chief Operating Officer	Chief Operating Officer	Ms	Mitchell	Angela		6516623607					Angela.Mitchell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/07/2024	2026	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	Chicago
S5743	Chief Information Officer		Ms	Her	Doua		6516628300					Doua.Her@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/04/2024	2026	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	Chicago
S5743	Chief Information Security Officer		Ms	Her	Doua		6516628300					Doua.Her@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/07/2024	2026	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	Chicago
S5743	CMS Casework Communication Contact	Senior Business Analyst		Blake	Tracy		6516623509					tracy.blake@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/22/2023	2026	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	Chicago
S5743	Complaints Tracking Contact	Senior Business Analyst		Blake	Tracy		6516623509					tracy.blake@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/22/2023	2026	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	Chicago
S5743	Contact for Fraud Investigations	Compliance Director		Hogan	Carrie		6516621900					carrie.hogan@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Coordination of Benefits Contact	Enrollment Manager		Williams	Julie		6516621736					julie.williams@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	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	Chicago
S5743	Corporate Mailing						6516623607					angela.mitchell@clearstonesolutions.com	Blue Cross Blue Shield Northern Plains Alliance	3400 Yankee Drive	Eagan	MN	55121	06/04/2024	2026	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	Chicago
S5743	Customer Service Operations Contact	Customer Service & Grievances Manager		Vang	Vanessa		6516627154					vanessa.vang@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/22/2023	2026	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	Chicago
S5743	DIR Contact			Voves	Alex		6516623606					alex.voves@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	DIR Contact (Secondary)			Kieffer	Ryan		6516624405					ryan.kieffer@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	04/15/2024	2026	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	Chicago
S5743	Discount Program Payment Contact			Voves	Alex		6516623606					Alex.Voves@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	Emergency Part D Contact	Director Pharmacy Operations Support		Ibrahim	Sonya		6516627412					sonya.ibrahim@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/02/2025	2026	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	Chicago
S5743	Emergency Part D Contact (Secondary)	Senior Director PBM Vendor Management		Mitchell	Angela		6516623607					Angela.Mitchell@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/02/2025	2026	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	Chicago
S5743	Enrollment Contact	Enrollment Manager		Williams	Julie		6516621736					julie.williams@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/22/2023	2026	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	Chicago
S5743	EOB Transfer Contact			Schmeling	Amy		6516624919				6516623500	Amy.Schmeling@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Financial Audit Contact	Compliance Manager	Miss	Kraus	Kathleen	M	6516621878					kathleen.kraus@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Financial Reporting Contact	Principal Financial Analyst		Harrelson	Michael		6516628490					michael.harrelson@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	Formulary Contact			Pharmacy Operations	ClearStone		6516627412					clearstone.pharmacy.operations@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/27/2022	2026	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	Chicago
S5743	Formulary Contact (Secondary)	Director, Pharmacy Operations		Mitchell	Angela		6516623607					Angela.Mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	General Contact			Mitchell	Angela		6516623607					angela.mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/04/2024	2026	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	Chicago
S5743	Government Relations Contact			Mitchell	Angela		6516623607					angela.mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/04/2024	2026	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	Chicago
S5743	HIPAA Privacy Officer	Compliance Officer		Happe	Paul		6516621234					paul.happe@bluecrossmn.com	Blue Cross Blue Shield Northern Plains Alliance	3400 Yankee Drive	Eagan	MN	55121	09/19/2023	2026	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	Chicago
S5743	HIPAA Security Officer	Compliance Officer		Happe	Paul		6516621234					paul.happe@bluecrossmn.com	Blue Cross Blue Shield Northern Plains Alliance	3400 Yankee Drive	Eagan	MN	55121	09/19/2023	2026	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	Chicago
S5743	Hospice Contact			Schmeling	Amy		6516624919				6516623500	Amy.Schmeling@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Interoperability Contact			Her	Doua		6516628300					Doua.Her@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/04/2024	2026	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	Chicago
S5743	Marketing Contact	Compliance Manager - Government Markets		Danisch	Gary		6516622072					Medicare.Materials@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	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	Chicago
S5743	Medical Director	Senior Medical Director	Dr.	Fendrich	Amy		6516620584					amy.fendrich@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/16/2023	2026	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	Chicago
S5743	Medicare Compliance Officer	Compliance Officer	Mr	Happe	Paul	M	6516621234					paul.happe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	03/01/2022	2026	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	Chicago
S5743	Medicare Coordinator			Mitchell	Angela		6516623607					Angela.Mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Medicare Part D Opioid Overutilization Contact	Supv Pharmacist		Anderson	Ally		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics	2900 Ames Crossing Rd	Eagan	MN	55121	12/15/2022	2026	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	Chicago
S5743	Medication Therapy Management Contact			Pharmacy Operations	ClearStone		6516627412					clearstone.pharmacy.operations@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	07/27/2022	2026	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	Chicago
S5743	Online Enrollment Center Contact (Back-up)	Enrollment Manager		Sawka	Julie		8776548810					CST-enrollment@ramtechinc.com	PO Box 31049		Tampa	FL	336313049	09/04/2025	2026	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	Chicago
S5743	Online Enrollment Center Contact (Optional)			Her	Doua		6516628300					Doua.Her@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	10/07/2024	2026	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	Chicago
S5743	Online Enrollment Center Contact (Primary)	Director of Enrollment and Billing		Siedlik	Thomas		8776548810					CST-enrollment@ramtechinc.com	PO Box 31049		Tampa	FL	336313049	10/07/2024	2026	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	Chicago
S5743	Part D Appeals			Ibrahim	Sonya							sonya.ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	6516627412				Medicare Prescription Drug Plan		5	Chicago
S5743	Part D Appeals Contact (Secondary)			Aschoff	Ted							theodore.aschoff@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	6516628777				Medicare Prescription Drug Plan		5	Chicago
S5743	Part D Application Contact			Ferlita	Carrie		6516629037					carrie.ferlita@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Part D Benefits Contact			Mitchell	Angela		6516623607					Angela.Mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Part D Claims Submission Contact	Functional Business Consultant		Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/16/2022	2026	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	Chicago
S5743	Part D Exceptions Contact			Ibrahim	Sonya							sonya.ibrahim@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	6516627412				Medicare Prescription Drug Plan		5	Chicago
S5743	Part D Exceptions Contact (Secondary)	Sr Pharmacy Analyst		Aschoff	Ted							theodore.aschoff@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	04/17/2025	2026	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	6516628777				Medicare Prescription Drug Plan		5	Chicago
S5743	Part D Price File Contact (Back-up)	Sr Pharmacy Analyst		Aschoff	Ted		6516628777					theodore.aschoff@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	Part D Price File Contact (Primary)			Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/16/2022	2026	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	Chicago
S5743	Part D Quality Assurance Contact			Mitchell	Angela		6516623607					Angela.Mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Part D Reporting Contact	Sr Pharmacy Analyst		Aschoff	Ted		6516628777					theodore.aschoff@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	Patient Safety Contact	Senior Medical Director	Dr.	Fendrich	Amy		6516620584					amy.fendrich@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	02/16/2023	2026	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	Chicago
S5743	Payment Contact	Principal Financial Analyst		Harrelson	Michael		6516628490					michael.harrelson@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	09/19/2023	2026	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	Chicago
S5743	Pharmacy Director			Mitchell	Angela		6516623607					Angela.Mitchell@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Pharmacy Network Management Contact	VP, Network Management		Conlin	Marci		6127772842				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/16/2022	2026	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	Chicago
S5743	Pharmacy Network Management Contact (Secondary)	Sr Dir, Network Client Services		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	12/16/2022	2026	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	Chicago
S5743	Pharmacy Technical Help Desk Contact	Senior Business Analyst		Lopez Diaz	David							david.lopezdiaz@bluecrossmn.com	2900 Ames Crossing Rd, Suite 200		Eagan	MN	55121	04/30/2024	2026	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	8662185002				Medicare Prescription Drug Plan		5	Chicago
S5743	Pharmacy Technical Help Desk Contact (Secondary)	Customer Service & Grievances Manager		Vang	Vanessa							vanessa.vang@bluecrossmn.com	2900 Ames Crossing Rd, Suite 200		Eagan	MN	55121	04/30/2024	2026	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	8662185002				Medicare Prescription Drug Plan		5	Chicago
S5743	Plan Directory Contact for Public Website			Service	Customer		8888320075					CST-enrollment@ramtechinc.com	MedicareBlue Rx Customer Service	PO Box 31049	Tampa	FL	336313049	10/07/2024	2026	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	Chicago
S5743	Plan to Plan Reconciliation Contact			Voves	Alex		6516623606					Alex.Voves@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	Processor Contact	Director, PBM Operations		Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/16/2022	2026	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	Chicago
S5743	Reconciliation Contact			Kieffer	Ryan		6516624405					ryan.kieffer@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	04/15/2024	2026	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	Chicago
S5743	Reconciliation Contact (Secondary)			Voves	Alex		6516623606					Alex.Voves@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	Recovery Audit Contact	Compliance Officer	Mr	Happe	Paul		6516621234					paul.happe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	12/06/2021	2026	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	Chicago
S5743	Surveillance Contact	Compliance Officer		Happe	Paul		6516621234					paul.happe@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	06/04/2024	2026	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	Chicago
S5743	System Contact			Her	Doua		6516628300					Doua.Her@bluecrossmn.com	3400 Yankee Drive		Eagan	MN	55121	01/04/2024	2026	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	Chicago
S5743	Third Party Administrator (TPA) Liaison			Voves	Alex		6516623606					alex.voves@clearstonesolutions.com	3400 Yankee Drive		Eagan	MN	55121	06/23/2023	2026	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	Chicago
S5743	User Access Contact	Compliance Manager		Danisch	Gary		6516622072					gary.danisch@bluecrossmn.com.com	3400 Yankee Drive		Eagan	MN	55121	08/19/2025	2026	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	Chicago
S5795	Agent/Broker Compensation Data Contact	Manager, Individual Sales Agent		Creasman	Matthew		5013993923					mdcreasman@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	06/12/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Automated TrOOP Balance Transfer Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Backup User Access Contact	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Best Available Evidence Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Bid Audit Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Bid Audit Site Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Bid Primary Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	CAP Report Contact for Public Website	Medicare Compliance Manager		Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	CEO - CMS Administrator Contact	VP Government Programs & Enterprise Analytics	Mr.	Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	12/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	CEO - Senior Official for Contracting	CEO	Mr.	Barnett	Curtis		5013782007					cebarnett@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	05/20/2021	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Chief Financial Officer	CFO	Mr.	Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Chief Operating Officer	Executive VP, Chief Operating Officer	Mr.	Dillard	Gray		5013782436					gddillard@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Chief Information Officer	VP Infrastructure & Operations	Mr.	Martin	David		5012940910					dbmartin@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/16/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Chief Information Security Officer	Chief Security Officer	Mr.	Shirley	Devin		5016880747					dmshirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	CMS Casework Communication Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Complaints Tracking Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Contact for Fraud Investigations	Director, Performance Mgt. & Investigations		Gunter	Debbie		5013786610					dsgunter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/13/2017	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Coordination of Benefits Contact	Manager, MedD Financial Operations		Davis	Brittany		4805364772					Brittany.Davis@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	07/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Corporate Mailing						5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Customer Service Operations Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	DIR Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	12/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	DIR Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Discount Program Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Emergency Part D Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Emergency Part D Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/03/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Enrollment Contact	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	EOB Transfer Contact	Account Manager		Ellinger	David		4802408415				4803146066	David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Financial Audit Contact	Medicare Compliance Manager	Mr.	Kirsch	Nick		5013409589					nkirsch@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	03/27/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Financial Reporting Contact	Director, Financial Reporting & Payroll		Russell	Holly		5013993954					hkrussell@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Formulary Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Formulary Contact (Secondary)	Clinical Advisor		Seto	Kim		6193460146					Kim.Seto@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/01/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	General Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Government Relations Contact	Sr Counsel Gov't Relation		Fenton	Janie		5013782103					jwfenton@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	01/28/2019	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	HIPAA Privacy Officer	Chief Privacy Officer		Gardner	Anne		5013932994					aegardner@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	HIPAA Security Officer	Physical Security/Chief Security Officer		Shirley	Devin		5016880747					DMShirley@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/11/2023	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Hospice Contact	Supervisor, Medicare Member Services		Taylor	Alicia		5013783743					aataylor@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/18/2021	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Interoperability Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Marketing Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Medical Director	Associate Medical Director	Dr.	Becker	Thomas		5013964196					tebecker@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/10/2020	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Medicare Compliance Officer	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/05/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Medicare Coordinator	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Medicare Part D Opioid Overutilization Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Medication Therapy Management Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	OffShore Subcontractor Contact	Director, Medicare Operations		Bradford	Wanda		5013782387					wlbradford@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	02/20/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Online Enrollment Center Contact (Back-up)	Supervisor, Medicare Operations		Kaiser	Ashley		5012941625					aekaiser@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/01/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Part D Appeals	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	4802408415				Medicare Prescription Drug Plan		5	New York
S5795	Part D Appeals Contact (Secondary)	Senior Counsel, Appeals		Phillips	Ashleigh						5013783366	adphillips@arkbluecross.com	PO Box 2181	Attn: Legal Appeals	Little Rock	AR	72203	01/11/2021	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	5013782025				Medicare Prescription Drug Plan		5	New York
S5795	Part D Application Contact	Manager Medicare Advantage Product Development		Pepper	Chad		5012941697	25635				wcpepper@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Part D Benefits Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Part D Claims Submission Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Part D Exceptions Contact	Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	4802408415				Medicare Prescription Drug Plan		5	New York
S5795	Part D Exceptions Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza							mbegovic@arkbluecross.com	601 S Gaines St.		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	5013932813				Medicare Prescription Drug Plan		5	New York
S5795	Part D Price File Contact (Back-up)	Manager, Medicare Operations		Sherer	Michael		5013783641					mcsherer@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Part D Price File Contact (Primary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Part D Quality Assurance Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Part D Reporting Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Patient Safety Contact	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Payment Contact	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Pharmacy Director	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Pharmacy Network Management Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Pharmacy Network Management Contact (Secondary)	Manager Medicare Pharmacy Operations		Begovic	Mirza		5013932813					mbegovic@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	11/17/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Pharmacy Technical Help Desk Contact			Customer Service	CVS								9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	10/10/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	8442805833				Medicare Prescription Drug Plan		5	New York
S5795	Pharmacy Technical Help Desk Contact (Secondary)	CVS Account Manager		Ellinger	David							David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active	4802408415				Medicare Prescription Drug Plan		5	New York
S5795	Plan Directory Contact for Public Website			Service	Customer		8442014934					MediPakAdvRx@arkbluecross.com	P O Box 3648		Little Rock	AR	72203	11/10/2020	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Plan to Plan Reconciliation Contact	Financial Analyst		Holt	Susan		5012942491				5013783258	sbholt@arkbluecross.com	P O Box 8084		Little Rock	AR	72203	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Processor Contact	Account Manager		Ellinger	David		4802408415					David.Ellinger@CVSHealth.com	9501 E Shea Blvd MC 121		Scottsdale	AZ	85260	05/21/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Reconciliation Contact	VP Government Programs & Enterprise Analytics		Vannatta	Matthew		5012944570					MDVANNATTA@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	12/18/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Reconciliation Contact (Secondary)	CFO		Winter	Scott		5013993951					sbwinter@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	07/18/2019	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Recovery Audit Contact	Financial Analyst	Ms.	Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Surveillance Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	System Contact	Lead Executive Medicare Products		Vermeulen	Chris		5012945872					cnvermeulen@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	10/15/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	Third Party Administrator (TPA) Liaison	Financial Analyst		Holt	Susan		5012942491					sbholt@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	09/05/2024	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5795	User Access Contact	Lead Executive Corporate Compliance	Mr.	Wilson	Thomas		9046698710					twilson@arkbluecross.com	601 Gaines Street		Little Rock	AR	72201	08/06/2025	2026	USABLE MUTUAL INSURANCE COMPANY	PDP	Arkansas Blue Medicare	Medicare Prescription Drug Plan		USAble Mutual Insurance Company	421	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5805	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Medicare Prescription Drug Plan		5	Boston
S5805	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Medicare Prescription Drug Plan		5	Boston
S5805	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Medicare Prescription Drug Plan		5	Boston
S5805	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Medicare Prescription Drug Plan		5	Boston
S5805	Plan Directory Contact for Public Website			Customer Service	UHC		8888675575					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5805	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Medicare Prescription Drug Plan		5	Boston
S5820	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Medicare Prescription Drug Plan		5	Boston
S5820	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Medicare Prescription Drug Plan		5	Boston
S5820	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Medicare Prescription Drug Plan		5	Boston
S5820	Plan Directory Contact for Public Website			Customer Service	UHC		8888675575					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5820	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INSURANCE COMPANY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S5857	Agent/Broker Compensation Data Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Automated TrOOP Balance Transfer Contact	Enrollment Coordinator		Rice	Lori		6164648667					PH-MedicareTrOOPContact@PriorityHealth.com	1231 East Beltline Ave NE	MS 1175	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Backup User Access Contact	Medicare Compliance Officer Director	Mrs	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Best Available Evidence Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Bid Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Bid Audit Site Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Bid Primary Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	CAP Report Contact for Public Website	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164862519					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	6164643510				Medicare Prescription Drug Plan		5	Seattle
S5857	CEO - CMS Administrator Contact	President and Chief Health Plan Officer	Mr	Gates	Nick		6164648144					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	CEO - Senior Official for Contracting	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Chief Financial Officer	Senior Vice President, Finance	Mrs.	McIntyre	Celeste		6167745142					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/20/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Chief Operating Officer	SVP, Government/Consumer Markets	Mrs.	Kincaid	Carrie		6164648969					phcompliance@priorityhealth.com	1231 East Beltine NE		Grand Rapids	MI	49525	02/10/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Chief Information Officer	Chief Information Officer	Mr	Crook	Chris		6164649939					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Chief Information Security Officer	SVP, IS Technology Services	Mr	Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE	MC 843	Grand Rapids	MI	49503	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	CMMI Model Point of Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	CMS Casework Communication Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Complaints Tracking Contact	Manager for Business Monitoring - G & A		LaBelle	Julie		9178417869					Radha.LaBelle@priorityhealth.com	1231 East Beltline Ave NE	MS 1115	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Contact for Fraud Investigations	Manager, Special Investigations Unit		Gross	Brenda		6164648152					Brenda.Gross@PriorityHealth.com	1231 E Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Coordination of Benefits Contact	Claims Manager		Ball	Jill		8883896648					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Corporate Mailing						6169420954				6164640145	PH-DistributionSE@PriorityHealth.com	1231 East Beltline Ave, NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Customer Service Operations Contact	Customer Care Center Manager, Medicare		Storment	Joe		5033309550					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	DIR Contact	Senior Accountant		Savic	Stephanie	M	6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	DIR Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel	K	6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	01/27/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Discount Program Payment Contact	Senior Accountant		Savic	Stephanie	M	6163912149					stephanie.savic@corewellhealth.org	100 Corewell Dr NW	Suite A506	Grand Rapids	MI	49525	06/18/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Emergency Part D Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Emergency Part D Contact (Secondary)	Manager, Medicare Pharmacy Operations		VanLoenen	Amanda		6164648750					Amanda.VanLoenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Employer Waiver Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Enrollment Contact	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	EOB Transfer Contact	Claims Manager		Ball	Jill		6164648044				6169750247	phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 2205	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Financial Audit Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Financial Reporting Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Formulary Contact	Medicare Part D Operations Manager		Van Loenen	Amanda		6164648750					PH-MedicareFormularyContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	General Contact	VP, Consumer Markets, Marketing & Ops	Mrs.	King	Kyla		6164641443					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	03/18/2025	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Government Relations Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	HIPAA Privacy Officer	VP, Compliance & Privacy Officer		Rollenhagen	Cindy		6164648424					phcompliance@priorityhealth.com	1231 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	HIPAA Security Officer			Dresen	Scott		6164864277					phcompliance@priorityhealth.com	100 Michigan Street NE		Grand Rapids	MI	49503	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Hospice Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Interoperability Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Marketing Contact	Sr. Markets & Product Development Director		Brown	Samia		6164648002					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Medical Director	SVP, Chief Medical Officer		Oker	Elif		6164643510					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Medicare Compliance Officer	Medicare Compliance Officer Director	Mrs	DeHaan	Heather	L	6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Medicare Coordinator	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Medicare Part D Opioid Overutilization Contact	Medicare Quality Manager		Gutierrez	Salvador		6165757622					salvador.gutierrez@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Medication Therapy Management Contact	Director of Pharmacy Operations		Chaffee	Jacob		6168261329					jacob.chaffee@priorityhealth.com	1231 East Beltline Dr Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	OffShore Subcontractor Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Online Enrollment Center Contact (Optional)	Government Programs Enrollment Coordinator		Rice	Lori		6164648667					lori.rice@priorityhealth.com	1231 East Beltline Ave NE	MS 1180	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment		Thomas	Sabrina		6164648578					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Appeals	Supervisor, Medicare Part D Appeals		Anderson	Melissa							PHMedicarePartDAPPLS@spectrumhealth.org	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	6164648547				Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Appeals Contact (Secondary)	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather							phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	6164643510				Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Application Contact	Product Development Director	Mrs.	Bishop	Janine		6163185715					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Benefits Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Claims Submission Contact	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Exceptions Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	8004666642				Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Exceptions Contact (Secondary)	Mgr, Medicare Part D Operations	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	6164648750				Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Price File Contact (Back-up)	Product Manager Advisor		Williams	Stephanie		5135091549					Medicarewebsitefiles@express-scripts.com	4865 Dixie Hwy		Fairfield	OH	45014	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Price File Contact (Optional)	Manager, Medicare Part D Operations		Van Loenen	Amanda		6164648750					part.d.ops@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Price File Contact (Primary)	Sr. Manager, Government Programs		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Quality Assurance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Part D Reporting Contact	Sr. Compliance Analyst		Eizinger	Eric		2178400871					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Patient Safety Contact	Clinical Pharmacy Program Manager	Mr	Chaffee	Jacob		6165756149					phcompliance@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	11/29/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Payment Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Personal Health Record Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Pharmacy Director	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Pharmacy Network Management Contact	Director Pharmacy Operations		Chaffee	Jacob		6165756149					jacob.chaffee@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Pharmacy Network Management Contact (Secondary)	Manager, Medicare Pharmacy Operations		Van Loenen	Amanda		6164648750					amanda.vanloenen@priorityhealth.com	1231 E. Beltline Avenue NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Pharmacy Technical Help Desk Contact			Help Desk	Pharmacy							part.d.ops@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	8004666642				Medicare Prescription Drug Plan		5	Seattle
S5857	Pharmacy Technical Help Desk Contact (Secondary)	Mgr, Medicare Part D Ops	Ms.	Van Loenen	Amanda							amanda.vanloenen@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active	6164648750				Medicare Prescription Drug Plan		5	Seattle
S5857	Plan Directory Contact for Public Website			Service	Customer		8883896648					phcompliance@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Plan to Plan Reconciliation Contact	Business Systems Analyst		Robinson	Aminah		6168629827					aminah.robinson@priorityhealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	07/01/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Processor Contact	ESI Sr Dir - Product Management Medicare		Mahon	Snezana		3146846361					SMahon@express-scripts.com	ESI	One Express Way	St. Louis	MO	63121	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Reconciliation Contact	Manager Financial Reporting		Mcglynn	Sara		3132936466					sara.mcglynn@priorityhealth.com	1231 E. Beltline Ave Ne		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Reconciliation Contact (Secondary)	Manager, Finance Reporting		Hendricks	Rachel		6164648205					rachel.hendricks@priorityhealth.com	1231 East Beltline NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Recovery Audit Contact	Manager Cost Recovery	Ms	Gross	Brenda		6164648152					brenda.gross@priorityhealth.com	1231 East Beltline NE	Mail Stop 2305	Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Surveillance Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	System Contact	Data Analytics Analyst-Senior, Sr Markets		Johnson	Joshua		6165755760					PH-MedicareSystemsContact@PriorityHealth.com	1231 East Beltline Ave NE		Grand Rapids	MI	49525	05/17/2023	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	Third Party Administrator (TPA) Liaison	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					heather.dehaan@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5857	User Access Contact	Medicare Compliance Officer Director	Mrs.	DeHaan	Heather		6164643510					phcompliance@priorityhealth.com	1239 East Beltline Ave NE	MS 3230	Grand Rapids	MI	49525	11/07/2024	2026	PRIORITY HEALTH INSURANCE COMPANY	PDP	Priority Health Medicare	Medicare Prescription Drug Plan		Corewell Health	190	Yes	Active					Medicare Prescription Drug Plan		5	Seattle
S5877	Agent/Broker Compensation Data Contact			Lowther	Ryan		8012702963					rlowther@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Automated TrOOP Balance Transfer Contact	Director, Pharmacy and Medicare Services	Mr.	Gedge	Nathan		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Backup User Access Contact			Proctor	Roger		8012627476					rproctor@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Bid Audit Contact	Director, Pharamcy and Medicare Services	Mr.	Gedge	Nathan		8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	Bid Audit Site Contact	Director, Pharmacy and Medicare Services	Mr.	Gedge	Nathan		8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	Bid Primary Contact			Pingree	Mark		8012702938				8012699734	mpingree@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	CAP Report Contact for Public Website	Compliance Officer		Smart	Brandon		8012627476	2981				bsmart@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	CEO - CMS Administrator Contact	President CEO	Mr.	Morrison	Steve		8012627476					smorrison@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	CEO - Senior Official for Contracting	President CEO	Mr.	Morrison	Steve		8012627476				8012703075	smorrison@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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		8012627476					mgreenhalgh@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Operating Officer	COO	Mr.	Lowther	Ryan		8012702963				8012699734	rlowther@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Information Officer		Mr	Campbell	Joseph		8012702933					jcampbell@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Information Security Officer	Chief Compliance Officer	Mr.	Smart	Brandon		8012702981					bsmart@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	Complaints Tracking Contact	Director, Pharmacy and Medicare Services		Gedge	Nathan		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Contact for Fraud Investigations	Chief Compliance Officer		Smart	Brandon		8012627476	2981				bsmart@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	Corporate Mailing						8012627476					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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		7722362738					Peggy_Bloomfield@Express-Scripts.com	10045 South Federal Highway		Port St. Lucie	FL	34952	03/30/2017	2026	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	DIR Contact	Director, Pharmacy & Medicare Services		Gedge	Nathan		8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Discount Program Payment Contact	Director of Pharmacy and Medicare Services		Gedge	Nathan	D	8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Emergency Part D Contact	Director, Pharmacy and Medicare Services		Gedge	Nate		8019794107					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Enrollment Contact	Director, Pharmacy and Medicare		Gedge	Nathan	D	8012627476					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	05/18/2023	2026	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	EOB Transfer Contact	Director, Pharmacy and Medicare Services		Gedge	Nate		8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	Financial Audit Contact	Actuary	Mr.	Pingree	Mark		8012627476	2938			8012699734	mpingree@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Financial Reporting Contact			Pingree	Mark		8012627476	2938			8012699734	mpingree@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Formulary Contact	Director, Pharmacy and Medicare Services		Gedge	Nathan		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	General Contact	Director, Pharmacy and Medicare Services		Gedge	Nathan		8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	HIPAA Privacy Officer	Compliance Officer		Smart	Brandon		8012627476	2981				bsmart@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	HIPAA Security Officer	Compliance Officer		Smart	Brandon		8012627476	2981				bsmart@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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		8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Interoperability Contact			Gedge	Nathan		8012702974					ngedge@emihealth.com	5101 S COMMERCE DRIVE		Murray	UT	84107	02/28/2022	2026	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	Marketing Contact	VP Marketing		Dunnavant	Cindy		8012627476					ctovey@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Medical Director	Medical Director		Rower	Jeremy		9528375511					JARower@express-scripts.com	6625 West 78th Street		Bloomington	MN	55439	12/08/2016	2026	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		8012702981					bsmart@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Coordinator	COO	Mr.	Lowther	Ryan		8012702963					rlowther@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Part D Opioid Overutilization Contact	Director, Medicare Clincal Product Management		Blair	Kelcey		3147971473					KABlair@express-scripts.com	One Express Way		St. Louis	MO	63121	06/04/2019	2026	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	Medication Therapy Management Contact	Director, Medicare Clinical Product Management		Blair	Kelcey		3147971473					KABlair@express-scripts.com	One Express Way		St. Louis	MO	63121	03/30/2017	2026	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	Online Enrollment Center Contact (Back-up)	Director, Pharmacy and Medicare Services		Gedge	Nate		8012627476					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Online Enrollment Center Contact (Optional)			Proctor	Roger		8012627476					rproctor@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Appeals	Senior Pharmacy Manager		Schumm	Brian							Brian_Schumm@express-scriptss.com	5151 Blazer Pkwy		Dublin	OH	43017	12/08/2016	2026	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active	8003443405	733326			Medicare Prescription Drug Plan		5	Dallas
S5877	Part D Application Contact	Director, Pharmacy and Medicare Services		Gedge	Nathan		8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Benefits Contact			Gedge	Natahn	D	8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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 Claims Submission Contact	Director - Product Management		Etherton	Jim		5133163889					jbetherton@express-scripts.com	8990 Duke Drive		Mason	OH	45040	06/16/2017	2026	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	2026	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active	6143363326				Medicare Prescription Drug Plan		5	Dallas
S5877	Part D Price File Contact (Back-up)	Sr. Manager - Government Programs		Dolfi	Amanda		6147613606					amanda_dolfi@express-scripts.com	5151 Blazer Pkwy		Dublin	OH	43017	03/30/2017	2026	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 Price File Contact (Optional)	Director, Pharmacy and Medicare Services		Gedge	Nate		8012627476					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Price File Contact (Primary)	Director-Government Program		Westrum	Josh		4807363132	433132				JWestrum@express-scripts.com	7909 S Hardy Drive Suite 106		Tempe	AZ	85284	12/08/2016	2026	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 Quality Assurance Contact	Director, Pharamcy and Medicare Services		Gedge	Nathan		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Reporting Contact	Director, Pharmacy and Medicare Services		Gedge	Nathan		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Patient Safety Contact			Gedge	Nathan		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	Payment Contact	Chief Financial Officer		Greenhalgh	Mike		8012627476					mgreenhalgh@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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 Director	Director, Pharamcy and Medicare Services		Gedge	Nate		8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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 Network Management Contact	Network Account Director, Retail Strategy & Contra		Kelly	Heather		3146921866					hakelly@express-scripts.com	One Express Way		St. Louis	MO	63121	03/30/2017	2026	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	2026	EDUCATORS MUTUAL INSURANCE ASSOCIATION	PDP	EMI Health	Medicare Prescription Drug Plan		Educators Mutual Insurance Association	79	Yes	Active	8009221557				Medicare Prescription Drug Plan		5	Dallas
S5877	Plan Directory Contact for Public Website	Director, Pharmacy and Medicare Services	Mr.	Gedge	Nathan	D	8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/04/2019	2026	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	Plan to Plan Reconciliation Contact			Clark	Anthony		8012627476	2965				aclark@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Processor Contact	Senior Director - Goverment Program, Medicare		Gibson	Sharon		8057779130					SGGibson@express-scripts.com	One Express Wasy		St. Louis	MO	63121	12/08/2016	2026	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	Reconciliation Contact	Medicare specialist		Clark	Anthony		8012627475	2965			8012699734	aclark@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Reconciliation Contact (Secondary)			Gedge	Nathan	D	8012702974					ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Recovery Audit Contact	Actuary	Mr.	Pingree	Mark		8012627476	2938			8012699734	mpingree@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Surveillance Contact	Medco Exceptions and Appeals		Exceptions Appeals	Medco		8012627476					ngedge@emihealth.com	5101 S Commerce Dr		Murray	UT	84107	02/29/2024	2026	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	System Contact			Proctor	Roger		8012627476					rproctor@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Third Party Administrator (TPA) Liaison	Director of Pharmacy and Medicare Services		Gedge	Nathan	D	8012702974				8012699734	ngedge@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	User Access Contact	Actuary		Pingree	Mark		8012627476					mpingree@emihealth.com	5101 S Commerce Drive		Murray	UT	84107	06/18/2018	2026	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	Agent/Broker Compensation Data Contact	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Backup User Access Contact	Associate Director, Compliance		Koser	Jordan		5027559315					jkoser@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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		McKim	Simon		5025800520					HumanaBAEReviewTeam@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Bid Audit Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Bid Audit Site Contact	Director		Erwin	Angela		5025808459					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Bid Primary Contact	Actuary, Risk and Compliance		Chung	Denward		5026946150					mabptcontact@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	CMS Casework Communication Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Complaints Tracking Contact	Supervisor		Autrey	Paul		5029387015					HumanaCTMCasework@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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		5025804329					cfessel@humana.com	101 E Main St.		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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		5024769797					trhodes2@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	DIR Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Emergency Part D Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Employer Waiver Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Enrollment Contact	Director, Enrollment		Bailey	Christy		5027740298					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Financial Audit Contact	Associate Director	Mrs.	Butler	Sarah		5025262173					auditcoordination@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Financial Reporting Contact	Business Support		Wentworth	Julia		5025802091					jwentworth1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Formulary Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Formulary Contact (Secondary)	Clinical Pharmacy Lead		Tucker	Michael		5024688635					mtucker10@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Hospice Contact	Risk Management Lead		Mcpherson	Brandon		5025806124					bmcpherson4@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		7142708117					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Marketing Contact	Director Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Medication Therapy Management Contact	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	OffShore Subcontractor Contact	Director		Prather	Devin		5025804739					dprather1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Online Enrollment Center Contact (Back-up)	Manager, Tech Solution Implementation		Ragsdale	Mike		5025807650					mragsdale@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Online Enrollment Center Contact (Optional)	Associate Director, Compliance		Miles	Margaret		5025801475					mroyar@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Online Enrollment Center Contact (Primary)	Tech Solutions Professional		Bruce	Darin		5025807079					dbruce@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	8593219075				Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	5024989871				Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Application Contact	Director, Insurance Product Compliance		Medley	Michael		5026324902					mmedley@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Claims Submission Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	8593219075				Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Exceptions Contact (Secondary)	Associate Director, Risk Management		Winebrenner	Austin							AWinebrenner2@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	5024682494				Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Price File Contact (Back-up)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Price File Contact (Optional)	Senior Pharmacy Professional		Powell	Joseph		5028811161					jpowell13@humana.com	500 West Market Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Price File Contact (Primary)	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Quality Assurance Contact	Manager, Regulatory Compliance		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	101 East Main Street		Louisville	KY	40202	11/19/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Patient Safety Contact	Manager		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Pharmacy Network Management Contact	Sr Compliance Professional		Stevens	Debra		5025800475					dstevens25@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Pharmacy Network Management Contact (Secondary)	Senior Compliance Professional		Gsell	Mike		5023023120					mgsell@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	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							CS_BA@sscinc.com	210 West 10th Street		Kansas City	MO	64105	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	8008658715				Medicare Prescription Drug Plan		5	Kansas City
S5884	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active	5025800475				Medicare Prescription Drug Plan		5	Kansas City
S5884	Plan Directory Contact for Public Website	Associate Director		Richter	Lisa		8004486262					lrichter@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Processor Contact	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Reconciliation Contact (Secondary)	Senior Compliance Professional		Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Recovery Audit Contact	Sr. Compliance Professional	Mrs.	Chesher	Amanda		5022965654					agoldsmith@humana.com	101 East Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5884	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	08/13/2025	2026	Humana Insurance Co. & Humana Insurance Co. of NY	PDP	Humana	Medicare Prescription Drug Plan		Humana Inc.	128	Yes	Active					Medicare Prescription Drug Plan		5	Kansas City
S5904	Agent/Broker Compensation Data Contact	VP Product, Growth and Operations		Davis	Andrea		8478265793					andrea.davis@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	11/01/2024	2026	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	Dallas
S5904	Automated TrOOP Balance Transfer Contact	Manager, PBM operations	Ms.	Hanson	Michelle		6127776755				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/27/2020	2026	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	Dallas
S5904	Backup User Access Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	04/11/2025	2026	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	Dallas
S5904	Best Available Evidence Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	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	Dallas
S5904	Bid Audit Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	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	Dallas
S5904	Bid Audit Site Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	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	Dallas
S5904	Bid Primary Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	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	Dallas
S5904	CAP Report Contact for Public Website	Sr. Director Govt Programs & Products Compliance		Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	12/29/2021	2026	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	Dallas
S5904	CEO - CMS Administrator Contact	EVP, Medicare Chief Innovation& Experience Officer	Mrs	Harrison	Camille		9049051801					Camille.Harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr.	Jacksonville	FL	32246	01/06/2025	2026	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	Dallas
S5904	CEO - Senior Official for Contracting	EVP, Medicare, Chief Innovation&Experience Officer	Mrs.	Harrison	Camille		9049051801					camille.harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	01/13/2022	2026	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	Dallas
S5904	Chief Financial Officer	VP Medicare CFO	Mrs	Dorsett	Kareen		4048087542					Kareen.Dorsett@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400,	Jacksonville	FL	32246	02/15/2024	2026	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	Dallas
S5904	Chief Operating Officer	Senior Vice President Medicare	Ms.	Pieraccini	Alisha		7164659217					Alisha.Pieraccini@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	11/01/2024	2026	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	Dallas
S5904	Chief Information Officer	SVP Chief Information Officer	Mr.	Anderson	Gary		9049050180					gary.anderson@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 8th Floor	Jacksonville	FL	32246	01/27/2016	2026	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	Dallas
S5904	Chief Information Security Officer	VP Chief Information Security Officer	Mr.	Raymond	Jason		9049050070					jason.raymond@floridablue.com	4800 Deewood Campus Parkway	DCC Building 600, 2nd Floor	Jacksonville	FL	32246	04/04/2024	2026	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	Dallas
S5904	CMS Casework Communication Contact	Sr Manager Med Ops & Integrity		Irizarry	Haydee		3212330635					Haydee.Irizarry@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	04/25/2023	2026	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	Dallas
S5904	Complaints Tracking Contact	Sr Manager Med Ops & Integrity		Irizarry	Haydee		3212330635					Haydee Irizarry@bcbsfl.com	4800 Deerwood Campus Parkway	Bldg. 400 2nd Floor	Jacksonville	FL	32246	04/25/2023	2026	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	Dallas
S5904	Contact for Fraud Investigations	Sr. Manager Fraud Investigation		Ramos	Jose		9049055835					jose.romas@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 400, 6th Floor	Jacksonville	FL	32246	04/04/2024	2026	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	Dallas
S5904	Coordination of Benefits Contact	Manager PBM Operations		Hanson	Michelle		6127776755				3127776706	COBMedD@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	02/16/2021	2026	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	Dallas
S5904	Corporate Mailing						9049054668					Hillary.Simpson@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/16/2018	2026	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	Dallas
S5904	Customer Service Operations Contact	Sr Director Member Contact		Gamble	LaTonya		9049052057					latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	05/10/2023	2026	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	Dallas
S5904	DIR Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	DIR Contact (Secondary)	Medicare Actuary Director		Dougherty	Emily		9049053894					Emily.Dougherty@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	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	Dallas
S5904	Discount Program Payment Contact	Accountant I, Corporate Receivables		Lance	Deavon		8134162412					Deavon.Lance@bcbsfl.com	4800 Deerwood Campus Pkwy	Bldg 100, 5th Floor	Jacksonville	FL	32246	12/03/2024	2026	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	Dallas
S5904	Emergency Part D Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9045259651					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Emergency Part D Contact (Secondary)	Sr. Director Govt Programs & Products Compliance		Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	12/29/2021	2026	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	Dallas
S5904	Employer Waiver Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4thFloor	Jacksonville	FL	32246	04/04/2024	2026	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	Dallas
S5904	Enrollment Contact	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	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	Dallas
S5904	EOB Transfer Contact	Sr Director Member Contact		Gamble	LaTonya		9049052057				9043576121	latonya.gamble@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 300, 4th Floor	Jacksonville	FL	32246	05/10/2023	2026	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	Dallas
S5904	Financial Audit Contact	Director External & Regulatory Audits	Mr.	Livingston	Matt		9049050168					matt.livingston@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	09/21/2023	2026	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	Dallas
S5904	Financial Reporting Contact	VP Medicare CFO		Dorsett	Kareen		9049051754					Kareen.Dorsett@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400	Jacksonville	FL	32246	08/20/2021	2026	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	Dallas
S5904	Formulary Contact	Medicare Clinical Pharmacist		Keaton	Stephanie		9049050114					stephanie.keaton@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	12/06/2024	2026	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	Dallas
S5904	Formulary Contact (Secondary)	Supervisor, Pharmacists		Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	10/08/2024	2026	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	Dallas
S5904	General Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	05/10/2023	2026	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	Dallas
S5904	Government Relations Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	05/10/2023	2026	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	Dallas
S5904	HIPAA Privacy Officer	Sr. Counsel		Resnick	Steven		9049055025					steven.resnick@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	05/08/2024	2026	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	Dallas
S5904	HIPAA Security Officer	VP Chief Information Security Officer		Raymond	Jason		9049050070					jason.raymond@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 600, 2nd Floor	Jacksonville	FL	32246	01/04/2019	2026	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	Dallas
S5904	Hospice Contact	Sr. Manager Pharmacy		Adams	Tangela		9049050002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Interoperability Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th FL	Jacksonville	FL	32246	01/26/2022	2026	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	Dallas
S5904	Marketing Contact	FBM Spec.IV Product Operations		Lilly	Wanda		9043573900					wanda.lilly@bcbsfl.com	4800 Deerwood Campus Parkway	Building 400, 3rd Floor	Jacksonville	FL	32246	04/27/2023	2026	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	Dallas
S5904	Medical Director	VP & CMO FBM	Dr.	Graf	Thomas		5704496647					Thomas.Graf@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 3rd Floor	Jacksonville	FL	32246	01/30/2024	2026	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	Dallas
S5904	Medicare Compliance Officer	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9044458502					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	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	Dallas
S5904	Medicare Coordinator	EVP, Medicare, Chief Innovation&Experience Officer	Mrs.	Harrison	Camille		9049051801					camille.harrison@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 100, 8th Flr	Jacksonville	FL	32246	11/17/2022	2026	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	Dallas
S5904	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists		Schons	Allison		8554570763				8557297221	partdoverutil@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	07/19/2021	2026	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	Dallas
S5904	Medication Therapy Management Contact	Sr. Manager Pharmacy		Martinez	Diony		9049058882					Diony.Martinez@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	OffShore Subcontractor Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					hillary.simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	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	Dallas
S5904	Online Enrollment Center Contact (Back-up)	Sr. Dir. Medicare Ops & Int		Chick	Benjamin		9049051711					benjamin.chick@floridablue.com	4800 Deerwood Campus Pkwy	DCC Building 300, 4th Floor	Jacksonville	FL	32246	01/30/2024	2026	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	Dallas
S5904	Online Enrollment Center Contact (Optional)	Sr. Manager Medicare Regulatory Ops		Stephens	Kate		9049055131					Kate.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Bldg 300 4th Flr	Jacksonville	FL	32246	08/04/2025	2026	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	Dallas
S5904	Online Enrollment Center Contact (Primary)			EMB Analysts	FBM Ops		9049051711					FB_Medicare_Ops_EMB_Analysts@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 400, 2nd Floor	Jacksonville	FL	32246	05/06/2021	2026	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	Dallas
S5904	Part D Appeals	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773736	56307			Medicare Prescription Drug Plan		5	Dallas
S5904	Part D Appeals Contact (Secondary)	Spec IIIb Business Support		Barr	Shamika						9043011849	Shamika.Barr@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773636	54283			Medicare Prescription Drug Plan		5	Dallas
S5904	Part D Application Contact	Sr. Product Manager		Kinard	Ronda		9049053018					ronda.kinard@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 200, 4th Floor	Jacksonville	FL	32246	04/04/2024	2026	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	Dallas
S5904	Part D Benefits Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Part D Claims Submission Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Part D Exceptions Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia							cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	8004773736	56307			Medicare Prescription Drug Plan		5	Dallas
S5904	Part D Exceptions Contact (Secondary)	Regulatory Manager & Audit Response		Gonzales	Santiago						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55120	07/19/2021	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5904	Part D Price File Contact (Back-up)	QA Analyst		Tastad	Emily		6127772557					emily.tastad@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	12/29/2021	2026	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	Dallas
S5904	Part D Price File Contact (Optional)	Director Business Support		Chaney	Saraye		9049055878					saraye.chaney@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Part D Price File Contact (Primary)	Business Support Specialist IIIb		Barr	Shamika		9049054283					Shamika.Barr@bcbsfl.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Part D Quality Assurance Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Part D Reporting Contact	Corporate Compliance Specialist		Perry	Mandy		3363543469					mandy.perry@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th floor	Jacksonville	FL	32246	04/11/2025	2026	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	Dallas
S5904	Patient Safety Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Payment Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	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	Dallas
S5904	Pharmacy Director	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Pharmacy Network Management Contact	VP Government Pharmacy Programs	Dr.	Griffin	Cynthia		9049056307					cynthia.griffin@floridablue.com	4800 Deerwood Campus Parkway	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	Pharmacy Network Management Contact (Secondary)	Sr. Dir, Network Client Services		Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55122	07/19/2021	2026	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	Dallas
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	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	8888776420				Medicare Prescription Drug Plan		5	Dallas
S5904	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Member Services		Garza-Rodriguez	Melissa							MGarzarodriguez@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	07/30/2018	2026	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	PDP	Florida Blue	Medicare Prescription Drug Plan		Guidewell Mutual Holding Corporation	594	Yes	Active	2143366770				Medicare Prescription Drug Plan		5	Dallas
S5904	Plan Directory Contact for Public Website			Mbr Svcs	Medicare		8009266565					Chrissy.This@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	05/05/2021	2026	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	Dallas
S5904	Plan to Plan Reconciliation Contact	Accounting Specialist		Williams	Lynn		9049054568					lynn.williams@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 3rd Floor	Jacksonville	FL	32246	01/04/2019	2026	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	Dallas
S5904	Processor Contact	FBM Dir. Claims		Stephens	Anquenette		2053353002					Anquenette.Stephens@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/30/2024	2026	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	Dallas
S5904	Reconciliation Contact	Medicare Actuary Director		Dougherty	Emily		9049053894					emily.dougherty@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	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	Dallas
S5904	Reconciliation Contact (Secondary)	Managing Actuary		Scott	Branson		9049054691					Branson.Scott2@bcbsfl.com	4800 Deerwood Campus Parkway		Jacksonville	FL	32246	01/10/2025	2026	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	Dallas
S5904	Recovery Audit Contact	Sr. Director Govt Programs & Products Compliance	Mrs.	Simpson	Hillary		9049054668					Hillary.Simpson@bcbsfl.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	06/13/2022	2026	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	Dallas
S5904	Surveillance Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	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	Dallas
S5904	System Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	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	Dallas
S5904	Third Party Administrator (TPA) Liaison	Sr. Manager Pharmacy		Adams	Tangela		9049050002					tangela.adams@floridablue.com	4800 Deerwood Campus Pkwy	Building 100, 3rd Floor	Jacksonville	FL	32246	09/30/2024	2026	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	Dallas
S5904	User Access Contact	Sr. Manager Corporate Compliance		Morant	Rolanda		9049059037					rolanda.morant@floridablue.com	4800 Deerwood Campus Parkway	DCC Building 100, 7th Floor	Jacksonville	FL	32246	03/13/2024	2026	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	Dallas
S5916	Agent/Broker Compensation Data Contact	VP Medicare Sales	Mr.	Hess	Brent		8013336143					Brent.Hess@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	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	Dallas
S5916	Automated TrOOP Balance Transfer Contact	Mgr Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
S5916	Backup User Access Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Best Available Evidence Contact	Membership Ambassador	Ms.	Wells	Trisha		8005438848	2751			8883352988	ORMEMMEDAmbassador@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Bid Audit Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	Bid Audit Site Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Bid Primary Contact	Vice President Actuarial Pricing	Mr.	Akopyan	Armen		2063323998					Armen.Akopyan@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	CAP Report Contact for Public Website	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	CEO - CMS Administrator Contact	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	CEO - Senior Official for Contracting	Cambia President and CEO	Mr.	Short	Jared		5032761870					Jared.Short@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Chief Financial Officer	Cambia SVP & CFO	Mr.	Rains	Mike		2063326521					Mike.Rains@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	Chief Operating Officer	VP Finance Controller	Ms.	Vannoy	Anjie		5032761865					Anjie.Vannoy@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Chief Information Officer	SVP STRATEGIC TECH SOL & CIO	Mr.	Rotival	Laurent		2063325034					Laurent.Rotival@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Chief Information Security Officer	Chief Info Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	05/29/2025	2026	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	Dallas
S5916	CMMI Model Point of Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	CMS Casework Communication Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Complaints Tracking Contact	Ops Reporting & Perf Analyst	Ms.	Aime	Cathleen		8667490355	2653			8883098784	cathleen.aime@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Contact for Fraud Investigations	Senior Investigator	Ms.	Grimes-Burke	Jennifer		5035873355					Jennifer.Grimes-Burke@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Coordination of Benefits Contact	Manager, Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Corporate Mailing						5032206237				5035884350	Jennifer.DelVillar@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Customer Service Operations Contact	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97504	03/18/2025	2026	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	Dallas
S5916	DIR Contact	Director Pharmacy Informatics & Tech	Ms.	Kidd	Vicki		2083957739					vicki.kidd@regence.com	1100 W Idaho St Suite 400		Boise	ID	83702	03/18/2025	2026	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	Dallas
S5916	DIR Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Discount Program Payment Contact	Treasury Analyst Sr I	Mr.	Gerken	Matthew		2063324809					Matthew.Gerken@cambiahealth.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	Emergency Part D Contact	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Emergency Part D Contact (Secondary)	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Employer Waiver Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	Enrollment Contact	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	EOB Transfer Contact	Manager, Project & Program Mngmnt	Ms.	Chesling	Beth		6127774823				6127776706	EOBP2P@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	07/17/2025	2026	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	Dallas
S5916	Financial Audit Contact	Government Programs Audit Consultant	Mr.	Hutt	Brian		5032206160					Brian.Hutt@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Financial Reporting Contact	Fin Acctg & Reporting, Assistant Director	Mr.	Striplin	Daniel	W	5032256069					Dan.Striplin@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Formulary Contact	Director Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
S5916	General Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Government Relations Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	HIPAA Privacy Officer	VP Chief Compliance & Privacy Officer	Ms.	Erbes	Kristen		5035256533					kristen.erbes@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	HIPAA Security Officer	Chief Information Security Officer	Mr.	Person	Steve		5037251654					Steve.Person@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Hospice Contact	Pharmacy Ops Oversight Specialist Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Interoperability Contact	VP & Chief Technology Officer	Mr.	Coogan	Chris		5035531421					Chris.Coogan@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	06/05/2025	2026	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	Dallas
S5916	Marketing Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					robyn.meirose@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Medical Director	SVP Chief Medical Officer	Ms.	Milavetz	Donna		8013336740					Donna.Milavetz@regence.com	2890 E Cottonwood Pkwy.		Salt Lake City	UT	84121	03/18/2025	2026	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	Dallas
S5916	Medicare Compliance Officer	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Medicare Coordinator	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Medicare Part D Opioid Overutilization Contact	Supervisor Pharmacists	Ms.	Anderson	Ally		8554570763					partdoverutil@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	03/18/2025	2026	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	Dallas
S5916	Medication Therapy Management Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	Online Enrollment Center Contact (Back-up)	Dir Medicare Operations	Ms.	Franke	Dana		5037251641					Dana.Franke@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Online Enrollment Center Contact (Optional)	Manager Member Services	Ms.	Christiansen	Stacy		5416181240					Stacy.Christiansen@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Online Enrollment Center Contact (Primary)	Spv Membership	Ms.	Cromwell	Krista		5416181286					Krista.Cromwell@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Part D Appeals	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	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	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5916	Part D Appeals Contact (Secondary)	Regulatory Pharmacist Sr	Ms.	Kaiser	Katrina						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossig Rd	Eagan	MN	55120	03/18/2025	2026	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	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5916	Part D Application Contact	VP Medicare Product Development	Ms.	Brewer	Dana		5037214095					Dana.Brewer@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	Part D Benefits Contact	Mgr Product Managment	Ms.	Holliston	Danica		5032254871					Danica.Holliston@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Part D Claims Submission Contact	Health Data Analyst Sr.	Mr.	Brook	Lance		4026862603					LBrooke@primetherapeutics.com	Prime Therapeutics LLC	2655 Eagan Woods Dr	Eagan	MN	55122	03/18/2025	2026	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	Dallas
S5916	Part D Exceptions Contact	Regulatory Pharmacist, Sr	Mr.	Spears	Scott						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	10/03/2025	2026	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	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5916	Part D Exceptions Contact (Secondary)	Director, Pharmacy Operations	Ms.	Yi	Edie							edie.yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	972071271	03/18/2025	2026	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	5032254801				Medicare Prescription Drug Plan		5	Dallas
S5916	Part D Price File Contact (Back-up)	Business Solutions Analyst Sr	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
S5916	Part D Price File Contact (Optional)	Price File Analyst	Ms.	Tastad	Emily		6127771699					emily.tastad@PrimeTherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
S5916	Part D Price File Contact (Primary)	VP Pharmacy Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	11/11/2025	2026	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	Dallas
S5916	Part D Quality Assurance Contact	Director, Pharmacy Operations	Ms.	Yi	Edie		5032254801				2083957744	Edie.Yi@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Part D Reporting Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Patient Safety Contact	Pharmacy Clinical Program Manager	Ms.	Chuang	Amy		2063325046					Amy.Chuang@regence.com	1111 Lake Washington Blvd North STE 900		Renton	WA	98056	03/18/2025	2026	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	Dallas
S5916	Payment Contact	Director Financial Acctg & Reporting	Mr.	Striplin	Dan		5032256069					Dan.Striplin@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Pharmacy Director	VP Clinical Pharmacy Services	Mr.	Robertson	David	W	5032268761					david.w.robertson@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Pharmacy Network Management Contact	VP, Network Mangement	Ms.	Conlin	Marci		6127772837				8778236373	marci.conlin@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55121	03/18/2025	2026	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	Dallas
S5916	Pharmacy Network Management Contact (Secondary)	AVP Network Relations	Ms.	Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Rd	Eagan	MN	55122	03/18/2025	2026	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	Dallas
S5916	Pharmacy Technical Help Desk Contact	Sr Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	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	8447656826				Medicare Prescription Drug Plan		5	Dallas
S5916	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Experience and Member Ops	Mr.	Schultz	Bret							bret.schultz@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55121	03/18/2025	2026	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	8444571209				Medicare Prescription Drug Plan		5	Dallas
S5916	Plan Directory Contact for Public Website	Manager Member Services	Ms.	Ciuro	Catina		5416181268					Catina.Ciuro@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Plan to Plan Reconciliation Contact	Pharmacy Operations Oversight Specialist, Sr.	Ms.	Manzer	Amy		5032255368					Amy.Manzer@regence.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Processor Contact	Director, PBM Operations	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing	Egan	MN	55121	03/18/2025	2026	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	Dallas
S5916	Reconciliation Contact	AD Actuarial	Mr.	Dekker	Michael		5032256785					Michael.Dekker@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Reconciliation Contact (Secondary)	Director Actuarial	Mr.	Collings	Jared		8013335291					Jared.Collings@cambiahealth.com	2890 E Cottonwood Pkwy		Salt Lake City	UT	84121	03/18/2025	2026	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	Dallas
S5916	Recovery Audit Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	Surveillance Contact	Director Government Programs Compliance Officer	Ms.	Hoey	Yen		5037214040					Yen.Hoey@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	System Contact	Medicare Business Operations, Product Owner	Ms.	Fredinburg	Deana		5033754426					Deana.Fredinburg@regence.com	PO Box 1827		Medford	OR	97501	03/18/2025	2026	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	Dallas
S5916	Third Party Administrator (TPA) Liaison	VP Pharm Ops & Compliance	Mr.	Weiss	Justin		5032256677					Justin.Weiss@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5916	User Access Contact	Compliance Analyst	Ms.	Meirose	Robyn		5033918668					Robyn.Meirose@cambiahealth.com	200 SW Market Street 11th Floor		Portland	OR	97201	03/18/2025	2026	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	Dallas
S5921	Agent/Broker Compensation Data Contact	VP, Finance		State	Tonya		9529314166					tonya_l_state@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Automated TrOOP Balance Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	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	Boston
S5921	Backup User Access Contact	Regulatory Affairs Consultant		Freese	Lynn		9529315765					lynn.freese@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	11/04/2025	2026	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	Boston
S5921	Best Available Evidence Contact	Supervisor, Enrollment & Eligibility		Prince	Shelli		7158585748					bae_requests@uhc.com	PO Box 30769		Salt Lake City	UT	841300769	12/27/2024	2026	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	Boston
S5921	Bid Audit Contact	Director, Business Process		McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Bid Primary Contact	VP, Actuary		Sporney	Aimee		9529316254					aimee.sporney@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	CAP Report Contact for Public Website	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	CEO - CMS Administrator Contact	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	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	Boston
S5921	CEO - Senior Official for Contracting	Business Segment CEO	Mr.	Hunter	Robert		9529314903					chief_exec_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	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	Boston
S5921	Chief Financial Officer	Business Segment CFO	Mr.	Colletti	Joseph		9529790814					joe.colletti@uhg.com	9800 Health Care Lane		Minnetonka	MN	55343	11/03/2025	2026	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	Boston
S5921	Chief Operating Officer	Business Segment COO	Mr.	Fulton	Ryan		9529795503					ryan.fulton@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	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	Boston
S5921	Chief Information Officer	VP, CIO	Mr.	Davit	Mukesh		8478995620					mukesh.davit@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Chief Information Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	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	Boston
S5921	CMMI Model Point of Contact	Regulatory Affairs Consultant		Smith	Gretchen		7633213772					gretchen.smith@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	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	Boston
S5921	CMS Casework Communication Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	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	Boston
S5921	Complaints Tracking Contact	Claims Bus Process Analyst		Padero	Kathryn		9522026694					UHCCTM_POC@uhc.com	6200 Northwest Parkway		San Antonio	TX	78249	12/27/2024	2026	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	Boston
S5921	Contact for Fraud Investigations	VP, SIU & Data Intelligence		Berls	Matthew		7326231829					matthew_h_berls@uhc.com	1 Tower Center Blvd	11 Floor	East Brunswick	NJ	08816	12/27/2024	2026	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	Boston
S5921	Coordination of Benefits Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	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	Boston
S5921	Corporate Mailing						9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Customer Service Operations Contact	Dir, Performance Enablement & Readiness		Crockett	Bradley		7633614330					brad_crockett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	DIR Contact	Director, Accounting		Gerbuz	Michael		9529315736					michael_v_gerbuz@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Discount Program Payment Contact	Accounting Manager		Ibrahim	Sadek		9522056655					sadek.ibrahim@optum.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	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	Boston
S5921	Emergency Part D Contact	COO Government Pharmacy		Freshwater	Jacob		6126557037					jacob_freshwater@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	01/06/2025	2026	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	Boston
S5921	Employer Waiver Contact	Regulatory Affairs Consultant		Haverstick	Chiaki		7145037919					chiaki.haverstick@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	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	Boston
S5921	Enrollment Contact	Associate Director, Business Process		Smith	Charlotte		7158585653					charlotte_a_smith@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	EOB Transfer Contact	Director, Business Process		Busbee	Nathanael		4438961223				8444832968	nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	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	Boston
S5921	Financial Audit Contact	Director, Business Process	Ms.	McCleary	Lisa		9529315543					lisa_mccleary@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Financial Reporting Contact	VP, Finance		Ludlow	John		9529315897					john_ludlow@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	11/17/2025	2026	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	Boston
S5921	Formulary Contact	Director, Clinical Pharmacy		Degen	Paul		9529315783					paul.degen@uhc.com	9800 Health Care Lane		Minneapolis	MN	55343	12/27/2024	2026	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	Boston
S5921	General Contact	Chief Compliance Officer		Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Government Relations Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	HIPAA Privacy Officer	Sr. Assoc. Gen. Counsel & Deputy Chief Privacy Off		Heiden	Randy		5036037029					uhc_privacy_office@uhc.com	PO Box 1459	UHC Privacy Office Attn: Randy Heiden	Minneapolis	MN	55440	12/27/2024	2026	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	Boston
S5921	HIPAA Security Officer	VP, Information Security	Mr.	Robertson	Brent		9499233268					brent.robertson@uhg.com	7 Technology Dr		Irvine	CA	92618	11/17/2025	2026	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	Boston
S5921	Hospice Contact	Director, Business Process		Busbee	Nathanael		4438961223					nathanael.busbee@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	12/27/2024	2026	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	Boston
S5921	Interoperability Contact	Chief Compliance Officer		Furlong	Erin		9529315444					erin.furlong@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Marketing Contact	Associate Director, Sales Operations		Proudfit	Susan		9529314230					Sales_Oversight@uhc.com	9800 Health Care Lane	MN006-W700	Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Medical Director	Business Segment Chief Medical Officer	Dr.	Billioux	Alexander		9529316380					alexander.billioux@uhc.com	PO Box 9472		Minneapolis	MN	554409472	01/16/2025	2026	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	Boston
S5921	Medicare Compliance Officer	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Medicare Coordinator	VP, Operations		Merrill	Andy		9529790114					andy_merrill@uhc.com	9700 Health Care Lane		Minnetonka	MN	55343	11/04/2025	2026	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	Boston
S5921	Medicare Part D Opioid Overutilization Contact	Director, Clinical Pharmacy Programs		Berkowicz	Teresa		4438961235					uhcmr_op@uhc.com	10175 Little Patuxent Parkway		Columbia	MD	21044	11/17/2025	2026	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	Boston
S5921	Medication Therapy Management Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	OffShore Subcontractor Contact	Regulatory Affairs Consultant		Baber	Madeleine		5013696152					mattie-baber@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	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	Boston
S5921	Online Enrollment Center Contact (Back-up)	Senior Business Process Analyst		Birky	Danielle		7633213818					danielle_m_birky@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	Online Enrollment Center Contact (Primary)	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	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	Boston
S5921	Part D Appeals	Director, Claims		Trabold	Debbie							debbie_m_trabold@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8889037587				Medicare Prescription Drug Plan		5	Boston
S5921	Part D Appeals Contact (Secondary)	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Medicare Prescription Drug Plan		5	Boston
S5921	Part D Application Contact	Director, Product		Becker	Laura		9527698714					laura_e_becker@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	Part D Benefits Contact	VP, Actuarial Services		Linn	Jennifer		9529314114					jennifer.linn@uhc.com	9800 Healthcare Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Part D Claims Submission Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	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	Boston
S5921	Part D Exceptions Contact	Assoc. Director, Part D A&G Audit Readiness		Seely	Kathryn							kathryn.seely@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8005959532				Medicare Prescription Drug Plan		5	Boston
S5921	Part D Price File Contact (Back-up)	Business Process Analyst		Gazmey	Odalys		8138183394					odalys_gazmey@uhc.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	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	Boston
S5921	Part D Price File Contact (Optional)	Senior Business Analyst		Lewis	LaToya		7637974298					medops_planfinder@optum.com	PO Box 9472		Minneapolis	MN	55440	12/27/2024	2026	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	Boston
S5921	Part D Price File Contact (Primary)	Business Process Consultant		Connor	Dana		4438961226					dana_connor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	Part D Quality Assurance Contact	VP, Stars, Quality & Perf. Improvement		Fitzgibbons	Michael		9529314123					michael_d_fitzgibbons@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Part D Reporting Contact	Director, Business Process		Kamehaiku	Tracy		7633613962					tracy.kamehaiku@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	Patient Safety Contact	Associate Director, Clinical Quality		Martin	Sarah		6152245257					sarah1.martin@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	11/17/2025	2026	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	Boston
S5921	Payment Contact	Director, Accounting		Berger	Steven		9529315597					steven_berger@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Personal Health Record Contact			Service	Customer		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Pharmacy Director	VP, Clinical Pharmacy		Mansoor	Aliya		4104020078					aliya.mansoor@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	Pharmacy Network Management Contact	Director, Business Process		Pham	Brittany		7632926567					brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	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	Boston
S5921	Pharmacy Technical Help Desk Contact	Director, Business Process		Pham	Brittany							brittany_pham@uhc.com	PO Box 9472		Minneapolis	MN	554409472	12/27/2024	2026	UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY	PDP	UnitedHealthcare	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8778896510				Medicare Prescription Drug Plan		5	Boston
S5921	Plan Directory Contact for Public Website			Customer Service	UHC		8664608854					UHCMedicareCustomerService@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	04/30/2024	2026	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	Boston
S5921	Plan to Plan Reconciliation Contact	Manager, Accounting		Crone	David		9529315204					p2padmin@uhc.com	Lockbox 5818		Carol Stream	IL	601975818	12/27/2024	2026	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	Boston
S5921	Processor Contact	VP, Claims		Bellis	Sarah		7633614078					sarah_bellis@uhc.com	9700 Health Care Lane		Minneapolis	MN	55343	11/17/2025	2026	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	Boston
S5921	Reconciliation Contact	Sr. Director, Finance		Rancourt	Timothy		2159048672					timothy_a_rancourt@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	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	Boston
S5921	Reconciliation Contact (Secondary)	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	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	Boston
S5921	Recovery Audit Contact	Chief Compliance Officer	Ms.	Furlong	Erin		9529315444					compliance_officer@uhc.com	9800 Health Care Lane		Minnetonka	MN	55343	12/27/2024	2026	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	Boston
S5921	Surveillance Contact	Functional Compliance Director		Golibart	Carlos		7145037912					Carlos.Golibart@uhc.com	5701 Katella Avenue		Cypress	CA	90630	12/27/2024	2026	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	Boston
S5921	System Contact	Assoc. Director, Business Process		Weingarten	Heather		7633306858					heather_weingarten@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	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	Boston
S5921	Third Party Administrator (TPA) Liaison	Associate Director, Finance		Eibel	Maureen		2159028234					maureen_m_eibel@uhc.com	600 Office Center Dr		Fort Washington	PA	19034	11/17/2025	2026	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	Boston
S5921	User Access Contact	Regulatory Affairs Analyst		Stinnett	Magdelana		9524065517					maggie_stinnett@uhc.com	PO Box 9472		Minneapolis	MN	554409472	11/17/2025	2026	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	Boston
S5953	Agent/Broker Compensation Data Contact	VP -  Medicare Advantage Operations		Edwards	Don		8032649482					Don.Edwards@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	05/08/2024	2026	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	Chicago
S5953	Automated TrOOP Balance Transfer Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	Chicago
S5953	Backup User Access Contact	Manager - Medicare Advantage Operations		Morris	Charles		8032641799					charles.morris@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	04/12/2023	2026	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	Chicago
S5953	Best Available Evidence Contact	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	04/12/2023	2026	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	Chicago
S5953	Bid Audit Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
S5953	Bid Audit Site Contact	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
S5953	Bid Primary Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
S5953	CAP Report Contact for Public Website	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
S5953	CEO - CMS Administrator Contact	CEO	Mr.	Mizeur	Michael	J	8032646000					CEO@BCBSSC.com	I-20 at Alpine Road	AA-X01	Columbia	SC	29219	01/03/2025	2026	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	Chicago
S5953	CEO - Senior Official for Contracting	CEO	Mr.	Mizeur	Michael	J	8032646000					CEO@BCBSSC.com	I-20 at Alpine Road	AA-X01	Columbia	SC	29219	01/03/2023	2026	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	Chicago
S5953	Chief Financial Officer	VP & CFO, BCBS Div	Mrs.	Srulevich	Heather		8032649488					Heather.Srulevich@BCBSSC.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	10/26/2017	2026	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	Chicago
S5953	Chief Operating Officer	President, BlueCross BlueShield of SC	Mr	Graves	Scott		8033825114					SCOTT.GRAVES@bcbssc.com	I-20 Apline Road	AA-X18	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Chief Information Officer	Executive VP, CIO	Mr.	Ackerson	Michael		8032646557					Michael.Ackerson@bcbssc.com	1-20 Alpine Road	AA-225	Columbia	SC	29219	02/26/2024	2026	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	Chicago
S5953	Chief Information Security Officer	Executive VP, CIO	Mr.	Ackerson	Michael		8032646557					Michael.Ackerson@bcbssc.com	1-20 Alpine Road	AA-225	Columbia	SC	29219	02/26/2024	2026	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	Chicago
S5953	CMS Casework Communication Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/11/2020	2026	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	Chicago
S5953	Complaints Tracking Contact	Manager - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/11/2020	2026	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	Chicago
S5953	Contact for Fraud Investigations	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
S5953	Coordination of Benefits Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	Chicago
S5953	Corporate Mailing						8032642944				8032649581	katrina.gesh-wilson@bcbssc.com	PO Box 100191		Columbia	SC	29202	11/15/2021	2026	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	Chicago
S5953	Customer Service Operations Contact	Senior Director		Surratt	Susan		8032641581					susan.surratt@BCBSSC.com	I-20 at Alpine Road	AX-F15	Columbia	SC	29219	03/01/2024	2026	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	Chicago
S5953	DIR Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		8032644347				8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	02/09/2015	2026	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	Chicago
S5953	DIR Contact (Secondary)	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
S5953	Discount Program Payment Contact	Director - Private Business Accounting		Campbell	Newt		8032640357					Newt.Campbell@bcbssc.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	12/11/2024	2026	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	Chicago
S5953	Emergency Part D Contact	AVP - Medicare Advantage Operations		Boggero	Laurin		8034224440				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Emergency Part D Contact (Secondary)	VP Medicare Advantage		Gesh-Wilson	Kat		2816841626					kat.gesh-wilson@bcbssc.com	I-20 at Alpine Road	Mail Code AG-770	Columbia	SC	29219	12/13/2022	2026	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	Chicago
S5953	Employer Waiver Contact	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AG - 780	Columbia	SC	29219	04/12/2023	2026	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	Chicago
S5953	Enrollment Contact	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	04/12/2023	2026	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	Chicago
S5953	EOB Transfer Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	Chicago
S5953	Financial Audit Contact	Compliance Officer	Mr.	Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
S5953	Financial Reporting Contact	Director - Financial Reporting		Haile	Karin		8032642089					Karin.Haile@bcbssc.com	1-20 at Alpine Road	AX-200	Columbia	SC	29219	08/09/2022	2026	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	Chicago
S5953	Formulary Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		8032644347				8038708162	Chris.Puffenbarger@bcbssc.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2026	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	Chicago
S5953	Formulary Contact (Secondary)	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	General Contact	AVP - Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Government Relations Contact	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
S5953	HIPAA Privacy Officer	Privacy Compliance Officer		Weeks	Linda		8032643562					linda.weeks@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	02/21/2020	2026	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	Chicago
S5953	HIPAA Security Officer	AVP, I/S Goverance		Hubbard	Elizabeth		8032646146					Elizabeth.Hubbard@bcbssc.com	I-20 at Alpine Road	AA-225	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Hospice Contact			DeWitt	Tanika		8032641103					tanika.dewitt@bcbssc.com	1-20 @ Alpine Rd. AX-155		Columbia	SC	29223	04/11/2018	2026	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	Chicago
S5953	Interoperability Contact	VP Medicare Operations		Boggero	Laurin		8032646635					laurin.boggero@bcbssc.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	10/27/2021	2026	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	Chicago
S5953	Marketing Contact	AVP -  Medicare Advantage Operations		Edwards	Don		8032649482					Don.Edwards@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	12/14/2016	2026	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	Chicago
S5953	Medical Director	Chief Medical Officer		Sungurov	Max		8032645729					max.sungurov@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	05/18/2023	2026	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	Chicago
S5953	Medicare Compliance Officer	Compliance Officer	Mr.	Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	01/05/2022	2026	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	Chicago
S5953	Medicare Coordinator	Manager Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	tanika.dewitt@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	03/11/2020	2026	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	Chicago
S5953	Medicare Part D Opioid Overutilization Contact	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	Medication Therapy Management Contact	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	OffShore Subcontractor Contact	AVP	Ms.	Boggero	Laurin		8032646635				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Online Enrollment Center Contact (Back-up)	VP Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	Laurin.Boggero@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	03/11/2020	2026	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	Chicago
S5953	Online Enrollment Center Contact (Optional)	Manager Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	Tanika.Dewitt@BCBSSC.com	I-20 at Alpine Road	AG-A10	Columbia	SC	29219	03/11/2020	2026	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	Chicago
S5953	Online Enrollment Center Contact (Primary)	Director Operations		Morris	Charles		8032641799				8032649581	charles.morris@bcbssc.com	I-20 at Alpine Road	AG-780	Columbia	SC	29219	04/12/2023	2026	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	Chicago
S5953	Part D Appeals	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris						8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/31/2020	2026	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	8032645355				Medicare Prescription Drug Plan		5	Chicago
S5953	Part D Appeals Contact (Secondary)	Supervisor - Medicare Advantage Operations		Dewitt	Tanika						8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	8032641103				Medicare Prescription Drug Plan		5	Chicago
S5953	Part D Application Contact			Gesh-Wilson	Katrina		8032642944					kat.gesh-wilson@bcbssc.com	I-20 @ Alpine Rd	AG-770	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	Part D Benefits Contact	Sr. Director - Medicare Pharmacy		Coleman	Terrica		8032642728				8032649581	terrica.coleman@bcbssc.com	I-20 at Alpine Road	AG-770	Columbia	SC	29219	07/12/2023	2026	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	Chicago
S5953	Part D Claims Submission Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	Chicago
S5953	Part D Exceptions Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris						8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/22/2016	2026	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	8032644347				Medicare Prescription Drug Plan		5	Chicago
S5953	Part D Exceptions Contact (Secondary)	Supervisor - Medicare Advantage Operations		Dewitt	Tanika							Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	8032641103				Medicare Prescription Drug Plan		5	Chicago
S5953	Part D Price File Contact (Back-up)	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	Part D Price File Contact (Primary)	Manager, MA Pharmacy Management		Puffenbarger	Chris		8032644347					Chris.Puffenbarger@bcbssc.com	1-20 Alpine Road	AX-740	Columbia	SC	29219	12/27/2016	2026	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	Chicago
S5953	Part D Quality Assurance Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	Chicago
S5953	Part D Reporting Contact	Corporate Compliance Director		Ortiz	Jason		8032643910					BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	02/26/2024	2026	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	Chicago
S5953	Patient Safety Contact	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	Payment Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
S5953	Personal Health Record Contact	AVP, Medicare Advantage Operations		Boggero	Laurin		8032646635				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Pharmacy Director	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	Pharmacy Network Management Contact	Manager - Medicare Part D Pharmacy Contracting		Puffenbarger	Chris		8032644347				8038708162	Chris.Puffenbarger@BCBSSC.com	I-20 at Alpine Road	AX-740	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Pharmacy Network Management Contact (Secondary)	Sr. Director, Medicare Pharmacy Management		Coleman	Terrica		8032642728					terrica.coleman@bcbssc.com	1-20 at Alpine Road	AX-740	Columbia	SC	29219	07/22/2022	2026	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	Chicago
S5953	Pharmacy Technical Help Desk Contact	Sr.		Villanueva	Juan							juan.villanueva@optum.com	11000 Optum Cir		Eden Prairie	MN	55344	03/27/2024	2026	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	8555405951				Medicare Prescription Drug Plan		5	Chicago
S5953	PHR Beneficiary Contact																	05/14/2015	2026	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	PDP	Blue Cross Blue Shield of South Carolina	Medicare Prescription Drug Plan	BlueCross BlueShield of South Carolina, Medicare Advantage	BlueCross BlueShield of South Carolina (BCBSSC)	2	Yes	Active	8886456025				Medicare Prescription Drug Plan		5	Chicago
S5953	Plan Directory Contact for Public Website			Services	Provider		8003342583					Provider.Education@BCBSSC.com	I-20 at Alpine Road	AX-624	Columbia	SC	29219	08/01/2011	2026	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	Chicago
S5953	Plan to Plan Reconciliation Contact	Director, Accounting		Campbell	Newt		8032640357				8038708623	Newt.Campbell@bcbssc.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	04/13/2023	2026	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	Chicago
S5953	Processor Contact	Supervisor - Medicare Advantage Operations		Dewitt	Tanika		8032641103					Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	03/15/2017	2026	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	Chicago
S5953	Reconciliation Contact	Director - Actuarial		Philips	Jeff		8032640783				8037361296	Jeff.Philips@BCBSSC.com	I-20 at Alpine Road	AX-555	Columbia	SC	29219	01/13/2025	2026	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	Chicago
S5953	Reconciliation Contact (Secondary)	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
S5953	Recovery Audit Contact	AVP	Ms.	Boggero	Laurin		8032646635				8032649581	Med.Partd@BCBSSC.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	12/22/2016	2026	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	Chicago
S5953	Surveillance Contact	AVP -  Medicare Advantage Operations		Edwards	Don		8032649482					Don.Edwards@bcbssc.com	I-20 at Alpine Road	AX-155	Columbia	SC	29219	12/14/2016	2026	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	Chicago
S5953	System Contact	Assistant Vice President - Information Systems		Aldinger	Eugenia		8032645410					Eugenia.Aldinger@bcbssc.com	I-20 at Alpine Road	AF-244	Columbia	SC	29219	02/26/2024	2026	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	Chicago
S5953	Third Party Administrator (TPA) Liaison	Accounting Manager		Shirey	Stephanie		8032641613					Stephanie.Shirey@bcbssc.com	I-20 at Alpine Road	AX-200	Columbia	SC	29219	12/11/2024	2026	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	Chicago
S5953	User Access Contact	Compliance Officer		Pierstorff	Joel		8032641971				8032644050	BCBSSC.MA.COMPLIANCE@bcbssc.com	I-20 at Alpine Road	AC-200	Columbia	SC	29219	12/01/2021	2026	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	Chicago
S5960	Agent/Broker Compensation Data Contact	Medicare Bus Relationship Director		Hayton	Annette		8056036822					annette.hayton@elevancehealth.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	10/21/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Automated TrOOP Balance Transfer Contact	Membership Representative III		McCurdy	Michelle		4083100551					FIRCommunications@elevancehealth.com	700 Broadway		Denver	CO	80273	08/28/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Backup User Access Contact	Compliance Analyst, Sr.		Garcia	Christina	M	8058901045					christina.garcia@anthem.com	21215 Burbank Blvd		Woodland Hills	CA	91367	05/10/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Best Available Evidence Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Bid Audit Contact	Associate Actuary		Hoogerwerf	Brad		3374964137					bradley.hoogerwerf@elevancehealth.com	11000 Weston Parkway		Cary	NC	27514	02/07/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Bid Audit Site Contact	Associate Actuary		Hoogerwerf	Brad		3374964137					bradley.hoogerwerf@elevancehealth.com	11000 Weston Parkway		Cary	NC	27514	02/07/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Bid Primary Contact	Senior Product Manager		Hayes	Cheryl		5405883356					cheryl.hayes@elevancehealth.com	5115 Blackhawk Circle		Salem	VA	24153	05/14/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	CAP Report Contact for Public Website	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	CEO - CMS Administrator Contact	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	CEO - Senior Official for Contracting	President Medicare Programs	Ms.	Dailey	Aimee		7576219273					aimee.dailey@elevancehealth.com	5800 Northampton Blvd		Norfolk	VA	23502	10/09/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Chief Financial Officer	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Chief Operating Officer	SVP & COO GBD	Mr.	Galle	Robert		8607193870					robert.galle@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	01/22/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Chief Information Officer	VP & CIO Government Health Benefits (US)	Mr.	Wali	Vikas		2243544199					vikas.wali@wellpoint.com	8600 Bryn Mawr Avenue		Chicago	IL	60631	01/22/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Chief Information Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	CMS Casework Communication Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/02/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Complaints Tracking Contact	Director II, GBD G&A		Sallee	Teia		5136497052				8884581406	teia.sallee@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	05/01/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Contact for Fraud Investigations	Director, Special Investigations		Utley	Chris		6155043875					chris.utley@amerigroup.com	22 Centrury Blvd., Suite 220		Nashville	TN	37214	02/28/2019	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	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		5025481076					beth.franke@carelon.com	13550 Triton Office Park Blvd		Louisville	KY	40223	05/01/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Corporate Mailing						8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive		Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Customer Service Operations Contact	Staff VP Contact Center		Barrios	Charles		8325840911					charles.barrios@elevancehealth.com	4361 Irwin Simpson		Mason	OH	45040	05/16/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	DIR Contact	Program Director		Diesburg	Sherry		5133349809					sherry.diesburg@elevancehealth.com	7741 Bonnie Dr.		West Chester	OH	45069	05/16/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	DIR Contact (Secondary)	Program Director		Browne	Nancy		3179197110					nancy.browne@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Discount Program Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Emergency Part D Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	06/28/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Emergency Part D Contact (Secondary)	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	02/02/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Employer Waiver Contact	Director & Actuary III		Farrell	Michael		2678466347					michael.farrell@elevancehealth.com	123 S. Justison Street		Wilmington	DE	19801	10/21/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Enrollment Contact	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	EOB Transfer Contact	Compliance Director, Med Part D/Pharm Oversight		Doss	Jennifer		5137484736				8558419706	jennifer.doss@anthem.com	4361 Irwin Simpson Road		Mason	OH	45040	10/08/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Financial Audit Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Financial Reporting Contact	VP Finance Medicare   Medicare CFO	Mr.	Dlugosz	Phillip		6303889140					phillip.dlugosz@elevancehealth.com	1792 Alysheba Way	Suite 200	Lexington	KY	40509	08/28/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Formulary Contact	Director, Clinical Pharmacy Operations		Vercueil	Alfonso		9492336807					alfonso.vercueil@carelon.com	4 Varesa		Irvine	CA	92620	05/01/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Formulary Contact (Secondary)	Manager Pharmacy Clinical Operations		Kazanfer	Kari		9738851430					Kari.Kazanfer@carelon.com	39 Lynwood Rd		Verona	NJ	07044	02/03/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	General Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	HIPAA Privacy Officer	Vice President, Chief Ethics and Privacy Officer		Robinson	Diidri		5623022326					privacy.office@elevancehealth.com	3080 Bristol Street	Ste 200	Costa Mesa	CA	92626	10/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	HIPAA Security Officer	Staff VP, Identity & Access Management	Ms.	Witte	Ginger		3174869495					ginger.witte@elevancehealth.com	220 Virginia Ave.		Indianapolis	IN	46204	08/28/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Hospice Contact	Manager II, Membership		Hayden	Donna		3038312025					donna.m.hayden@elevancehealth.com	700 Broadway	Mail Drop CO0109-0951	Denver	CO	80273	02/02/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Interoperability Contact	Director II Technology		Turney	Sheryl	A	2034649969					InteroperabilityWorkgroup@anthem.com	3080 Bristol Street	Suite 200	Costa Mesa	CA	92626	06/28/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Marketing Contact	Director I Health Plan Compliance		Martinez	Kati		8135576920					kati.martinez@elevancehealth.com	5411 Sky Center Drive		Tampa	FL	33607	05/16/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Medical Director	VP & Chief Medical Ofcr Government		McFadden	Adrienne		9842650109					Adrienne.McFadden@elevancehealth.com	5411 Sky Center Drive	7th Floor	Tampa	FL	33607	09/17/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	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		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Medicare Coordinator	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Medicare Part D Opioid Overutilization Contact	Manager Pharmacy Clinical Operations		Leason	Aneatria		8337282037					CMSRx@Carelon.com	740 W. Peachtree ST NW		Atlanta	GA	30308	07/03/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Medication Therapy Management Contact	Director of Clinical Pharmacy Strategies		Taylor	Stephanie		7572978692					stephanie.taylor@ingenio-rx.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	10/07/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	OffShore Subcontractor Contact	Director I Compliance		Bunch	Karlie		5138146208					karlie.bunch@elevancehealth.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/07/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Online Enrollment Center Contact (Back-up)	Staff VP E&B Strategy/Planning		Atkins	Gretchen		3174734141					gretchen.atkins@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	03/15/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Online Enrollment Center Contact (Optional)	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Online Enrollment Center Contact (Primary)	Director Program Management		Salvietti	Kerensa		2035984738					Kerensa.Salvietti@elevancehealth.com	108 Leigus Road		Wallingford	CT	06492	11/14/2022	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Appeals	Manager Medical Director, MD, RPh Medicare CAG	Dr.	Dearworth	David							david.dearworth@elevancehealth.com	4361 Irwin Simpson Rd	Mailstop OH0205-A537	Mason	OH	45040	10/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	5133167654				Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Appeals Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	7577562058				Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Application Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Benefits Contact	Staff VP, Medicare Compliance		Meidl	Chris		4144771533					christopher.meidl@elevancehealth.com	N5108 Fox River Lane		Princeton	WI	54968	05/29/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Claims Submission Contact	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	10/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	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@elevancehealth.com	4361 Irwin Simpson Rd		Mason	OH	45040	10/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	5133167654				Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Exceptions Contact (Secondary)	Pharmacist Clinical		Ciccolella	Lisa						8884581406	lisa.ciccolella@elevancehealth.com	5800 Northhampton Blvd		Norfolk	VA	23502	02/05/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	7577562058				Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Price File Contact (Back-up)	Business Change Manager		Mendez	Daniela		3232193390					Daniela.Mendez@carelon.com	1723 Loma Rd		Montebello	CA	90640	06/28/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Price File Contact (Optional)	Staff VP, Medicare Pharmacy Management		Arsenault	Bill		7574074167					william.arsenaultjr@carelon.com	5800 Northampton Blvd		Norfolk	VA	23502	05/01/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Price File Contact (Primary)	Business Change Manager		Nicholson-Sampson	Amanda		8053190159					Amanda.Nicholson-Sampson@carelon.com	2716 Brewer St		Lakewood	CA	90712	05/01/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Quality Assurance Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Part D Reporting Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Patient Safety Contact	VP Clinical Pharmacy		Morris	Lisa		5135158565					lisa.morris@carelon.com	4241 Irwin Simpson Road	OH0202-A844	Mason	OH	45040	02/29/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Payment Contact	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Personal Health Record Contact	VP IT Assoc Exper Chief Technology  Office		Wilson	Geeta		5133792409					geeta.wilson@anthem.com	4241 Irwin Simpson Road		Mason	OH	45040	02/03/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Pharmacy Director	Clinical Pharmacist Program Manager		Seto-Formica	Kristin		6265320026					Kristin.Seto-Formica@carelon.com	220 Virginia Ave		Indianapolis	IN	46204	07/09/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Pharmacy Network Management Contact	Pharmacy Network Management Director		Damon	Ben		5133823982					ben.damon@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	10/31/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Pharmacy Network Management Contact (Secondary)	Staff VP Pharmacy Management		Decembrele	Stacy		3393682432					Stacey.Decembrele@carelon.com	500 Unicorn Park Dr		Woburn	MA	01801	12/15/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Pharmacy Technical Help Desk Contact	Pharmacy Network Management Director		Damon	Ben							ben.damon@carelon.com	4241 Irwin Simpson Rd		Mason	OH	45040	02/29/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	8333774266				Medicare Prescription Drug Plan		5	Chicago
S5960	Pharmacy Technical Help Desk Contact (Secondary)	Director Pharmacy Management		Matthews	Amy							amyM.Matthews@carelon.com	4241 Irwin Simpson Rd.		Mason	OH	45040	02/29/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active	8333774266				Medicare Prescription Drug Plan		5	Chicago
S5960	PHR Beneficiary Contact																	11/05/2015	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan	Unicare	Elevance Health, Inc.	1	Yes	Active	8004671199				Medicare Prescription Drug Plan		5	Chicago
S5960	Plan Directory Contact for Public Website			Service	Customer		8882307338					DirectoryRequest_MMP@anthem.com	4361 Irwin Simpson Rd		Mason	OH	45040	05/23/2023	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Plan to Plan Reconciliation Contact	Financial Accountant		Tran	Phuong		8057131098					Phuong.Tran@anthem.com	21215 Burbank Blvd.	Suite 100 Mailstop:  CA9304-R04H	Woodland Hills	CA	91367	05/10/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Processor Contact	Staff Vice President, Pharmacy Strategy Management		Tartol	Sandy		3313137509					sandra.tartol@carelon.com	233 S. Wacker Drive		Chicago	IL	60606	10/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Reconciliation Contact	Director & Actuary III, Medicare FP&A		Reynolds	Jeffrey		5023811362					jeffrey.reynolds@elevancehealth.com	13550 Triton Office Park Blvd		Louisville	KY	40223	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Recovery Audit Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	05/16/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Surveillance Contact	Staff VP, Health Plan Compliance		Korty	Tina		4633202863					tina.korty@elevancehealth.com	220 Virginia Ave		Indianapolis	IN	46204	05/16/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	System Contact	Director, Engineering Govt. Medicare - Medicaid		Dani	Swapna		4044915994					Swapna.Dani@wellpoint.com	750 Peachtree St. NW		Atlanta	GA	30308	06/03/2025	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	Third Party Administrator (TPA) Liaison	Financial Accounting Database Analyst Sr.		Racine	Max		8058163930					max.racine@anthem.com	21215 Burbank Blvd.		Woodland Hills	CA	91367	05/06/2021	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5960	User Access Contact	Vice President, Medicare Compliance Officer	Ms.	Turano	Michelle		8132951367					MedicareCO@anthem.com	5411 SkyCenter Drive	Suite 700	Tampa	FL	33607	07/10/2024	2026	WELLPOINT LIFE AND HEALTH INSURANCE COMPANY	PDP	Wellpoint	Medicare Prescription Drug Plan		Elevance Health, Inc.	1	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S5966	Agent/Broker Compensation Data Contact	Dir. Medicare Sales		Pappalardo	Kimberly		6464477024					kpappalardo@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Automated TrOOP Balance Transfer Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					JEwen@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Backup User Access Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Best Available Evidence Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Bid Audit Contact	Medicare Compliance Leader		Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Bid Audit Site Contact	Sr. Medicare Audit Spec.		Chan	Tat		6464470218					tchan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Bid Primary Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	CAP Report Contact for Public Website	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	CEO - CMS Administrator Contact	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	CEO - Senior Official for Contracting	Office of the Executive Chair	Mr.	Palmateer	Michael		6464476170					mpalmateer@emblemhealth.com	55 Water Street	Admin-Corp Exec. Office	New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	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		6464476174					htamborino@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Chief Operating Officer	Chief Operating Officer	Mr.	MacMillan	Thomas		6464474401					tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Chief Information Officer	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Chief Information Security Officer	VP, Technology and CISO	Mr.	McDermott	Thomas	M	6464474110					tmcdermott@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	CMMI Model Point of Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	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	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Complaints Tracking Contact	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A	6464477215				2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Contact for Fraud Investigations	Director, Special Investigations		Lupo	Chris		6318442453					Clupo@EmblemHealth.com	395 North Service Road		Melville	NY	11747	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Coordination of Benefits Contact	AVP, Provider Claim Resolution		Maxwell	Christine		8606745751					cmaxwell@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Corporate Mailing						6464475000					Cborenkind@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Customer Service Operations Contact	VP Customer Service		Tirado	Nicole		5184466981					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	DIR Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	DIR Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Discount Program Payment Contact	Financial Operations and Treasury		Czerczak	Ewelina		8606745716					egradka@emblemhealth.com	175 Scott Swamp Rd		New York	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Emergency Part D Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Emergency Part D Contact (Secondary)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Employer Waiver Contact	AVP, Product Dev., Admin., & Perf. Analysis		Averyanova	Nataliya		6464475044					naveryanova@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Enrollment Contact	Dir., Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	EOB Transfer Contact	Dir., Claims Operations		Salcedo	Clifford		2126150511				2125105319	csalcedo@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Financial Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Financial Reporting Contact	Dir., Financial Reporting		Nogajewski	Scott		7086461563					snogajewski@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Formulary Contact	Sr. Formulary Specialist		Sitilides Cimino	Irene		6864477926					isitilidescimino@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Formulary Contact (Secondary)	Director, Formulary Development & UM		Sandoval	Natalie		3479132921					nasandoval@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	General Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Government Relations Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	HIPAA Privacy Officer	VP, Corporate Compliance		Lurin	Joseph		6464475203					jlurin@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	HIPAA Security Officer	AVP, IT Governance		McDermott	Thomas		6464474110					TMcDermott@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Hospice Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Interoperability Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Marketing Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Medical Director	Chief Medical Officer		Knecht	Daniel		6464476172					dknecht@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Medicare Compliance Officer	Dir., Govt. Program Regulatory/MCO	Mr.	Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Medicare Coordinator	VP, Medicare	Mr.	Walsh	Eric		6464477893					ericwalsh@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Medicare Part D Opioid Overutilization Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Medication Therapy Management Contact	Clinical Pharmacy Program Leader		Mhajan	Ruby		6464477632					rumhajan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	OffShore Subcontractor Contact	Lead Admin., Regulatory Pgm.		Kelly	Veronica		6464477494					vkelly@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Online Enrollment Center Contact (Back-up)	Knowledge Manager, Enroll. & Bill.		Gonzalez	Gabriel		6464477722					gabriel.gonzalez@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Online Enrollment Center Contact (Optional)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com.com	55 water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Online Enrollment Center Contact (Primary)	Dir, Enrollment & Billing		Ewen	Jillian		8606745780					jewen@emblemhealth.com	175 Scott Swamp Road		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Appeals	Dir., G & A and Pharmacy Ops.		Marie	Jacqueline	A					2125108130	jmarie@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	6464477215				Medicare Prescription Drug Plan		5	New York
S5966	Part D Appeals Contact (Secondary)	Mgr., G & A, Expedited Claims		Montana	Kim						2125108130	kgrace@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	6464470523				Medicare Prescription Drug Plan		5	New York
S5966	Part D Application Contact	Medicare Product Strategy Leader		Benoit	Theresa		8604096415					tbenoit@connecticare.com	175 Scott Swamp Road		Farmington	CT	06032	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Benefits Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Claims Submission Contact	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Exceptions Contact	Pharmacy Client Ops Director		Der Weer	J'Nisha							jderweer@emblemhealth.com	55 Water street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	6464477198				Medicare Prescription Drug Plan		5	New York
S5966	Part D Exceptions Contact (Secondary)	Pharmacy Perf. Mgmt. Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	4015251683				Medicare Prescription Drug Plan		5	New York
S5966	Part D Price File Contact (Back-up)	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Price File Contact (Optional)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Price File Contact (Primary)	Sr. Manager Regulated Markets		Dolfi	Amanda		6147349264					Medicarewebsitefiles@express-scripts.com	One Express Way - Bldg 1		St. Louis	MO	63121	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Quality Assurance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Part D Reporting Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Patient Safety Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Payment Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Personal Health Record Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Pharmacy Director	VP, Chief Pharmacy Officer		Smith	Jonalan		7858407007					jsmith@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Pharmacy Network Management Contact	Pharm. Govt. Programs Manager		Der Weer	J'Nisha		7869186890					jderweer@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Pharmacy Network Management Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory		4015251683					GrBrown@emblemhealth.com	55 Water St		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	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	13051 N. Telecom PKWY STE 150		Temple Terrace	FL	33637	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	8009221557	2			Medicare Prescription Drug Plan		5	New York
S5966	Pharmacy Technical Help Desk Contact (Secondary)	Pharmacy Client Ops Director		Brown	Gregory							grbrown@emblemhealth.com	55 Water street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active	4015251683				Medicare Prescription Drug Plan		5	New York
S5966	PHR Beneficiary Contact																	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan	EmblemHealth	EmblemHealth, Inc.	361	Yes	Active	8773447364				Medicare Prescription Drug Plan		5	New York
S5966	Plan Directory Contact for Public Website	VP Customer Service		Tirado	Nicole		8773447364					ntirado@emblemhealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Plan to Plan Reconciliation Contact	Accounts Payable Manager		Siozios	Jacqueline		6464473017					jsiozios@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Processor Contact	AVP, Claims Operations		Gauthier	Kathleen	H	8604096435					kgauthier@connecticare.com	175 Scott Swamp Road	PO BOX 4050	Farmington	CT	06034	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Reconciliation Contact	Dir., Enrollment & Billing		Ewen	Jillian	L	8606745780					jewen@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Reconciliation Contact (Secondary)	Mgr., Enrollment & Billing		Roman	Erica		6464477125					eroman@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Recovery Audit Contact	Medicare Compliance Leader	Mrs.	Helt	Nicole		6464470011					nhelt@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Surveillance Contact	Dir., Govt. Program Regulatory/MCO		Genovese-Scullin	Anthony		6464477110					agenovese@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	System Contact	Chief Information Officer	Mr.	MacMillan	Thomas	A	6464474401	34401				tmacmillan@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	Third Party Administrator (TPA) Liaison	Dir., Treasury		Pastorello	Thomas		9172248582					tpastorello@emblemhealth.com	55 Water Street		New York	NY	10041	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5966	User Access Contact	Lead Medicare Regulatory Spec.		Handy	Michelle		5184466949					mhandy@EmblemHealth.com	80 Wolf Road		Albany	NY	12205	12/03/2025	2026	EMBLEMHEALTH PLAN, INC	PDP	EmblemHealth	Medicare Prescription Drug Plan		EmblemHealth, Inc.	361	Yes	Active					Medicare Prescription Drug Plan		5	New York
S5975	Agent/Broker Compensation Data Contact	Senior Medicare Product Manager	Mrs.	Camp	Emily		5039525228					emily.camp@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	11/15/2019	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Automated TrOOP Balance Transfer Contact	Supervisor, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	Relay.Health@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/04/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Backup User Access Contact	Deputy Medicare Compliance Officer		Seon Hye-McInnes	Jangmie		5039525245					jangmie.seonhyemcinnes@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/02/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Best Available Evidence Contact	Supervisor, Membership Accounting		Windell	Jennifer		5032433951					jennifer.windell@modahealth.com	601 SW 2nd Avenue		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Bid Audit Contact	Senior Medicare Product Manager	Mrs.	Camp	Emily		5039525228					emily.camp@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/08/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Bid Audit Site Contact	Director, Actuarial & Underwriting	Ms.	Grantham	Jenna		5032652942					jenna.grantham@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/29/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Bid Primary Contact	Senior Medicare Product Manager	Mrs.	Camp	Emily		5039525228					emily.camp@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/08/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	CAP Report Contact for Public Website	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	CEO - CMS Administrator Contact	CEO	Mr.	Gootee	Robert		5032434491					robert.gootee@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/06/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	CEO - Senior Official for Contracting	CEO	Mr.	Gootee	Robert		5032434491				5032654790	robert.gootee@modahealth.com	601 S.W. Second Ave Suite 900		Portland	OR	97204	01/04/2024	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Chief Financial Officer	Sr VP CFO	Mr.	Evans	Dave		5032433952				5039485557	dave.evans@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	07/11/2018	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Chief Operating Officer	VP Claims, Customer Service and Configuration	Ms.	Thornburg	Margaret		5032654787					margaret.thornburg@modahealth.com	601 S.W. Second Ave Suite 900		Portland	OR	97204	11/10/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Chief Information Officer	Chief Information Officer	Mr.	Luther	David	A	5032655608					david.luther@modahealth.com	601 SW Second Ave.		Portland	OR	97204	05/29/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Chief Information Security Officer	Director, Information Security	Mr	James	Dayle		5039485597					dayle.james@modahealth.com	601 SW Second Ave.		Portland	OR	97204	04/08/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	CMS Casework Communication Contact	Lead Appeals Coordinator	Ms.	Shattuck	Mica		5034124021				8339491888	mica.shattuck@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/11/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Complaints Tracking Contact	Lead Appeals Coordinator	Ms.	Shattuck	Mica		5034124021				8339491888	mica.shattuck@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/11/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Contact for Fraud Investigations	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Coordination of Benefits Contact			Service	Customer		8772999062				5039485577	PharmacyMedicare@modahealth.com	PO Box 40327		Portland	OR	97240	04/19/2022	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Corporate Mailing						8772999062				5039485577	MedicalMedicare@modahealth.com	PO Box 40384		Portland	OR	972400384	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Customer Service Operations Contact	Customer Service Manager	Ms.	Duncan	Colleen		5037653424					colleen.duncan@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	02/11/2019	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	DIR Contact	Manager, Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	DIR Contact (Secondary)	Rx Government Programs Analyst		Beebe	Colin		5034124175					colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	02/23/2022	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Discount Program Payment Contact	Corporate Controller	Ms.	Stalsberg	Katie		5034124030					katie.stalsberg@modahealth.com	601 SW Second Ave		Portland	OR	97204	08/17/2016	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Emergency Part D Contact	Manager Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 SW Second Ave		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Emergency Part D Contact (Secondary)	Pharmacy PAC Govt Programs II		Beebe	Colin		7276566998					colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/13/2022	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Employer Waiver Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Enrollment Contact	Supervisor, Membership Accounting		Windell	Jennifer		5032433951					jennifer.windell@modahealth.com	601 SW 2nd Avenue		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	EOB Transfer Contact	Supervisor, Rx Quality and Compliance		Brokaw	Katie		5032654771				8339491891	katie.brokaw@modahealth.com	601 SW 2nd Avenue		Portland	OR	97204	04/01/2022	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Financial Audit Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Financial Reporting Contact	Corporate Controller	Ms.	Stalsberg	Katie		5034124030					katie.stalsberg@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	09/01/2016	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Formulary Contact	Manager Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 SW Second Ave		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Formulary Contact (Secondary)	Medicare Team Lead, Formulary Services		Paddock	Deanna		6087291628				6087292628	deanna.paddock@navitus.com	2601 West Beltline Highway, Suite 600		Madison	WI	53713	01/21/2021	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	General Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Government Relations Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	HIPAA Privacy Officer	Privacy Officer	Ms.	Adolphson	Lindsay		5032433955					Lindsay.Adolphson@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/14/2023	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	HIPAA Security Officer	Director, Information Security		James	Dayle		5039485597					dayle.james@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	06/24/2021	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Hospice Contact	Rx Government Programs Analyst	Mr.	Beebe	Colin		5034124175	4175			8002078235	colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	06/04/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Interoperability Contact	Director Regulatory Affairs and Privacy Officer	Mr	White	Scott		5039525044					scott.white@modahealth.com	601 SW Second Ave		Portland	OR	97204	04/17/2023	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Marketing Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/14/2023	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Medical Director	Medical Director	Dr.	Popowich	Yale		5039525022					Yale.Popowich@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/06/2021	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Medicare Compliance Officer	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Medicare Coordinator	Senior Medicare Product Manager	Ms.	Camp	Emily		5039525228					emily.camp@modahealth.com	601 SW Second Ave		Portland	OR	97204	09/04/2024	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Medicare Part D Opioid Overutilization Contact	Supervisor Quality & Compliance		Brokaw	Katie		5032654771					katie.brokaw@modahealth.com	601 SW Second Ave		Portland	OR	97204	08/26/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Medication Therapy Management Contact	Manager Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Appeals	Manager Medical Claims		Craft	Jessica							jessica.craft@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/30/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active	5032193675				Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Appeals Contact (Secondary)	Lead Appeals Coordinator	Ms.	Shattuck	Mica						8339491888	mica.shattuck@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	05/11/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active	8772999062				Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Application Contact	Senior Medicare Product Manager	Mrs.	Camp	Emily		5039525228					emily.camp@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	11/15/2019	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Benefits Contact	Manager Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Claims Submission Contact	Manager, Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/04/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Exceptions Contact	Pharmacy, Customer Service		Service	Customer						8002078235	PharmacyMedicare@modahealth.com	601 S.W. Second Ave.		Portland	OR	97204	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active	8887867509				Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Exceptions Contact (Secondary)	Manager Pharmacy Operations		Saint	Jenny							Jenny.Saint@modahealth.com	601 SW Second Ave		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active	9715016597				Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Price File Contact (Back-up)	Supervisor Pharmacy Operations	Mr.	Beebe	Colin		5034124175	4175			8339491889	colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/28/2021	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Price File Contact (Primary)	Supervisor	Mr.	Beebe	Colin		5034124175	4175			8002078235	colin.beebe@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	03/30/2018	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Quality Assurance Contact	Manager Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 SW Second Ave		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Part D Reporting Contact	Deputy Medicare Compliance Officer		Seon Hye-McInnes	Jangmie		5039525245					jangmie.seonhyemcinnes@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	12/02/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Patient Safety Contact	Manager Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 SW Second Ave		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Payment Contact	Corporate Controller		Stalsberg	Katie		5034124030					katie.stalsberg@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Pharmacy Director	Director, Pharmacy		Rodriguez	Carly		5039525011					carly.rodriguez@modahealth.com	601 SW Second Ave		Portland	OR	97204	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Pharmacy Network Management Contact	VP Network Management		Santos	Christina		6088204408				6088204408	Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	04/11/2024	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Pharmacy Network Management Contact (Secondary)	Manager		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 SW Second Ave		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						9202214724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	06/04/2020	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active	8662703877	4224			Medicare Prescription Drug Plan		5	Dallas
S5975	Plan Directory Contact for Public Website			Service	Customer		8772999062				5039485577	MedicalMedicare@modahealth.com	PO Box 40384		Portland	OR	972400384	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Plan to Plan Reconciliation Contact	Lead Pharmacy Benefit Formulary Coordinator	Ms	Brokaw	Katie		5032654771	4771				katie.brokaw@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	10/29/2019	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Processor Contact	Manager, Pharmacy Operations		Saint	Jenny		9715016597					Jenny.Saint@modahealth.com	601 S.W. Second Ave		Portland	OR	97204	12/03/2025	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Reconciliation Contact	Supervisor, Rx Quality and Compliance		Brokaw	Katie		5032654771					katie.brokaw@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	02/23/2022	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Recovery Audit Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Surveillance Contact	Medicare Compliance Officer		McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	System Contact	Medicare Compliance Officer		McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue		Portland	OR	97204	01/25/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	Third Party Administrator (TPA) Liaison	Corporate Controller	Ms.	Stalsberg	Katie		5034124030					katie.stalsberg@modahealth.com	601 SW Second Ave		Portland	OR	97204	08/18/2016	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5975	User Access Contact	Medicare Compliance Officer	Mr.	McWhorter	Gary		5039525075					gary.mcwhorter@modahealth.com	601 S.W. Second Avenue Suite 900		Portland	OR	97204	12/27/2017	2026	MODA HEALTH PLAN, INC.	PDP	Moda Health Plan, Inc.	Medicare Prescription Drug Plan		Moda Partners, Inc.	226	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S5993	Agent/Broker Compensation Data Contact	Regulatory Compliance Assoc.	Ms.	Jenkins	Nicole		9734668149					nicole_jenkins@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	06/05/2024	2026	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	Dallas
S5993	Automated TrOOP Balance Transfer Contact	Director, PBM Ops.	Ms.	Cain	Christina		6127776722				6127771330	EOBP2P@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	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	Dallas
S5993	Backup User Access Contact	Medicare Program Analyst		Vargas	Mario		9734666379					mario_vargas@horizonblue.com	3 Penn Plaza East	16-C	Newark	NJ	07105	07/23/2019	2026	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	Dallas
S5993	Best Available Evidence Contact	Supervisor, Govt. Programs		Achoe	Kisha		9734667328					Kisha_Achoe@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	07/27/2023	2026	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	Dallas
S5993	Bid Audit Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319					jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	02/21/2013	2026	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	Dallas
S5993	Bid Audit Site Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319					jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	02/21/2013	2026	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	Dallas
S5993	Bid Primary Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319					jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	02/21/2013	2026	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	Dallas
S5993	CAP Report Contact for Public Website	VP, Reg. Compliance/MCO	Mr	McGrady	Daniel		6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	04/06/2023	2026	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	Dallas
S5993	CEO - CMS Administrator Contact	SVP, Government Programs	Ms.	Rittenour	Debbie		4124451886					debbie_rittenour@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	03/27/2025	2026	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	Dallas
S5993	CEO - Senior Official for Contracting	SVP, Government Programs	Ms.	Rittenour	Debbie		4124451886					debbie_rittenour@horizonblue.com	3  Penn Plaza	PP-16	Newark	NJ	07105	03/27/2025	2026	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	Dallas
S5993	Chief Financial Officer	SVP & Chief Financial Offcr.	Mr.	Rosenberg	David		9734664600					david_rosenberg@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/02/2022	2026	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	Dallas
S5993	Chief Operating Officer	SVP, Government Programs	Ms.	Rittenour	Debbie		4124451886					debbie_rittenour@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	03/27/2025	2026	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	Dallas
S5993	Chief Information Officer	Chief Information Officer	Ms.	Lavoie	Heather		9734664650					heather_lavoie@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	07/02/2025	2026	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	Dallas
S5993	Chief Information Security Officer	Chief Information Security Officer	Mr.	Patel	Niraj		9734664409					niraj_patel@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	CMS Casework Communication Contact	Director, GP Operations		Maramraju	Venkata		6095372113					venkata.maramraju@horizonblue.com	1700 American Boulevard		Pennington	NJ	08534	01/03/2022	2026	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	Dallas
S5993	Complaints Tracking Contact	Mgr, Exec DOBI Compl & Appls		Mestres	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	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	Dallas
S5993	Contact for Fraud Investigations	Sr. Director, Special Investigations		Dineen	Timothy		9734668723					timothy_dineen@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Coordination of Benefits Contact	Director, PBM Ops	Ms.	Cain	Christina		6127776722				6127771330	COBMedD@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	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	Dallas
S5993	Corporate Mailing						6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	04/06/2023	2026	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	Dallas
S5993	Customer Service Operations Contact	Director, Service Operations	Mr.	Yanek	John		5182208000					john_yanek@horizonblue.com	3 Penn Plaza		Newark	NJ	07105	06/13/2022	2026	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	Dallas
S5993	DIR Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542				9734664665	athena_patrikios@horizonblue.com	3 Penn Plaza East,  PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	DIR Contact (Secondary)	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	3 Penn Plaza East	PP-12	Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Discount Program Payment Contact	Supervisor-Accounting		Fuentes	Yunetsi		2018895531					yunetsi_fuentes@horizonblue.com	3 Penn Plaza E		Newark	NJ	07101	09/17/2025	2026	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	Dallas
S5993	Emergency Part D Contact	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	01/06/2025	2026	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	Dallas
S5993	Emergency Part D Contact (Secondary)	Manager, Clinical Pharmacy		Sun	Jane		9734665044					jane_sun@horizonblue.com	3 Penn Plaza	PP 12-Q	Newark	NJ	07105	12/11/2018	2026	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	Dallas
S5993	Enrollment Contact	Director, G. P. Operations		Maramraju	Venkata		6095372113					venkata_maramraju@horizonblue.com	1700 American Blvd. HL-03		Pennington	NJ	08534	10/31/2017	2026	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	Dallas
S5993	EOB Transfer Contact	Director, PBM Ops.	Ms.	Cain	Christina		6127776722				6127771330	EOBP2P@primetherapeutics.com	2990 Ames Crossing Rd		Eagan	MN	55121	11/28/2023	2026	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	Dallas
S5993	Financial Audit Contact	Director, Regulatory Compliance	Ms.	Ventura	Jill		6095372611					Jill_Ventura@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/22/2023	2026	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	Dallas
S5993	Financial Reporting Contact	Corporate Controller		Concepcion	Ivan		9734664188					Ivan_Concepcion@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	05/01/2023	2026	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	Dallas
S5993	Formulary Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					athena_patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Formulary Contact (Secondary)	Supervisor, Pharmacists	Ms.	Godfrey	Cindy		6127776307					cindy.godfrey@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	06/09/2025	2026	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	Dallas
S5993	General Contact	Director, Regulatory Compliance	Ms.	Ventura	Jill		6095372611					Jill_Ventura@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/22/2023	2026	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	Dallas
S5993	Government Relations Contact	Director, Regulatory Compliance	Ms.	Ventura	Jill		6095372611					Jill_Ventura@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	11/22/2023	2026	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	Dallas
S5993	HIPAA Privacy Officer	Privacy Official		Dates	Chris	A	9734667669					chris_dates@horizonblue.com	3 Penn Plaza East, PP-16C		Newark	NJ	07105	07/07/2015	2026	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	Dallas
S5993	HIPAA Security Officer	Chief Information Security Officer	Mr.	Patel	Niraj		9734664409					niraj_patel@horizonblue.com	3 Penn Plaza	PP-16	Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Hospice Contact	Manager, Clinical Pharmacy		Sun	Jane		9734665044					Jane_Sun@horizonblue.com	3 Penn Plaza	12-Q	Newark	NJ	07105	02/15/2018	2026	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	Dallas
S5993	Interoperability Contact	Director, Mandate Implementation		Gregory	Stacey		9734668278					Stacey_Gregory@horizonblue.com	3 Penn Plaza	PP-09	Newark	NJ	07105	01/04/2023	2026	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	Dallas
S5993	Marketing Contact	Sales Manager II		Cennamo	Steven	P	9084160480					steven_cennamo@horizonblue.com	3 Penn Plaza East	PP-12F	Newark	NJ	07105	02/09/2022	2026	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	Dallas
S5993	Medical Director	Senior Medical Director	Dr.	Abidi	Fatema		8566383042					fatema_abidi@horizonblue.com	1700 American Blvd	HL-01	Pennington	NJ	08534	12/13/2024	2026	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	Dallas
S5993	Medicare Compliance Officer	Director, Reg. Requirements/ MCO	Mr	McGrady	Daniel		7325393680					daniel_mcgrady@horizonblue.com	1700 American Blvd.	HL-03	Pennington	NJ	08534	07/12/2021	2026	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	Dallas
S5993	Medicare Coordinator	VP, Reg. Compliance/MCO	Mr.	McGrady	Daniel		6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East	PP-16	Newark	NJ	07105	04/06/2023	2026	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	Dallas
S5993	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacists		Anderson	Ally		8554570763				8557297221	PartDoverutil@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	03/21/2022	2026	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	Dallas
S5993	Medication Therapy Management Contact	Manager, MTM and Case/Care Management		Helbling	Matthew		8666862223				8666862220	MTM.Leadership@primetherapeutics.com	PRIME Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/21/2022	2026	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	Dallas
S5993	OffShore Subcontractor Contact	Manager, Medicaid Regulatory Requirements		McGrady	Daniel		6095372617					daniel_mcgrady@horizonblue.com	1700 American Blvd	HL-03P	Pennington	NJ	08534	12/11/2018	2026	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	Dallas
S5993	Online Enrollment Center Contact (Back-up)	Supervisor		Johnson	Cheryl		9734666931					cheryl_johnson@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	12/22/2016	2026	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	Dallas
S5993	Online Enrollment Center Contact (Optional)	Team Leader		Johnson	Cheryl		9734666931					Cheryl_Johnson@horizonblue.com	3 Penn Plaza - PP12L		Newark	NJ	07105	04/18/2016	2026	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	Dallas
S5993	Online Enrollment Center Contact (Primary)	Manager, Medicare Operations		Santiago-Mercado	Nitza		9734667346					Nitza_Santiago-mercado@horizonblue.com	3 Penn Plaza East, PP-12L		Newark	NJ	07105	09/13/2018	2026	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	Dallas
S5993	Part D Appeals	Regulatory Director	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	03/21/2022	2026	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5993	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd	Clinical Review	Eagan	MN	55121	03/21/2022	2026	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5993	Part D Application Contact	Director, Medicare Products, Community & Sales		Kudgis	Len		6095372085					len_kudgis@horizonblue.com	3 Penn Plaza	PP-12	Newark	NJ	07105	01/08/2025	2026	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	Dallas
S5993	Part D Benefits Contact	Director, Benefits Ops.	Ms.	Gergen	Ashley		6127772506					agergen@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	10/06/2020	2026	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	Dallas
S5993	Part D Claims Submission Contact	Functional Business Consultant - Govt. Programs	Mr.	Brooke	Lance		4026862603					LBrooke@primetherapeutics.com	PRIME Therapeutics, LLC	2655 Eagan Woods Drive	Eagan	MN	55122	04/09/2019	2026	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	Dallas
S5993	Part D Exceptions Contact	Director, Reg/Audit Response	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Rd		Eagan,	MN	55121	04/15/2021	2026	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5993	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	Prime Therapeutics LLC	2900 Ames Crossing Road	Eagan	MN	55120	03/21/2022	2026	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Dallas
S5993	Part D Price File Contact (Back-up)	Price File Analyst	Ms.	Tastad	Emily		6127771699					Emily.Tastad@PrimeTherapeutics.com	Prime Therapeutics	2900 Ames Crossing Road	Eagan	MN	55121	11/28/2023	2026	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	Dallas
S5993	Part D Price File Contact (Optional)	Manager, Pharmacy Ops - Medicare		Farber	Keri	A	9734668995					keri_farber@horizonblue.com	Horizon Blue Cross Blue Shield of NJ	3 Penn Plaza, PP-12	Newark	NJ	07105	01/06/2025	2026	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	Dallas
S5993	Part D Price File Contact (Primary)	Sr. Business Solutions Analyst	Ms.	Trudeau	Ashley		6127771338					Ashley.Trudeau@primetherapeutics.com	PRIME Therapeutics, LLC	2900 Ames Crossing Road	Eagan	MN	55121	11/28/2023	2026	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	Dallas
S5993	Part D Quality Assurance Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					Athena_Patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Part D Reporting Contact	Manager, Audit Readiness	Mrs.	Santoro	Cynthia		9734668395					cynthia_santoro@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Patient Safety Contact	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					Athena_Patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Payment Contact	Supervisor-Accounting		Fuentes	Yunetsi		2018895531					yunetsi_fuentes@horizonblue.com	3 Penn Plaza		Newark	NJ	07101	09/17/2025	2026	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	Dallas
S5993	Pharmacy Director	Director, Pharmacy - Medicare		Patrikios	Athena		9734664654					athena_patrikios@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Pharmacy Network Management Contact	AVP, Network Mgmt	Ms	Conlin	Marci		6127772842					Marci.Conlin@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55121	04/15/2021	2026	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	Dallas
S5993	Pharmacy Network Management Contact (Secondary)	Sr. Director Network Client Svcs.	Ms	Hanley	Megan		6127773969				8778236373	Megan.Hanley@primetherapeutics.com	2900 Ames Crossing Rd		Eagan	MN	55122	01/05/2021	2026	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	Dallas
S5993	Pharmacy Technical Help Desk Contact	Director, Member Services		Schultz	Bret							bret.schultz@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/12/2024	2026	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	8003911926				Medicare Prescription Drug Plan		5	Dallas
S5993	Pharmacy Technical Help Desk Contact (Secondary)	AVP, Customer Exp. & Member Ops.		Bunch	Jonathan							jonathan.bunch@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	06/12/2024	2026	HORIZON INSURANCE COMPANY	PDP	Horizon Blue Cross Blue Shield of New Jersey	Medicare Prescription Drug Plan		Horizon Mutual Holdings, Inc	126	Yes	Active	8003911926				Medicare Prescription Drug Plan		5	Dallas
S5993	Plan Directory Contact for Public Website	Mgr, Exec DOBI Compl & Appls		Mestres	Suze		9734665503					suze_mestres@horizonblue.com	3 Penn Plaza East	PP-14	Newark	NJ	07105	06/15/2020	2026	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	Dallas
S5993	Plan to Plan Reconciliation Contact	Pharmacy Business Admin		Cunningham	Theresa		9734667886				9734664665	theresa_cunningham@horizonblue.com	3 Penn Plaza East, PP-12Q		Newark	NJ	07105	10/14/2016	2026	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	Dallas
S5993	Processor Contact	Director, PBM Ops.	Ms.	Allie	Cindy		6127776722				6127776706	MedicareClaimResearch@primetherapeutics.com	2900 Ames Crossing Rd	PRIME Therapeutics	Eagan	MN	55121	09/28/2022	2026	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	Dallas
S5993	Reconciliation Contact	Director, Actuarial Services		Schindler	Jeffrey	P	7322565319				7322565428	jeffrey_p_schindler@horizonblue.com	1427 Wyckoff Road   WL-03R		Wall	NJ	07727	03/26/2014	2026	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	Dallas
S5993	Reconciliation Contact (Secondary)	Manager, Actuarial		Muellers	Barbara		7322565313				7322565428	barbara_muellers@horizonblue.com	1427 Wyckoff Road	WL-03R	Wall	NJ	07727	03/26/2014	2026	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	Dallas
S5993	Recovery Audit Contact	Sr. Director, Special Investigations	Mr.	Dineen	Timothy		9734668723					timothy_dineen@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	Surveillance Contact	VP, Reg. Compliance/MCO	Mr.	McGrady	Daniel		6095372317					daniel_mcgrady@horizonblue.com	3 Penn Plaza East		Newark	NJ	07105	04/06/2023	2026	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	Dallas
S5993	System Contact	Director, Information Security		Andreano	Matthew		9734667330					Matthew_Andreano@horizonblue.com	3 Penn Plaza East, PP-16K		Newark	NJ	07105	05/19/2022	2026	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	Dallas
S5993	Third Party Administrator (TPA) Liaison	Director, Pharmacy - Medicare		Patrikios	Athena		9734666542					athena_patrikios@horizonblue.com	3 Penn Plaza East	PP-12	Newark	NJ	07105	12/13/2024	2026	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	Dallas
S5993	User Access Contact	Regulatory Compliance Assoc.	Mr.	Vargas	Mario		9734666379					Mario_Vargas@horizonblue.com	3 Penn Plaza	16-C	Newark	NJ	07105	06/05/2024	2026	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	Dallas
S6875	Agent/Broker Compensation Data Contact	Mgr. Sales Onboarding		Heckman	Jim		2152411994					jim.heckman@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	07/09/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Automated TrOOP Balance Transfer Contact	Lead Business Systems Support Admin		Jimenez	Barbara		2676751825					barbara.jimenez@ibx.com	1901 Market Street	16th Floor	Philadelphia	PA	19103	02/27/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Backup User Access Contact	Reg. Performance Mgmt. Analyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/27/2020	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Best Available Evidence Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Bid Audit Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Bid Audit Site Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Bid Primary Contact	Mgr & Actuary   Medicare & Ancillary Pricing		Dixon	John		2152411485					john.dixon@ibx.com	1901 Market Street	40th Floor	Philadelphia	PA	19103	05/08/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	CAP Report Contact for Public Website	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	CEO - CMS Administrator Contact	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		6094050539					Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	CEO - Senior Official for Contracting	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Chief Financial Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Chief Operating Officer	EVP, CFO, & Treasurer	Mr.	Lopez	Juan		2152414614	24614				Jaun.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	06/15/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Chief Information Officer	EVP and Chief Strategy, Corp. Dev., & Info Officer	Mr.	Vennera	Michael		2152419525					Michael.Vennera@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	04/24/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Chief Information Security Officer	Chief Information Security Leader	Mr.	Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901 Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	CMS Casework Communication Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Complaints Tracking Contact	Manager, Process Svcs Performance & Admin		Davis	Isabel		2676751635					isabel.davis@ibx.com	1900 Market Street	4th Floor	Philadelphia	PA	19103	11/12/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Contact for Fraud Investigations	Director, Financial Investigations		Deery	Christophe	E	2156407302	27302			2152382287	christopher.deery@ibx.com	1901 Market Street	42nd Floor	Philadelphia	PA	19103	12/30/2015	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Coordination of Benefits Contact	Manager, COB/OPL		Hawkins	Veronica		2156407507	27507				Veronica.Hawkins@ibx.com	1901 Market Street	17th Floor	Philadelphia	PA	19103	12/24/2020	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Corporate Mailing						2152412400					mitchell.goldberg@ibx.com	1901 Market Street		Philadelphia	PA	19103	02/27/2012	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Customer Service Operations Contact	Director, Contact Center		Lentz	Michael		2157933262	63262				michael.lentz@ibx.com	1900 Market Street	5th Floor	Philadelphia	PA	19103	11/01/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	DIR Contact	Manager Gov. Markets - Commercial Risk Adjustment		Sanders	Sean		2152419420					Sean.Sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	06/29/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	DIR Contact (Secondary)	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2152417265					Geoffrey.Wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Discount Program Payment Contact	Lead Accountant		Murphy	Stacey		2152413522	23522				Stacey.Murphy@ibx.com	1901 Market Street, 36th Floor	Corporate Accounting	Philadelphia	PA	19103	04/24/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Emergency Part D Contact	Process & Governance Dir   Pharmacy		Erdman	Kathy		6107723634					kathy.erdman@ibx.com	1901 Market Street		Philadelphia	PA	19103	12/17/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Emergency Part D Contact (Secondary)	Manager, Regulatory Performance Management		Adams	Desiree		2153279829					Desiree.Adams@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/24/2020	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Employer Waiver Contact	SVP Government Markets, Sales & Marketing Leadersh	Ms.	Cruz	Kortney		2152414762					Kortney.Cruz@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Enrollment Contact	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	EOB Transfer Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Financial Audit Contact	VP Corporate Compliance	Mr	Zipfel	Michael		2152414908				2155674542	Michael.Zipfel@ibx.com	1901 Market Street		Philadelphia	PA	19103	09/05/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Financial Reporting Contact	EVP, CFO, & Treasurer		Lopez	Jaun		2152414614					Juan.Lopez@ibx.com	1901 Market Street	45th Floor	Philadelphia	PA	19103	11/01/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Formulary Contact	Clinical Pharmacist		Urbanek	Michael		2152419003					Michael.Urbanek@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	11/12/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Formulary Contact (Secondary)	Clinical Consultant-Optum Rx		Sosinsky	Inna		7633616985					Inna.Sosinsky@Optum.com	1100 Optum Circle		Eden Parairie	MN	55344	02/06/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	General Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Government Relations Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	HIPAA Privacy Officer	Director, Privacy Officer		Rieben	Laura		2152414462					laura.rieben@ibx.com	1901 Market Street		Philadelphia	PA	19013	02/13/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	HIPAA Security Officer	Director Information Security		Crabtree	Charles		2152414561					charles.crabtree@ibx.com	1901 Market Street	6th Floor	Philadelphia	PA	19103	10/19/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Hospice Contact	Pharmacy Service Process & Governance Director		Erdman	Kathy		2152412654					kathy.erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	06/29/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Interoperability Contact	Healthcare Interoperability Director		Denyer	James		2152410858					james.denyer@ibx.com	1901 Market Street	20th Floor	Philadelphia	PA	19103	04/10/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Marketing Contact	RPM Analyst II, NJMA Government		Dunn	DeVonda		2152413837					devonda.dunn@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	02/16/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Medical Director	Medical Director		Ramos	Luz		2152414040					luz.ramos@ibx.com	1901 Market Street		Philadelphia	PA	19103	11/12/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Medicare Compliance Officer	Director, Corporate Compliance, Medicare and Comme	Mr.	Goldberg	Mitchell		2152419516				2155674542	Mitchell.Goldberg@ibx.com	1901 Market Street	42nd Floor	Philadelphia	PA	19103	02/13/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Medicare Coordinator	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist		Soribe	Nneka		2152414729				2152413526	nneka.soribe@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	03/05/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Medication Therapy Management Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Online Enrollment Center Contact (Back-up)	Manager, Enrollment Services		Kelley	Josh		2152414829					Joshua.Kelley@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/19/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Online Enrollment Center Contact (Optional)	Regulatory Performance Mgmt. Analyst II		Smith	Janet		2152419308					janet.smith@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	12/19/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Online Enrollment Center Contact (Primary)	Sr. Business Analyst		Caldwell	Geraldine		2676751809					Geraldine.Caldwell@ibx.com	1901 Market Street, 16th Floor		Philadelphia	PA	19103	12/16/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Appeals	Manager, Medicare Member Appeals and Grievances		Tobias	Bobbi							Bobbi.Tobias@ibx.com	1901 Market Street	Mailstop, 12TH floor	Philadelphia	PA	19103	04/19/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	8887183333				Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Appeals Contact (Secondary)	Supervisor, Medicare Member Appeals and Grievances		Byrd	Kelly							Kelly.Byrd@ibx.com	1901 Market Street	Mailstop, 12TH floor	Philadelphia	PA	19103	06/28/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	8887183333				Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Application Contact	Senior Product and Capability Mgr.		Keenan	Kate		2152419495					kate.keenan@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	02/28/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Benefits Contact	Pharmacy Services Process & Governace Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Claims Submission Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Exceptions Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	8886787015				Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Exceptions Contact (Secondary)	Manager, Prior Authorization		Mourad	Hala							Hala.Mourad@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	8886787015				Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Price File Contact (Back-up)	Senior Business Analyst, Plan Finder		Moore-Elliott	Shalandria		7637974305					Mshalandria.moore-elliott@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Price File Contact (Optional)	Project Leader		Coursey	Yaminah		2152413955					yarminah.coursey@ibx.com	1900 Market Street	29th Floor	Philadelphia	PA	19103	02/15/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Price File Contact (Primary)	Senior Business Analyst, Plan Finder		Lam	Annie		6124286588					annie.lam@optum.com	11000 Optum Circle		Eden Prairie Eden	MN	55344	10/25/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Quality Assurance Contact	Director Quality Management		Donohue	Kathleen		2152413277					Kathleen.Donohue@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/27/2018	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Part D Reporting Contact	Manager, Government Markets Reporting		Pippett	Andrew		2152417416					Andrew.Pippett@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/29/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Patient Safety Contact	Clinical Pharmacist		Patel	Parshil		2152410941				2152413526	parshil.patel@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	07/03/2025	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Payment Contact	Manager, Risk Analytics		Buscher	Harry		2152410806					harry.buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	06/17/2015	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Pharmacy Director	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Pharmacy Network Management Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Pharmacy Network Management Contact (Secondary)	Manager, Retail Network Operations		Perez	Felix	M	7632833503					felix.perez@optum.com	11000 Optum Circle		Eden Prairie	MN	55344	05/17/2023	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Pharmacy Technical Help Desk Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy						2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	12/19/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	8886787015				Medicare Prescription Drug Plan		5	Chicago
S6875	Pharmacy Technical Help Desk Contact (Secondary)	Manager Pharmacy Help Desk		Villanueva	Juan							juan.villlanueva@optum.com	11000 Optum Cir City		Eden Prairie	MN	55344	12/19/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active	8886787015				Medicare Prescription Drug Plan		5	Chicago
S6875	Plan Directory Contact for Public Website			Service	Customer		8886787009					info@ibxmedicare.com	PO Box 7799		Philadelphia	PA	191017799	04/29/2015	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Plan to Plan Reconciliation Contact	Lead GM Data Audit & Sub Analyst		Wyher	Geoffrey		2156407265				2152412408	geoffrey.wyher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	02/18/2022	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Processor Contact	Pharmacy Services Process & Governance Director		Erdman	Kathy		2152412654				2152413526	Kathy.Erdman@ibx.com	1901 Market Street	29th Floor	Philadelphia	PA	19103	04/16/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Reconciliation Contact	Director Risk Adjustment & Data Delivery		Buscher	Harry		2152410806					harry.buscher@ibx.com	1901 Market Street	37th Floor	Philadelphia	PA	19103	03/27/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Reconciliation Contact (Secondary)	Mgr. Gov. Mkts. - Commercial Risk Analytics		Sanders	Sean		2152419420					Sean.Sanders@ibx.com	1901 Market Street	35th Floor	Philadelphia	PA	19103	01/15/2021	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Recovery Audit Contact	Director of Regulatory Performance Management	Ms.	Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Surveillance Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	System Contact	Director   Solution Delivery		Basvapatri	Satish	A	2156407504					Satish.Basvaptri@ibx.com	1901 Market Street	8th Floor	Philadelphia	PA	19103	06/27/2017	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	Third Party Administrator (TPA) Liaison	Lead Accountant		Murphy	Stacey		2152413522	23522				Stacey.Murphy@ibx.com	1901 Market Street, 36th Floor	Corporate Accounting	Philadelphia	PA	19103	04/24/2024	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6875	User Access Contact	Director of Regulatory Performance Management		Wyka	Tara		2152413648					Tara.Wyka@ibx.com	1901 Market Street	22nd Floor	Philadelphia	PA	19103	06/25/2019	2026	QCC INSURANCE COMPANY	PDP	Independence Blue Cross	Medicare Prescription Drug Plan		Independence Health Group, Inc.	609	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S6939	Agent/Broker Compensation Data Contact	VP, Sales		Gabryjelski	Andre		9783608216					agabryjelski@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Automated TrOOP Balance Transfer Contact	Vice President, Business Operations		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Backup User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Best Available Evidence Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Bid Audit Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Bid Primary Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	01701	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	CAP Report Contact for Public Website	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	CEO - CMS Administrator Contact	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	CEO - Senior Official for Contracting	President	Mr	Tringale	Steve		8572827652					sjtringale@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Chief Financial Officer	Chief Financial Officer	Ms	Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Chief Operating Officer	Chief Operations Officer	Mr	Mcormick	Mark		8572823180					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Chief Information Officer	Chief Information Officer	Mr	Bundela	Yogi		8572822863					ybundela@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Chief Information Security Officer	Chief Information Security and Privacy Officer	Mr	Tsuchida	Toby		8572823518					ttsuchida@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	CMS Casework Communication Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Complaints Tracking Contact	Director, Appeals and Grievances		Swasey	Andrea		8004335556	1005				aswasey@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Contact for Fraud Investigations	Director, Special Investigation Unit		Roy	Jessica		6179594150					jroy22@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/02/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Coordination of Benefits Contact	Manager, Recoveries		Ryan	Cathy		8572829131					cryan17@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Corporate Mailing						8572823348					bbowen1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Customer Service Operations Contact	Director, Customer Services		Armstrong	Carolyn		4134270087					carmstrong6@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	DIR Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Discount Program Payment Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Emergency Part D Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Emergency Part D Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Enrollment Contact	Director, Enrollment		Merrill	Benjamin		8572822831					bmerrill2@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	EOB Transfer Contact	Manager, Reporting		Devereux	Mary		8472244888				1111111111	mary.devereux@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Financial Audit Contact	Finance Director	Ms.	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Financial Reporting Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Formulary Contact	Manager Pharmacy Operations Medicare		Hart	Maegen		8572825333					mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	09/23/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Formulary Contact (Secondary)	Director of Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	09/23/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	General Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Government Relations Contact	Director, Government Affairs		Sullivan	John		8572823376					jsullivan77@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	HIPAA Privacy Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	HIPAA Security Officer	SVP, Legal, Regulatory Affairs and Compliance		Moore	Alice		8572826589					amoore19@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Hospice Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Interoperability Contact	Vice President, Legal and Regulatory Affairs		Richardson	Stephanie		5087760489					srichardson1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Marketing Contact	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Medical Director	Chief Medical Director	Dr	Yoon	Ed		2074581035					ebyoon@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/03/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Medicare Compliance Officer	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Medicare Coordinator	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Drive		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Medicare Part D Opioid Overutilization Contact	Director, Pharmacy		Gallagher	Angela		8572823348					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Medication Therapy Management Contact	MTM Contact		Carter	Cimone		7633481324					cimone_carter@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Part D Appeals	Manager, Prior Authorization Appeals		Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active	7148253783				Medicare Prescription Drug Plan		5	Boston
S6939	Part D Appeals Contact (Secondary)	Pharmacy Technician Lead		Jackson	Shannon							shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active	7633615070				Medicare Prescription Drug Plan		5	Boston
S6939	Part D Application Contact	Medicare Product Manager		O'Connor	Shantelle		4132043980					soconnor21@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Part D Benefits Contact	Director, Product		Sepko	Amy		8572823348					asepko@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Part D Claims Submission Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Part D Exceptions Contact	Manager, Prior Authorization Appeals		Le	Christina							christina.le@optum.com	PO Box 2975		Mission	KS	66201	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active	7148253783				Medicare Prescription Drug Plan		5	Boston
S6939	Part D Exceptions Contact (Secondary)	Pharmacy Technician Lead		Jackson	Shannon							shannon.jackson@optum.com	PO Box 2975		Mission	KS	66201	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active	7633615070				Medicare Prescription Drug Plan		5	Boston
S6939	Part D Price File Contact (Back-up)	Senior Business Analyst		Lyman	Dorothy		6514955369					dorothy.lyman@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Part D Price File Contact (Primary)	Director		Molberg	Brandi		6514955369					brandi.molberg@optum.com	1600 McConnor Parkway		Schaumburg	IL	60173	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Part D Quality Assurance Contact	Director, Pharmacy		Gallagher	Angela		8572822438					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Part D Reporting Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Patient Safety Contact	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Payment Contact	Chief Financial Officer		Silva	Lucy		8572826595					lsilva16@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Pharmacy Director	Director, Pharmacy		Gallagher	Angela		8572822493					agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Pharmacy Network Management Contact	Manager, Retail Network Operations		Perez	Felix		3053313044					felix.perez@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Pharmacy Network Management Contact (Secondary)	Director, Retail Network Operations		Ashby	JoLynn		4696470504					jashby@optum.com	11000 Optum Circle		Eden Prarie	MN	55344	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Pharmacy Technical Help Desk Contact	Director, Pharmacy		Gallagher	Angela							agallagher9@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active	8443688732				Medicare Prescription Drug Plan		5	Boston
S6939	Pharmacy Technical Help Desk Contact (Secondary)	Manager, Pharmacy Operations Medicare		Hart	Maegen							mhart15@mgb.org	399 Revolution Dr		Somerville	MA	02145	12/16/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active	8572825333				Medicare Prescription Drug Plan		5	Boston
S6939	Plan Directory Contact for Public Website	Director, Customer Engagement Marketing		Miller	Chris		8572823360					cmiller28@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Plan to Plan Reconciliation Contact	Finance Director	Ms	Umashankar	Kamini		8608393151					kumashankar@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Processor Contact	Chief Operating Officer		McCormick	Mark		2153786043					mmccormick11@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Reconciliation Contact	Chief Actuary		Sanghvi	Sujata		8572827525					ssanghvi@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Recovery Audit Contact	Medicare Compliance Officer	Ms	Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Surveillance Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	System Contact	Director, Business Systems Configuration		Malvo	Donovan		8572823015					dmalvo@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	Third Party Administrator (TPA) Liaison	Lead Financial Analyst		Boyadjian	James		2018323300					jboyadjian@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S6939	User Access Contact	Medicare Compliance Officer		Trembley	Shannon		2079394468					strembley1@mgb.org	399 Revolution Dr		Somerville	MA	02145	02/04/2025	2026	MASS GENERAL BRIGHAM HEALTH PLAN, INC	PDP	Mass General Brigham Health Plan	Medicare Prescription Drug Plan		Mass General Brigham Incorporated	784	Yes	Active					Medicare Prescription Drug Plan		5	Boston
S8067	Agent/Broker Compensation Data Contact	Director, Government Program Sales	Mr.	McCook	Mike		7175417505					mike.mccook@capitalbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/05/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Automated TrOOP Balance Transfer Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Backup User Access Contact	Sr. Medicare Compliance Specialist	Ms.	Peterson	Nicole		7175416419				7173465811	nicole.peterson@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	01/12/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Best Available Evidence Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Bid Audit Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Bid Audit Site Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Bid Primary Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	CEO - CMS Administrator Contact	President and CEO	Mr.	Shamash	Todd		7175417747				7176518913	todd.shamash@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	CEO - Senior Official for Contracting	President and CEO	Mr.	Shamash	Todd		7175417747				7176518913	todd.shamash@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Chief Financial Officer	Chief Financial Officer	Mr.	Woodard	Ralph		7175417181					ralph.woodard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Chief Operating Officer	EVP & Chief Operating Officer	Mr.	Heisey	Glenn		7175417288				7176518497	glenn.heisey@capbluecross.com	2500 Elmenrton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Chief Information Officer	Senior Vice President and CIO	Mr.	Bhasin	Aman		7175417100					aman.bhasin@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	07/29/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Chief Information Security Officer	Chief Information Security Officer	Mr.	Burd	Aaron		7175416939					aaron.burd@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	CMS Casework Communication Contact		Ms.	Drawbaugh	Cindy		7175416257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Complaints Tracking Contact		Ms.	Drawbaugh	Cindy		7175416257					cindy.drawbaugh@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Contact for Fraud Investigations		Ms.	Livelsberger	Jennifer		7177753756					Jennifer.Livelsberger@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Coordination of Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Corporate Mailing						7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	171779799	03/26/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Customer Service Operations Contact	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	jonathan.koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	DIR Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	DIR Contact (Secondary)	Actuarial Business Consultant, Actuarial and Under	Mr.	Shafer	Brian		7175416263				7176514214	Brian.Shafer@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Discount Program Payment Contact			Balseiro	Julia	A	7175417458					Julia.Balseiro@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/24/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Emergency Part D Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7175864604				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Emergency Part D Contact (Secondary)	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Employer Waiver Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Enrollment Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	EOB Transfer Contact	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Financial Audit Contact	Senior Compliance Specialist	Ms.	Leonard	Kellie		7175417117					kellie.leonard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/20/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Financial Reporting Contact	VP Finance and Controller	Mr.	Hershberger	Josh		7173710410					Josh.Hershberger@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	09/13/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Formulary Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Formulary Contact (Secondary)	Manager Clinical Pharmacist Review		Godfrey	Cindy		6127776703					cindy.godfrey@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	03/18/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	General Contact	Chief Government Programs Officer	Mr.	Biesecker	Gregory		7172520587					Gregory.Biesecker@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	17177	09/05/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Government Relations Contact	Sr. VP & General Counsel	Mr.	Hopkins	Joel		7175416358				7176514445	Joel.Hopkins@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	HIPAA Privacy Officer	Privacy & Data Protection Officer	Mr.	Stambaugh	Alan		7175417077					Alan.Stambaugh@CapBlueCross.COM	2500 Elmerton Avenue		Harrisburg	PA	171779799	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	HIPAA Security Officer	Chief Information Security Officer	Mr.	Burd	Aaron		7175416939					aaron.burd@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Hospice Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Interoperability Contact	Senior Director, Information Technology		Blackwell	William		7175417246					William.Blackwell@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Marketing Contact	Director, Marketing	Mr.	Londre	Michael		7175416467				7175402499	Michael.Londre@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Medical Director	Chief Medical Officer	Dr.	Wigginton	Jeremy	A	7175417152				7176518665	Jeremy.Wigginton@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/16/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Medicare Coordinator			Wilbert	Tiffany		7175417606					tiffany.wilbert@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	08/10/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Medicare Part D Opioid Overutilization Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue	P.O. Box 779846	Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Medication Therapy Management Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Online Enrollment Center Contact (Back-up)	Director Medicare Operations	Mr.	Koch	Jonathan		7178292114				7176518873	Jonathan.Koch@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Online Enrollment Center Contact (Primary)	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Appeals	Regulatory Director	Ms.	Davis	Megan						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Appeals Contact (Secondary)	Regulatory Pharmacist		Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55121	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Application Contact	Dir Medicare Product Development	Ms.	Koch	Connie		7175416768					Connie.Koch@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Benefits Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Claims Submission Contact	Manager, Medicare Pharmacy Operations	Ms,	Cook	Tammy	L	7177038749				7173466836	tammy.cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Exceptions Contact	Director, Medicare Pharmacy	Ms	Watts	Christa							christa.watts@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active	8669874213				Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Exceptions Contact (Secondary)	Regulatory Pharmacist	Ms	Emerson	Kimberly						8006936703	clinicalreviewmeddaudit@primetherapeutics.com	2900 Ames Crossing Road		Eagan	MN	55120	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active	8006936651				Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Price File Contact (Back-up)	QA Analyst Sr		Nguyen	Kim		6127776931					kim.nguyen@PrimeTherapeutics.com	Prime Therapeutics, LLC	1305 Corporate Center Drive	Eagan	MN	55121	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Price File Contact (Optional)	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Price File Contact (Primary)	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Quality Assurance Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Part D Reporting Contact		Ms.	Leonard	Kellie		7175417117					Kellie.Leonard@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Patient Safety Contact	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Payment Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Pharmacy Director	Director, Medicare Pharmacy	Ms.	Watts	Christa		7175417405				7176518146	christa.watts@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/15/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Pharmacy Network Management Contact	Manager Pharmacy Benefits Operations	Ms.	Cook	Tammy		7177038749				7173466836	Tammy.Cook@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Pharmacy Network Management Contact (Secondary)			Hanley	Megan		6127773969				8778236373	megan.hanley@primetherapeutics.com	1305 Corporate Center Drive		Eagan	MN	55121	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Pharmacy Technical Help Desk Contact	Sr. Director, Member Services	Mr.	Scott	Shane							shane.scott@primetherapeutics.com	Prime Therapeutics LLC 2655 Eagan Woods Drive		Eagan	MN	55122	12/16/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active	8888780151				Medicare Prescription Drug Plan		5	Chicago
S8067	Plan Directory Contact for Public Website	Medicare Compliance Officer	Ms.	Leedock	Melissa		8666882242					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Plan to Plan Reconciliation Contact	Accountant I	Ms.	Balseiro	Julia		7175417458					FinanceP2P-CASH@CapBlueCross.com	2500 Elmerton Avenue	Mail Drop 3237	Harrisburg	PA	17177	05/07/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Processor Contact	Manager, PBM Operations	Ms.	Hanson	Michelle		6127776755					MedicareClaimResearch@primetherapeutics.com	Prime Therapeutics LLC 2900 Ames Crossing Road		Eagan	MN	55121	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Reconciliation Contact	VP and Chief Actuary	Mr.	Spitler	Mark		7175416613					mark.spitler@capbluecross.com	2500 Elmerton Ave.		Harrisburg	PA	17177	01/13/2025	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Reconciliation Contact (Secondary)	Actuarial Business Consultant	Mr.	Shafer	Brian		7175416263					Brian.Shafer@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	03/07/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Recovery Audit Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Surveillance Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	System Contact	Manager, Medicare Enrollment, Billing & Recon	Mr.	Abdur-Rashid	Jawad		7175416954				7176518675	jawad.abdur-rashid@capbluecross.com	2500 Elmerton Ave		Harrisburg	PA	17177	10/11/2023	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	Third Party Administrator (TPA) Liaison			Balseiro	Julia	A	7175417458					Julia.Balseiro@CapBlueCross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	05/24/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8067	User Access Contact	Medicare Compliance Officer	Ms.	Leedock	Melissa		7175416934					Melissa.Leedock@capbluecross.com	2500 Elmerton Avenue		Harrisburg	PA	17177	12/02/2024	2026	Avalon Insurance Company	PDP	Avalon Insurance Company	Medicare Prescription Drug Plan		CAPITAL BLUE CROSS	41	Yes	Active					Medicare Prescription Drug Plan		5	Chicago
S8841	Agent/Broker Compensation Data Contact	VP Government Programs Operations	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Automated TrOOP Balance Transfer Contact	Manager, Business Process	Mr.	Diaz	Mario		9494753517					mario.diaz@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Backup User Access Contact	Director, Compliance	Ms.	Oswald	Sheri		2242311694					sheri.oswald@optum.com	1 Optum Circle		Eden Prairie	MN	55344	09/24/2025	2026	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	Boston
S8841	Best Available Evidence Contact	Director, Medicare Enrollment	Mr.	Johnson	Kent	E	5187275630					kent.johnson@optum.com	64 Loughberry Lake Road		Saratoga Springs	NY	12866	08/24/2020	2026	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	Boston
S8841	Bid Audit Contact	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Bid Audit Site Contact	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Bid Primary Contact	VP Government Programs	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	CAP Report Contact for Public Website	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	CEO - CMS Administrator Contact	CEO, OptumRx	Ms.	Altman	Kimberly	L	2149912247					optumrx_chief_exec_officer@optum.com	1861 Tranquility Court		Prosper	TX	75078	06/10/2024	2026	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	Boston
S8841	CEO - Senior Official for Contracting	CEO, OptumRx	Ms.	Altman	Kimberly	L	2149912247					optumrx_chief_exec_officer@optum.com	1861 Tranquility Court		Prosper	TX	75078	06/10/2024	2026	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	Boston
S8841	Chief Financial Officer	CFO, OptumRx	Mr.	Vesledahl	Matthew		9529795574					optumrx_chief_fin_officer@optum.com	6022 Blue Circle	Attn: MN101 E400	Minnetonka	MN	55343	10/03/2025	2026	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	Boston
S8841	Chief Operating Officer	Chief Operating Officer	Mr.	Greenberg	Jason	E	5308798254					jason.greenberg@optum.com	2080 E 20th Street		Chico	CA	95928	05/23/2024	2026	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	Boston
S8841	Chief Information Officer	VP Information Technology	Mr.	Charette	Francois		9529175563					francois.charette@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Chief Information Security Officer	Chief Info Security Officer	Ms.	Cardwell	Aimee		6174061087					aimee.cardwell@optum.com	1325 Boylston St.		Boston	MA	02215	05/24/2022	2026	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	Boston
S8841	CMS Casework Communication Contact	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Complaints Tracking Contact	Director, Compliance	Ms.	Oswald	Sheri		2242311694					sheri.oswald@optum.com	1 Optum Circle		Eden Prairie	MN	55344	09/24/2025	2026	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	Boston
S8841	Contact for Fraud Investigations	Associate Dir, Pharmacy Audit	Ms.	Regalado	Lisa		7633615812					lisa.regalado@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Coordination of Benefits Contact	OptumRx EGWP COB Mailbox		EGWP COB Mailbox	OptumRx		2242311694					subrogation_optuminsuranceofohio@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Corporate Mailing						6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Customer Service Operations Contact	Manager, Customer Service	Ms.	Ortiz	Lisa Marie		7148253805					lisamarie.ortiz@optum.com	1 Optum Circle		Eden Prarie	MN	55344	05/12/2025	2026	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	Boston
S8841	DIR Contact	Director, Accounting	Mr.	Woldehawariat	Million		9522057859					million.woldehawariat@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	DIR Contact (Secondary)	Accounting Consultant	Ms.	Kolasz	Sarah		7164257146					sarah_kolasz@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Discount Program Payment Contact	Director, Accounting	Mr.	Woldehawariat	Million		9522057859					million.woldehawariat@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Emergency Part D Contact	VP, Government Programs Operations	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Emergency Part D Contact (Secondary)	VP Pharm PA/ Appeals	Mr.	Petsch	Jesse		9522050125					jesse.petsch@optum.com	1 Optum Cir		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Employer Waiver Contact	VP Government Operations	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Enrollment Contact	Director, Medicare Enrollment	Mr.	Johnson	Kent	E	5187275630					kent.johnson@optum.com	64 Loughberry Lake Road		Saratoga Springs	NY	12866	08/24/2020	2026	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	Boston
S8841	EOB Transfer Contact	Manager, Business Process	Mr.	Diaz	Mario		9494753517				2242311912	mario.diaz@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Financial Audit Contact	Director, Compliance	Ms.	Oswald	Sheri		2242311694					sheri.oswald@optum.com	1 Optum Circle		Eden Prairie	MN	55344	09/24/2025	2026	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	Boston
S8841	Financial Reporting Contact	Director, Accounting	Mr.	Woldehawariat	Million		9522057859					million.woldehawariat@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Formulary Contact	Manager, Medicare Formulary Development	Mr.	Murphy	Jeff		7176457534					jeff.murphy@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Formulary Contact (Secondary)	VP, Formulary Services	Mr.	Noga	Mark		7178054359					mark.noga@optum.com	2 Enck Circle		Enola	PA	17025	08/06/2015	2026	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	Boston
S8841	General Contact	Director, Compliance	Ms.	Oswald	Sheri		2242311694					sheri.oswald@optum.com	1 Optum Circle		Eden Prairie	MN	55344	09/24/2025	2026	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	Boston
S8841	Government Relations Contact	Senior Director, Regulatory Affairs Optum	Ms.	Field	Lily		9526874280					lily.field@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	HIPAA Privacy Officer	Chief Privacy Officer	Ms.	Soderberg	Elizabeth	A	9522056264					elizabeth.soderberg@optum.com	1 Optum Circle	MN101-E013	Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	HIPAA Security Officer	Chief Info Security Officer	Ms.	Cardwell	Aimee		6174061087					aimee.cardwell@optum.com	1325 Boylston St.		Boston	MA	02215	05/24/2022	2026	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	Boston
S8841	Hospice Contact	Director- Prior Authorization Governance.	Ms.	Mourad	Hala		6308905558					hala.mourad@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Interoperability Contact	Sr Principal Proj-Prgm Mgr	Mr.	Ephraim	Mark		9492525524					mark.ephraim@optum.com	2300 Main Street		Irvine	CA	92614	05/19/2022	2026	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	Boston
S8841	Marketing Contact	VP Government Programs Operations	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Medical Director	SVP, Chief Medical Officer	Dr.	Dutta	Sumit		3122617807					sumit.dutta@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Medicare Compliance Officer	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Medicare Coordinator	VP Government Programs Operations	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Medicare Part D Opioid Overutilization Contact	Clinical Pharmacist	Ms.	Shah	Purvi		8474144804					purvi.shah@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Medication Therapy Management Contact	VP, Clinical Engagement	Ms.	Solak	Elizabeth		2242311722					elizabeth.solak@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	OffShore Subcontractor Contact	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Part D Appeals	Mgr Pharm PA/Appeals	Ms.	Le	Christina						8772394565	christina.le@optum.com	PO Box 2975		Mission	KS	66201	10/28/2024	2026	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8884033398				Medicare Prescription Drug Plan		5	Boston
S8841	Part D Appeals Contact (Secondary)	Pharmacy Technician Lead, PA Appeals	Ms.	Jackson	Shannon						8772394565	rxsol_prior_auth_redirected_queue_DL@uhc.com	PO Box 2975		Mission	KS	66201	10/28/2024	2026	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8884033398				Medicare Prescription Drug Plan		5	Boston
S8841	Part D Application Contact	VP Government Programs	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Part D Benefits Contact	Manager, Pharmacy Help Desk	Mr.	Summers	Todd		8664431095					todd.summers@optum.com	755 Research Pkwy	Suite 300	Oklahoma City	OK	73104	01/26/2021	2026	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	Boston
S8841	Part D Claims Submission Contact	VP Government Programs	Mr.	Olson	Paul		6128504331					paul_olson@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Part D Exceptions Contact	Manager, Prior Authorization Appeals	Ms.	Le	Christina						8772394565	christina.le@optum.com	PO Box 2975		Mission	KS	66201	04/08/2024	2026	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	7148253783				Medicare Prescription Drug Plan		5	Boston
S8841	Part D Price File Contact (Back-up)	Senior Business Analyst	Ms.	Lyman	Dorothy		6514955369					dorothy.lyman@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Part D Price File Contact (Primary)	Director, Business Analytics	Ms.	Molberg	Brandi		6514955369					brandi.molberg@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Part D Quality Assurance Contact	Director, Medicare Clinical Program Oversight	Ms.	Marks	Iny		6303526658					iny.marks@optum.com	5000 Firwood Drive		Canonsburg	PA	15317	08/06/2015	2026	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	Boston
S8841	Part D Reporting Contact	Mgr. IT DT Analytics	Mr.	Zahurak	Peter		2242312075					peter.zahurak@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Patient Safety Contact	Quality Initiatives Pharmacist	Ms.	Tyra	Michelle		2102782077					michelle.tyra@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Payment Contact	Director, Accounting	Mr.	Woldehawariat	Million		9522057859					million.woldehawariat@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Personal Health Record Contact	Director, Compliance	Ms.	Oswald	Sheri		2242311694					Sheri.Oswald@optum.com	1 Optum Circle		Eden Prairie	MN	55344	09/24/2025	2026	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	Boston
S8841	Pharmacy Director	VP Medical Clinical Operations	Mr.	Calabrese	David		5089441443				5089261308	david.calabrese@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Pharmacy Network Management Contact	Manager, Retail Network Operations	Mr.	Perez	Felix		3053313044					felix.perez@optum.com	1 Optum Cir		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Pharmacy Network Management Contact (Secondary)	Director, Retail Network Operations	Ms.	Ashby	JoLynn		4696470504					jashby@optum.com	1 Optum Cir		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Pharmacy Technical Help Desk Contact	Manager, Pharmacy Help Desk	Mr.	Villanueva	Juan							juan.villanueva@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	OPTUM INSURANCE OF OHIO, INC.	PDP	Optum Insurance of Ohio, Inc.	Medicare Prescription Drug Plan		UnitedHealth Group, Inc.	239	Yes	Active	8007887871				Medicare Prescription Drug Plan		5	Boston
S8841	Plan Directory Contact for Public Website	Manager, Pharmacy Help Desk	Mr.	Summers	Todd		8664431095					todd.summers@optum.com	755 Research Pkwy	Suite 300	Oklahoma City	OK	73104	01/26/2021	2026	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	Boston
S8841	Plan to Plan Reconciliation Contact	Director, Accounting	Mr.	Woldehawariat	Million		9522057859					million.woldehawariat@optum.com	Lockbox 5818		Carol Stream	IL	60197	04/08/2024	2026	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	Boston
S8841	Processor Contact	Senior Manager, Benefits	Ms.	Casata	Mercedes		6307809152					mercedes.cassata@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Reconciliation Contact	Director, Accounting	Mr.	Woldehawariat	Million		9522057859					million.woldehawariat@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Reconciliation Contact (Secondary)	Senior Director, Accounting	Ms.	Schroller	Linda		9492219983					linda.schroller@optum.com	2300 Main St		Irvine	CA	92614	04/08/2024	2026	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	Boston
S8841	Recovery Audit Contact	Director Audit Advisory Services	Ms.	Tilden	Kathleen		6314067862					kathleen.tilden@optum.com	PO Box 9472		Minneapolis	MN	55440	08/05/2020	2026	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	Boston
S8841	Surveillance Contact	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	System Contact	Director, Information Technology	Mr.	Trippett	Ken		2242311663					ken.trippett@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	Third Party Administrator (TPA) Liaison	Director, Accounting	Mr.	Woldehawariat	Million		9522057859					million.woldehawariat@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S8841	User Access Contact	Medicare Compliance Officer	Ms.	Shocklee	Beth		3017756358					beth.shocklee@optum.com	1 Optum Circle		Eden Prairie	MN	55344	05/12/2025	2026	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	Boston
S9701	Agent/Broker Compensation Data Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott. Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Automated TrOOP Balance Transfer Contact	Operations Manager, Enrollment and Eligibility		Sherman	Mandy		9202214083				9202214583	Relay.Health@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Backup User Access Contact	Manager - Compliance	Mr.	Herbst	Travis		6088282856					travis.herbst@deancare.com	1277 Deming Way		Madison	WI	53717	12/12/2024	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Best Available Evidence Contact	Client Onboarding Advisor		Pagel	Ben		9202214127					ben.pagel@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Bid Audit Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Bid Primary Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	CAP Report Contact for Public Website	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	CEO - CMS Administrator Contact	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	CEO - Senior Official for Contracting	President and Chief Executive Officer	Ms	Erickson	Lisa		9529922753					CEO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Chief Financial Officer	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Chief Operating Officer	Chief Operations Officer	Mr	Hjerpe	Adam		6123861065					COO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	06/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Chief Information Officer	VP, Chief Technology Officer	Mr	Peterson	Scott		9529922625					Scott.Peterson@medica.com	301 Carlson Parkway		Minnetonka	MN	55305	09/05/2024	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Chief Information Security Officer	Sr. Director, CISO	Mr.	Beckett	Barry		9202214532					Barry.Beckett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/16/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	CMS Casework Communication Contact	Supervisor, Grievance and Appeals		Blair	Rachel		9202214372				8442689791	Rachel.Blair@Navitus.com	1025 W Navitus Dr.		Appleton	WI	54913	10/07/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Complaints Tracking Contact	Supervisor, Grievance and Appeals		Blair	Rachel		9202214372				8442689791	Rachel.Blair@Navitus.com	1025 W Navitus Dr.		Appleton	WI	54913	09/19/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Contact for Fraud Investigations	Director, Special Investigations Unit		Kalin	Dan		9529922587					Daniel.Kalin@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	09/05/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Coordination of Benefits Contact	Operations Manager, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	mandy.sherman@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/07/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Corporate Mailing						6088274061				6088274152	hpmsceo.inbox@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Customer Service Operations Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle		9202214224					Danielle.Nett@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	DIR Contact	Sr. Financial Analyst, Medicare Part D		Seehafer	Angela		9202214098				9202214598	Angela.Seehafer@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	DIR Contact (Secondary)	Mgr, Medicare Finance Operations		Tesch	Jessica		9202214503					Jessica.Tesch@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/12/2024	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Discount Program Payment Contact	Mgr, Medicare Finance Operations		Tesch	Jessica		9202214503					Jessica.Tesch@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/12/2024	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Emergency Part D Contact	Sr. Director, Government Programs		Bisser	David		4804986264					david.bisser@navitus.com	9185 E Pima Center Parkway, Ste. 200		Scottsdale	AZ	85258	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Emergency Part D Contact (Secondary)	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	01/06/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Employer Waiver Contact	Manager - Compliance		Herbst	Travis		6088282856					Travis.Herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Enrollment Contact	Operations Manager, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	mandy.sherman@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/09/2022	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	EOB Transfer Contact	Operations Manager, Enrollment & Eligibility		Sherman	Mandy		9202214083				9202214583	mandy.sherman@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/07/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Financial Audit Contact	Manager - Compliance	Mr.	Herbst	Travis		6088282856					travis.herbst@deancare.com	1277 Deming Way		Madison	WI	53717	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Financial Reporting Contact	CFO	Ms	Dusil	Krista		9529923908					CFO@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Formulary Contact	Sr. Analyst, Formulary Operations		Paddock	Deanna		6087291628				6087292628	Deanna.Paddock@navitus.com	361 Integrity Drive		Madison	WI	53717	10/19/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Formulary Contact (Secondary)	Clinical Pharmacist		Seabright	Diane		9203514627					Diane.Valeo-Seabright@deancare.com	1277 Deming Way		Madison	WI	53717	10/23/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	General Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	scott.jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/13/2022	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Government Relations Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	scott.jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/13/2022	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	HIPAA Privacy Officer	SVP, Chief Compliance Officer		Aiken	Carrie		6082985763				6082985863	carrie.aiken@navitus.com	361 Integrity Drive		Madison	WI	53717	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	HIPAA Security Officer	Sr. Director, CISO		Beckett	Barry		9202214532				9202214566	Barry.Beckett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/16/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Hospice Contact	Sr. Business Analyst, Enrollment and Eligibility		Noel	Bailee		9202214008				9202214583	Bailee.Noel@Navitus.com	1025 West Navitus Drive		Appleton	WI	54913	11/17/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Interoperability Contact	Director of Privacy		Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/24/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Marketing Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Medical Director	Medical Director	Dr.	Hirsch	Thomas		6086980440				6087292613	thomas.hirsch@navitus.com	361 Integrity Drive		Madison	WI	53717	03/27/2019	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Medicare Compliance Officer	VP Compliance	Mrs	Koranteng	Milly		9529922090					complianceofficer@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Medicare Coordinator	Sr. Director, Government Programs		Bisser	David		4804986264					david.bisser@navitus.com	9185 E Pima Center Parkway, Ste. 200		Scottsdale	AZ	85258	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Medicare Part D Opioid Overutilization Contact	Pharmacist, Population Health		Ulloa	Gabrielle		6083101842					Gabrielle.Ulloa@navitus.com	361 Integrity Way		Madison	WI	53717	11/09/2020	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Medication Therapy Management Contact	Sr. Product Manager, Clinical Engagement Center		Singer	Samantha		6087291500					samantha.singer@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/07/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	OffShore Subcontractor Contact	Director of Privacy		Chastanet	Yvonne		9529923957					yvonne.chastanet@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	01/24/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Appeals	Supervisor, Grievance and Appeals		Blair	Rachel						8442689791	Rachel.Blair@Navitus.com	1025 W Navitus Dr.		Appleton	WI	54913	10/07/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active	9202214372				Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Appeals Contact (Secondary)	Assoc Director, Clinical Prior Authorization		LeClair	Christophe						9202214176	Christopher.LeClair@navitus.com	1025 W Navitus Dr.		Appleton	WI	54913	10/07/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active	9202214676				Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Application Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087					Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Benefits Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Claims Submission Contact	Sr. Manager, Technical Operations		Derks	Bob		9202214404				9202214904	DL-TO-PDE@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Exceptions Contact	Assoc Director, Clinical Prior Authorization		LeClair	Christophe						9202214676	Christopher.LeClair@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	04/09/2024	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active	9202214176				Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Price File Contact (Back-up)	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Price File Contact (Primary)			Plan Finder	Navitus		6087291578				6087292578	PlanFinder@navitus.com	361 Integrity Drive		Madison	WI	53717	12/08/2022	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Quality Assurance Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Part D Reporting Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Patient Safety Contact	Director, Clinical Services		Wickizer	Marleen		6087291581				6087292581	Marleen.Wickizer@navitus.com	361 Integrity Way		Madison	WI	53717	02/01/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Payment Contact	Mgr, Medicare Finance Operations		Tesch	Jessica		9202214503					Jessica.Tesch@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	12/12/2024	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Pharmacy Director	Director of Pharmacy Services		Wilhelm	Sue		6088287576					Sue.Wilhelm@medica.com	1277 Deming Way		Madison	WI	53717	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Pharmacy Network Management Contact	VP, Network Management		Santos	Christina		6088204408					Christina.Santos@navitus.com	361 Integrity Drive		Madison	WI	53717	04/09/2024	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Pharmacy Network Management Contact (Secondary)	Director, Specialty Pharmacy Network Management		Robinson	Jan		6087291688				6087292688	Jan.Robinson@navitus.com	361 Integrity Drive		Madison	WI	53717	10/19/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Pharmacy Technical Help Desk Contact	Sr. Manager, Customer Care Accounts		Nett	Danielle						9202214724	Danielle.Nett@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active	8662703877	4224			Medicare Prescription Drug Plan		5	Dallas
S9701	Plan Directory Contact for Public Website	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	scott.jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/13/2022	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Plan to Plan Reconciliation Contact	Sr. Financial Analyst, Medicare Part D		Seehafer	Angela		9202214098				9202214598	Angela.Seehafer@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/19/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Processor Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Reconciliation Contact	Sr. Financial Analyst, Medicare Part D		Seehafer	Angela		9202214098				9202214598	Angela.Seehafer@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/19/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Reconciliation Contact (Secondary)	Mgr, Medicare Finance Operations		Tesch	Jessica		9202214503					Jessica.Tesch@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Recovery Audit Contact	Sr. Director, Government Programs	Mr.	Bisser	David		4804986264					david.bisser@navitus.com	9185 E Pima Center Parkway, Ste. 200		Scottsdale	AZ	85258	03/11/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Surveillance Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	System Contact	General Manager, Medicare Part D Programs		Jacoby	Scott		9202214087				9202214587	Scott.Jacoby@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	05/04/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	Third Party Administrator (TPA) Liaison	Sr. Financial Analyst, Medicare Part D		Seehafer	Angela		9202214098				9202214598	Angela.Seehafer@navitus.com	1025 West Navitus Drive		Appleton	WI	54913	10/19/2023	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
S9701	User Access Contact			Harrington	Dana		6122129075					dana.harrington@medica.com	401 Carlson Parkway		Minnetonka	MN	55305	07/01/2025	2026	DEAN HEALTH INSURANCE, INC.	PDP	Navitus MedicareRx	Medicare Prescription Drug Plan		Medica Holding Company	439	Yes	Active					Medicare Prescription Drug Plan		5	Dallas
X0001	Automated TrOOP Balance Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5024768814					HumanaEOBTransfer@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Backup User Access Contact	Compliance Lead		Keffer	Ellen		5024769797					ekeffer@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Best Available Evidence Contact	Associate Dir., Consumer Service		Beasley	Tasha		5024767452					MedicareLINET@humana.com	500 West main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	CAP Report Contact for Public Website	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	CEO - CMS Administrator Contact	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	07/02/2024	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	CEO - Senior Official for Contracting	Chief Executive Officer	Mr.	Rechtin	James	A	5713637446					jrechtin@humana.com	500 West Main Street	6th floor-Humana Tower	Louisville	KY	40202	07/02/2024	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Chief Financial Officer	Chief Financial Officer	Ms.	Mellet	Celeste		5025801117					cmellet@humana.com	500 West Main Street		Louisville	KY	40202	03/11/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Chief Operating Officer	Chief Operating Officer	Mr.	Renaudin	George		6153701801					grenaudin@humana.com	320 Seven Springs Way	Suite 200	Brentwood	TN	37027	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Chief Information Officer	Chief Information Officer	Mr.	Mehta	Japan		5022999753					jmehta1@humana.com	500 West Main Street		Louisville	KY	40202	03/12/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Chief Information Security Officer	Chief Information Security Officer	Mr.	Raheja	Aman		5024765796					ARaheja@humana.com	321 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	CMS Casework Communication Contact			Beasley	Tasha		5024766134					tcovington1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Complaints Tracking Contact			Beasley	Tasha		5024766134					tcovington1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Contact for Fraud Investigations	Director, Fraud and Waste		Popik	David		9043808114					DPopik@humana.com	8935 Prominence Pkwy	Building 3, Suite 100	Jacksonville	FL	32256	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Coordination of Benefits Contact	Associate Director, Pharmacy Claims		Fessel	Christie		5025804329					cfessel@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Corporate Mailing						5025803830					WShrank@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Customer Service Operations Contact			Beasley	Tasha		5024766134					tcovington1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	DIR Contact	Accounting Lead		Watson	Gabrielle		5024289679					gwatson@humana.com	500 West Main Street		Louisville	KY	40202	07/02/2024	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	DIR Contact (Secondary)	Senior Compliance Professional		Cooper	Cris		5024768880					ccooper7@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Discount Program Payment Contact	Accountant		Ibisate	Paris		5025802845					Fibisate@humana.com	500 W. Main Street	Floor 11	Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Emergency Part D Contact	Associate Director, Regulatory Compliance		Licht	Susie	M	5024762343					slicht@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Emergency Part D Contact (Secondary)	Medicare Compliance Officer		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Enrollment Contact	Director, Enrollment		Bailey	Christy		5025804944					cbailey7@humana.com	101 East Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	EOB Transfer Contact	Pharmacy Claims Lead		Fleming	Brandi		5022623849				5026616361	humanaeobtransfer@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	General Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Government Relations Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	HIPAA Privacy Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	HIPAA Security Officer	Associate VP, Privacy and Ethics		Theiss	James		5025804322					jtheiss@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Hospice Contact	Senior Risk Management Professional		Enriquez	Melissa		5023012619					menriquez6@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Interoperability Contact	AVP, Enterprise transformation		Walker	Chris		5024760699					cwwalker@humana.com	500 West Main Street		Louisville	KY	40204	12/20/2023	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Medical Director	VP, Physician Review and Market Insights	Dr.	Lueken	Kathryn		8003222758	1024881				KLueken@humana.com	500 W Main Street		Louisville	KY	40202	09/01/2023	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Medicare Compliance Officer	MCO	Mr.	Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Medicare Coordinator	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Medicare Part D Opioid Overutilization Contact	Supervisor, Pharmacy Claims		Johnson	Margaret		8008951305					OMS_Plan_to_Plan_Sharing@Humana.com	1100 Employers Blvd		DePere	WI	54344	12/20/2023	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Part D Appeals	Associate Director, Risk Management		Johnson	Courtnay							CJohnson136@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active	5025809138				LI NET Sponsor		5	Philadelphia
X0001	Part D Appeals Contact (Secondary)	Associate Director, Compliance		Oppel	Cynthia							coppel@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active	5025807929				LI NET Sponsor		5	Philadelphia
X0001	Part D Application Contact	Director, Insurance Product Compliance		Setzer	Ruth		5024760867					rwright4@humana.com	500 W Main Street	19th floor	Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Part D Benefits Contact	Associate VP, Insurance Product Management		Caldwell	Barbara		5025808386					bcaldwell@humana.com	500 W Main	19th floor	Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Part D Claims Submission Contact	Senior Compliance Professional		Cooper	Cris		5024768880					ccooper7@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		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	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active	5025809138				LI NET Sponsor		5	Philadelphia
X0001	Part D Exceptions Contact (Secondary)	Manager, Risk Management		Carter	Jonathan							jcarter45@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active	5024682494				LI NET Sponsor		5	Philadelphia
X0001	Part D Quality Assurance Contact	Associate Director, Regulatory Compliance		Licht	Susie		5024762343					slicht@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Part D Reporting Contact	Sr Compliance Professional		Lynch	Carol Ann		5024328302					clynch1@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Patient Safety Contact	Sr Compliance Professional		Piepenburg	Lisa		5024763994					lpiepenburg@humana.com	500 West Main Street	Floor 22	Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Payment Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Pharmacy Director	Director, Risk Management		Renn	Kate		5024762499					krenn@humana.com	500 West Main Street		Louisville	KY	40202	12/20/2023	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Pharmacy Technical Help Desk Contact			Pharmacy Solutions	DST							cms.partD@dsthealth.com	210 West 10th Street		Kansas City	MO	64105	12/09/2024	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active	8008564060				LI NET Sponsor		5	Philadelphia
X0001	Pharmacy Technical Help Desk Contact (Secondary)	Sr Compliance Professional		Stevens	Debra							dstevens25@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active	5025800475				LI NET Sponsor		5	Philadelphia
X0001	Plan to Plan Reconciliation Contact	Lead, Financial Planning		Van Drisse	Ann Marie		5026327904				5025083512	P2PAdministration@humana.com	Humana Insurance Co.	P. O. Box 635600	Cincinnati	OH	452635600	08/19/2025	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Processor Contact	Senior Compliance Professional		Cooper	Cris		5024768880					ccooper7@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Reconciliation Contact	Director, Financial Planning		Snearly	John		5025803915					jsnearly@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Reconciliation Contact (Secondary)	Senior Compliance Professional		Cooper	Cris		5024768880					ccooper7@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Surveillance Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	System Contact	MCO		Duffy	Conor		5025800428					HumanaMCO3@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	Third Party Administrator (TPA) Liaison	Finance Professional		Hughes	Donald		5026893844					dhughes7@humana.com	500 W. Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
X0001	User Access Contact	Compliance Professional		Barbetto	George		5024769797					gbarbetto@humana.com	500 West Main Street		Louisville	KY	40202	12/29/2022	2026	HUMANA INSURANCE COMPANY OF NEW YORK	LI NET Sponsor	Medicare's Limited Income NET Program	LI NET Sponsor		Humana Inc.	128	Yes	Active					LI NET Sponsor		5	Philadelphia
